Box Turtle Bulletin

Doctors Treating Pregnant Women To Prevent Lesbian Babies

There has been a considerable body of research trying to examine the role that pre-natal hormones may play in the development of homosexuality and other types of perceived gender-variant identities, interests and behavior in adulthood. Researchers Alice Dreger, Ellen K. Feder, and Anne Tamar-Mattis have raised the alarm that some doctors are giving pregnant women doses of dexamethasone (or just “dex”), a risky Class C steroid, to prevent congenital adrenal hyperplasia (CAH) from developing in female fetuses.

CAH can lead to ambiguous genitalia in females leading to a form of an intersex condition. A few researchers have linked CAH with sexual orientation. Dreger, et al., write:

Pediatric endocrinologist Maria New, of Mount Sinai School of Medicine and Florida International University, and her long-time collaborator, psychologist Heino F. L. Meyer-Bahlburg, of Columbia University, have been tracing evidence for the influence of prenatal androgens in sexual orientation. In a paper entitled “Sexual Orientation in Women with Classical or Non-Classical Congenital Adrenal Hyperplasia as a Function of Degree of Prenatal Androgen Excess” published in 2008 in Archives of Sexual Behavior, Meyer-Bahlburg and New (with two others) gather evidence of “a dose-response relationship of androgens with sexual orientation” through a study of women with various forms of CAH.

They specifically point to reasons to believe that it is prenatal androgens that have an impact on the development of sexual orientation. The authors write, “Most women were heterosexual, but the rates of bisexual and homosexual orientation were increased above controls . . . and correlated with the degree of prenatal androgenization.”

They go on to suggest that the work might offer some insight into the influence of prenatal hormones on the development of sexual orientation in general. “That this may apply also to sexual orientation in at least a subgroup of women is suggested by the fact that earlier research has repeatedly shown that about one-third of homosexual women have (modestly) increased levels of androgens.” They “conclude that the findings support a sexual-differentiation perspective involving prenatal androgens on the development of sexual orientation.”

In another paper published in 1999, Meyer-Bahlburg suggests that CAH in women can cause such “a lower interest … in getting married and performing the traditional child-case/housewife role” — a condition that Focus On the Family, I’m sure, would agree must be avoided at all costs. Dreger, et al., also point to another paper published this year by New and Saroj Nimkam of Weill Cornell Medical College, which links women’s interest in traditionally male occupations and games as “abnormal.” This, Dreger et al. say, shows how preposterous these assumptions are in scientific research:

It seems more than a little ironic to have New, one of the first women pediatric endocrinologists and a member of the National Academy of Sciences, constructing women who go into “men’s” fields as “abnormal.” And yet it appears that New is suggesting that the “prevention” of “behavioral masculinization” is a benefit of treatment to parents with whom she speaks about prenatal dex. In a 2001 presentation to the CARES Foundation (a videotape of which we have), New seemed to suggest to parents that one of the goals of treatment of girls with CAH is to turn them into wives and mothers. Showing a slide of the ambiguous genitals of a girl with CAH, New told the assembled parents:

“The challenge here is . . . to see what could be done to restore this baby to the normal female appearance which would be compatible with her parents presenting her as a girl, with her eventually becoming somebody’s wife, and having normal sexual development, and becoming a mother. And she has all the machinery for motherhood, and therefore nothing should stop that, if we can repair her surgically and help her psychologically to continue to grow and develop as a girl.”

Today, New doesn’t think surgery is necessary, but administering dex to pregnant mothers is another matter altogether. And so, without ethical oversight and without informing mothers of the risks of taking a powerful Class C steroid during pregnancy, New and her colleagues have been undertaking a dangerous, unregulated experiment to try to prevent lesbianism in fetuses.

It is widely accepted in the gay community that the more people come to believe that homosexuality is biological in origin, the greater the willingness of the general public to accept the notion of equal rights for gay people. While opinion polls bear a strong correlation between accepting a biological origin and gay rights, that attitude does not necessarily extend to the medical community.

This case isn’t the first time we’ve seen researchers suggest that trying to prevent homosexuality is an ethically defensible position.In 2001, Aaron Greenberg and the controversial J. Michael Baily, both of Northwestern University, published a paper in the Archives of Sexual Behavior noting that “As we learn more about the causes of sexual orientation, the likelihood increases that parents will one day be able to select the orientation of their children.” They gave a number of reasons why parents might seek to prevent homosexuality in their children or even abort a fetus if a test were to determine that the fetus were homosexual. Interestingly, they deny that the reasons are based on heterosexism, yet go on to raise a number of heteronormative reasons why parents might want to abort or treat gay fetuses:

Parental desires to avoid having a homosexual child may, however, arise out of motives that are less blameworthy than heterosexism. In fact, the motive may be praiseworthy. In attempting to avoid having a homosexual child, a parent may be motivated by a desire to spare the child the unhappiness that may arise out of living in a society that often treats homosexual people badly in a variety of ways. Surely such a motive deserves moral approval as would an action based on the motive, at least so long as the benefits of sparing the child are not outweighed by any harms the action might cause (see discussion of costs, given later).

Finally, selecting for a heterosexual child may stem from motives that are neither good nor bad, but simply acceptable, from a moral standpoint. For example, parents may wish, understandably, to guarantee themselves the highest probability of one day having grandchildren. Although homosexual people often have children, one’s chances of being a grandparent would certainly seem to be maximized by having heterosexual children. The desire for grandchildren is one that seems morally neutral and that a great many people would no doubt understand and sympathize with.

Heterosexual parents may also wish to have heterosexual children for the simple reason that they wish to have children more like themselves, with whom they can more easily and completely fulfill the role of parent in connection with their children’s sexual lives. That role involves such activities as teaching, advising, empathizing, and vicariously experiencing, all of which would be, at least in many cases, facilitated by parents’ sharing the sexual orientation of their children. A comparison may be made here with a child’s religious upbringing. Catholic parents, let us say,would very often be deeply disappointed and saddened by the conversion to, say, Judaism, of their children. This is not necessarily because the parents are anti-Semites or even value Judaism less than Catholicism. Rather, such parents may wish to have children who are like themselves in this respect and with whom they can share certain feelings and experiences that are important to them. Few people would claim that such parents are acting immorally when they enculturate a child in their religion. Similarly, heterosexual parents might wish to have heterosexual children not because they object to homosexuality but to have more in common with their children in an important area of life. Such a motive seems understandable and morally acceptable.

Of course, many on the religious right would still condemn all abortions regardless of the reason. But for them, finding a medical “cure” for homosexuality would be perfectly acceptable. In 2007, Rev. Albert Mohler, president of Southern Baptist Theological Seminary in Louisville, Kentucky, noting the possible “ram”-ifications of gay sheep studies, acknowledged that there may indeed be a biological basis for homosexuality. That acknowledgment nearly made him a pariah among fellow conservatives who view that possibility an anathema, particularly to the ex-gay dogma that clings to the “curable” viewpoints based on environmental theories of homosexuality. But Mohler had a simple way out of that dilemna:

If a biological basis is found, and if a prenatal test is then developed, and if a successful treatment to reverse the sexual orientation to heterosexual is ever developed, we would support its use as we should unapologetically support the use of any appropriate means to avoid sexual temptation and the inevitable effects of sin.

The problem however is that, like the “treatments” deployed in ex-gay therapy, these latest highly experimental medical treatments are being performed without ethical oversight or professional standards. Alice Dreger worries that New, Meyer-Bahlburg, and other researchers are placing pregnant women under enormous risks:

This drug is unequivocally experimental and risky. … In spite of Dr. Maria New’s outrageous FDA-regulation-flaunting claims that this off-label drug use “has been found safe for mother and child,” it ain’t been. New is a rogue pediatrician whom medical societies have been nudging (and sometimes yelling at) for years. Because she apparently wouldn’t stop experimenting on these women and children without ethics oversight, in January I got called in to help by a few freaked-out clinicians. And I called in my colleagues to call out the feds. New just looks and sounds safe for mothers and children. Which is why she’s really dangerous.

In fact, much as is the case with the ex-gay movement, Dr. New is not only ignoring the risks, but she’s flying completely blind as well:

In the Q&A period, during a discussion of prenatal dex treatments, an audience member asked New, “Isn’t there a benefit to the female babies in terms of reducing the androgen effects on the brain?” New answered, “You know, when the babies who have been treated with dex prenatally get to an age in which they are sexually active, I’ll be able to answer that question.” At that point, she’ll know if they are interested in taking men and making babies.

[Hat tip: Dan Savage]

Update: In her blog post at Psychology Today, Alice Dreger handily demolishes each of the reasons that many (Greenberg and Bailey, for example) give to justify trying to prevent gay children from being born. My favorite is #6:

6. Puppies make great grandchildren, not least because if your child goes away and you’re too busy to care for them, you can put them in a kennel.