Gender Genetics and Sex Selection Review summarySex and gender are both important determinants of health. Biological sex and socially-constructed gender interact to produce differential risks and vulnerability to ill health, and differences in health-seeking behaviour and health outcomes for women and men. (1) ‘Gender’ describes those characteristics of women and men that are largely socially created, while ‘sex’ encompasses those that are biologically determined. However, these terms are often mistakenly used interchangeably in scientific literature, health policy, and legislation.The World Health Organization’s Constitution states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” (2) It is clear, however, that there are differences in the factors determining health and the burden of ill-health for women and men. Gender analysis identifies, assesses and informs actions to address health inequity arising from the different roles of women and men, or the unequal power relationships between them, and the subsequent consequences of these inequalities on their lives and health.This section of the GRC presents an overview of the major ethical, legal, and social implications (ELSI) associated with gender and genetics. The principal issues addressed are the genetic components of sex and gender, including sex chromosome abnormalities and sexual ambiguity; behavioural genetics pertaining to sexuality and gender; gender differences between male and female genetic carriers and stigmatization; sex selection and discrimination; unsafe abortion following identification of a genetic disorder; and assisted reproductive technologies and issues of social and distributive justice.Sex Selection and DiscriminationSex selection refers to the practice of using medical techniques to choose the sex of offspring. The term “sex selection” encompasses a number of practices including selecting embryos for transfer and implantation following IVF, separating sperm, and selectively terminating a pregnancy. The topic of sex selection is particularly relevant to a discussion on gender and genetics because genetic technologies and services may be used to preferentially choose one sex over the other. Sex selection has a wide range of ethical, legal and social implications. A significant ethical concern is that sex selection for non-medical reasons will reinforce discrimination, particularly against women.The are three core motivations for engaging in sex determination and sex selection: medical reasons—such as preventing the birth of children affected or at risk of X-linked disorders. family balancing reasons—where couples choose to have a child of one sex because they already have one or more children of the other sex. gender preference reasons—
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