A Right to Choose?: Sex Selection in the International Context

While there is some debate among doctors, ethicists, and the general public about the level of medical necessity that should justify a sex-selection procedure, most accept that sex selection for medical reasons is beyond ethical reproach, and in some situations, should even be encouraged.9 However, elective, non-medical sex-selection, which is often performed for social or financial reasons, is the subject greater scrutiny and impassioned ethical debate.10 Currently, doctors and geneticists are able to diagnose more than five hundred separate medical conditions in a developing fetus.11 Among these conditions are devastating genetic diseases such as hemophilia, Down syndrome, cystic fibrosis, Huntington\u27s disease,12 and Hunter syndrome

A Right to Choose?: Sex Selection in the International Context

While there is some debate among doctors, ethicists, and the general public about the level of medical necessity that should justify a sex-selection procedure, most accept that sex selection for medical reasons is beyond ethical reproach, and in some situations, should even be encouraged.9 However, elective, non-medical sex-selection, which is often performed for social or financial reasons, is the subject greater scrutiny and impassioned ethical debate.10 Currently, doctors and geneticists are able to diagnose more than five hundred separate medical conditions in a developing fetus.11 Among these conditions are devastating genetic diseases such as hemophilia, Down syndrome, cystic fibrosis, Huntington\u27s disease,12 and Hunter syndrome

Replacing Myths with Facts: Sex-Selective Abortion Laws in the United States

Sex selection is the practice of attempting to control the sex of one's offspring in order to achieve a desired sex. One method of sex selection is sex-selective abortion. Laws banning sex-selective abortion are proliferating in the United States. Eight states have enacted laws prohibiting sex-selective abortion. Twenty-one states and the federal government have considered such laws since 2009. Those laws prohibit the performance of an abortion if sought based on the sex of the fetus and provide for both criminal and civil penalties in most cases.A great deal of misinformation exists regarding sex selection in the United States. We have identified six inaccuracies commonly associated with sex-selective abortion and laws prohibiting it. They appear, among other places, in statements made by legislators, testimony submitted to legislatures, and reports issued by legislative committees that have considered or adopted laws banning sex-selective abortion. We present each piece of inaccurate information as a "myth." This Report draws on legal research, empirical analysis of U.S. birth data, field-work, and an extensive review of scholarly publications in social sciences, law and other disciplines to replace these myths with facts

Prenatal Sex Selection and Girls' Well-Being: Evidence from India

In this paper, we study the impact of prenatal sex selection on the well-being of girls by analyzing changes in children's nutritional status and mortality during the years since the diffusion of prenatal sex determination technologies in India. We further examine various channels through which prenatal sex selection might affect girls’ outcomes. Using repeated cross-sections from a rich survey dataset, we show that high sex ratios at birth reflect the practice of sex selective abortion. We then exploit the large regional and time variations in the incidence of prenatal sex selection to analyze whether changes in girls' outcomes relative to boys within states and over time are associated with changes in sex ratios at birth. We find that an increase in the practice of prenatal sex selection appears to be associated with a reduction in the incidence of malnutrition among girls. The negative association is stronger for girls born in rural households and at higher birth parities. An examination of the various mechanisms linking between prenatal sex selection and children outcomes suggests that prenatal sex selection does not lead to a selection of girls into better endowed families, but there is some evidence of a larger reduction in family size for girls relative to boys. We also find an increase in girls' breastfeeding duration suggesting an improvement in parental care and treatment. On the other hand, prenatal sex selection does not appear to be associated with a reduction in excess female child mortality, or a reduction in son preference.son preference, prenatal sex selection, ultrasound, sex ratio at birth, gender discrimination, child health

Sex Preference and Interest in Preconception Sex Selection: A Survey Among Pregnant Women in the North of Jordan

BACKGROUND Preconception sex selection for non-medical reasons is a controversial issue in bioethics. Little research has described preferences for preconception sex selection among Arab populations. This study describes the sex preference and interest in employing sex selection techniques among pregnant women in northern Jordan. METHODS A self-reported questionnaire was administered to 600 pregnant women in Irbid, Jordan. χ2 test and binary logistic regression were used to examine the factors associated with interest in preconception sex selection. RESULTS In general, the interest in using sex selection was low. Women who preferred boys were more likely to be interested in sex selection, if paid for by the couple [odds ratio (OR) = 4.40, 95% confidence interval (CI): 1.75–11.11] or by health insurance (OR = 3.42, 95% CI: 1.94–6.06), or, if feasible, administered through oral medication (OR = 8.84, 95% CI: 5.05–15.63). Women with lower education were more likely to be interested in sex selection, if paid by health insurance (OR = 1.96, 95% CI: 1.10–3.45) and were more likely to believe that sex selection is legal (OR = 1.79, 95% CI: 1.06–2.86). Women who had no boys were more likely to be interested in sex selection, if paid by health insurance (OR = 1.94, 95% CI: 1.10–3.42) or, if feasible, through medication (OR = 3.03, 95% CI: 1.82–5.00). CONCLUSIONS The majority of participants were not in favor of using preconception sex selection. Those with a preference to have boys, with lower education, and those with an imbalanced family were more likely to be interested in using sex selection technology

Amniocentesis and sex selection

"This paper examines the introduction, spread and impact of amniocentesis (and more recently other sex-selection technologies) in India roughly since the mid-70s, to isolate the key actors, the driving forces of propulsion, and the historical context for the phenomenon of female foeticide following such tests. An attempt is made to demystify the runaway spread of the practice by comparing it with the emergence of female infanticide, also within the last two decades, in a region and a community with no previous history of such a practice. The two stories are presented as manifestations of the same process - though some of the actors are widely different - in terms of class. culture, ethnic traditions, gender role history, population, geography and exposure to debates on reproductive rights, freedom and the autonomy of choice. In the last section, some questions are raised on these philosophical concepts and their social implications.

Engendering harm: a critique of sex selection for 'family balancing'

The most benign rationale for sex-selection is deemed to be “family balancing.” On this view, provided the sex-distribution of an existing offspring group is “unbalanced,” one may legitimately use reproductive technologies to select the sex of the next child. I present four novel concerns with granting “family balancing” as a justification for sex-selection: (a) families or family subsets should not be subject to medicalization; (b) sex selection for “family balancing” entrenches heteronormativity, inflicting harm in at least three specific ways; (c) the logic of affirmative action is appropriated; (d) the moral mandate of reproductive autonomy is misused. I conclude that the harms caused by “family balancing” are sufficiently substantive to over-ride any claim arising from a supposed right to sex selection as an instantiation of procreative autonomy

Ethical Attitudes of German Specialists in Reproductive Medicine and Legal Regulation of Preimplantation Sex Selection in Germany

The majority of German specialists in reproductive medicine opposes preimplantation sex selection for nonmedical reasons while recommending preimplantation sex selection for medical reasons, e.g. X-linked diseases like haemophilia

Where have all the young girls gone? Identification of sex selection in India

This paper presents the first estimates of the causal effect of facilities for prenatal sex diagnosis on the sex ratio at birth in India. It conducts a triple difference analysis across cohort, birth order and sex of previous births. Treated births are those that occur after prenatal sex detection becomes available at birth order two or more in families that have not yet had their desired number of sons (or daughters). The three implied control groups are births that occur pre-ultrasound, births of first order and births that occur after the family has achieved its desired sex mix of births. We identify a significant divergence between the treated and control groups. We consider alternative hypotheses and conduct an array of robustness checks to show that the divergence of the sex ratio of the treated group from the normal biological range that characterizes the control groups is on account of female foeticide. We estimate that as many as 0.48 million girls p.a. were selectively aborted during 1995-2005, which is more than the number of girls born in the UK each year. The estimates suggest that Indian families desire two boys and a girl; previous studies often assume that the desire is for at least one boy. The incentive to conduct sex selection is increasing in birth order and family socioeconomic status, both consistent with stronger incentives to sex‐select as fertility approaches its target.sex selection, abortion, sex ratio, son preference, prenatal sex diagnosis, ultrasound, gender, India, triple difference estimator, differences in differences.

Is sex ratio at birth an appropriate measure of prenatal sex-selection? Findings of a theoretical model and its application to India

Son preference and prenatal sex selection against females have resulted in significant sex ratio at birth (SRB) imbalances well documented in several Asian countries, including India and China. The SRB bias is generally used as indicator for the extent and trends of prenatal sex selection against females. Decreasing fertility levels are expected to increase sex selection and thus SRB bias, since desiring fewer children increases the risk for families to remain sonless (fertility squeeze effect). We developed and employ mathematical models linking family size, birth order and childbearing strategies with population SRB bias. We show that SRB bias can increase despite fewer sex selection interventions occurring, inconsistent with the expectation of the fertility squeeze effect. We show that a disproportionality effect of fertility reduction amplifies SRB bias, in addition to the fertility squeeze effect, making SRB bias an inaccurate indicator for changes in sex selection practices within a population. We propose to use sex selection propensity (proportion of couples intervening) to measure behavioural change and evaluate policies targeting sex selection practices. We apply our findings to India, showing for instance that sex selection propensity in Punjab and Delhi was lower than in Rajasthan or Uttar Pradesh, despite significantly higher SRB bias in the former. While we observe a continuous overall increase in the SRB over the 2005-2010 period in India, our results indicate that prenatal sex selection propensity started declining during that period