A future without tomboys and lesbians? New study explores ethics of gender difference “correction”

Discussions about gender expression tend to get very intense very quickly. We see it happen a lot in AfterEllen.com comments, as people react to certain words or misinterpret another comment. Frankly, the level of anger that often comes up makes me shy away from writing about certain topics.

But something recently came across my feed that is so outrageous – and so frightening – that I have to write about it. And in this case, I invite you to be outraged along with me.

Advocate.com reported the release of a new study from Northwestern University’s Feinberg School of Medicine that details some dangerous experiments in fetal engineering. Doctors have been using a synthetic steroid to prevent female babies from being born with “behavioral masculinization” – which means lesbianism, bisexuality, intersexuality, and tomboyism. (Yes, “tomboyism” is a thing.)

Let that soak in for a minute.

The paper, cumbersomely titled Prenatal Dexamethasone for Congenital Adrenal Hyperplasia An Ethics Canary in the Modern Medical Mine, appears in Journal of Bioethical Inquiry and is written by Alice Dreger, professor of clinical medical humanities and bioethics at Feinberg; Ellen Feder, associate professor of philosophy and religious and American University; and Ann Tamar-Mattis, executive director of Advocates for Informed Choice. All three of these women have written and spoken extensively about the rights of individuals born with variations in sexual anatomy, especially children. Under the Freedom of Information Act, the women found details of the “extremely troubling off-label medical intervention” to “normalize” sex in fetuses.

I remember reading something about this several years ago. But soon after the initial articles came out, others said that those reports were overreacting, that the trials were about using dex to prevent birth defects. So, I sort of shrugged the whole thing off. I wish I’d kept reading, because if anything, those initial reports were under reacting. Now that the JBI paper is published, we can see the extent – and implications – of the dex trials.

My knowledge of genetics and related science is somewhere between primitive and basic, but here’s how I understand the experiments. Some physicians have been using prenatal dexamethasone (dex) to prevent congenital adrenal hyperplasia (CAH), an endocrine abnormality that can cause females to be born with intersex or male-typical genitals and brains. The steroid, which is not FDA approved for treatment of CAH, has to be started as soon as pregnancy is confirmed. If the fetus has CAH (which can be diagnosed several weeks into the treatment), dex administration continues throughout the pregnancy. If the fetus is male or doesn’t have CAH, treatment stops immediately.

In lay terms, that means that a pregnant woman can take a steroid to increase the changes that her daughter will grow up to be a feminine straight woman. Not that I object to feminine straight women. What I do object to – vehemently – is an organized medical study with the objective of preventing the birth of females that are anything other than stereotypically femme heterosexuals. Especially right after watching all of those women’s Olympic soccer games.

Frankly, reading the paper and related articles and research has made me rethink something I’ve believed for years – that proof of homosexuality being genetic is a good thing. I naively thought that if science found conclusive evidence that we’re born this way, objections that being gay is “unnatural” would vanish. If I am not choosing to be a lesbian, how can it be “sin,” regardless of your (mis)interpretation of the Bible?

People who hate queers will simply shift their attention from our bad choices to our bad genetics – and support ways to purify human DNA so that we will no longer exist. Of course, the irony is that the same people who think women should not have the right to choose whether to have a child should have the right to change it in the womb. The people who think stem cell research is an abomination will love the idea that cellular research can find a way to get rid of the homo gene.

I want to hear your thoughts about this research. Do we have a right to correct intersex conditions in the womb? Should parents be able to “correct” genetic “problems?” Where do we draw the line? If you could choose whether or not to have a lesbian child (assuming she is healthy in every way), what would you do? Does the prospect scare you as much as it scares me?