Dubious choice

A U.S.-based company's advertisement campaign in an Indian newspaper to market a pre-conception sex selection technique, exploiting the son-preference in Indian society, runs into rough weather.

PARVATHI MENON SROBONA ROY CHOUDHURY in Bangalore

INDIAN women, under social and familial pressure to produce sons, are very often forced to find ways to do so, often at great risk to their health. Commonly available techniques such as ultrasound scanning make it possible to determine the sex of the foetus within the first trimester of pregnancy. The demand for this relatively simple and inexpensive technique is so high that unregistered mobile diagnostic clinics have mushroomed, and female foetuses are often aborted. The status of the girl child in India is reflected in the juvenile sex-ratio, which has registered a sharp decline over the last decade - from 945 females per 1,000 males in the 1991 Census to 927:1,000 in 2001.

Cashing in on son-preference, a value that is entrenched in Indian society, a new sex-selection procedure has entered the market. A United States-based company recently ran a series of advertisements in The Times of India for a gender selection approach that is "safe", "easy-to-use" and "upto 96 per cent effective". "Gender Selection is now a reality," the advertisement read, along with a photograph of a bonny baby boy.

The advertisement provoked immediate protests from women's and child rights groups in Bangalore that are fighting retrograde social attitudes and practices that discriminate against the girl-child. The groups were equally critical of the newspaper that carried the advertisement, for allowing commercial objectives to overshadow its social responsibilites. Vimochana, a city-based women's organisation, held a demonstration outside the newspaper's office, which it followed with a letters-to-the-editor campaign. In this it was joined by the Network to Empower Women Journalists (NEWJ), a Bangalore-based women journalists' organisation.

The Times of India subsequently stopped running the advertisement, but not before it had made its editorial judgment on the matter. In an editorial entitled "Sophie's Choice", it acknowledged the widespread misuse of sex-determination techniques and the failure of legislation to bring new and questionable technologies for sex-selection within its ambit. However, it also justified its decision to carry the advertisement by arguing that women must be given the "freedom of choice", a fundamental tenet of democracy. "Can we abridge an individual's right to choose the gender of her child before conception?" the editorial asked.

The newspaper's stand has added a new dimension to the ongoing controversy. What are the ethical and social responsibilities of the media with respect to social issues, and in this specific case, a blatant form of discrimination that women face? "Almost every day, newspapers publish at least one case of a woman being murdered or driven to suicide because she failed to produce a male child," Dona Fernandes of Vimochana told Frontline. "The toll-free international number for India provided in the advertisement clearly shows that the company is trying to exploit the Indian market. Allowing Gen-Select to market its product will mean giving encouragement to the obsession for male babies that is widespread in our country," she added. Vimochana has filed a complaint against the product with the Health and Family Welfare Department, stating that it violates the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994.

Gen-Select, the company, provides sketchy details about its product both in its advertisement and on its website. Frontline contacted the promoters, Jill and Scott Sweazy, who offered through e-mail information on the procedure and the reasons for promoting it in India. The Sweazys' claim that it was not the commercial opportunities India offered which led them to market the product in India, but a deeper moral and ethical urge. The procedure, they emphasise, is not a pre-natal, but a pre-conception one.

"We found that the people of India have a strong desire to choose the sex of their children and frequently go to the extreme of foeticide to achieve this goal," Jill Sweazy said, side-stepping any mention of the fact that it is the female foetus that is inevitably aborted. "With our product, the freedom to choose the gender of your next child is preserved, while the moral, ethical and legal issues of foeticide are put at ease," said Sweazy.

Hardly anyone will incur the expense and make the effort to acquire a kit, unless they are desperate. The Indian experience ("the strong desire of the people of India" that Jill Sweazy alludes to) shows that it is the desperation for sons that drives couples to commit female foeticide. She claims that a part of the proceeds from the sale of every Gen-Select kit sold in India would be donated to the cause of prevention of foeticide. The website received thousands of hits in the first week of the product's advertising, she said.

While she did not disclose the actual number of requests for the kit from India, Jill Sweazy said that they were "encouraged by the favourable response to their product in India" and were " already processing requests for both boy and girl kits". Claiming scientific validity for the method, which is known as the "Fully Integrated Programme," she said that they had put in a patent application for it a year ago.

The method, "as simplistic as it is intricate," is dressed up in pseudo-scientific jargon. It has four components as described by its developers. First, there is a prescribed dose of "carefully formulated gender specific nutriceutical supplement". The nutriceuticals include "specific univalent and divalent cationic elements" which "combined with appropriate vitamins and herbal extracts", can create the "strongest bias possible for successfully accomplishing a conception of the requested gender". The nutriceuticals are produced in Food and Drug Administration-approved facilities in the U.S., they add.

The second aspect of the method is monitoring monthly ovulation cycles by recording changes in body temperature (here the kit helpfully provides a digital thermometer) and charting instructions for timing sexual union. Here the Sweazys offer a proposition that effectively knocks the bottom off their method. "Strong evidence exists," Jill Sweazy notes, "which shows that the ratio of viable 'y' carrying (male) sperm and 'x' carrying (female) sperm differ in concentration in the female reproductive tract depending upon when they were deposited."

The third element of the method lies in the use of external sprays or douches which will alter the acidic/alkaline environment of the female reproductive tract. The mysterious "'x' carrying (female) sperms have a survival advantage in acidic secretions while the 'y' carrying (male) sperms have motility advantage in more alkaline solutions."

The last component recommends "specific dietary guidelines" that will change the "critical elements in the male and female reproductive fluid". The kit is "specially priced" at $196 (approximately Rs.5,800) for India.

DR. LEELA PAI, a leading obstetrician and gynaecologist in Bangalore, told Frontline that pre-conception sex-selection technologies are not scientifically validated. A procedure such as the Fully Integrated Programme would fall in the category of "hit or miss" techniques.

According to Dr. C.M. Francis of the Community Health Cell, Bangalore, altering the alkalinity of the body through the use of external sprays is risky and can lead to infertility. The Gen-Select method and kit, Dr. Francis said, was designed in such a way that the company will have the least legal accountability. "In case the method fails, the company can get away by saying that the instructions were not followed, or that they only promised 'up to 96 per cent' effectiveness," he added.

Gen-Select cannot be prosecuted under the provisions of Indian law, Jill Sweazy told Frontline in an e-mail. According to her, the relevant law (the PNDT Act, 1994) only applies to pre-natal diagnostic techniques, not to pre-conception techniques. "Our product is a pre-conception product and is subsequently not governed by provisions addressing pre-natal concerns," she said.

Anitha Shenoy, a Delhi-based lawyer, disagrees. She is part of the Lawyers Collective, which is representing the petitioners in a public interest petition filed in the Supreme Court, seeking changes in the PNDT Act. Since the Act aims to prohibit the use of modern medical techniques in ways that discriminate against women, Shenoy said, it can be interpreted widely. In fact, in medical dictionaries, the word 'pre-natal' includes the pre-conception period as well. She said that the newspaper that carried the offending advertisement also violated the PNDT Act. Section 22 of the Act prohibits any advertisement that relates to pre-natal determination of sex.

The Supreme Court is monitoring the implementation of the PNDT Act. Drawing a link between the declining juvenile sex ratio and the proliferation of sex determination diagnostic clinics, the Supreme Court had, on May 4, 2001, issued a directive to the Centre and the State governments to "monitor and review the implementation of the PNDT Act" (Frontline, June 22, 2001). On August 6, the apex court issued summons, to appear on August 10, to the Chief Secretaries of the 13 States which had failed to submit progress reports on the implementation of the Act.

The court directive came after a public interest petition was filed jointly by the Centre of Enquiry into Health and Allied Themes (CEHAT), Mumbai; the Mahila Sarvangeen Utkarsh Mandal (MASUM), Pune; and Dr. Sabu M. George, a health policy expert and activist in the campaign against female foeticide. The petitioners have asked for the inclusion of pre-conception sex-selection techniques within the purview of the Act. They have also asked for a ban on advertisements promoting the use of sex-selection techniques. "It is significant that apart from Bangalore, few other cities had any objection to the advertisement," Dr. George told Frontline. He was also critical of the media in general for having remained silent on the Gen-Select issue. "Despite seeing the effects of discriminatory technologies like these on India's demographic pattern, it is tragic that people are still willing to endorse the product. When pre-natal sex-determination techniques became common, there was an alarming increase in the number of foeticides. Now if pre-conception sex-selection technologies become easily available, the possibilities are frightening," he said.