or post-implantation methods.
There are two pre-implantation methods of sex selection: (1) sperm sorting combined with artificial insemination (also known as intrauterine insemination, or IUI), and (2) in vitro fertilization (IVF) combined with pre-implantation genetic diagnosis (PGD). Sperm sorting involves sorting sperm into those that carry the X-chromosome and those that carry the Y-chromosome. If a girl is desired, then the woman will be artificially inseminated only with sperm bearing the X-chromosome. If a boy is desired, then the woman is inseminated with Y-chromosome-bearing sperm.5
Dr. Ronald Ericsson developed a method for sperm sorting in the 1970s. By the 1980s, it was available in the United States.6 MicroSort recently developed another method of sperm sorting. According to the company, this technology is proven to be 93% effective for selecting girls and 82% effective for selecting boys.7 The MicroSort process works by exposing spermatozoa to a fluorescent dye. The sperm are passed through a flow cytometer, which is able to sort the sperm on the basis of cell fluorescence. Sperm with an X-chromosome (indicating a girl) glow more brightly.8
The Food and Drug Administration (FDA) banned MicroSort from continuing to conduct clinical trials for family balancing purposes, but allowed it to continue trials for sex-linked diseases. With this seemingly insignificant regulation, the FDA has weighed in on the ethics of sex selection in the United States without any public process.9 In places outside the United States, MicroSort advertises its services for people who already have at least one child and want to have another child of an “underrepresented gender in the family.”10 Thus, MicroSort will deny its services to a family that wants only girls or only boys. Although MicroSort is not legally available in the United States for family balancing purposes, other methods of sperm sorting are available and are being advertised. One clinic in the United States offers sperm sorting for $1,300 to $2,500.11
Once sperm are sorted according to X-chromosome and Y-chromosome, the selected sperm are inserted into the uterine cavity, but artificial insemination does not result in a pregnancy every time. Indeed, its success rate is only approximately 20% per cycle.12 The procedure may need to be repeated several times to achieve pregnancy. In addition, no sperm sorting procedure is 100% effective in properly sorting the sperm according to X- and Y-bearing chromosomes. Thus, even when pregnancy is achieved through artificial insemination, it is possible that the sperm-sorting process failed and the child will be of a sex other than the one that was desired.
There is, however, another procedure, widely available in the United States that is more effective for sex selection: in vitro fertilization (IVF)13 combined with pre-implantation genetic diagnosis (PGD).14 PGD is used to test the genes of an embryo to identify genetic diseases, but it can also be used for sex selection purposes.15 In the IVF procedure, medical professionals remove eggs from a woman and fertilize them outside of the body.16 One or two cells are removed from the embryo three days after fertilization, and the sex of the embryo is determined through chromosomal analysis of the removed cells using PGD.17 Only the embryos of the desired sex are implanted in the uterus. Although more than one embryo is typically inserted into the woman’s body, IVF does not always result in pregnancy. Indeed, its success rate for achieving pregnancy is less than 50%.18 Thus, a woman may have to repeat the procedure. If a pregnancy is achieved, however, then it is certain that the embryos placed in the uterus will be of the desired sex.
IVF costs approximately $15,000 to $20,000 for each round in the United States. IVF is typically used mainly by infertile couples, but there is enormous profit potential for providers to market their services for sex selection. These procedures are legally available in the United States and, indeed, some fertility clinics actively promote them for sex selection purposes.19 Incidentally, none of the proposed or enacted bills attempts to prohibit the use of sperm sorting or PGD for sex selection purposes.
The post-implantation method of sex selection is abortion, which I refer to here as “sex-selective abortion.” There are several ways to identify the future sex of a fetus. The most commonly used test for sex determination is the ultrasound. In an ultrasound test, a medical professional uses a machine that emits and receives high-frequency sound waves to create an image, also known as a sonogram, of a woman’s uterus.20 A medical professional can observe the anatomy of the fetus and detect its future sex at around eighteen weeks of gestation. About 90 percent of abortions occur in the United States well before the future sex of the fetus can be known using an ultrasound.21 Even at eighteen weeks of gestation, medical professionals cannot detect the sex with 100% accuracy, particularly if the fetus is not in an appropriate physical position to allow for such a determination.22
Amniocentesis and chorionic villus sampling are other tests that can determine the sex of the fetus.23 Amniocentesis involves withdrawing amniotic fluids and testing them for the sex of the fetus; this procedure can be conducted during or after the fifteenth week of gestation. Chorionic villus sampling involves the insertion of a needle into the pregnant woman’s uterus and the removal of a sample of the chorionic villi from the placenta for testing.24 This test can be performed between the ninth and twelfth weeks of gestation. Both of these tests involve a risk of miscarriage. As a result, less than 2% of pregnant women in the United States undergo an amniocentesis or the chorionic sampling test.25
Finally, blood tests, a rapidly evolving technology, are relatively inexpensive and easy to administer. A pregnant woman can simply prick her finger and send a sample of her blood to a lab for analysis. One study found that blood tests to determine the sex of the fetus are very reliable around seven weeks of gestation, with accuracy rates between 95% and 99%.26 Having defined sex selection and the methods by which it can be accomplished, I now turn to a discussion about decontextualization in the discourse around the bans on sex-selective abortion in the United States.
Decontextualization in Debates on Sex-Selective Abortion Bans in the United States
In our increasingly global world more people are moving across borders and settling in new countries. Information is also increasingly global. An important news event in India reaches the United States almost instantaneously. Media in one country may often report on human rights abuses in another country. But the knowledge that is conveyed across borders is usually a snapshot of the nuanced reality.
People in migrant-receiving countries sometimes use the limited knowledge they have about certain groups of people in foreign countries and see migrants from that country through the lens of that knowledge. Advocates and policymakers may inadvertently assume that many migrants will undertake practices for the same reasons as people who are from the country of origin of the migrant. I identify three ways in which decontextualizaton occurs—behavior, motives, and harms. To assume that people who live in one country behave in a certain way and for the same reasons based on knowledge of people in another country is like stereotyping across borders. Those who decontextualize incorrectly assume that women who trace their origins to a particular country share similar characteristics as people who have been raised and live in another country. As further explained in the next section, some people who assume that first- and second-generation immigrants share the same patterns of behavior as people from the country of origin of the immigrants overemphasize culture rather than context in explaining behavior.
Additionally, advocates and legislators sometimes incorrectly suggest that harms that ensue from a practice that is the subject of the ban are similar to the harms and impact of that practice in the foreign country. Theories that accept that the substantive content of rights are universal are not able to articulate a significant basis to resist this type of decontextualization. Using the lens of decontextualization, below I examine the discourse surrounding laws to ban sex-selective abortion, which have mushroomed in state legislatures in the United States.
Supporters of bans on sex-selective abortion decontextualize behavior when they assume people in India and China
