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Report: Doctors Engineering Fetuses to Prevent Intersex, Tomboy, and Lesbian Children

The Journal of Bioethical Inquiry recently published a paper detailing an increasing amount of off-label medical intervention used by U.S. doctors to prenatally engineer fetuses with steroids in order to prevent intersex, tomboy, and lesbian babies, according to a Northwestern University report compiled largely with findings obtained from Freedom of Information Act requests:

WombThe pregnant women targeted are at risk for having a child born with the condition congenital adrenal hyperplasia (CAH), an endocrinological condition that can result in female fetuses being born with intersex or more male-typical genitals and brains. Women genetically identified as being at risk are given dexamethasone, a synthetic steroid, off-label starting as early as week five of the first trimester to try to “normalize” the development of those fetuses, which are female and CAH-affected. Because the drug must be administered before doctors can know if the fetus is female or CAH-affected, only one in eight of those exposed are the target type of fetus.

The off-label intervention does not prevent CAH; it aims only at sex normalization. Like Diethylstilbestrol (DES) -- which is now known to have caused major fertility problems and fatal cancers among those exposed in utero -- dexamethasone is a synthetic steroid. Dexamethasone is known -- and in this case intended -- to cross the placental barrier and change fetal development. Experts estimate the glucocorticoid dose reaching the fetus is 60 to 100 times what the body would normally experience.

According to Northwestern, the report provides evidence that proponents of the intervention are interested in reducing rates of "behavioral masculinization" and the NIH has funded experiments to this end.

There is "a nearly 20 percent 'serious adverse event' rate among the children exposed in utero." Mothers have been told that it is safe but there is no scientific evidence, and the FDA cannot prevent the procedure being advertised as safe because the advertising is done by "a clinician not affiliated with the drug maker."

90 percent of those exposed to the procedure cannot benefit, and medical societies have been saying this for a decade.

According to Northwestern, "The paper is authored by Alice Dreger, professor of clinical medical humanities and bioethics at Northwestern University Feinberg School of Medicine and is co-authored by Ellen Feder, associate professor of philosophy and religion at American University, and Anne Tamar-Mattis, executive director of Advocates for Informed Choice."

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  1. People are so far gone about all this that they hate their children before they're even born?

    Posted by: yuninv | Aug 6, 2012 9:52:45 AM

  2. But these aren't children, right? They're blobs of protoplasm. The hosts can do what they like to these blobs. I know I've read that somewhere ...

    Posted by: One small problem | Aug 6, 2012 9:54:57 AM

  3. Won't work.

    Why won't people stop this foolishness and just concentrate on something important like Husain Bolt's cute booty

    Posted by: Derrick from Philly | Aug 6, 2012 9:55:28 AM

  4. Because heaven forbid there would be a small percentage of women who aren't likely contributing to overpopulation and overuse of the planet's resources.

    Posted by: sparks | Aug 6, 2012 10:20:36 AM

  5. This is inevitable. Why would anyone paying attention be surprised. Our future will be a eugenics paradise. Margaret Sanger, th early 20th century eugenicist, the Nazis, would be green with envy. Our present and especially our future will be:

    1) Mass usage of psychotropic pharmaceuticals to keep everyone 'level', no highs, no lows, flat and pliable.

    2) A scientific dictatorship based on advanced psychological techniques, a revolution in genetics and the pharmaceutical empire I mentioned above.

    Life is more and more imitating art:

    Brave New World


    Posted by: ratbastard | Aug 6, 2012 10:21:00 AM

  6. If we actually had full knowledge of the mechanism we're messing with here, THEN we could begin the ethical discussion about the arrogance of fetus-customizing.

    As it is, the only ethical question that's relevant here is whether it's okay to give steroids with incompletely understood effects when there is no medical need to do so.

    Obviously, it isn't okay.

    Posted by: distinguetraces | Aug 6, 2012 10:44:11 AM

  7. Most radical 'progressives' will be confused by what the appropriate response should be here. They believe a woman can do whatever she wants with her body, including unborn baby [fetus] and that a fetus is just a piece of meat. It's a slippery slope. Careful what you wish for.

    Posted by: ratbastard | Aug 6, 2012 10:51:18 AM

  8. *winces* Uh-oh...

    Posted by: Oz in OK | Aug 6, 2012 10:56:27 AM

  9. Oh dear Lord, this is a horrifically composed piece of faux science. CAH is an endocrinological disorder with a distinct pathophysiology. It's about preventing children who are born with enzyme deficiencies from having abnormal physical features and correcting their genetic phenotype. I mean, don't complain that a female XY chromosome is born with the correct genitalia and say that's transphobic.

    This is literally Daily Mail quality science.

    Posted by: Cburg | Aug 6, 2012 11:42:19 AM

  10. @Cburg,

    I hear what you're saying. But you have to admit the age of genetic tinkering, including for things that have nothing to do with real abnormalities, is upon us. And we well on a slippery slope.

    Posted by: ratbastard | Aug 6, 2012 11:45:02 AM

  11. We have existed in a world that "medicalizes" a variety of normal variations of the human species for the last 100 years. In many ways, having a variation "medicalized" (i.e., conceived as a treatable illness) is better than having it "criminalized" or defined as a moral failure. The problem, as too often, arises with the lack of choice: a condition either must be treated or is treated without the patient's consent. For the most part, our society only deals this way with children or the otherwise incompetent. My question is this: who is the patient in this kind of engineering? Is it the mother, the family, the fetus, or the society? To what degree does this happen simply to confirm a vague sense of "what is normal"?

    Posted by: Chuck Mielke | Aug 6, 2012 12:07:30 PM

  12. With each passing day I hope more and more that the Mayans were right…this planet needs an enema!

    Posted by: VoenixRising | Aug 6, 2012 12:22:33 PM

  13. @cburg

    Thanks for making some clarifications. The title and the tone of this article are very misleading and not complete.

    At no point was it indicated that this is being done to "prevent... lesbian children." As was mentioned CAH is a genetic abnormality in an enzyme or enzymes involved in synthesis of glucocorticoids, mineralocorticoids, and sex steroids. There are a few different mutations which all fall under this umbrella and they present themselves differently (phenotypic variance) depending on what mutation exists.

    In residency I did a pediatric endocrinology rotation and since my school has one of the best pediatric urology programs a lot of kids get referred there for eval. Surprisingly, the pediatric urologists have become much more progressive about it. It used to be considered a "social emergency" and the kid would have immediate reconstructive surgery with so so results (you can imagine turning an enlarged proto-penis to a clitoris on a newborn would be tough because of the small size). They have moved to an evaluation as to if the baby has a functional urinary system (some kids are born without a patent urethra and can't pee without surgery) and if they do they wait for the kid to grow some and they make more decisions as the kid gets older, trying to give the kid the most input possible.

    In reading the longer linked article I think it makes this clear that this is more of a fringe practice and many societies have come out against this, as they should. To me, the way that this is being done seems like a grope in the dark by some people that are a little nuts. Northwestern specifically has a tradition of someone in their psych department being very vehemently against the concept of transgender people, I wonder if he was involved in this, as typically peds endo, peds urology and psychiatry all co-manage these patients

    Posted by: maddM@ | Aug 6, 2012 12:59:12 PM

  14. I remember attending an International Academy of Sex Research meeting years ago, and one of the members commented, "The door to the gas chamber is after the door of research in what 'causes' homosexuality."

    Posted by: Ty Nolan | Aug 6, 2012 1:01:34 PM

  15. I love the anti-Margaret Sanger/planned parenthood trolls latching on to this story to make it, somehow, about their cause.

    This is inevitable, but the fear that one might have a tomboy leading to the use of experimental drugs is kind of alarming. It will be fascinating, and possibly sad, to see what the long term affect is on the possibly resultant children will be.

    Posted by: PTBoat | Aug 6, 2012 1:31:16 PM

  16. Thanks for posting this. Yes, CAH is a serious disease, and this prenatal intervention doesn't cure or prevent CAH. It has been used purely for the purposes of sex normalization.

    You can read the whole paper for free -- it is available for free download -- at

    All of the factual claims are fully documented therein.

    Alice Dreger, PhD
    Professor of Clinical Medical Humanities and Bioethics
    Feinberg School of Medicine
    Northwestern University

    Posted by: Alice Dreger | Aug 6, 2012 1:36:40 PM

  17. First do no harm...

    Posted by: Randy | Aug 6, 2012 2:35:24 PM

  18. I am fine with this kind of eugenics; a fetus is not a person and no harm is done in this situation.

    Posted by: Endo | Aug 6, 2012 2:46:45 PM

  19. It will never work, this is one thing that they can not play god with.

    Posted by: Mike | Aug 6, 2012 3:44:11 PM

  20. I have warned all of you before about touting the "I was born gay" argument, pointing out that if a genetic cause of homosexuality IS ever found, it will result in attempts to genetically engineer homosexuality out of existence and make us extinct.

    This example should serve as fair warning.

    Be careful what you wish for.......

    Posted by: Rick | Aug 6, 2012 3:56:03 PM

  21. @ptboat,

    Guess what PT? Margaret Sanger WAS a proponent of eugenics, her published works WERE used as justification by the Nazis for some of the things they did, and she WAS racist and unabashedly admitted it, even to the point of saying efforts must be made to basically commit genocide against black people but that they must be secretive and under-handed so as not to alarm them. All 100% historical fact. And yes, she and others like her in the EUGENICS MOVEMENT founded Planned Parenthood as a way of re-branding eugenics with a 'clean' name.

    I'm not making any of the above up. Call me a troll if you want.

    Posted by: ratbastard | Aug 6, 2012 3:57:58 PM

  22. "Husain Bolt's cute booty"

    Not into his "booty", but he is still THE MAN! I have rarely been as excited by an athlete....and I am not even a track fan!

    Posted by: Rick | Aug 6, 2012 3:57:59 PM

  23. And by the way, it is Usain, without an H. He is not a Muslim.

    Posted by: Rick | Aug 6, 2012 3:58:45 PM

  24. I was in a heavily Jewish neighborhood of Boston [Brookline, actually, which is 40-50% Jewish] a few days ago and lo and behold a few young chirpy women were canvassing with clip-boards for Planned Parenthood in a central business district [Coolidge Corner]. I've actually nothing against birth control or even abortion within reason [I think partial birth abortions are murders], but the irony wasn't lost on me. I'm sure the Nazis would have been amused also.

    Posted by: ratbastard | Aug 6, 2012 4:04:46 PM

  25. Brave New World is already here.

    Posted by: jaragon | Aug 6, 2012 5:44:10 PM

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