title: Preconception sex selection demand and preferences in the United States.
abstract: OBJECTIVE
  Preconception sex selection for nonmedical reasons raises important moral, legal, and social issues. The main concern is based upon the assumption that a widely available service for sex selection will lead to a socially disruptive imbalance of the sexes. For a severe sex ratio distortion to occur, however, at least two conditions have to be met. First, there must be a significant preference for children of a particular sex, and second, there must be a considerable interest in employing sex selection technology. Our objective was to ascertain such demand and preferences among the United States general population.
  
  
  METHODS
  Cross-sectional web-based survey.
  
  
  METHODS
  United States general population.
  
  
  METHODS
  One thousand one hundred ninety-seven men and women aged 18 to 45 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Web-based questionnaire assessing preferences for sex of children and demand for preconception sex selection for nonmedical reasons.
  
  
  RESULTS
  Eight percent of respondents would use preconception sex selection technology, 74% were opposed, and 18% were undecided. If the sex selection process was simplified to taking a pill, 18% would be willing to use such a medication, 59% were opposed, and 22% were undecided. In terms of gender choices, 39% of respondents would like their first child to be a son, 19% would like their first child to be a daughter, and 42% had no preference. Overall, 50% wished to have a family with an equal number of boys and girls, 7% with more boys than girls, 6% with more girls than boys, 5% with only boys, 4% with only girls, and 27% had no preference.
  
  
  CONCLUSIONS
  Preconception sex selection technology via sperm separation is unlikely to be used by the majority of the United States population and is unlikely to have a significant impact on the natural sex ratio.
authors.affiliation: Center for Bioethics and Humanities, State University of New York Upstate Medical University, Syracuse, New York, USA.
authors.forename: Edgar
authors.initials: E
authors.lastname: Dahl
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Gupta
authors.forename: Manfred
authors.initials: M
authors.lastname: Beutel
authors.forename: Yve
authors.initials: Y
authors.lastname: Stoebel-Richter
authors.forename: Burkhard
authors.initials: B
authors.lastname: Brosig
authors.forename: Hans-Rudolf
authors.initials: HR
authors.lastname: Tinneberg
authors.forename: Tarun
authors.initials: T
authors.lastname: Jain
mesh_terms: D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D005306:Fertilization; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D012743:Sex Preselection; D012744:Sex Ratio; D011795:Surveys and Questionnaires; D014481:United States