If you could, would you swap you daughter for a son? Jade Bremner finds out the pros and cons of genetic diagnosis, available in Dubai
Shoppers can buy practically anything in Dubai: gold bars from vending machines, alligator-skin Rolls-Royces, million-dirham abayas. Now, for Dhs20,000, parents-to-be can buy the latest commodity – a designer baby.
Dubai has joined the likes of the United States as a gender selection destination, offering preimplantation genetic diagnosis (PGD) a 100 per cent accurate medical service that allows wannabe parents to determine the sex of their child. Couples from different parts of Asia and the UK (where gender selection is illegal) can now incorporate choosing the sex of their baby into their holiday.
Jeffrey Steinberg, Medical Director of The Fertility Institutes explains that, theoretically, gender selection is a fairly uncomplicated procedure. “We extract the eggs surgically, we ask the partner for a sperm specimen, we filter the sperm and add it to the eggs. Embryos result. We biopsy the embryos, and our genetics laboratory then provides us with the results. We can check for more than 200 different genetic disorders, plus distinguish the gender.”
Bourn Hall International, in Dubai, is one clinic now offering PGD. “Sex selection may be relevant for certain diseases that only affect males or females,” explains David Robertson, the Group Medical Director at the clinic. “[PGD] may also be requested for social reasons or ‘family balancing,’ which is more controversial,” he says.
Many believe gender selection should be prohibited, so it’s not used to discriminate against women or severely affect the gender balance in society. Mara Hvistendahl, author of Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men, explains that while there are legitimate medical reasons for using PGD, this is not the reason most couples sign up for the treatment. “By and large [PGD] is used negatively,” she says, “most people do it do it simply because they prefer a certain type of gender – usually boys.”
Hvistendahl warns that PGD is dangerous and could potentially cause a population imbalance similar to China’s – in 2010 there were five boys born for every four girls. Boys are culturally preferred in China, due to the fact that males traditionally carry on the family line and can perform ancestral rites. The nation’s one-child policy means that potential parents only have one chance to get it ‘right’. The predilection for males in China, and the tendency to abort females has led the government to outlaw PGD. Having more men than women in society has resulted in a marriage crisis in China – there are not enough brides for the swelling male population.
In India, the preference is also for baby boys. “This may be because of the skyrocketing cost of dowries,” explains Hvistendahl, “there is this overwhelming preference for boys in much of the world, with individual cultural reasons varying.
“The irony is, in today’s economy, daughters may actually be a better investment,” she says. Employment studies show that women are often preferred for manufacturing and service jobs. “They also tend to adapt well to shifting global trends,” she continues, “It’s important to look at the technology that makes [gender] selection possible.”
Medical representatives believe views such as Hvistendahl’s are ill informed. Jeffrey Steinberg explains: “The initial negative bias [towards PGD] is based on lack of information and fear.” He urges the importance of PGD for picking up ‘sex linked’ diseases. “Only a boy will get a certain disease or only a girl, these diseases can be prevented with gender selection.” Examples of such diseases include XLA, a genetic disorder that affects the X (male) chromosome and stops the body being able to fight infection, or Fragile X syndrome – a genetic disorder that causes autism in boys. Steinberg urges that if clinics are treating couples for non-medical reasons they have a responsibility to evaluate their patients psychologically prior to treatment. At his clinic, they treat couples on a case-by-case basis.
“All of our couples are screened extensively and are counselled psychologically,” says Steinberg. “We had a couple from Nigeria visit us. The couple had two lovely daughters, but their only son was assassinated two years earlier by a rebel group in Nigeria. They were desperate for another boy. The mother was 40 years old and feared that if she became pregnant and had another daughter, by the time the baby was delivered nine months later she might be too old to try again for a boy. We assisted them and they were fortunate enough to become pregnant with twin boys. They were very happy and their family is now ‘balanced’.” Time and loss are key factors in the Nigerian couple’s situation. But to what extent should couples be able to choose the gender of their baby? While most of us can understand choosing the sex of our children to avoid them suffering from diseases, or after a loss in the family, can we understand gender selection as a commodity, or for fashion’s sake?
Steinberg recalls another example – an Italian couple he helped. “The father is a famous fashion designer,” he explains. “He and his wife had several boys. The father said he spent his life designing beautiful fashion for women and girls and had always dreamed of doing this for his own daughter. We assisted them and they now have a lovely little girl. The couple will be releasing a new line of children’s clothes.”
Do society’s cultural gender stereotypes (only the son can carry the family name/only a daughter can follow fashion), need to be addressed before legalising sex specification? Are these stereotypes enough to justify medically determining the sex of our children? Hvistendahl believes not.
“I don’t agree with allowing sex selection for the purpose of [having a boy] and I don’t think it’s any better if couples do it because they want a daughter, either.”
David Robertson, from Bourn Hall International, can see the potential for serious demographic consequences with extensive selection, but cultural preferences differ from case to case and from country to country. “For some, social indications, such as a cultural preference for a boy, are unacceptable,” he says. “For others, it is a significant social issue, related to prestige, image, future issues with inheritance and so on.” One thing’s for sure, physicians are in a very powerful position: “It is they who carry the medical responsibility, and they have to be involved in determining whether a certain treatment is appropriate or not.” We can only hope they use their power wisely.
