J Assist Reprod Genet (2006) 23:311–318 DOI 10.1007/s10815-006-9064-y AROUND THE WORLD Social sex selection and the balance of the sexes: Empirical evidence from Germany, the UK, and the US E. Dahl · M. Beutel · B. Brosig · S. Gr ¨ ussner · Y. St¨ obel-Richter · H.-R. Tinneberg · Elmar Br¨ ahler Received: 1 August 2006 / Accepted: 7 August 2006 / Published online: 17 September 2006 C  Springer Science + Business Media, Inc. 2006 Abstract Preconception sex selection for nonmedical reasons is one of the most controversial issues in bioethics today. The most powerful objection to social sex selection is based on the assumption that it may severely distort the nat- ural sex ratio and lead to a socially disruptive imbalance of the sexes. Based on representative social surveys conducted in Germany, the United Kingdom, and the United States, this paper argues that the fear of an impending sex ratio distortion is unfounded. Given the predominant preference for a “gender balanced family,” a widely available service for social sex selection is highly unlikely to upset the balance of the sexes in Western societies. Keywords Sex selection . Sex ratio . Gender preferences . Public policy E. Dahl () · S. Gr ¨ ussner · H.-R. Tinneberg Center for Gynaecology and Obstetrics, University of Giessen, Klinikstr. 32, D-35392 Giessen, Germany e-mail: presse@repromedizin.de B. Brosig Clinic for Psychosomatic Medicine and Psychotherapy, University of Giessen, Germany M. Beutel Clinic for Psychosomatic Medicine and Psychotherapy, University of Mainz, Germany Y. St¨ obel-Richter · E. Br¨ ahler Department of Psychology and Medical Sociology, University of Leipzig, Germany Introduction For centuries, couples have been trying to influence the sex of their children by myriads of dubious tricks. Italian men were biting their wife’s left ear during intercourse to beget a daughter and their right ear to sire a son. Swedish men were hanging their pants on the left bedpost to father a girl and on the right one to father a boy. German woodcutters were taking an axe to bed and then chanted: “Ruck, ruck, roy, you shall have a boy!” or “Ruck, ruck, raid, you shall have a maid!” [1, 2]. Sex selection is no longer a fantasy. Thanks to flow cy- tometric sperm separation and to preimplantation genetic diagnosis, parents are now able to choose the sex of their children prior to conception [3–7]. However, the prospect of a safe and effective technology for sex selection has not only raised old hopes, but also new fears. Thus, it has been claimed that choosing one’s offspring’s sex is “unnatural,” is “playing God,” is “sexist,” or is the first step onto a slippery slope that will inevitably lead to the creation of “designer babies” [8–15]. To our mind, none of these objections is conclusive. More importantly, even if they were, they would not justify a legal ban on social sex selection [16–23]. As far as we can see, the only valid justification for state interference would be a clear and present danger to the sex ratio. If a widely available ser- vice for sex selection were apt to cause a socially disruptive imbalance of the sexes, the legislature could require fertility centers to set a strict limit on access to sex selection and to impose a precautionary measure such as “family balancing”: If access to sex selection is limited to parents having at least two children of the same sex, then helping them to have a child of the opposite sex will, if at all, only marginally alter the sex ratio [24–29]. Springer