Nov. 28 2012 12:00 AM

Choosing your baby's sexuality


Alice D. Dreger, professor of clinical medical humanities and bioethics at Northwestern University, is the 11th speaker in Michigan State University’s semester-long series, “Whom You Love: the biology of sexual orientation,” which aims to demonstrate that homosexuality is a natural occurrence in humans. Her speech is called “Trying to ‘Choose’ Our Children’s Sexual Orientation: Missteps, Misunderstandings, and the Marketplaces of Motherhood.”

Dreger’s TEDx lecture “Is Anatomy Destiny?” has been viewed over 250,000 times on Netflix, and she received the Guggenheim Fellowship and a Charlotte Newcombe Fellowship from the Woodrow Wilson Foundation. She also writes for the mainstream press, including The New York Times and The Atlantic.

What general themes will your lecture cover?

I’m going to present an overview of my work on a fetal intervention that’s been aimed at sex normalization (prenatal dexamethasone for congenital adrenal hyperplasia), and talk generally about why some people have felt compelled to try to prevent homosexuality — and other minority sex, gender, and sexual orientation types — in the womb. I’ll speak to why I think such attempts are problematic politically, ethically, and psychologically.

What inspired you to pursue this field of research?

I worked as one of the leaders in the intersex rights movement from 1996-2006, and came back to do this work in 2009 because a number of old friends in the movement, including clinicians, called me very alarmed about what was going on with pregnant women who were being given dexamethasone to women at risk of having a child with congenital adrenal hyperplasia (an inherited disorder of the adrenal gland that sometimes causes ambiguous genitalia to develop prenatally in females). I asked a group of academics to join with me in asking the federal government to look into this matter.

What’s the problem with prenatal dexamethasone for CAH?

It is not a benign drug for pregnant women, nor for the children exposed in utero. The studies we do have on the early prenatal use of “dex” are worrisome. The number of women and children missing from the follow-up studies of this drug use is more worrisome still. This drug is unequivocally experimental and risky. Yet it has been used for 30 years almost entirely outside of clinical trials, and has been advertised as “safe for mother and child.” A recent paper in the American Journal of Obstetrics & Gynecology concluded in fact that the risks outweigh the alleged benefits of this intervention. I say “alleged,” because the intervention’s efficacy has not even been scientifically established with well controlled studies.

What’s the difference between this and prenatally screening for birth defects?

Screening is different from attempting fetal engineering. Prenatal dexamethasone has been aimed at engineering female fetuses to be sex typical, in terms of genitals and also brains. One researcher has expressed interest in seeing if it can “successfully” reduce rates of “behavioral masculinization” in this population. That’s code for tomboyish behaviors and lesbianism.

Trying to prevent homosexuality in the womb is akin to cosmetic “medical” procedures in that it is inherently anti-democratic. The bottom line is that an attempt to prenatally prevent homosexual orientation isn’t just bad medicine (because it isn’t necessary or safe), it’s bad for American democracy, because it sends the message that you must conform to the most conservative social norms to count as acceptable and to be allowed to live, with full rights, free of discrimination and abuse in American society. In fact, the beauty of American history is that we have repeatedly changed our society to give oppressed people access to equal privilege.

We know that gay and lesbian people suffer a lot of discrimination. And in theory, it seems reasonable to try to prevent a child from suffering discrimination. But any attempt to prevent homosexuality from developing positions gay and lesbian people as the problem to be cured, where we ought to see that it’s our society that’s suffering from a disease.
Having a child is not like taking a spouse; there is no mutual agreement entered into. It is up to the parent to make the commitment. And to make the commitment by saying, “I’m willing to have you, but only if you are a boy, and a straight boy at that, and a straight boy with blue eyes and a very high IQ,” is, frankly, to not really make the commitment that parenting requires. 

Am I suggesting that people who want to engineer their children´s sexual orientations are unfit to be parents? Yes, I am. Being gay is not a terrible, tragic disease that requires prevention or treatment chosen for you by your parents.

What do you think this lecture series could do for the social views of homosexuality?

My hope is that it gives people a more scientific attitude towards the origins of sexual orientation, be those orientations homosexual, heterosexual, bisexual or whatever. I hope people will also understand that scientific inquiries into the origins of sexual orientation doesn’t solve for us the social question of how we manage those orientations.
I like to think that maybe in listening to these lectures, people are starting to understand that the origins of heterosexuality are pretty much as fuzzy as the origins of homosexuality. We just tend to ask more questions about where gay people come from. We know that evolution would have favored heterosexuality — no question about that — but we don’t understand yet why most people turn out to be straight.

I’m told you have some interesting ties to the Lansing area.

Yes — my essay “Lavish Dwarf Entertainment,” which is about Lansing-based dwarf entertainment entrepreneur Danny Black, was chosen for Norton´s annual anthology of “Best Creative Nonfiction.”

For more information on this series, go to

Alice Dreger
“Trying to ‘Choose’ Our Children’s Sexual Orientation: Missteps, Misunderstandings”
4 p.m.
Wells Hall room 115B
MSU Campus