03-08-2025
IVF and gender bias: Why are we still choosing boys?
Dr Rhythm Bhalla
A well-off, educated couple from Canada walked into my clinic last week, seeking consultation for in-vitro fertilization (IVF). 'After ten years of marriage, we've been yearning for a child and would value your guidance,' the wife said. It was a standard conversation—until she quietly added, 'I would like a male child.' Her husband, though slightly hesitant, nodded in agreement.
As a gynecologist, such requests are, unfortunately, not rare. IVF, while a medical marvel offering hope to countless childless couples, has also opened the door to something far more problematic: sex selection.
It prompts a painful question—why this persistent preference for boys?
From the operating table to the boardroom, women have proved themselves over and over. Whether it is medicine, law, aviation, science, or governance, women are thriving. They run countries, lead corporations, and redefine success across every domain. Yet, a slice of society continues to believe that a male child holds higher value—a belief not just outdated but dangerous.
In the Indian context, this preference has deep cultural roots. Traditionally, lineage and inheritance have been perceived as the domain of the male child. Whether it's lighting the funeral pyre or passing down the family name and business, the responsibility has always been reserved for sons. 'A father cannot exist without a mother,' I remind my patients, yet many still hesitate to envision a daughter performing these roles.
Underpinning these decisions are centuries-old expectations and pressures. Indian women are often burdened—silently or overtly—with the expectation of giving birth to a boy. I've seen couples devastated by the birth of a second girl. I've met women emotionally blackmailed—threatened with abandonment or divorce—because they failed to provide a 'male heir.' And I've had educated, affluent couples ask for male sex selection in IVF simply to appease family elders with ideas of inheritance and legacy.
To such couples, I ask: Why not a girl? Can't she lead your legacy, inherit your business, care for aging parents, and bring the same joy, prosperity, and pride? Yet, most often, my questions are met with awkward chuckles and patronizing smiles. We remain shackled by beliefs that a male child is central to carrying forward the family line—beliefs that desperately need to change.
Denied legal sex selection in India, many such couples head to international clinics in Dubai, Thailand, or Singapore, where the practice is not illegal, thus legitimizing their biased preferences. But regardless of venue or legality, the problematic sentiment remains the same.
Here in India, our laws are clear. The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, amended in 2003, strictly prohibits sex selection before or after conception. While illegal centers do continue to operate, the government has intensified scrutiny to curb this menace. However, this vigilance, while necessary, often leads to undue pressure on ethical doctors and innocent couples navigating the IVF journey the right way.
Beyond legal enforcement, however, we must shift mindsets. Education and public awareness campaigns should aim to dismantle these damaging beliefs. Legal reform alone won't suffice; societal expectations, especially those that quietly coerce women into choosing male offspring, must be publicly challenged.
Empowering women economically can create ripples of change.
IVF may be a gift of science, but how we choose to use it reveals who we are as a society. Until every child, regardless of gender, is equally welcomed and celebrated, the work remains unfinished.
(The writer is Dr. Rhythm Bhalla is a senior gynaecologist based in Chandigarh)
