Sex selection and the unbalanced family

Since it's possible to select the sex of a child, people want to do it. Should they?

There are medical reasons why parents might want to choose an embryo of a certain sex. They might have a family history of an X-linked recessive disorder, like hemophilia, Duchenne muscular dystrophy or Fragile X, for instance, and by choosing a female, they avert illness.

But knowing how to screen for sex opens the door to doing it for non-medical reasons. Lots of families undergoing IVF these days request sex selection for reasons of "family balance" or "gender variety" — the idea that a family might want to include both boys and girls.

It sounds benign enough. I mean, why not? 

I hadn't given a lot of thought to this before hearing a talk at the Reproductive Ethics Conference, held last month via Zoom. The talk was called "Reexamining Non-Medical Sex Selection: The Logic of 'Family Balancing,' Heteronormativity and Gender Essentialism," and it was delivered by Arjun Byju, a third-year medical student at Albert Einstein College of Medicine in New York. He made it clear that he was not persuaded by the family balancing argument. 

Like all good presentations, though, it raised a lot of questions...

2 minute 30 second read

What is a balanced family?

What is an unbalanced family?

Is it dangerous that my family is unbalanced?

Is a balanced family better?

How exactly does a boy balance out a girl?


When a family imagines balancing their family with a girl, what girl do they imagine?

Do they imagine a girly girl?

A tidy girl?

A tomboy?

A science geek?

Do they imagine an engineer?

What happens if their balance child is intersex?

What happens if their balance child is trans?

Should children be used as ballast?

When people say they want the experience of raising a boy, what experience is that?

What is it about the male sex that they want to experience?

Is it the genitalia?

The testosterone?

Something about the Y chromosome?

Is it okay if the boy is not interested in sports?

Is it okay if he cries? 

What is the experience of raising a boy about?

Is it a parent's right to have at least one child of each sex?

(How many is that?)

Is it a parent's right to have only the child they think they want?

Will not having the right-sex child cause the parent harm?

Is Gender Disappointment a real condition?

Is it a mental illness?

Is a child of the correct sex a treatment that can be prescribed?

Is family imbalance a medical problem?

If it's not a medical problem, is it okay to medicalize it?

Are single-parent families inherently unbalanced?

Can a male child balance a single mom?

Can a female child balance a single dad?

Should two moms always have two boys? 

Are non-binary families already in balance? 

What if a family is bigger than nuclear — bigger than mom-dad-two-kids?

What about mom's new partner and dad's new partner and all the kids? 

What about aunties and spunkles and donor sibs?

How do you balance open, sprawling, unconventional families?

Do cousins count?


Are two gay dads parenting with two lesbian moms inherently more balanced than a traditional mom and dad?

Is there a formula?

If parents can decide to put two embryos into a womb, why can't they decide a child's sex?

If parents can decide to pluck cells from an embryo and send them off for testing, why can't they decide a child's sex? 

If a parent can make a kid eat their greens, brush their teeth, play violin, and go to private school, why can't they decide a child's sex?

Isn't sex selection just another example of parental autonomy?

If sex selection doesn't hurt anyone, why should we ban it?

Does sex selection hurt anyone?

Who does sex selection hurt?

If a family will abort all wrong-sex children anyway, shouldn't we just let them select?

Why do we allow one and not the other?

If we ban sex selection, won't parents just end up having more children than they want?

Is banning sex selection a type of oppression?

Why is it okay to do sex selection after your first kid but not before?

Is the first kid the dues?

If balance is important for socializing children, why do we let them play with so many same-sex mates?

Is balance important for socializing children?

Will children with only same-sex siblings be unprepared for a world with different genders?

Is it better to say "gender variety"?

Is this about sibling-sibling relationships, or about parent-sibling relationships?

Is sex selection necessarily sexist?

Does sex selection reinforce stereotypes? 

If assisted reproduction is state-funded, does the state get to decide about sex selection?

If we just let people pick their desired gender, won't it all even out?

Is two daughters and a son balanced enough?


Related links

Tereza Hendl and Tamara Kayali Browne. "Is 'gender disappointment' a unique mental illness?" Medicine, Health Care and Philosophy. 2020.

Arianne Shahvisi. "Engendering harm: A critique of sex selection for "family balancing." Journal of Bioethical Inquiry. 2018.

Tamara Kayali Browne. "How sex selection undermines reproductive autonomy." Journal of Bioethical Inquiry. 2017.