The sex selection debate: more evidence is needed

Allowing parents to select embryos purely on the basis of their sex is one of the most controversial uses of reproductive technology, and usually one that generates plenty of press coverage every time it's mentioned. Not so last week, however, when the journal Nature reported on (and press-released) details of a forthcoming US study to look at the possible social effects of this practice.

The lack of comment in both the UK and US media was surprising, given that the study was deemed so ethically worrying that it has apparently taken nine years for the researchers to get the go-ahead. This in itself seems a little strange in a country where sex selection for non-medical reasons, while not encouraged, has never been outlawed. Why permit a medical procedure and yet discourage any research on its possible effects?

The study, being carried out by Sandra Carson and her colleagues at the Baylor College of Medicine in Texas, will follow up babies born following the use of PGD to choose the child's sex. The trial will only enrol couples who already have at least one child of a particular sex, and want to have a baby of the opposite sex - so-called 'family balancing'. When carried out for this reason, sex selection is felt by some to be less ethically problematic, since two of the arguments against sex selection - the possibility that its widespread practice could skew the gender ratio, and that it condones cultural preferences for one gender over another - are felt to be ameliorated.

Other arguments against 'social' sex selection are that it diverts resources from PGD for medical reasons, and that it represents a 'slippery slope' into a world in which babies are increasingly viewed as consumer 'objects'. Such children, it is argued, will not be valued for themselves, and will carry an unacceptable weight of parental expectation to behave in way that befits their selected gender. However, there has been little research carried out into whether or not allowing parents to choose their babies' sex has any effect on the children's future wellbeing, or on the family as a whole. Given that the practice is already allowed in several countries, studies such as the one now underway in Texas are long overdue.

In the UK, social sex selection is currently banned by the Human Fertilisation and Embryology Authority, which concluded in 2003 that an existing ban should remain in place, partly because 80 per cent of those who responded to a public consultation did not think it should be permitted. After pondering the issue as part of its review of the 1990 Human Fertilisation and Embryology (HFE) Act, the House of Commons Science and Technology Committee cautiously opposed this ban, concluding that 'on balance we find no adequate justification for prohibiting the use of sex selection for family balancing'.

Although it was only one of many recommendations made by the committee, saying that there are no good reasons to ban social sex selection provoked the most media comment, and outrage in some quarters. But public opinion alone is not a good enough reason to ban a practice - policies should be informed by careful consideration of possible harms and benefits. The US study should inject some evidence into a debate so far dominated by supposition and assumptions.

The UK Department of Health (DH) is seeking views on whether social sex selection (for family balancing reasons only) should be permitted, as part of its current review of the HFE Act. The public are invited to respond formally to the DH. BioNews readers and any other interested individuals are also invited to informally debate their views on family balancing now, on a DH-funded online discussion forum run by Progress Educational Trust the charity which publishes BioNews. Family balancing is being discussed in the 'Open Forum' area. Feedback from this time-limited website will be submitted to the DH after the public consultation closes on 25 November 2005. Your views are much valued and all are welcome to contribute.