The rise of gender reveals: a global health perspective

Pink or blue? Expectant parents want to know, and the question of what sex their baby will be has become a major enterprise in the English-speaking world over the past twenty years. Throwing full-size parties with binary balloons and a colored cake has come to represent a moment of celebration for families and excited followers on social media. In a world of constant comparison and one-upmanship, it’s usually the flashier, the better.

At first glance, the event seems delightful and harmless, like a baby shower with a twist. But what started out simple has come to involve elaborate pyrotechnics and other extreme displays (including guns, stunt cars, skydiving planes, and exotic animals), all fueled by an increasingly obsessive cultural climate and need for attention. Some participants have been issued serious criminal charges for reckless conduct. Over the past few years, misfired explosives at gender reveal parties have caused millions of dollars in damage by setting off wildfires in Arizona and California. In a tragedy, one woman in attendance was struck in the head by projectile debris from a homemade pipe bomb and was killed instantly.

Beyond the physical harm that can occur, many LGBT activists decry the practice as unnecessary reinforcement of gender stereotypes and heteronormative thinking. Reveal parties often operate under the assumption that gender roles are predetermined at birth and conformity will be expected. Perpetuating and imposing these views on an unborn baby can leave a bad taste in the mouth of people who faced rejection in their homes for not fitting the mold. Publicly emphasizing a child’s chromosomes may downplay more important aspects of their future identity.

In the medical field, finding out the fetus’s biological sex is typically accomplished via sonogram performed for separate health reasons. A statement from the American Institute of Ultrasound in Medicine strongly discourages the use of ultrasound for nonmedical purposes, and imaging is not indicated solely for prenatal sex determination. In certain parts of the world, doctors are even more restricted in terms of disclosure.

In China, physicians are forbidden by law from revealing information about an infant’s sex before birth. The controversial one-child policy regrettably drove female infanticide since having a male child was socially preferred. Some Chinese mothers sought illegal ultrasounds and underground abortion services to ensure they would have a baby boy. As a result, the sex ratio became 120 males for every 100 females in certain regions. Similarly by law, doctors in India cannot share the anticipated biological sex with parents for fear that mothers will terminate their pregnancy if a girl is undesired.

Certain hospitals in Scotland have done away with prenatal sex determination to avoid potential legal repercussions. Parents can be verbally abusive and threaten to sue if hospital staff are unable to discern the sex or get it wrong. The development of in vitro fertilization (IVF) has raised ethical questions about sex-selection and family balancing throughout the world. Medical and legal professionals must learn to navigate an ever-evolving cultural landscape to satisfy competing demands from legislatures, health care administrators, and patients.

Sex and gender are important in many sociocultural contexts, and discovering a child’s biological sex can be a meaningful experience for expecting couples. This opportunity is not accessible to over a billion women living in Eastern countries where laws were established to prevent discrimination against female fetuses. In the developing world, prenatal diagnostic imaging may be limited by a lack of ultrasound equipment and trained technicians. Where sex determination is legal and available, ridiculous gender reveal parties have caused massive destruction, potential harm to LGBT individuals, and needless loss of life.

Seeing a child before birth is a gift, and children should be celebrated for all parts of their identity. Learning the sex in pregnancy should be guarded as a special trust, not taken for granted or used as a spectacle for Instagram. This knowledge comes with great responsibility – an ultrasound wand might be mightier than the sword.

Steven G. Duncan is a medical student. 

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