Insights from the PET/ESHRE report: Sex selection

Our report Fertility, Embryo Research and Genome Editing: Public Attitudes in Europe presents research on public attitudes in four European countries (see BioNews 1346a and 1346b). One of the issues explored in the report is sex selection.

Nationally representative samples of the public in the UK, the Netherlands, Spain and Italy were asked: 'Should people undergoing private (ie, not paid for by the state) fertility treatment be able to choose the biological sex of their child, based on their personal preference?'

In response to our question, a substantial proportion of respondents in all four countries surveyed – indeed, a majority in every country except Spain – did not support people undergoing private fertility treatment being able to choose the biological sex of their child, based on personal preference. Opposition to sex selection being permitted was strongest in the Netherlands (72%) followed by the UK (59%), Italy (55%) and Spain (47%).

At the same time, a significant minority of respondents in all four of the countries surveyed did support people undergoing private fertility treatment being able to choose the biological sex of their child, based on personal preference. This support was strongest in Spain (32%) followed by the UK (26%), Italy (22%) and the Netherlands (18%).

Above: Proportion of respondents (per country) who gave particular answers, when asked 'Should people undergoing private (ie, not paid for by the state) fertility treatment be able to choose the biological sex of their child, based on their personal preference?'
Base: n=2217 UK, n=2174 Netherlands, n=2171 Spain, n=2126 Italy, all adults aged 16-75. Online fieldwork conducted by Ipsos, 6-14 February 2026.

In all four of the countries surveyed, women were more likely than men to oppose sex selection being permitted, while men were more likely than women to support sex selection being permitted.

Furthermore, in all four of the countries surveyed, younger respondents were more likely than older respondents to support sex selection being permitted. This trend is clearest in the Netherlands, where support for permitting sex selection begins at 37% among respondents aged 16-24 and then decreases steadily to 8% among respondents aged 65-75. In the UK, support for sex selection rises from 36% among respondents aged 16-24 to 39% among respondents aged 25-34, and diminishes thereafter.

In Spain, by contrast, support for permitting sex selection does not decline until we reach respondents aged 55 or older.

Above: Proportion of respondents in particular age bands (per country) who answered either 'Yes, definitely' or 'Yes, probably', when asked 'Should people undergoing private (ie, not paid for by the state) fertility treatment be able to choose the biological sex of their child, based on their personal preference?'
Base: n=2217 UK, n=2174 Netherlands, n=2171 Spain, n=2126 Italy, all adults aged 16-75. Online fieldwork conducted by Ipsos, 6-14 February 2026.

Four years ago, we posed the same question – 'Should people undergoing private fertility treatment be able to choose the biological sex of their child, based on their personal preference?' – to UK respondents, as part of a survey whose results were published in our 2022 report Fertility, Genomics and Embryo Research: Public Attitudes and Understanding.

Responses from UK respondents in our newer survey were very similar to the responses we received in 2022, suggesting that UK public attitudes to this issue have not changed substantially in the interim. Additionally, the same generational trend – whereby younger respondents in the UK are more likely than older respondents to support sex selection being permitted – was observed in both 2022 and 2026.

When we launched our 2026 report at ESHRE's recent annual conference in London, we took the opportunity to pose the sex selection question for a third time – not to samples of the public but rather to professionals, researchers and patient representatives from around the world, who were attending ESHRE's conference. The question formed part of our 'Dilemma of the Day' exercise, which involved asking visitors to our exhibition stand to respond to a different dilemma each day.

Clearly, this exercise was far less rigorous than the surveys that resulted in our 2022 and 2026 reports. However, the exercise did succeed in prompting a number of lively discussions at our exhibition stand, and suggested that the views of ESHRE attendees on this issue were generally in accordance with the views of the broader public. Although some of the visitors to our stand thought that fertility patients should be able to choose the biological sex of their child, based on personal preference, this was far outweighed by the number of visitors to our stand who did not support this.

It is worth clarifying that while there are certainly some countries where people are permitted to choose the biological sex of their child, based on personal preference, fertility patients are not currently permitted to do this in any of the four countries we surveyed (the UK, the Netherlands, Spain and Italy). On this issue, then – unlike other some of the other issues explored in our report, where public opinion runs ahead of current law – prevailing opinion seems to be consistent with present-day policies.

Nonetheless, we are intrigued to see that there is greater support for permitting sex selection among younger members of the public. Any move to permit sex selection in future – even if it were limited to so-called 'family balancing', whereby people are permitted to ensure that a prospective child is not of the same biological sex as their existing child(ren) – could have significant ethical ramifications, and would require thoroughgoing discussion and debate.

If you would like to offer us your views on sex selection – or if you have any insights into why our survey respondents, in different countries and age bands, responded as they did – then please get in touch.

For further detail on public opinion of sex selection in different European countries, and for data on public views on a wide range of other issues, please see our full report Fertility, Embryo Research and Genome Editing: Public Attitudes in Europe. If you are interested in helping us build on this work, by proposing and collaborating with us on related events and initiatives, then – again – please get in touch.

All percentage calculations above are rounded to the nearest whole number. Where percentages do not add up to 100%, or do not otherwise add up as expected, this is due to rounding.

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Registration is now open for this year's PET Annual Conference – AI and Automation in Fertility and Genomics: Pipeline? Or Pipe Dream? – which is supported by ESHRE, and is taking place in central London on Wednesday 9 December 2026.

Find out more and register here.