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Sex selection for non-medical reasons: where do we stand?

The remarkable advancements in technology and science in recent years have led us to question our beliefs, practices and to essentially create unprecedented ethical dilemmas.

Choosing the sex of a child before conception is one of them. Due to the increasing global demand for sex selection and its legalization in certain countries such as the United States, the debate about this topic starts to raise many concerns about the legitimacy of such legalization.

To understand this issue comprehensively, we need to explain the involved processes. The use of the term ‘sex in the scientific sense refers to the biological categorization of males and females.

While on the other hand, gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. Sex selection, currently, is well known as the practice of utilizing medical techniques to determine the sex of the offspring. For centuries, couples tried to perform sex selection by utilizing dubious tricks. In Sweden, for example, men used to hang their pants on the right side of the bed if they want to father a female and on the left for a male offspring.

Currently, in the twenty-first century with all the developed medical practices and technologies, couples do not need such dubious tricks or traditions. Many techniques and procedures are being used to perform sex-selection such as sperm sorting, pre-implantation genetic diagnosis (PGD), and selective abortion.

The most common method to select the sex of embryos before the transfer is PGD. It simply involves removing one to two cells from an embryo generated in vitro to check whether the embryo is XX (Female) or XY (male). According to the World Health Organization (WHO), sex selection is used for medical reasons and in some cases for non-medical or social reasons.

Sex selection for medical reasons is used to prevent the transmission of sex-linked genetic disorders. The controversy arises when couples seek sex selection for non-medical reasons because of a personal or social preference or for family-balancing reasons. Yet, others might also argue that even sex selection for medical purposes is unethical for many religious and moral reasons.

In the Arab World, this specific issue is worth examining. Surprisingly, the region has no regulatory bodies, governmental organizations, or even constitutional laws that discuss the issue of sex selection. It is safe to assume that most couples in Arab countries take religious opinions on sex selection as the foundation for such a decision.

For instance, in Islam, the Islamic Fiqh Council belonging to the Muslim World League, in its nineteenth session held in Makkah al-Mukarramah, 22-27 Shawwaal 1428 AH/3-8 November 2007 CE, examined the issue of choosing the sex of the fetus. After listening to the research that was presented and consulting health professionals and specialists, they came to three main realizations.

Firstly, it is considered permissible to choose the sex of the fetus by natural means, such as following a certain nutrition plan, chemical washes, and choosing times for intercourse according to the time of ovulation, because these are permissible means and there are no reservations about them.

However, it is important to note that there isn’t a single evidence-based scientific data/statistic that suggests sex selection by those “natural means” even works. Secondly, it is not permissible to use any kind of medical intervention to choose the sex of the fetus, except in cases of medical necessity with regard to hereditary diseases which affect males but not females or vice versa. In that case intervention is permissible, subject to established shar‘ia guidelines. This is under the condition that it is done on the basis of a committee of specialist doctors consisting of no less than three doctors of good character, who would produce a medical report stating that the case calls for medical intervention so that the fetus will not be affected by the hereditary disease.

Then after that, this medical report should be submitted to the Department for Issuing Fatwas so that they may issue a ruling as they see fit in that case. Lastly, it is essential to establish “watchdog” committees that will keep a close watch on hospitals and medical centers which carry out such procedures in Muslim countries. In those countries, official bodies should set up systems and guidelines to achieve this.

Yet, no “watchdog” committees can be found in  reality while almost every clinic in the Arab region provides sex selection for both medical and social reasons in exchange for $3000 on average.

On the other hand, Christians argue that they cannot know with certainty what life has for them, or their children, but they believe that God holds the future and works for our good in all things. This does not mean that they are necessarily protected from suffering, but rather that God will help them to cope with life’s burdens. Christians believe that living with burdens can enable a person’s character to grow as God gives them the strength, both directly and through the help of others to face it. Bearing one another’s burdens is at the heart of Christian morality.

Why shouldn’t sex selection for non-medical reasons be allowed?

  1. Sex selection for non-medical reasons is ‘playing God’ as God is the only power to determine the sex of an offspring. Aside from that, sex selection for non-medical reasons is similar to divine law, and they are concerned about the artificial suppressing of human flourishing and defying the human integrity
  2. Sex selection for non-medical reasons can result in sex discrimination
  3. The welfare of the child can also be affected by sex selection for non-medical reasons
  4. The ‘slippery slope’, when parents will choose their children according to specific characteristics, such as appearance, height, intelligence, etc (Designer babies).
  5. Sex selection for non-medical reasons can result in long-term medical risks. The invasive nature of the techniques that used to select the sex of the offspring might impose unknown long-term medical risks on the offspring.

Why should sex selection for non-medical reasons be allowed?

  1. Freedom is not to be constrained for any reason unless it violates other individuals’ freedom (John Stuart Mill). This statement is claimed to be the strongest argument in favor of sex selection for non-medical reasons. Yet, the statement was not stated for sex selection reasoning.
  2. Family balancing is one of the main arguments that branch from reproductive liberty. Couples may plan to raise children with specific sex and not another for several reasons, like culture, future, and others.
  3. Sex selection may offer a solution for the issue of abortions due to undesired embryos’ sex.
  4. The technology is available.
  5. Other people are doing it already in other countries.


Sex selection –especially for non-medical reasons- raised various arguments for and against it. Finally, this issue needs more investigation in a more systematic way with more public and constitutional involvement.