Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.

Fetal Genetic Tests Facilitate Sex-Selective Abortion

Michelle Crotwell Kirtley


September 2, 2011
by Michelle Crotwell Kirtley

Last year, the Economist devoted their cover and several stories to the 100 million “missing girls” who have been killed worldwide—either through abortion or infanticide—simply for the crime of being female. The lead article was appropriately titled “The worldwide war on baby girls: Technology, declining fertility, and ancient prejudice are combining to unbalance societies.” 

The absence of girls is most pronounced in China, due in part to China’s explicit “one child policy” and a long-standing cultural preference for sons. But even in the absence of explicit government policy, sex selection remains widespread.  Sex ratios are often skewed in wealthy areas—including developed countries such as South Korea and the U.S.—which have access to ultrasound technology and fetal genetic testing that allow girls to be aborted early and more privately, without the social stigma that might come from infanticide.  Earlier this year, researchers found that for certain subpopulations in the U.S., the male to female ratio for third children strongly suggests prenatal sex selection.

In fact, recent technological advances have made sex selection easier than ever.  Several companies have developed noninvasive genetic tests which claim to identify the sex of a developing fetus as early as 7 weeks gestation.  In August, researchers conducted a meta-analysis of over 57 studies evaluating the accuracy and sensitivity of these tests, which sample a mother’s blood or urine.  Remarkably, this study found that some of these fetal genetic tests are over 98% accurate between 7 and 12 weeks gestation. 

Fetal genetic tests are not regulated by the Food and Drug Administration, although the agency is considering regulation of the larger, direct-to-consumer genetic testing industry.  All of these tests are available over the counter or online, without any required input by physicians or genetic counselors. Given the availability of abortion on demand during the first trimester, it is inevitable that some families will use the test to selectively abort an unwanted girl (or boy). 

The role of technology in facilitating sex selection raises several issues.  First, as a nation, we are so enamored with technology and its contribution to our economic and military might that we are reluctant to do anything to “slow the tide of progress.”   We must develop a more robust philosophy of technology and a framework for technological regulation that enables technology to serve, and not undermine, human dignity and the common good.   

Second, we must recognize that the obvious, egregious affronts to human dignity such as sex-selective abortion are symptoms of a much more fundamental, insidious, and ancient disease: a lack of respect for women.  Christians—despite our checkered history—need to be on the frontlines, affirming the value of women, combating gender-driven injustice in all its forms, including spousal abuse, prostitution, and workplace inequities.  And Christians should be supporting international efforts to improve maternal health, education, and job prospects for women in developing countries.  While these measures are important acts of justice in their own right, they also raise the stature of women, creating a culture in which girls are increasingly valued, thereby undermining the cultural impulses driving violence against women—including sex-selective abortion.

Third, we must examine our attitudes towards children and family.  Are children a means to our own gratification?  Assets that we can design to our specification? Or are children a gift from God, to be cherished and stewarded for His glory?  Although sex selection is not widespread in the United States, there is the growing view in our culture that we have the “right” to have the kind of children we want to have.   For years now, couples have been advertising for egg donors at high profile universities, searching for just the “right” women—in appearance, in intelligence, in athleticism.   Choosing the eye color of your egg donor is only a few steps away from sex-selective abortion.

In the case of these new, fetal genetic tests, the FDA should prohibit over-the-counter and online sales.  State licensure boards and professional medical associations should enact policies that clearly prohibit physicians from prescribing the test without medical need.  And governments should consider banning their use in sex-selective abortion.  As a society, we have not yet come to a consensus on the priceless value of a child with Down’s syndrome or Duchenne’s muscular dystrophy, and, tragically, children with these conditions are routinely aborted after fetal genetic testing.  But we should be able to agree on the equal value of girls and boys and join together to combat the practice of sex selection here and abroad.

—Michelle Crotwell Kirtley is the Editor of Capital Commentary, a Trustee of the Center for Public Justice, and a former health and science policy advisor on Capitol Hill. She also serves as the Bioethics and Public Policy consultant for the Center for Bioethics and Human Dignity at Trinity International University in Deerfield, IL.



















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Capital Commentary is a weekly current-affairs publication of the Center for Public Justice. Published since 1996, it is written to encourage the pursuit of justice. Commentaries do not necessarily represent an official position of the Center for Public Justice but are intended to help advance discussion. Articles, with attribution, may be republished according to our publishing guidelines.”