Sex has been the subject of religious and political discourse for millennia because of its role in reproduction. Imagine, if you will, a world where most people do not have sex in order to reproduce. This is precisely what Professor Hank Greely does in his recent book The End of Sex and the Future of Human Reproduction (Harvard University Press, 2016), for which the Center for Biomedical Ethics and the McCoy Center for Ethics in Society held a public lecture on February 16th, 2017 at Stanford’s Cubberley Auditorium.
With a down-to-earth sense of humor and a remarkable talent for making genetics understandable to general audiences, Professor Greely laid out his vision for what human reproduction will look like in western countries over the next 20–40 years. Greely discussed five Assistive Reproductive Technologies (ARTs). Preimplantation Genetic Diagnosis (PGD) involves taking a handful of cells off an early embryo to conduct genetic testing to decide if it should be transferred to a woman’s uterus. In Vitro Fertilization (IVF) involves facilitating the union of an egg and sperm outside the womb. Greely calls a process using skin cells to produce egg and sperm cells from males or females “Easy PGD”, or embryonic skin cells, which would allow all couples—or even an individual—to have children. Mitochondrial transfer involves transferring mitochondria from one woman’s egg cell to another’s in order to prevent an embryo from developing mitochondrial disease. Somatic Cell Nuclear Transfer (SCNT) is the technical term for cloning.
While Greely acknowledged that these technologies sound like those out of the movie Gattaca, he argues that in a few decades they will be commonplace. They will become affordable and widely used because they could offer a large market for the medical industry and save insurance costs. They will enable parents to choose what kinds of traits they want their children to have, including gender and whether their children are born with genetic conditions like Down Syndrome.
As a disabilities scholar and a sex educator, Greely’s lecture left me with many questions. He openly discussed the possibility that this might pose challenges for the disability rights movement. From my perspective, this possibility should not be underestimated. Over the past 40 years, people with disabilities have made significant gains in civil rights protections which acknowledge that society can be as, if not more, disabling than individual pathology. If ARTs are not used ethically, I worry that there may be a cultural shift towards wanting to cure all foreseeable disabilities rather than accommodating them. This is of course a double-edged sword because some disabilities do cause health problems that most people would not wish on anyone. At the same time, the medical community can be a source of stigmatization and discrimination for those with disabilities and their families. Therefore, if these ARTs become commonplace, disability activists will need to mobilize so that public policy strikes a balance between promoting public health and embracing what we think of as disability as a valuable form of diversity.
From the perspective of sex education, I have another question. What is to become of sex? How will the decrease in procreative sex shape the future of sexual intimacy? How will debates on abstinence-only sex education and reproductive rights evolve? Greely himself points out that thus far, many pro-life activists have surprisingly embraced the possibilities of these ARTs. Will this remain true if these technologies become the primary method of reproduction? Will these technologies contribute to those who wish to have procreative sex, becoming stigmatized or marginalized? How will these technologies shape the future of LGBTQ+ rights in terms of access to these technologies to individuals or same-sex couples? Also, what implications could these technologies have for those who express a non-binary gender identity, or who are intersex? These are questions that need to be at the forefront of political debates as reproductive policy inevitably plays catch-up with advances in science and technology. The end of procreative sex, therefore, will only mark an evolution in debates about sexuality, reproduction, and social policy.
KEVIN MINTZ is a Ph.D. Candidate in Political Science and an Ethics in Society Graduate Fellow. He holds an AB in Government from Harvard College, an MSc in Political Theory from the London School of Economics and Political Science, and a Doctorate of Human Sexuality from the Institute for the Advanced Study of Human Sexuality. His Ph.D. dissertation, Sex-Positive Political Theory: Pleasure, Power, Public Policy, and the Pursuit of Sexual Liberation, focuses on developing a justification for political institutions and civil society taking proactive roles in promoting sexual liberties. His research interests include the application of sexology to political theory, LGBTQi activism, and disability politics.