The publicity given to the recent opening of a “gender clinic” in London, offering sex selected conceptions to those prospective parents for whom such a choice is apparently vital will doubtless provide a much needed boost to the bio-ethics industry as well as that other secondary service industry - counselling. The predicted 30 per cent of failures, children of an unwanted sex, should be sufficient, and sufficiently possessed of trauma (“gender challenged”?), to justify the appointment of a further 10,000 social workers each year in the next decade.
Parental concern over the sex of offspring is, of course, a universal, if marginal, human phenomenon. In ancient societies selective infanticide, through physical exposure, often involved unwanted female births but was more generally applied to those births considered “unusual” i.e. twin births, breech-births and infants born with hair1. In medieval Europe a folklore on self-induced sex determination (involving, in the absence of an even rudimentary knowledge of the physiology of reproduction, ritualistic or dietary activities during pregnancy) co-existed with a belief in the intervention of a “providence” which ensured that balance of male and female births demanded by a society’s or community’s needs. This latter notion persisted into the twentieth century. The increased ratio of male to female births in Britain following World War I was frequently cited as a “providential” or compensating response to the three-quarters of a million young men - Britain’s “lost generation” - killed in action between 1914 and 1918.
With the development of a more detailed, though still incomplete, knowledge of the physiology of reproduction in the nineteenth century volitional activities designed to secure an infant of a particular sex centred on the timing2, location or position of coitus. (Once again a persisting folklore was created and in 1920 Marie Stopes recommended to those couples desiring a male child the placing of the marital bed in alignment with the Earth’s magnetic field.) For one particular social group reproductive outcome was both supremely important and recurrently problematic. A landed aristocracy founded on primogenital inheritance was perpetually threatened by the curious propensity of its members either to primary infecundity or to the production of a succession of daughters. Here, a solution based on biological realism was adopted: surrogate paternity.
The adulterous liaisons of members of England’s aristocracy during the nineteenth century served to mitigate these biological defects; a self-indulgent morality permitting a pattern of sexual behaviour now emerging from the biographies of the period. Twenty years ago Anita Leslie catalogued the “complicated love games” of the late nineteenth and early twentieth century upper classes in Edwardians in Love3: sufficient archival material has been unearthed by subsequent biographers to provide a dozen supplements to the series of case histories detailed in her book4. In the English shires semi-professional surrogate parenting was a specialism of Harry Cust (1861-1917), brother of the 5th Baron Brownlow of Belton House, a friend of Curzon, George Wyndham, Winston Churchill and T E Lawrence, whom Edith Wharton described as “one of the most eager and radio-active intelligences in London”5. Lady Diana Cooper, whose legal father was the 8th Duke of Rutland at nearby Belvoir Castle, acknowledged Cust as her biological father6 and Anita Leslie comments that “so much of the Cust strain entered England’s peerage and from such a number of cradles there gazed babies with eyes like sapphires instead of the black boot-buttons of their legal fathers”7.
Belton House is four miles from Grantham and it is perhaps predictable that attempts have been made to seek in Margaret Thatcher’s idiosyncratic qualities some evidence of the Cust genetic endowment8.
Although the early years of the twentieth century saw advances in scientific knowledge of the physiology of reproduction it was a further fifty years before the reality of sex determination became possible. The event was presciently anticipated by H G Wells who, in The World Set Free: A Story of Mankind, published in 1914, saw it as an effective counter-threat to the militant feminist movement then developing. “The modern world”, he cautioned, “has no room for sexual heroines. Woman must stop flaunting her sexuality and if she does not men must remember that genetic engineering allows them to determine the sex of children. If woman is too much for us we will reduce her to a minority”9.
During the 1920s Dr. Norman Haire, one of the many colourful characters in the English birth control movement and a stalwart of the Eugenics Society, operated a private nursing home in East Sussex to which women were admitted during early pregnancy for a short regime guaranteed to ensure that the eventual resulting birth was of the desired sex. The “treatment” comprised nothing more than a wholesome diet and a placebo (tablets which Haire saucily coloured pink or blue) and there was never a shortage of patients because Haire cheerfully operated a money-back guarantee. The disappointed couples thus lost nothing, and would perhaps return; the contented couples were a vocal source of recommendations for the clinic and, because the overall ratio of preferences was identical to the ratio of expected births the good doctor profited nicely from an actuarial certainty of a 50 per cent success rate. Indeed he was able slightly to improve his odds; by refusing (either as unsuitable or too late for treatment) potential patients wanting a child of a particular sex after a number of births of the opposite sex he gave himself a further intelligent edge.
A member of the Institute’s Council recalls too, a Professor of Obstetrics at one of London’s teaching hospitals who during the 1930s, confidently predicted to his patients, on the basis of a sounding of the fetal heartbeat, the sex of the unborn child. But he recorded in his diary the precise opposite of what he had informed each patient enabling him to provide, in the event of a subsequent challenge, “authentic” evidence that the patient’s recollection was at fault.
Human artificial insemination by donor (AID) and by husband (AIH), developed during the 1950s, provided the first theoretically plausible means of scientific sex selection. These derived from the fact that the female X-carrying sperm is heavier and larger than the male Y-carrying sperm and attempts were made to centrifuge the ejaculate before insemination to provide fractions high in one or the other and thus give a higher probability of the desired resultant sex. Despite the fact that such techniques had for years been about 80 per cent successful in the insemination of dairy cattle (where the differential is more pronounced) no convincing results were ever obtained in humans. In Britain, unlike the United States, artificial insemination long remained a fringe activity; when the Eugenics Society established its AID Investigation Committee in 1959, reporting to the Government in May of that year, it located fewer than a dozen doctors undertaking the procedure.
It was only with the enactment of the 1967 Abortion Act that sex determination became a practical, as well as a theoretical, possibility. Early amniocentesis followed by termination during the first trimester of pregnancy offered a combination of techniques with a certainty of outcome. But although the Act allowed for a broad interpretation of “social” factors preferred sex was not one of them and few surgeons would have undertaken amniocentesis, with its small but significant risks to health, for this purpose. The subsequent development of ultra-sound techniques greatly reduced this danger and a determined potential mother could in any event obtain the necessary verdict on the sex of the fetus at one centre and present for termination, giving acceptable grounds for doing so, at another. There is little evidence, however, that any significant number of women in this country felt motivated to such subterfuge.
It is widely assumed that, provided with the opportunity for exercising the choice, that choice will be predominantly in favour of male offspring. One distinguished American sociologist, writing in the mid-1970s when a large number of American states were liberalising their abortion laws, published a book-length prognosis detailing the far reaching social and economic consequences - serial polyandry, increased homosexuality, increased crime and social violence but a more prosperous economy based on high levels of male employment - which would result from the assumed rapid increase in the ratio of males within a population able to use the new laws for this purpose. In fact there is no evidence that in western societies any such preference exists, at any rate on such a scale as to produce a significant distortion of the demographic structure.
The many surveys which have been conducted on family building intentions (and especially those longitudinal studies measuring outcome against prediction10) have revealed an overwhelming preference, at all socio-economic levels, for a two-child family comprising a boy and a girl. The three-child family was predominantly an outcome of the subsequent decisions of those in this modal group who, having had two boys or two girls, proceeded to a third pregnancy in the hope of securing a child of the unrepresented sex. Although the absolute number of such couples would furnish a potentially large clientele (50 per cent of all those primarily wanting a boy and a girl) for a safe and simple method of sex determination, that same statistical imperative would ensure that boys and girls were wanted in equal numbers as an outcome to the third pregnancy.
In many third world countries, however, the strong desire for male progeny would indeed create, and where easy access to abortion is available, is already creating a sexual imbalance. The widespread desire for a son per se, in countries where females have no access to the labour force and a dowry system operates11, may result in an unwillingness to raise any female offspring. In India, for example, abortion is now widely sought as a means of sex selection12. And though this may have reduced earlier reliance on female infanticide it is still a crude and expensive procedure. One peripatetic doctor in Bombay is said to earn a thousand pounds a week (in an area where annual average income is £120 per year) by the use of a portable ultrasound machine.
As with many medical procedures the greatest initial benefits of a cheap and reliable form of sperm separation would probably therefore be felt in underdeveloped countries. The most recently discussed method now available at the London Gender Clinic at a fee of £650 per prospective parent seems not to offer any such hope. It is apparently based on the differential motility, as opposed to size, of the X- and Y-bearing spermatozoa which are separated by a form of horizontal chromatography across a plate of human protein albumen. A success rate of 70 per cent is claimed by the Clinic but it is apparently equivocal on whether it is offering this procedure solely to parents who fear some sex-linked inherited illness or on the more general grounds of parental sex preference.
Whether or not this particular technique, or some refinement of it, eventually leads to an effective method of sperm filtration and the consequent ability of parents to choose the sex of their offspring, such a procedure is obviously the imminent next step in medical intervention in the physiology of reproduction; nor would it appear that the ability of parents to choose the sex distribution of their families raises qualitatively differential problems to those arising from their present ability to determine family size.
John Peel
1. K. Hopkins, “Fertility in Classical Societies”, PhD thesis, University of Leicester 1965.
2. There is, in England and Wales, a significant seasonal variation in sex ratios at birth.
3. Anita Leslie, Edwardians in Love, Hutchinson 1972.
4. Robert Rhodes James, in his recent biography Anthony Eden (Weidenfeld and Nicholson, 1985) suggests that Cust’s friend,George Wyndham, could have been Eden’s biological father.
5. Edith Wharton, A Backward Glance, Century Hutchinson, 1987,p.220.
6. Artemis Cooper, Mr. Wu and Mrs. Stitch: The Letters of Evelyn Waugh and Diana Cooper, Hodder and Stoughton, 1991, p.16
7. op. cit. p.279
8. Alan Watkins, A Conservative Coup: The Fall of Margaret Thatcher, Duckworth 1991, p. 43. See also Alan Clarke, Diaries, Weidenfeld and Nicholson, 1993, p.69.
9. Quoted in John Carey, The Intellectuals and the Masses, Faber & Faber 1992 p. 122
10. See for example, John Peel “The Hull Family Survey”, Parts I and II, Journal of Bosocial Science, Vol. 2 No. 1, 1970 and Vol. 4 No. 3, 1972. Also John Peel and Griselda Rowntree, Contraception and Family Design: Birth Planning in Contemporary Society, Churchill Livingstone 1975.
11. V. Rao, “Dowry inflation in rural India”, Population Studies, Vol.47, No. 2, July 1993.
12. Cleland has demonstrated a corresponding preference for daughters in some Caribbean countries, see Cleland J. et al WFS Cross-National Summaries No. 27, ISI, Voorburg, Netherlands, 1983.