(bioethics) Gender Genetics and Sex Selection Review summary

Gender and Genetics

Sex and gender are both important determinants of health. Biological sex and socially-constructed

gender interact to produce differential risks and vulnerability to ill health, and differences in health-

seeking behaviour and health outcomes for women and men. (1) ‘Gender’ describes those

characteristics of women and men that are largely socially created, while ‘sex’ encompasses those that

are biologically determined. However, these terms are often mistakenly used interchangeably in

scientific literature, health policy, and legislation.

The World Health Organization’s Constitution states that “the enjoyment of the highest attainable

standard of health is one of the fundamental rights of every human being without distinction of race,

religion, political belief, economic or social condition.” (2) It is clear, however, that there are differences

in the factors determining health and the burden of ill-health for women and men. Gender analysis

identifies, assesses and informs actions to address health inequity arising from the different roles of

women and men, or the unequal power relationships between them, and the subsequent consequences

of these inequalities on their lives and health.

This section of the GRC presents an overview of the major ethical, legal, and social implications (ELSI)

associated with gender and genetics. The principal issues addressed are

 the genetic components of sex and gender, including sex chromosome abnormalities and sexual

ambiguity;

 behavioural genetics pertaining to sexuality and gender;

 gender differences between male and female genetic carriers and stigmatization;

 sex selection and discrimination;

 unsafe abortion following identification of a genetic disorder; and

 assisted reproductive technologies and issues of social and distributive justice.

Sex Selection and Discrimination Sex selection refers to the practice of using medical techniques to choose the sex of offspring. The term

“sex selection” encompasses a number of practices including selecting embryos for transfer and

implantation following IVF, separating sperm, and selectively terminating a pregnancy. The topic of sex

selection is particularly relevant to a discussion on gender and genetics because genetic technologies

and services may be used to preferentially choose one sex over the other. Sex selection has a wide range

of ethical, legal and social implications. A significant ethical concern is that sex selection for non-medical

reasons will reinforce discrimination, particularly against women.

The are three core motivations for engaging in sex determination and sex selection:

 medical reasons—such as preventing the birth of children affected or at risk of X-linked

disorders.

 family balancing reasons—where couples choose to have a child of one sex because they

already have one or more children of the other sex.

 gender preference reasons— often in favour of male offspring stemming from cultural, social,

and economic bias in favour of male children and as a result of policies requiring couples to limit

reproduction to one child, as in China.

Ethical Issues Raised by Sex Selection Sex selection for non-medical reasons raises serious moral, legal, and social issues. The principal

concerns are that the practice of sex selection will

 distort the natural sex ratio leading to a gender imbalance and

 reinforce discriminatory and sexist stereotypes towards women by devaluing females.

In some countries, such as India and China, it is commonly known that the practice of sex-selective

abortion has resulted in distortions of the natural sex ratio, in favour of males. In addition, there is

concern that sex selection involves inappropriate control over nonessential characteristics of children

and may place a potential psychological burden on, and hence cause harm to, sex-selected offspring.