In some countries where there is a strong preference for sons due to cultural and religious reasons, women sometimes choose to have an abortion after learning the sex of the fetus they carry is female, which is often referred to as sex selection abortion. For example, sex selection abortion is common in India and has increased significantly in the couple of last decades, especially for pregnancies following a firstborn daughter. The prevalence of sex selection abortion is also common in China, often referred to as the “missing girls of China” phenomenon, and is due to a similar cultural preference for sons as well as the One Child Policy.
Given the strong pressure women are under to have sons, is ethical for them to have sex selection abortions? Some point out that it may not be women’s authentic choice that is leading them to abort female fetuses but rather familial pressure from their husband and other family members as well as broader social pressure. In these situations, paternalistic approaches may be more justifiable in order to protect women from oppressive social forces that may coerce them into having sex selection abortion. From a justice perspective, outlawing sex selection abortion sends the message that sex discrimination is wrong, seeks to protect female fetuses, and attempts to ensure a balanced birth ratio between females and males.
Should sex selection be more permissible in countries where there is not a strong preference for children of a particular sex? For example, should sex selection be prohibited in countries like India and China where there is a strong preference for male children but legal in countries where sex selection technology is used to have girls as frequently as boys? Or is sex selection problematic regardless of where and why it is performed?
Some believe sex ethical inherently problematic because it not only implies that there are important biological and social differences between the sexes, but it also reinforces these differences. For example, a man may want a son so he could play football with him and a daughter who he can spoil as his “little princess.” The concern here is that sex selection will further buttress the gender binary and reify gender norms.
Others support sex selection under certain circumstances that they feel are not sexist. For instance, some argue that sex selection can be considered medically indicated when there is the possibility of passing on a X-linked recessive disease, such as Duchenne muscular dystrophy, to male offspring. In these cases, according to the principles of nonmaleficence and beneficence, sex selection to select for female fetuses is ethical because it prevents harm (i.e. the birth of a child could have a serious medical condition).
Some argue that there can be justifiable social reasons and not just medical reasons for allowing sex selection. “Family balancing” usually refers to parents wanting a mix of daughters and sons, not just children of one sex. For example, if a couple has 3 sons, they may want to use sex selection to have a daughter and thereby ensure family balancing (i.e. having children of both sexes). Some believe it is not problematic for parents to want children of both sexes since it is not prioritizing one sex over the other but rather showing a desire for both.
Whereas some claim that sex selection should never be allowed or only under certain circumstances, others assert that prohibiting sex selection is paternalistic and unjustly limits women’s reproductive autonomy. They claim that if abortion is permitted for a variety of reasons, including other characteristics of the fetus, then it is unfair to prevent women from choosing an abortion based on fetal sex. They believe that women should be given the autonomy to make their own reproductive decisions without state interference.
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