'I know it's a girl, and I need your help to get it out of me.'

Dr. Carpenter's brow furrowed as she told me about the first time she met Priya. Carpenter was an OB-GYN resident at the time. Priya was a recent immigrant from India who worked as a manager in a retail store and had come to the central California clinic on her lunch break. Punctuating her story with glances at her watch, she told Carpenter how, one week earlier, she had used another lunch break to go to a private ultrasound clinic, where she learned that she was pregnant with a girl. With her arms tightly crossed along her abdomen, she explained that her husband and his parents expected a boy, and that Carpenter's help could change her life. "I have a daughter," Priya said. "I don't need another one." 

. . . Reproductive choice and patient autonomy are pillars of American medical practice, after all. Asking a woman for her reasons for wanting a boy or a girl, one doctor told me, is simply not a physician's responsibility or business; educating her on the latest technology is. Doctors have to trust that patients know their lives, families, and needs best, he said. In some cases, a physician may know—and loathe—the reasons behind a patient's choice, yet still believe that providing sex selection may help her. If a woman faces threats of divorce, abandonment, or abuse, or if her child would ultimately be mistreated or neglected, then aborting an unwanted female or implanting male embryos may help keep that woman—and any future children—safe.

. . . Ultimately, physicians are on their own when making these ethically and emotionally charged decisions. The professional medical societies they might otherwise turn to offer conflicting advice: The American College of Obstetrics and Gynecology recommends that providers not meet requests for sex selection, given the risk of reinforcing sexist beliefs and practices, while the American Society of Reproductive Medicine states that it would be premature to prohibit such technologies without studies suggesting their potential harm in the United States. Slate