Many expectant parents often joke about having a gender preference for their as yet unborn child: a boy, perhaps, to go to baseball games with dad, or a girl, to one day see her in a wedding dress. But what if those preferences could become a choice, one that could be guaranteed even before a pregnancy, all for the price tag of $20,000?
I investigated this new reality in a piece published a week ago in Slate, a culmination of five months of reporting looking into the shocking, surprising, and controversial practice of prenatal sex selection in the United States. According to my report, which was supported by the Stabile Center for Investigative Journalism at Columbia University, sex selection -- or gender selection, as it is sometimes called -- rakes in revenues of at least $100 million year, and doctors say that the growth could explode in the next decade.
But is this new reality, the ability to choose the sex of our babies, one that Americans feel comfortable with? Is there a line when it comes to the use of reproductive technologies, and does sex selection cross it?
Boisterous and bold fertility doctors I interviewed, from New York to California, say no. Families have the right to "balance" the genders of their children, they argued. Ethicists and some scientists say yes, likening the practice to "high-tech eugenics," as Marcy Darnovsky, the director for the Center for Genetics and Society, called it.
But this black-and-white view became a little grey when I spoke to mothers who desperately turn to sex selection. Nearly all the women encountered on sites like in-gender.com and genderdreaming.com -- sites geared toward helping women choose the sex of their babies, whether through natural or high-tech methods -- are seeking girls.
These mothers spoke of understanding the ethical controversies with using pre-implantation genetic diagnosis (PGD), the technology used to screen embryos for their chromosomes before being implanted into the uterus, for sex selection. In fact, the fear of stigma for themselves and their children (both current and unborn) led nearly all of them to request that their names be changed when I interviewed them for the Slate story.
Yet these mothers often spoke calmly and sincerely about what having a daughter, in an existing family of boys, would mean to them personally. They did not seem to want to use the technology in response to a hatred toward their sons but out of a yearning and a love for daughters. And they spoke of feeling empowered in being able to make this choice and create their families, supported by the possibilities of science and a lack of regulations in the use of reproductive technologies that has come to define America.
"Some people say that this is playing God," wrote one of these women, a 32-year-old mother of three children who used sex selection to create her youngest and only daughter, in an email to me. "I am a Christian and believe that if God did not want me to have a daughter, then there is nothing I could have done to have one. I believe it's all up to Him anyway. Other than that, I am not sure what my critics would say."
A lack of regulation in the U.S. allows prenatal sex selection to be left to the market. In contrast, Canada's Assisted Human Reproduction Act states that no person shall "for the purpose of creating a human being, perform any procedure or provide, prescribe or administer any thing that would ensure or increase the probability that an embryo will be of a particular sex." Similar restrictions on sex selection also exist in Australia and Britain.
Besides the "slippery slope toward eugenics" fear, medical ethicists worry that if the number of consumers seeking gender selection becomes significant, the demand may one day displace resources for those actually experiencing infertility in the country.
"There is a reluctance among Americans to think about these issues as a business. As a result, no one is minding the store," said Darnovsky. "The response, then, is to look for more revenue, more customers. But how much can we leave to the market?"
Many of the recent efforts to regulate sex selection in the United States have focused on the other end of the human reproduction spectrum. This past May a Republican-sponsored bill aiming to ban sex-selective abortions failed to pass in Congress. The Prenatal Nondiscrimination Act (PRENDA) would have made it illegal to perform an abortion on a woman if the reason for the abortion was because of the gender of the fetus.
But many argue that sex-selective abortion is not the same as prenatal sex selection. Weeding out the "boy embryos" from the "girl embryos" in a petri dish in a laboratory seems a far cry from the seemingly ruthless sex-selective abortion phenomenon that has haunted India and China and has been blamed for millions of "missing girls" in the region.
And it would seem that in America, at least, there are some who are all too willing to limit women's access to reproductive technologies in the name of political or partisan goals.
In the meantime, however, women will continue to turn to doctors who enthusiastically advertise the practice within their fertility clinics. It is yet to be seen whether this will lead to a world where wondering about the gender of a prospective child will be a thing of the past.