title: The choice of gender: is elective gender selection, indeed, sexist?
abstract: BACKGROUND
  Like a number of international organizations before them, the American College of Obstetricians and Gynecologists (ACOG) recently issued an ethics opinion, which condemned all indications of elective gender selection as devaluatory to women and sexist and, therefore, given the choice, assumed automatic preference for male gender selection in all populations. This study intended to investigate this notion for accuracy.
  
  
  METHODS
  We investigated the desired gender in 92 couples who had undergone between January 2004 and December 2006 first in vitro fertilization (IVF) cycles in attempts at gender selection for family balancing purposes. Their choices were then also investigated stratified for the ethnicity of the couple.
  
  
  RESULTS
  Among 92 cycles, 36 cycles were selected for female and 56 for male (P = 0.037). An analysis based on the couples' ethnicities revealed, however, considerable differences in gender selection patterns. Especially Chinese (21 out of 22), Arab/Muslim (5 out of 6) and Asian-Indian (5 out of 5) couples primarily selected for males. Other ethnicities, however, actually preferentially selected for female gender (34 female, 25 male selections in 59 cycles). Gender choices thus varied in a statistically significant way between ethnicities (P < 0.001).
  
  
  CONCLUSIONS
  In an ethnically mixed patient population, elective gender selection for family balancing purposes in most ethnic groups does not represent a discriminatory procedure against female equality. However, cultural biases against females are, indeed, still maintained in some minority populations. Ethics opinions should be considerate of minority opinions, but should be based on prevalent sentiments in a majority of the population.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA. ngleicher@thechr.com
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003466:Cultural Characteristics; D005006:Ethnicity; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D019836:Preimplantation Diagnosis; D011287:Prejudice; D027724:Reproductive Techniques, Assisted; D012737:Sex Factors; D012743:Sex Preselection / Q000941:ethics*