Letter to American Society for Reproductive Medicine Regarding Sex Selection
January 15, 2002
J. Benjamin Younger, M.D.
American Society for Reproductive Medicine
1209 Montgomery Highway
Birmingham, Alabama 35216-2809
Dear Dr. Younger,
We are writing to express our deep concern about the recent letter from John Robertson, the acting head of your Ethics Committee, supporting the use of preimplantation genetic diagnosis for sex selection in cases where a couple desires "gender variety" in their children. While we understand that the sentiments expressed in his letter do not reflect a shift in the ASRM's official policy on this matter (as expressed in its 1999 report), we believe that the actual repercussions of this widely publicized letter should be of great concern to the committee, to ASRM, and to the fertility field as a whole.
According to media reports, the letter is already being used by some fertility specialists to justify offering IVF/PGD even to fertile couples for the sole purpose of sex identification and selection. One fertility center's website seems to suggest that ASRM approves of this practice, citing ASRM's "official opinion" that PGD is no longer "considered an experimental procedure" and then stating a few sentences later that "PGD also lends itself to non-medically indicated gender selection." (See http://www.centerforhumanreprod.com/treatment_assisted.html.)
Your own 1999 report asserts that this scenario "holds greater risk of unwarranted gender bias, social harm, and the diversion of medical resources from genuine medical need."
Nearly concurrent with Robertson's approval of PGD for sex selection, ads placed by American fertility practitioners offering both pre- and post-conception sex selection have targeted the South Asian community in North America. (See "Indians Abroad Get Pitch on Gender Choice," The New York Times, 8/15/01.) Those marketing this "service" to South Asians are surely aware that sex selection in India disfavors female children, capitalizing on the strong son preference and overall gender discrimination that have led to alarming gender imbalances in the population. India's experience with sex selection should leave no doubt that all methods of sex selection are potentially abusive and discriminatory.
The fact that some clinics in the United States are willing to exploit such practices should act as a warning to proceed with extreme caution in these matters. Fertility specialists who offer potentially lucrative yet ethically problematic services threaten to erode public trust in the fertility field as a whole.
Our organizations, which work to promote the rights, health, and reproductive freedoms of women, believe that condoning the non-medical use of PGD for sex selection would promote an already controversial technology for an inherently discriminatory use. While motivations for desiring a child of a particular sex may vary, there are no non-sexist reasons for pre-selecting sex except in cases of preventing serious sex-linked diseases. This is true even in the United States, where economic and social pressures to raise male children are minimized in comparison to other societies.
PGD presents serious ethical dilemmas precisely because it is so often difficult to distinguish medical from non-medical conditions. Allowing PGD for "gender variety" is a clear example of a non-medical application. Preselecting traits such as sex opens the door to embryo selection based on other non-medical traits, and constitutes a major step toward the "designing" of children.
We urge ASRM to take the earliest and strongest possible actions to discourage the use of pre- and post-conception sex selection for anything other than the prevention of serious medical conditions. A strong stand by ASRM on this matter would be an important step in promoting a climate in which reproductive and genetic technologies are not misused. We ask that you be in touch with a response.
Nahar Alam, Co-Founder and Organizer, Andolan (Organizing South Asian
Workers), New York City
Rajani Bhatia, Coordinator, Committee on Women, Population and the Environment
Marcy Darnovsky, PhD, Program Director, Center for Genetics and Society
Shamita Das Dasgupta, Ph.D., DVS, Manavi, Inc.
Judy Norsigian, Executive Director, Boston Women's Health Book Collective
Tania Simoncelli, Program Director, Center for Genetics and Society
Cc: William R. Keye, Jr. Karen D. Bradshaw
Sandra A. Carson G. David Adamson
Marian D. Damewood Sarah L. Berga
Michael R. Soules Bryan D. Cowan
R. Jeffrey Chang George A. Hill
John A. Robertson Jamie A. Grifo
Andrea L. Bonnicksen Lawrence S. Ross
Robert W. Rebar Steven J. Ory
Thomas T.F. Huang, Jr. Sue Prescott
Stuart S. Howards Jim Howard
Charles C. Coddington, III Sean Tipton
Steven J. Ory
Signatories as of January 14, 2002
(Organizational endorsements are indicated by boldface print.
Plain text indicates organizational affiliation listed for identification purposes only.)
Amy Allina, National Women's Health Network
Karen Artichoker, Director, Cangleska, Inc.
Byllye Y. Avery, Founder, National Black Women's Health Project
Jane Bai, Executive Director, CAAAV: Organizing Asian Communities
Patricia Baird, Former Chair, Canadian Royal Commission on New Reproductive Technologies
Prof Rosalyn Baxandall, Chair, American Studies, SUNY Old Westbury
Diane Beeson, Chair, Department of Sociology and Social Services, California State University, Hayward
Prof. Philip L. Bereano (University of Washington), Washington Biotechnology Action Council
Rini Bhattacharya, Gender Activist, Maitree, Calcutta, India.
Alexander Morgan Capron, University Professor, Co-Director, Pacific Center for Health Policy and Ethics, University of Southern California
Claudia J. Carr, Associate Professor, College of Natural Resources, University of California, Berkeley
Madhu Chandra, Sneha, Cheshire, CT
Ignacio H. Chapela, PhD, Assistant Professor, Environmental Science, Policy and Mangement, University of California, Berkeley
Amparo Claro, Coordinator, Red de Salud de las Mujeres Latinoamericanas y del Caribe/Latin American and Caribbean Women's Health Network
Irene Crowe, PhD. Pettus Crowe Foundation
Radha Dayanidhi, Manavi, Inc.
Bhairavi Desai, New York Taxi Workers Alliance
Dazon Dixon Diallo, President, SisterLove, Inc., Atlanta, GA
Sunita Dhumale, Sneha, Cheshire, CT
Gretchen Eckroate, Membership Director, National Coalition Against Domestic Violence, Denver, CO
Espace Femmes International (EFI), Geneva, Switzerland
Kathleen J. Ferraro, Director, Women's Studies Program, Arizona State University
Adrienne Germaine, President, International Women's Health Coalition
Adriana Gómez, Chief editor, Red de Salud de las Mujeres Latinoamericanas y del Caribe/Latin American and Caribbean Women's Health Network
Meena Gopal, Forum Against Oppression of Women, Mumbai (FAOW), Mumbai, India
Manisha Gupte, Co-Convenor, MASUM, Pune, India
Betsy Hartmann, Director, Population and Development Program, Hampshire College
Ruth Hubbard, Professor Emerita Biology, Harvard University, and founding director, Council for Responsible Genetics
Sheila Jasanoff, Professor of Science and Public Policy, John F. Kennedy School of Government, Harvard University
Anne S. Kasper, PhD., first co-chair of the board of directors of the National Women's Health Network.
David King, Human Genetics Alert, United Kingdom
Sabala and Kranti, Initiatives Women in Development, Mumbai (IWID), Mumbai, India
Abby Lippman, PhD, Mcgill University
Ngina Lythcott, Dr.P.H., Associate Dean, Mailman School of Public Health, Columbia University
Swatija Manorama, Forum for Women's Health (FFWH), Mumbai, India
Shukti Mazumdar, Manavi, Inc.
Medico Friends Circle (MFC), India
Kamlesh Mehrotra, member, Manavi, Inc.
Sumita Menon and Qudsiya Contractor, CEHAT (Centre for Enquiry into Health and Allied Themes), Research Centre of Anusandhan Trust, Mumbai, India.
Mamata Misra, Saheli
Dr. Merry Morash, Ph.D, Michigan State University
Shree Mulay, Professor, Department of Medicine, McGill University, Montreal, Canada
Dr. Thelma Narayan MBBS, M.Sc(Epid), PhD(London), Coordinator, Community Health Cell, India.
Stuart A. Newman, Ph.D., Professor of Cell Biology and Anatomy, New York Medical College
Deepika Parikh, Counselor, Manavi, Inc.
Amita B. Preisser, Founder, Mediart Communications
Dr. Bandana Purkayastha, Sneha, Cheshire, CT
Shanthi Rao, Sneha, Cheshire, CT
Alejandra Rotania, Ser Mulher, Centro de Estudos e Ação da Mulher, Nova Friburgo, RJ, Brasil
Dr. Sharmila Rudrappa, CAAS and Sociology, University of Texas-Austin
Saheli, New Delhi, India
Sama, New Delhi, India
Marsha Saxton, Ph.D, Research Associate, World Institute on Disability, University of California, Berkeley
Sarah Sexton, The CornerHouse, United Kingdom
Sonia Shah, South End Press
Shodhini Network, India
Sara Shostak, MPH, University of California, San Francisco
Evelyne Shuster, PhD, Former member of the American Society of Reproductive Medicine, Board member of Global Lawyers and Physicians
Jael Silliman, Assistant Professor of Women's Studies, University of Iowa.
Betsy Strausberg, Women's Health Education Network
Sangeeta Subramanian, Executive Director, South Asian Women's Centre, Toronto, Canada
April J. Taylor, Director, Cancer Prevention and Elder Health, Boston Public Health Commission
Martin Teitel, Ph.D., President, Council for Responsible Genetics
Lisa Tsering, Journalist, India-West, San Leandro, CA
Kamala Visweswaran, Associate Professor, Anthropology, University of Texas, Austin
Jyoti Wadiker, Child Relief and You (CRY), Bombay, India
Shabana Warne, Child Relief and You (CRY), Bombay, India
Jon Weil, Ph.D., Program in Genetic Counseling, School of Public Health, University of California, Berkeley
Gail Wight, Assistant Professor, Electronic & Intermedia Arts, Mills College
Diane Williams, MPH, Native American Health Center, Oakland, CA
Madhu Chandra, Sneha, Cheshire, CT
Leslie R. Wolfe, President, Center for Women Policy Studies
Women's Global Network for Reproductive Rights (Coordination Office), Amsterdam, The Netherlands
Joy Wright, Chicago Metropolitan Battered Women's Network
Additional Individual Signatories:
Jacquelyn C. Campbell, PhD, RN, Baltimore, MD
Tammi L. Coles, Washington, DC
Renu Khanna, Baroda, India
Cynthia Wilcox Lischick, Ph.D. D.V.S., Hackettstown, NJ
Arnold Nath, Toronto
Carrie Rathmann, Baltimore, MD
Kalyan Ray, Hackettstown, NJ
Susan Rosenthal, Oakland, CA
Vinaya Saijwani, JD
Vincent Schiavo, Warwick, New York
Sona Varma, PhD
Madhu Verma, Scarborough, Ontario, Canada.
Annette Will, Amsterdam, The Netherlands