in the news
I was fascinated to read (h/t surromoms online) about a recently-published Dutch study discussing a new test that reveals the gender of a developing fetus as early as 5 weeks' gestation and requires only a blood sample from the mother* (and, if possible the father).
Obviously, such a non-invasive test has some medical value, for example, allowing prenatal treatment of certain rare sex-linked diseases. But, by letting people know gender very early in pregnancy, it might also encourage people to terminate if they didn't get the gender they preferred.
What's your view? Do you think such a test is a good idea? Would you ask for it if you were pregnant?
*Or, I suppose (not that I really understand this stuff), more accurately, from the woman carrying the baby, since the initial screening is for Y-chromosome-associated pieces of DNA and doesn't really depend on whether the carrier is also the genetic mother. However, if the Y-chromosome markers are absent, it sounds like you need the genetic parents' DNA, because the researchers check for genetic alterations unique to the father (no Y-chromosome marker + unique paternal polymorphism = female). Also, (based, again on my limited understanding) it sounds like the blood test may not work for multiples.
26 comments:
I see the ethical dilemma that presents itself, but I would certainly have taken advantage of the test. I'm not a fan of surprises.
Although they have 100% accuracy in a sample size of 200, that's not a very large sample size. It may turn out to have the same accuracy as ultrasound, which would then make me lean towards omitting that test from protocols, unless some rare sex-linked disease was suspected. There was only one disease mentioned that could be treated in utero, and there was no mention of the timing necessary for treatment. So, maybe as an adjunct to other diagnostics, it might be useful? And the timing could be limited to try to forestall gender selection?
I believe those are toasted hazelnuts, a task I just did yesterday myself.
Prior to "the very bad thing" I thought finding out the sex of your baby at birth was one of life's greatest surprises, and I love surprises! (I pause here for laughter.) This time I want no surprises, save for the big life/death thing at the end, so I figured sex was just one less. However, since I'd be doing other screening, I'd probably just wait to find out until then. While no fan of surprises, I'm surprisingly still pretty patient.
I could see this being popular -- I'm not sure in this country it would be such a big deal, though other cultures/places I could see it being used in the way you described.
Gender is a social construct. What you're referring to here is sex.
Sorry. Pet peeve of mine.
As a test, in and of itself, I don't see that it's a whole lot different from so many of the other sorts of pre-natal tests.
I'm pro-choice; I don't feel that it's for me to decide what a "good enough" reason for termination is.
My two cents, or four, since you asked, and, for some peculiar reason, I felt like sharing.
@Ellie: Of course, you're absolutely right about the sex/gender distinction. (Though, I realize that some intersex/transex people make the argument that sex is also a social construct).
But (and I actually thought about this for far too long before posting) this is one of the few cases where I prefer the common usage, even though I know it's technically incorrect.
Just a quirk of mine.
Well, it's certainly true that there is far great diversity in terms of biological sex than many folks realize, thus complicating (or exciting) the range of possibilities regarding what is considered sexually/biologically "female" or "male". Gender, though, is far more of a social construct than sex is.
Some common usages that are technically incorrect I don't mind; this is one that bugs me. Funny lot, people :-)
It would not change anything for me. I never found out that my boys were boys in utero--however, I did need to know the sex of the baby I lost--desperately.
-e
i would've wanted it, though would have been uncomfortable with my own reasons for wanting it...a strong sex preference. not one i would have used as a basis for termination...rather i would've thought i simply needed as much time as possible to get used to the idea of having a boy. or would've wanted that "worry" off my plate as early as possible. having been raised in an all-female family, with men as suspect, i feared boys, basically.
yep, i was a twit.
however, as per Tash, that was prior to the the very bad thing. which taught me a great deal. not that i didn't struggle with my sex preference the following round, because i did, in spite of myself, in spite of knowing far better. but pre-pregnancy, yep, i'd have jumped at a 5 wk gender test. naive me.
in response to Ellie, i've been reading Judith Butler's Gender Trouble, and she problematizes the construct of sex as being predicated on the same dualities and discourse as that of gender, so really...for those of us who buy the construct idea, can there be a "correct" term?
I actually didn't want to know the sex of the baby, but, for age related reasons, I had a CVS, and my husband really did want to know, so we had the secret revealed. But we kept it a secret. If I'd been younger, and not a candidate for amnio or CVS, I'd skip it.
The chromosome stuff kind of made my head explode earlier today - but I've since had lunch and am better equipped to understand arcane science. If one can only get a blood sample from the mama, and there are no Y-chromosome fragments, how can the test have any medical value? Then again - I haven't read the link yet.
Anyway - nuts? Some kind subtle of Y-chromosome joke?
@magpie I'm hoping that Julia will eventually explain all the sciencey stuff to me.
And it was subconscious. Really it was. And, yes, I'm an idiot.
I want to leave a name lol
Clarissa
Camilla
Lottie
Alicia
oh and...
Martha
:o)
Haha! Nuts. (Sorry I can't help it)
Anyway, I would have wanted to know. Just as I did with all four of my pregnancies. The earlier, the better, because I don't like surprises either.
I agree that it could be an ethical issue in terms of whether someone would terminate as a result.
As mother of kids with a disease that is much worse in females, my daughter is gearing up for her first attempt at reproduction, and it does not involve candlelight or dinner. Rather 2010 will see IVF with PGD and the freezing of all female embryos until a genetic test is available and then a single male embryo transfer.
My daughter is in her early 20's, however her health is an issue, so she does not have time to wait for all of medical science's advances in the coming years, her doctors tell her that if she wants to have a family she needs to do it now.
So I called her and asked her if they could save the money and have the test instead and she said no, that the emotional cost was not worth it to her. She then told me that without IVF and PGD they would not be having children (I knew this, as EDS is very painful for females and no genetic test exists yet.) Until her insurance had made IVF with PGD an option she and her husband had not planned on having children for fear of having female children who would suffer with our family illness. Perhaps this test while not perfect, can some day offer hope to families for whom IVF with PGD is not an option.
Niobe, thanks for asking such a thought provoking question.
My question is, what if the woman has had previous pregnancies and/or losses? Reality is that many of us have, even if we think we haven't. (Late period, anyone?)
My geneticist told me he thought it was a long way off to get any blood tests on the market that could definitively do this; mostly because of this problem. For example, for the rest of my life there will always be a few male cells floating in my blood that contain Trisomy 18. Do you have any idea what it would have done to me if any of those few tiny cells had popped up as a result on a blood test with my perfectly healthy now 18 months old baby?
Nope, I'd rather wait for CVS or Amnio results. Why shit myself over the wrong result?
Let's presume the test is 100% accurate. Nope. I wouldn't have wanted to know that early. I did want to know, and was excited to finally learn at 20 weeks that I am carrying a boy. But it was really FUN up until then to contemplate and consider the possibility that my baby could be a girl...or a boy. Just a fun part of the process for me.
How patronising, to assume that parents (yes, the same ones who will eventually raise the child) can't be trusted with the information.
Lacri, patronizing though you may find it, there is good reason to fear any technology that tells the sex of the fetus before birth. Some cultures value girls less than boys; this is not judgement of those cultures, it is fact. Have you not heard of the sex imbalance in parts of India, where boys and men out number girls and women 120 to 100? This is attributed to the use of early ultrasounds to determine the sex of the fetus; many female fetuses were aborted when their parents were told they were having a girl. In parts of China, many girls are abandoned at birth; perhaps their parents were unable to get an ultrasound before the birth. Due to the one child law, they don't want to 'waste' their one shot at a child on a girl.
So maybe it is patronizing. It's possible not all parents can be trusted with this information. There's a good reason that some areas outlaw the use of ultrasounds to determine sex unless there is a compelling medical reason. A blood test that allows you to know even earlier? I think it could have catastrophic results. Not everyone wants to know so they can know what color to paint the nursery or if they can buy frilly pink clothing.
I don't think I would have a blood test done. The baby we lost had birth defects that may have a genetic link; any future children will be carefully scanned so I would just wait for the scan.
@Lacri, sadly, and to pick up also on Anon's point below yours, patronizing aside, it is optimistic to assume that parents, as opposed to say, in-laws, are the ones making such decisions. I'm strongly pro-choice and also strongly aware of how far from the ideal of "my body, my decision" many parts of the world are.
That said, to address Niobe's original question, I'm inclined to figure that it's better to offer a useful test, if one exists, than to deny it on the grounds that it might be misused. (As Anon. also points out, there are sadly plenty of other ways to avoid bearing and/or parenting an unwanted child)
A woman walks into her doctor's office and says, "Hey Doc, my girly parts have been killing me lately. What gives?" The doctor takes a peek at her girly parts, finds a tumor, performs a biopsy, and sends a few extra cells to a mad scientist down the street, without her consent. The woman is sent home with her husband and children. She dies in horrific cancer fashion soon after. Meanwhile the mad scientist has been tinkering with the woman's cancer cells. He suddenly looks up from his bench exclaiming, "Gadzooks these cells are what we've been searching for!" Decades later those little buggers are in most research labs around the world. They've catalyzed research, cures, stuff, and things. But uh oh. All the mad scientists realize that the HeLa cells are like Ice-9. Billions of bucks are at stake. They need Henrietta's DNA. The mad scientists talk to the tricky lawyers. They call Henrietta's children. They lie. They make false promises. They get the DNA. Billions of dollars are safe. Research continues on. Today, those freaking cells continue to be used in almost every lab around the world.
Ethics? Do you think the mad scientists and tricky lawyers didn't know the cells and DNA were defacto stolen property? They both read Kant. They knew. As our 20th century Homer said, "Just because I don't care doesn't mean I don't understand."
I'm glad they didn't care. Millions of lives have been saved because of it. I'm glad they won't care when it comes to fetal free-flaoting DNA. Somehow we silly humans usually end up doing the right thing. The right thing is often the unethical thing, the thing that results in far less suffering and cruelty.
-Shamela
@Alexicographer - I cringe every single time I hear or read someone say "my body my choice". It's intellectually dishonest. It isn't our body we're aborting. It's someone else's body we're having destroyed.
-Shamela
@Shamela, that is not the subject of discussion right now, right here. In many parts of the world, a woman NEVER has the right to say "my body, my choice" regarding anything - much less abortion. I'm happy I live somewhere where my father, my husband, or my in-laws, wonderful as they are, do not dictate how and when and where and why I do almost anything, much less when I have children or what children I bear (or bore, as the case may be). While I can't do anything and everything I could want to do due to the laws and moral sensibilities of my culture, I have thousands of freedoms that other women elsewhere do not.
Yes, this discussion of blood tests to determine sex of one's fetus is sorta fun to contemplate in our here and now, but it could have far-reaching and deadly consequences in other places. I'm glad I don't live someplace where my husband or his family can throw acid in my face and discard me for failing to bear a son, or force me to abort my much-wanted daughter because they don't value me or any other female.
@Jen-
Whether or not women have control over their bodies does not change the fact that the free-floating DNA belongs to a different body than that of the mother.
If an embryo/fetus/infant is going to be terminated because of its sex chromosomes, better it happen at 7 weeks gestation than at 24, 40, or 2 hours after birth.
-Shamela
@Anonymous
How patronising (not to mention crass) to assume it falls to you to moderate the good behaviour of the Chinese and the Indians. White man's burden, hmmm?
@Lacri. I feel there are many places where such a technology would be misused. There are plenty of Westerners who would choose to bear only a girl or only a boy if they could find out so early. If there are people who would selectively reduce twins because twins don't fit their lifestyle, I'm sure some would pick a girl because they want a dress up doll up or a boy because 'boys are easier,' or whatever reason they may have.
I cannot and will not moderate anyone else's behavior, only my own. I expressed why _I_ have misgivings. I wasn't saying I would control or moderate other's behaviours if I could. I don't know that all parents, regardless of culture or nationality and including those of _my_ culture and nationality, would choose to raise that child if they found out his or her sex (or gender for that matter) at 8 weeks. Some parents would choose to abort rather than raise a child of whatever gender. It has happened before (and in many countries, not just India and China), it may happen again. Ignoring it or painting over the possibility does not eliminate the possibility.
You may certainly find me patronizing. I own my words and my intentions and I recognize you may interpret them differently than I intended. However, I'm Hispanic. Please don't assume you know me or my background from a few words online.
@Anon -
Who defines misuse?
-Shamela
Shamela, you have a point. I find the use of technology which causes to the abortion of a fetus of an undesired sex to be an abuse and a misuse of the technology. But that is certainly subjective. You are right - I'm letting my distaste flavor my definition and others may disagree that this is a misuse.
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