Several times over the past few months, a small
but striking ad from a Virginia-based fertility clinic has appeared
in the Sunday Styles section of The New York Times. Alongside
a smiling baby, its boldface headline asks, "Do You Want
To Choose the Gender Of Your Next Baby?"
If so, the ad continues, you can join "prospective parents…from
all over the world" who come to the Genetics & IVF
Institute (GIVF) for an "exclusive scientifically-based
sperm sorting gender selection procedure." The technique,
known by the trademarked name MicroSort, is offered as a way
to choose a girl or boy either for the "prevention of genetic
diseases" (selecting against the sex affected by an X-linked
or Y-linked condition) or for "family balancing" (selecting
for a girl in a family that already has one or more boys, or
has been promoting MicroSort on its website for several years,
and a few other fertility clinics offer other "family balancing"
methods online. But the MicroSort ads in The New York Times
represent a bolder and higher-profile approach. They mark the
first time that high-tech methods for sex selection, and their
use for clearly social purposes, have been openly marketed in
a mainstream US publication.
Two years ago, when newspapers aimed at Indian expatriates
in the United States and Canada carried fertility clinic ads
for sex selection, The New York Times covered the event
as a news story (3). The article included hard-hitting
criticism from Indian feminists in the United States, and discussed
the hugely skewed sex ratios in South and East Asia (some demographers
estimate as many as 100 million "missing girls") that
are the result of female infanticide, neglect of girl babies,
and prenatal diagnosis followed by sex-selective abortion. It
noted that the sex-selection ads would be illegal in India,
and reported that one of the publications dropped them after
The New York Times has also covered other aspects of
the debate about sex selection. To date, however, it has taken
no note of the MicroSort ad campaign. Nor have other newspapers.
The marketing tactics
GIVF's ads note that MicroSort sperm sorting is currently "investigational,"
and is being used in the context of an FDA clinical trial. But
the company is marketing the procedure with a classic consumer
come-on: It promises "FREE MicroSort for qualifying patients"
who sign up for either its "Donor Egg" or "Preimplantation
Genetic Diagnosis" program. GIVF repeats the offer in a
pop-up ad on its MicroSort website, where another smiling baby
sits in front of a pink-and-blue double helix (4).
Both egg "donation" and PGD (in which embryos are
produced outside the body, and then screened and selected for
genetic characteristics) require that women undergo an invasive
egg-harvesting procedure. Sex selection via sperm sorting is
usually accomplished by artificial insemination, and so doesn't
require egg harvesting or in vitro fertilization. GIVF's offer
can thus be read as luring women to undergo riskier (and in
the case of PGD, more expensive) procedures.
The MicroSort story
The technology behind MicroSort was developed in the late 1980s
by a government scientist at the US Department of Agriculture
for use in producing livestock. In 1992, USDA granted GIVF founder
Dr. Joseph Schulman an exclusive US license to apply the method
in humans for the patent's full 17-year life. The first MicroSort
baby was born in 1995.
now has established relationships with dozens of "physician
collaborators" in the US and six other countries, who ship
semen samples to GIVF for sorting and freezing. In October 2002,
GIVF launched a second MicroSort lab, in partnership with the
Huntington Reproductive Center in southern California (5).
GIVF's Schulman is not only a technical and entrepreneurial
pioneer of sex selection, but also an early popularizer of the
notion of "family balancing." The concept has been
floated in assisted reproduction circles as a justification
for sex selection at least since the early 1990s. According
to the website Word Spy, which traces the origins and usage
of recently coined words and phrases, the earliest use of the
term in the mainstream media was a quote from Schulman in a
1994 Fortune article (6).
"Family balancing" is, of course, an application
of high-tech sex selection with considerable commercial potential.
GIVF's base charge for MicroSort is $2300; couples try an average
of three times before a pregnancy is achieved or they drop out.
When Fortune followed up on MicroSort in 2001 with a long article,
it quoted an analyst at OrbiMed Advisors, an asset management
firm focused on the "global healthcare industry,"
who estimated a market for sperm sorting in the US alone of
"between $200 million and $400 million, if [it] is aggressively
The fertility industry's trade organization
It's difficult to imagine that such projections did not play
some role in a 2001 decision by the American Society of Reproductive
Medicine (ASRM)-the fertility industry's trade organization-to
give an ethical go-ahead to sperm sorting for "family balancing."
A report by its Ethics Committee noted but overrode a range
of social and ethical objections, including those that led to
its rejection, just two years earlier, of using PGD for such
purposes. In that earlier report, ASRM explicitly acknowledged
that both PGD and sperm sorting have "the potential to
reinforce gender bias in a society" (8).
ASRM remains officially opposed to the use of PGD for "family
balancing," though it waffled on the point in 2001. In
September of that year, an opinion issued by the acting chair
of ASRM's Ethics Committee that seemed to overturn the organization's
opposition to PGD for sex selection "stunned many leading
fertility specialists," according to The New York Times.
One fertility doctor quoted in the Times coverage asked,
"What's the next step?...As we learn more about genetics,
do we reject kids who do not have superior intelligence or who
don't have the right color hair or eyes?" (10).
ASRM's apparent turnaround also sparked protest from feminists
and others advocating responsible uses of human genetic technologies.
A letter to ASRM asking that it maintain its stand against PGD
for "family balancing" was jointly drafted by Center
for Genetics and Society and several women's groups, and quickly
signed by nearly 100 organizations and individuals. A few months
later ASRM issued an official reaffirmation of its earlier conclusion
While GIVF's website heralds ASRM's blessing of sperm sorting
for "family balancing," its online offers fail to
mention the organization's disapproval of PGD for this purpose
(12). Of course, adherence to ASRM guidelines
is purely voluntary, and they are regularly flouted (for example,
GIVF is not the only US fertility business openly offering PGD
for "family-balancing" on the Internet). But the existence
of the guidelines is often cited as an argument against effective
regulation of the assisted reproduction industry.
Global policy and implications
There are no legislative limits on the applications of PGD
or sperm sorting in the United States. In a significant number
of other countries, however, legislative or regulatory prohibitions
on "non-medical" sex selection procedures are in place
or pending. The Council of Europe's Convention on Human Rights
and Biomedicine explicitly forbids them (13).
But new methods of sperm sorting and the promotion of "family
balancing" in the US are sure to affect practices and policies
worldwide. If Americans start controlling the sex of their children,
people and policy makers in other parts of the world will take
The UK provides one example. Its public regulatory agency,
the Human Fertilisation and Embryology Authority (HGEA), has
prohibited the use of PGD for "family balancing."
But last year the HFEA began a "comprehensive review"
of sex selection, in part to decide whether or not to regulate
sperm sorting (14). HFEA's decision to re-open
the question of sex selection may also have been influenced
by publicity about Britons who traveled to the US to get access
to PGD. (Information about the HFEA's "public consultation"
and about a "Take Action on Sex Selection" campaign
is available from the UK-based Human Genetics Alert (15).)
In South and East Asian countries, sex-selection technologies
raise an additional set of concerns. Feminists assert that any
increased acceptance of sex selection in the US will legitimize
its use, and seriously aggravate urgent problems for women in
societies where preference for sons is strong. They point to
the persistence of female infanticide, neglect of girls, and
sex-selective abortions, even in countries with laws against
them, and to the prevalence of violence against women who fail
to give birth to sons (16).
"An abusive spouse may use the birth of a daughter as
a pretext for violence towards his wife, and then be violent
towards the unwanted daughter," says a fact sheet on sex
selection prepared for a national conference later this month
of South Asian women living in the US. Even Fortune recognizes
the gravity of the problem. "It is hard to overstate the
outrage and indignation that MicroSort prompts in people who
spend their lives trying to improve women's lot overseas,"
its reporter notes (17).
High-tech sex selection poses a range of difficult policy dilemmas,
especially the problem of addressing it without weakening women's
rights and access to abortion. But address it we must, because
of the grave concerns it raises about exacerbating sexism, undermining
disability rights, threatening the well-being of children, and
setting the stage for a consumer eugenics in which parents are
sold techniques to select not just their child's sex, but a
range of other traits as well. As Human Genetics Alert asks,
if we allow sex selection, how will we be able effectively "to
oppose `choice' of...appearance, height, intelligence, etc.
The door to `designer babies' will not have been opened a crack-it
will have been thrown wide open" (18).
What technology can do; what technology should
According to the limited public opinion data and marketing
projections that are available, about a quarter of Americans
would like to be able to select the sex of their offspring.
That number indicates the potential for significant societal
effects, and evokes the misogynist uses of sex selection in
South and East Asia, and the decades of struggle by women's
groups against them.
In the United States, preference for sons is much less strong
than in some other parts of the world, although a 1995 study
found that 34 percent of US geneticists would perform prenatal
testing because a family wanted a son-a ten percent increase
from ten years earlier (19). But anecdotal
evidence-based on reports from the companies offering various
methods for sex control, and on perusals of the "Gender
Determination" message board at http://www.parentsoup.com
(which has over a quarter million postings) suggests that of
the Americans actively trying to determine the sex of their
next child, many are women who want daughters.
That Americans may not use new technologies to produce huge
numbers of "extra" boys doesn't necessarily mean that
sex selection and sexism are unrelated. One study, by Roberta
Steinbacher at Cleveland State University, found that 81 percent
of women and 94 percent of men who say they would use sex selection
would want their firstborn to be a boy. Steinbacher points out
that the research literature on birth order is clear: firstborns
are more aggressive and higher-achieving than their siblings.
"We'll be creating a nation of little sisters," she
Observers of sex selection point to another discriminatory
impact: its potential for reinforcing gender stereotyping. Parents
who invest large amounts of money and effort in order to "get
a girl" are likely to have a particular kind of girl in
mind. As the mother of one of the first MicroSort babies put
it in a fairly typical comment, "I wanted to have someone
to play Barbies with and to go shopping with; I wanted the little
girl with long hair and pink and doing fingernails" (21).
Of course, there are many reasons that people may wish for
a daughter instead of a son, or a boy rather than a girl. In
a sympathetic account, The New York Times reporter and
feminist Lisa Belkin describes some of the motivations of US
women who are "going for the girl." "They speak
of Barbies and ballet and butterfly barrettes," she writes.
But "they also describe the desire to rear strong young
women. Some want to recreate their relationships with their
own mothers; a few want to do better by their daughters than
their mothers did by them. They want their sons to have sisters,
so that they learn to respect women. They want their husbands
to have little girls. But many of them want a daughter simply
because they always thought they would have one" (22).
Compelling though some of these longings may be, the issue
raised by sex selection is not primarily one of the rightness
or wrongness of parental desires. The preferences of prospective
parents are obviously relevant in matters of child-bearing,
but so are the well-being of future children, and the social
consequences of a set of technologies that are certain to be
As effective technologies for predetermining sex have moved
into commercial application, a disturbing number of fertility
industry figures have shed their deference to ethical and social
deliberations. But serious considerations of sex selection,
no matter what their conclusions, continue to raise a bevy of
concerns about its potential to promote sexism and gender stereotyping,
to commodify children and put them at risk of parental disapproval
(if the child turns out to be the "wrong" sex) or
rigid expectations (if the child turns out to be the "wrong
kind" of girl or boy), to create societal distortions in
sex ratios and in the number of firstborn boys, and to move
us toward the "designing" of future generations.
From a social and political perspective, the paramount question
is this: If new technologies make it possible to fulfill desires
and satisfy preferences, is that reason enough to use them?
More succinctly: If we can, does that mean we ought?
- Gina Kolata, "Fertility Ethics Authority Approves
Sex Selection," The New York Times, September
- Susan Sachs, "Clinics' Pitch to Indian Emigrés:
It's a Boy," The New York Times, August 15, 2001
- GIVF press release,
- Meredith Wadman, "So You Want A Girl?," Fortune,
- The Ethics Committee of the American Society of Reproductive
Medicine, "Sex selection and preimplantation genetic
- Kolata, op. cit.
- Kolata, op. cit.
- Accounts of this episode can be found at
- Excerpts from the Council of Europe's Convention on
Human Rights and Biomedicine can be found at
- Human Fertilisation & Embryology Authority, "Sex
Selection: Choice and responsibility in human reproduction,"
- Human Genetics Alert, "Take Action on Sex Selection,"
- Rupsa Mallik, "A Less Valued Life: Population Policy
and Sex Selection in India," 2002
- Wadman, op. cit.
- Human Genetics Alert, op. cit.
- Lisa Belkin, "Getting the Girl," The New York
Times Magazine, July 25, 1999
- "Choosing Your Baby's Gender," cbsnews.com, November
7, 2002; posted in the "News Articles" section of
the MicroSort website, http://www.microsort.com
- Belkin, op. cit.