Alice Dreger, on the Hasting Center blog, alerts us to Dr. Maria New, who's been giving the experimental medication dexamethasone (dex) to pregnant women concerned their child might have congenital adrenal hyperplasia (CAH, an adrenal condition that results sometimes in intersexuality in girls, rarely in death, sometimes in life-long medication, but has also been associated with tomboyishness and lesbianism) without informed consent. It's not approved for use by pregnant women, it doesn't cure CAH so much as reduce some of the masculinization associated with it, and there are studies showing that it results in birth defects in animals.
Dreger, who's been working to get the off-label use banned, also found that New is selling the treatment as a way of preventing daughters from growing up lesbian and making sure that girls will be willing to enjoy sex submit to men and produce babies:
[New and colleagues] go on to suggest that the work might offer some insight into the influence of prenatal hormones on the development of sexual orientation in general. "That this may apply also to sexual orientation in at least a subgroup of women is suggested by the fact that earlier research has repeatedly shown that about one-third of homosexual women have (modestly) increased levels of androgens." They "conclude that the findings support a sexual-differentiation perspective involving prenatal androgens on the development of sexual orientation."
Dreger goes on to describe how these doctors' goal is to make girls conform to the heterosexist expectations of their parents:
And it isn't just that many women with CAH have a lower interest, compared to other women, in having sex with men. In another paper entitled "What Causes Low Rates of Child-Bearing in Congenital Adrenal Hyperplasia?" Meyer-Bahlburg writes that "CAH women as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role. As children, they show an unusually low interest in engaging in maternal play with baby dolls, and their interest in caring for infants, the frequency of daydreams or fantasies of pregnancy and motherhood, or the expressed wish of experiencing pregnancy and having children of their own appear to be relatively low in all age groups."
In the same article, Meyer-Bahlburg suggests that treatments with prenatal dexamethasone might cause these girls' behavior to be closer to the expectation of heterosexual norms: "Long term follow-up studies of the behavioral outcome will show whether dexamethasone treatment also prevents the effects of prenatal androgens on brain and behavior."
In a paper published just this year in the Annals of the New York Academy of Sciences, New and her colleague, pediatric endocrinologist Saroj Nimkarn of Weill Cornell Medical College, go further, constructing low interest in babies and men - and even interest in what they consider to be men's occupations and games - as "abnormal," and potentially preventable with prenatal dex:
"Gender-related behaviors, namely childhood play, peer association, career and leisure time preferences in adolescence and adulthood, maternalism, aggression, and sexual orientation become masculinized in 46,XX girls and women with 21OHD deficiency [CAH]. These abnormalities have been attributed to the effects of excessive prenatal androgen levels on the sexual differentiation of the brain and later on behavior." Nimkarn and New continue: "We anticipate that prenatal dexamethasone therapy will reduce the well-documented behavioral masculinization..."
"The challenge here is... to see what could be done to restore this baby to the normal female appearance which would be compatible with her parents presenting her as a girl, with her eventually becoming somebody's wife, and having normal sexual development, and becoming a mother. And she has all the machinery for motherhood, and therefore nothing should stop that, if we can repair her surgically and help her psychologically to continue to grow and develop as a girl."
There's a lot to be said in a debate about whether it's ethical to try to medically prevent a child from growing up queer or gender-nonconforming or just interesting in something other than child-bearing. But when the goal is to eliminate part of human diversity in order to make some people feel more comfortable, there doesn't seem to be much need for discussion: this is a simple crime against humanity.
It'd be easy to write off New, et al., as people who aren't even close to reaching that goal so we shouldn't be concerned (they're working on one treatment that'll work on, at most, one-third of women, with no hard data as of yet to show that it works, with a treatment that will remain inaccessible to most parents), if it weren't for the fact that they aren't the first, won't be the last, and definitely aren't the only medical professionals working on this.
I'm working through some of George Rekers's (the virulently anti-gay Baptist psychologist who was caught with a rentboy) old child psychology papers on preventing homosexuality in boys through what can only be described as psychological torture, which he was doing well after homosexuality was removed from the DSM and deemed a normal variation of human sexuality instead of a psychological disorder. But curing it is still some scientists' goal. They're probably uncomfortable with their own sexuality and are looking for a cure so because they think it'll make them feel better about themselves, and as long as there's homophobia and smart researchers with access to resources, they'll keep on working on it. Eventually they're going to stumble on something.
There are lots of reasons why this is bad when it comes to bioethics, reasons that should appeal to both the right and the left should this question ever become political. Alice Dreger discusses a few bioethical issues with engineering sexual orientation in Psychology Today, but here's the one that gets to the heart of the issue:
The fact is that children are inherently unpredictable, and so (surely) what it means to decide to be a parent is to agree that you will accept the uncertainty that comes with being a parent. Having a child is not like taking a spouse; there is no mutual agreement entered into. It is up the parent to make the commitment. And to make the commitment by saying, "I'm willing to have you, but only if you are a boy, and a straight boy at that, and a straight boy with blue eyes and a very high IQ" is, frankly, to not really make the commitment that parenting requires.
Am I suggesting that people who want to engineer their children's sexual orientations are unfit to be parents? Yes, I am. Being gay is not a terrible, tragic disease that requires prevention or treatment chosen for you by your parents.
I am reminded here of a colleague who works as a social worker on a craniofacial team at a children's hospital. She was telling me one day, despairingly, of having a consultation with a pair of expectant parents. Their fetus had been diagnosed with a cleft lip, one that would be reasonably correctable without major trauma. It was true the baby would be born with the odd-looking mouth, and that the child might always have a noticeable lip scar. But this was not a child with a fatal disease or anything. Yet the father was flipping out, saying to his wife and the social worker, "I can't handle this! I can't handle this!" He wanted to abort for this.My friend and I both were both thinking: Come on! If you can't handle this, what are you going to do when your kid smokes a little dope? What are you going to do if she ends up pregnant at 16? What are you going to do if she sucks at math or suffers from a lot of acne? Sure, abort. But don't have any children if you can't handle this.
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“CAH women as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role.”
So what? Is there something wrong with not wanting to prostitute yourself as a housewife? Not that there’s anything wrong with a stay at home mom, but if a woman wants her own life and career, is that a medical problem? Women are not farm animals to be used for breeding.
Dr. Maria New should have her medical license revoked for performing research on babies and women without their knowledge or permission.
I would not support this treatment because of the potential risks to both the mother and the baby, but if you look at the majority of comments here, they focus on the "crime" of "curing gay people". If we are focusing purely on the ethics of this treatment, though, everyone here needs to look critically and truthfully at what they believe. It is intellectually dishonest and inconsistent to maintain a pro-choice stance when it comes to the life or death of the baby, but then abandon that stance when it comes to issues of sexuality.
The comments here expose the pro-choice movement for what it is - selfish people who strive to remove the natural consequences of our bad choices. Your movement has contributed to the over-sexualization of our culture, and in the process, has demeaned the very women it claims to support.
At the Thursday session, the majority of physicians attending agreed that the Royal College of Psychiatrists and other mental health standard-setting organizations should reject and ban the treatments.
“Sexuality is such a fundamental part of who a person is that attempts to change it just result in significant confusion, depression and even suicide,” said Tom Dolphin, vice-chair of the BMA’s junior doctors committee. “You can’t just wish away same-sex attraction no matter how inconvenient it might be.”
http://advocate.com/News/Daily_News/2010/07/02/Gay_Cure_Therapies_Deemed_Harmful/
The British Medical Association's majority of physicians says BAN all cures and claims of cures. The Machiavellian str8=normal are defacto Dr. Mengele types. Human sexuality is not for others to predetermine, no matter how much certain behaviorists and theocrats promote stereotypes of norms.
So, now it's NOT a choice, but a medical condition? Treatable in the womb?
Wow. That seems to make the heterosexual's discrimination against their gay children even more ugly.
Punishing your gay children for YOUR 'mistakes', whether those 'mistakes are nature OR nurture (both of those being the responsibility of heterosexuals) hardly seems fair, does it?
When I think of my parents, I think of how lucky I am to have people who have always loved me for who I am. They may have judged at times, and voiced their opinions, but in the end they were always on my side, and just wanted me to be happy. They loved me the same whether I did exactly what they wanted or chose my own path. I know that not all children are so blessed, but shouldn't they be? This is exactly the opposite of that.
Why would any woman risk possible birth defects to prevent something that does not harm her child? How prevalent is CAH, anyway? And trying to ward off a lesbian daughter with questionable drugs in this "supposedly" more enlightened age is unbelievably barbaric.
The implications of the article are chilling as an expression of eugenics - a movement that should have died with Nazi Germany or remained marginalized within the story treatments of science fiction authors.
I wonder how quickly a 'gay exception' will be made in their belief that ALL life is sacred.
This is nothing new. It's been known for YEARS, I don't recall how long. Scientists have known that the timing of fetal exposure to high levels of certain androgens / estrogens is what determines sexuality. They have CREATED gay and lesbian animals in the lab by manipulating these levels, conclusively proving that sexuality is determined in the womb via hormone exposure. However, this was such sensitive science that the cat was never let out of the bag because everyone feared it would lead to SELECTIVE ABORTION. Well, THE CAT IS NOW OUT OF THE BAG.
Just as important as what the pro-lifers do is, what will the pro-choicers do? (I am pro-choice) What about the "right to choose"? What about "no one has the right to tell a woman what she does with her own body"? Will they respect both? Or will they say it's OK to terminate a pregnancy (after all, it's not a baby, just a fetus, right?) but NOT OK to decide to take a steroid (which has been around for FIFTY YEARS!) while pregnant? Pretty sure we'd know if it caused birth defects after 50 years!