The costs of using IVF to choose only boys or girls

The practice of in vitro fertilization in the United States is unlike that of almost every other developed nation. Most of our peer nations specifically ban sex-selective IVF, with a few caveats for families facing sex-linked inherited diseases. For many nations, the bans are an attempt to keep families from throwing away girls; some countries still struggle to prevent selective killing of girls in the womb. In this landscape, the United States stands out twice — first, by permitting preimplantation selection by sex, and second, by having communities with strong preferences against boys.
In some American immigrant communities, parents retain their country of origin’s preference for males. Overall, sex selective IVF does not show a strong tilt in the U.S., which suggests there are also pockets of families who prefer girls. A recent Slate article featured some of these families and their reasons for dispreferring boys.
Emi Nietfeld spoke to 15 families who strongly preferred to have girls and only girls and who were willing to use IVF to achieve their goal. These families aren’t typical IVF clients, but they cast some contemporary concerns about gender into high relief. For many of the parents Nietfeld speaks to, choosing girls is about avoiding boys. It’s not a matter of misandry but of something verging on despair. These parents want to give their children the best life possible, and they’re worried that a good life is harder for a son to achieve.
Several of the parents speak openly about having an image of female excellence to invite a daughter into (“I think I’ll raise really powerful women who are going to be rock-star leaders,” one said) and yet they struggle to see the same bright future for a son. A girl feels like an underdog, someone they can root for to triumph over all comers. These days, a boy is more complicated — what exactly (or whom) are you hoping he will conquer?
I see a better option for parents and children. The struggle for self-mastery doesn’t require anyone else to lose for a person to grow in virtue. But parent after parent that Nietfeld talks to seems unsure about how to help a boy achieve a full, generous, flourishing life.
“I don’t know a guy who has a strong relationship with his mother or his father,” one mother tells Nietfeld. Another offers similar reasoning: “Boy children tend to be less caring towards their parents.” The woman is careful not to assign the blame to the boys themselves, saying it might be a biological or social hurdle, but either way, it’s not one she’s confident she and her husband can overcome.
Their concerns aren’t totally groundless. American boys and men are struggling today. Men are much less likely than women to say they receive emotional support from friends or that they share personal problems with a friend. From an early age, little boys are more likely than girls to lack strong same-sex adult models. There are many missing fathers, and when boys go to school, it’s harder and harder to find a male teacher in the lowest grades. When they grow up, it’s hard to find a psychologist or a social worker they can talk to man-to-man. The share of both men and women with no close friends is growing, but the share of friendless men is spiking faster.
Still, it’s sad to see parents respond to this data with a kind of fatalistic despair. It’s especially odd coming from married, heterosexual couples. Here, the decision to avoid boys seems to indicate that the father believes he either has nothing worthwhile to invite his son into or doesn’t know how to pass on the good things he himself received. These parents see sons as riskier than girls, and seem to see their job more as avoiding harm than embracing the good alongside turbulence.
Reading through these affluent parents’ concerns about boys, I was reminded of the concerns raised by parents when prenatal screening reveals their child has a disability. IVF moves the decision point earlier than for parents who elect in utero genetic screening and then have a doctor ask about termination. In both cases, parents may feel pressured by the responsibility of deciding. When parents are asked to affirmatively choose a child they feel will have a harder life than an imagined, alternative child — a child who will need extra support to succeed — some feel they become the author of their child’s difficulties.
Natural conception, or fertility treatments that don’t involve picking and choosing among embryos, relieves this burden of perceived culpability. But for many parents exploring IVF for non-sex-selective reasons, the choice can come upon them unasked. Many clinics include questions about sex preferences in intake forms, causing parents to pause and consider. For several of the parents Nietfeld interviewed, the chance to choose only girls began with learning their company covered IVF for any reason, even without a history of infertility. Once the choice was on the table, they started thinking about the best choice they could make. For them, making the strongest possible family meant no boys.
Sex-selective IVF amplifies concerns about what a good life for boys looks like. A culture of despair around masculinity hurts the boys who are thrown away, of course, but also the boys brought to term. Parents can’t guarantee a good life for any child. Rather than adopt a narrow view of which children have a potential for a good life, they can better their children’s odds by widening their view. Parents should prioritize inviting others into their family life who have found diverse paths to a full and flourishing life.
I can hope my children share some of my particular inclinations and joys, but none of them, whatever their sex, are mini-me’s. My daughters need to see more models of being a woman than the one I offer, and my son needs more than his father’s (very good) example. Our kids meet other families, single friends and those living a consecrated religious life. When a family starts to feel the possible futures narrowing, it’s a good reason to expand its friendships.
Leah Libresco Sargeant is the author of “Arriving at Amen” and “Building the Benedict Option.” She runs the substack Other Feminisms, focused on the dignity of interdependence.