Should Human Beings Have Sex? Sexual Dimorphism and Human Enhancement

Abstract

Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a “post sex” humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more “open” future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine.

Keywords:

• ethics
• human enhancement
• intersex conditions
• PGD
• sex
• sex selection

Acknowledgments

I thank Hilary Bambrick, Linda Barclay, Victor Cole, Kate Crawford, Toby Handfield, Belinda Johnson, Neil Levy, Terry MacDonald, Larry May, Catherine Mills, and Justin Oakley for comments and discussion that have assisted with the development of this paper. I also thank Nicole Kouros and Emilio Mora for their assistance in preparing the paper for publication.

Notes

¹Since the early 1950s, however, when the first sex change operations were performed, individual sex has come to be, to some extent at least, a technological artifact (Meyerowitz 2002). For the small fraction of individuals born “intersex,” sex has always been a socially constructed imperative (Fausto-Sterling 2000).

²For the first of these interpretations, see Sparrow (2007); for the second, see Savulescu (2001). If parents do have an obligation to take social circumstances into account when choosing the best possible child, this will not open up space for choosing children of either sex; it may establish an obligation to have male children who will benefit from the existence of institutional sexism.

³There is, inevitably, a certain difficulty in understanding such “cross-life” comparisons, which raise the “non-identity problem” (Parfit 1984; Brock 1995). It is not my goal here to settle the dispute about how to best interpret such claims or, indeed, whether they are possible. The argument that we are obligated to choose the best child possible presumes that such comparisons are coherent and morally significant, as indeed does any argument that we have obligations (beyond avoiding bringing into existence persons who would prefer to be dead) relating to what sort of children we should bring into the world. Later in the paper I discuss an example that avoids the philosophical difficulties associated with the non-identity problem.

⁴In the industrialized world, women live on average roughly 3 to 7 years longer than men, with a “health-adjusted life expectancy” of 2–4 years greater than men (World Health Organization 2009, Table 1). If the difference in male and female life expectancies is a result of social circumstances in sexist societies then this reason lapses. However, it seems likely that at least some of this difference in life expectancy reflects differences in male and female biology that will be expressed across a wide range of environments (Institute of Medicine Committee on Understanding the Biology of Sex and Gender Differences 2001).

⁵The caveat here relates to the question as to whether we should be concerned with total welfare over a lifetime or with the average welfare per day (or some other unit of time). A longer life will likely produce a greater total welfare over the course of that life; it may or may not produce a greater average welfare. For a recent discussion of the relationship between longevity and welfare, see Walker (2007).

⁶This possibility looms especially large where the diversity in question is diversity in the human form as conceived in debates around disability. It is one thing to argue that the presence of people with disabilities in the community makes possible certain goods; it is quite another to argue that parents should be required to bring children with disabilities into the world in order to produce these goods.

⁷Genetic engineering for hermaphrodism, on the other hand, may well be risky and consequently is likely to be unethical until we can be confident that the process has been rendered safe and reliable. In its favor, however, is the fact that it would allow children maximally open futures.

⁸Although MRKH is thought to have a genetic cause, the gene or genes involved have yet to be identified; to that extent, the following scenario is hypothetical. However, with our rapidly increasing knowledge of human genetics it is unlikely to remain so for too much longer.

⁹For the sake of the argument here, let us simply stipulate that the loss of life expectancy associated with this disorder is the same as the gap in the life expectancy of men and women.

¹⁰Given the philosophical advantages of this example, the question might be asked, why I didn't begin with this case? I did not because the technology involved is hypothetical, whereas the technology involved in the two-embryo case—sex selection—is readily available. Any conclusions we reach about the two-embryo case will consequently have dramatic implications for contemporary practice. I offer the single-embryo case here in support of the main argument about the implications of denying normative significance to the idea of a “normal human body” for sex selection.

¹¹This argument has been made by some conservative thinkers (Kass 1997; Scruton 2006).

¹²It would be interesting to speculate as to why this implication of contemporary bioethical and transhumanist argument has not been more widely publicized; one suspects that the men who constitute the overwhelming majority of those writing in these literatures are reluctant to entertain the possibility that they are, by their own lights, obsolete.

¹³Seeing both male and female variants of the species as normal is a relatively recent historical phenomenon. For most of the history of Western medicine, for instance, women have been held to be deviant and “lesser” versions of men (Laqueur 1990, 149).

¹⁴The idea of individual flourishing is unlikely to be able to do the appropriate work here and produce two normal types.

¹⁵In particular, my conclusion seems likely to have significant implications for debates around gender reassignment surgery and intersex conditions. As I noted at the beginning of the paper, the range of sexual variation in the human species is wider than just the two sexes. There exists a range of intersex and other conditions that produce people who are not easily categorizable as belonging to either the male or female sex (Kessler 1998). In recent decades, some intersex persons have conducted a vigorous political campaign for the idea that intersex conditions should be understood not as deviations from a normatively significant ideal type but rather as part of the normal range of human variation. See, for instance, Intersex Society of North America (2008) and Lareau (2003). My argument here suggests that this project is more problematic than it might otherwise appear. As I have argued, abandoning the notion of a normal human body altogether has theoretical consequences that in the long run are likely to be extremely deleterious to the continued existence of diversity in the human form. It is possible, of course, that we might instead recognize that there are more than two “normal” sexes. Once we allow that there are two sets of normal human capacities, we open the door to the possibility that there might be more than two. However, it seems unlikely that every intersex condition could represent a set of capacities that we had no reason to assess against another set. Nor does it appear as though Aristotelian arguments about species flourishing will be available to support the conclusion that the rarer constellations of bodily capacities are normal. However, while the notion of a normal human body is clearly relevant to debates about surgery to assign and change sex/gender, nothing I have said thus far is intended to argue for any particular course of action in relation to the treatment of children who are born intersex or for any particular conclusion as to the appropriate social attitudes toward sexual variation.

¹⁶I am continuing to wrestle with these questions in my research; another attempt to explore the implications of sexual dimorphism for the debate about human enhancement may be found in Sparrow (2010).