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Pathways and Barriers to Parenthood pp 173–183Cite as

Reproductive Autonomy: Sex Selection as a Defining Case Study

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Abstract

Scientific advances enable parents to choose the sex of their offspring. This innovative technology has confronted society with the need to decide whether what is possible is also permissible, and under what terms. The debate over sex selection invokes various important issues, including gender stereotypes, discrimination of women, personal and parental reproductive autonomy, abortion, and more. As a result, different societies have made different determinations, reflecting their particular circumstances, social norms, culture, history, and religion. While some abstain from any formal regulation, which in effect allows unrestricted practices in respect to sex selection, others enforce a strict prohibition. Israel has chosen an intermediate position, conforming to the prevailing prohibitive stance (in Europe and Canada for instance), but allowing for certain exceptions. The Israeli regulations represent an authentic resolution of the issue that demonstrates Israel’s unique, autonomous bioethics status among Western liberal democratic nations.

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Notes

  1. 1.

    For a discussion of this issue see: Mieszczak, Houk, and Lee (2009); Wherrett (2015).

  2. 2.

    Gamete denotes a single sperm and/or ovum.

  3. 3.

    PGD involves removal of one cell from the developing pre-embryo, usually around day 3–6 after fertilization, for genetic testing. Among the tests performed (mainly for medical purposes), sex can be determined. PGD requires substantial expertise, is costly, and may not be available in all fertility clinics.

  4. 4.

    This practice has an undetermined risk/benefit ratio. Following an FDA probe, MicroSort relocated its business outside the USA.

  5. 5.

    This raises the question of the fate of the pre-embryos of the undesired sex. This issue is discussed below.

  6. 6.

    In other words, PGD does not substantially reduce the chance of pregnancy by IVF.

  7. 7.

    As PGD for non-medical reasons is expensive and not generally covered by health insurance plans or national health insurance, only wealthy parents are able to enjoy this technology, creating an access inequality.

  8. 8.

    Examples of similar situations exist in medicine and healthcare, such as reconstructive surgery techniques which became the foundation of elective plastic surgery, a multi-billion dollar industry.

  9. 9.

    Griswold v. Connecticut, 381 U.S. 479 (1965); Eisenstadt v. Baird, 405 U.S. 438 (1972); Roe v. Wade, 410 U.S. 113 (1973); Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992).

  10. 10.

    Available at http://chdslsa.gov.in/right_menu/act/pdf/PNDT.pdf (last visited April 1, 2018).

  11. 11.

    S. 5(1)(c), 2004.

  12. 12.

    https://www.congress.gov/bill/115th-congress/house-bill/4660.

  13. 13.

    Available at https://www.legislation.gov.uk/ukpga/2008/22/contents (last visited April 1, 2018).

  14. 14.

    https://cbhd.org/content/g12-country-regulations-assisted-reproductive-technologies.

  15. 15.

    A clear indication of the low interest of the vast majority of Israeli families in sex selection for non-medical reasons.

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Acknowledgements

I would like to thank Aisha Haley JD, UVA Law School for her superb research assistance, and Saralee Glasser MA, from the Gertner Institute, for her constructive comments.

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Authors and Affiliations

  1. University of Virginia School of Law, Charlottesville, VA, USA

    Gil Siegal

  2. The Israeli National Committee for Non-Medical Sex Selection, Jerusalem, Israel

    Gil Siegal

  3. Center for Health Law, Bioethics and Health Policy, Ono Academic College, Kiryat Ono, Israel

    Gil Siegal

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  1. Gil Siegal
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Correspondence to Gil Siegal .

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Editors and Affiliations

  1. Bar-Ilan University, Ramat Gan, Israel

    Orit Taubman – Ben-Ari

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Siegal, G. (2019). Reproductive Autonomy: Sex Selection as a Defining Case Study. In: Taubman – Ben-Ari, O. (eds) Pathways and Barriers to Parenthood. Springer, Cham. https://doi.org/10.1007/978-3-030-24864-2_10

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