How might reproductive technologies revolutionize parenting?

If scientists from just a few decades ago were to visit a fertility clinic today, they would be astonished by the progress that has been made. The first baby created through in vitro fertilization, the process by which an egg and sperm are combined outside of the body, was born in 1978. Since then, new developments have allowed for genetic testing of embryos, surrogate carriers, three-parent genetic babies, and even uterine transplants. In 2017, a woman gave birth to a baby conceived from an embryo created 24 years prior—only one year after the mother herself had been born.

The prospects for future reproductive technologies are almost beyond our imaginations. Science fiction movies have suggested for years that artificial wombs will one day take over as our main means of reproduction. Transgender women and cisgender men may one day be able to have uterus transplants and give birth. While we are not quite there yet, it does seem likely that before too long we will have that capability, as there have now been successful uterine transplants in cisgender women.

So what does the future of reproductive technology look like for the next few decades? One thing that is fairly certain is that we are going to have much improved genetic testing of p. 152↵embryos created through in vitro fertilization. Preimplantation genetic screening is already being used to test for chromosomal disorders such as Down syndrome, where there is a third copy of chromosome 21, and to identify the sex of the embryo. Preimplantation genetic diagnosis can identify mutations that cause certain genetic diseases.

The 1997 film Gattaca depicted a world in which the majority of people were created through genetic selection of embryos. The main character, Vincent, was born through “natural” means and, like other genetically inferior “invalids,” is relegated to menial tasks and expected to have a short lifespan. His adventure begins when he uses DNA samples from a “valid” to pose as a different breed of citizen.

The fictional future of Gattaca seems a stretch, but it is likely that within just a decade or two, genetic testing will be able to predict many more characteristics of an embryo—eye and hair color, height, weight, and certain risk factors, such as having a propensity for developing diabetes or heart disease. Perhaps just a decade or two later, we may be able to not just screen embryos, but to alter their genetic material to insert desired characteristics. In addition, as these screening techniques become better understood, they will likely also become more affordable, making them available to a larger portion of the population, and, at a certain point, expected. As in Gattaca, it is conceivable that one day we could live in a world where those who have not been created through genetic selection live as second-class citizens.

Another area of reproductive technology that is likely to significantly change our understanding of parenting is the creation of eggs and sperm from stem cells. Currently, we are limited to the eggs and sperm our own bodies can produce or to using donated eggs or sperm. However, scientists have now been able to take stem cells from mice and push them to differentiate into sperm cells, then inject these into mice eggs to create embryos that grow into healthy mice.

p. 153↵The creation of “artificial” sperm and eggs could open up possibilities for all kinds of changes in our reproductive capacity. On a basic level, it could allow those who are infertile, either because of low sperm count or age-related changes in eggs, to create brand-new viable sperm or eggs. Men with nonfunctioning sperm or women in their 50s or 60s could be capable of having biological children. But even beyond that, stem cells from someone of any sex could theoretically be used to create either sperm or eggs, allowing transgender men to produce sperm or transgender women to produce eggs if they wanted. It could also allow same-sex couples to have biological children together.

What is gender-neutral parenting?

Once upon a time, a baby named X was born. This baby was named X so that nobody could tell whether it was a boy or a girl. Its parents could tell, of course, but they couldn’t tell anybody else. They couldn’t even tell Baby X at first. You see, it was all part of a very important Secret Scientific Xperiment, known officially as Project Baby X. (Gould, 1978, p. 1)

So begins Lois Gould’s 1978 children’s book X: A Fabulous Child’s Story. In the book, a couple, the Joneses, work with scientists to raise a baby outside the confines of gender stereotypes, not telling friends or neighbors the baby’s sex. At first, there is significant pushback. Friends and neighbors don’t know what to buy for the baby. Store clerks tell the Joneses they can’t help them pick out clothing or toys. The Joneses worry about sending baby X to school. But when the other children see how liberating it is for X to be able to play with dolls, but also be star quarterback and to win relay races alongside baking contests, they all decide they want to be just like X. Despite p. 154↵the children’s excitement, the other parents remain wary, but eventually give in and welcome the Joneses to the parents’ association.

Written at the tail end of second wave feminism, Gould’s book represents an idealistic approach to parenting with the goal of providing as many opportunities as possible for a child while avoiding gender stereotypes. In the early 1970s, prior to its publication, numerous studies had been conducted that stressed the ways in which parents and other adults treated children differently based on gender, leading to disparities in children’s intellectual, physical, and emotional abilities. Girls lagged behind in science, math, and sports, while boys lacked verbal and emotional skills.

Gender stereotypes and their consequences are not a thing of the past. Sociologist Elizabeth Sweet has analyzed over 7,000 toy advertisements in Sears catalogues and found that toys are more gendered today than at any other point in the past century. The 2017 Global Early Adolescent Study found that girls who conform to gender stereotypes are more likely to be depressed, leave school early, and be exposed to violence. Boys who conform to gender stereotypes have a shorter life expectancy, are more likely to engage in physical violence, and are more prone to substance abuse and suicide.

Given the amount of harm caused by gender stereotypes, many parents today attempt to shield their children from the negative effects and encourage them to explore a variety of activities and interests. However, even with conscientious parents, outside influences can be substantial. Because of this, some parents have taken a stance similar to the Joneses, raising their children gender neutral or genderless, not revealing the sex of the child until later in life.

Genderless or gender-neutral parenting can include choosing a gender neutral name and using gender neutral pronouns like they, instead of he or she. Some families may buy clothing and toys that are gender-neutral. Others may alternate between stereotypically masculine and feminine items or p. 155↵dress the child in multiple items of clothing, some of which are considered more masculine and some more feminine. There are Facebook groups to connect parents who are raising their children gender-neutral. Some parents have social networking accounts to show others what they have learned. Working with daycare programs and schools can be challenging. School activities as simple as lining up or choosing seating arrangements may be gendered. Parents often talk to their child’s school in advance to ensure that as much as possible can be done so that gender stereotypes are not perpetuated.

There has been a significant amount of controversy about the idea of gender-neutral parenting and derision directed toward parents who decide to take this route, especially when the decision is made public outside of a neighborhood or small community. Although children, particularly when they are young, can be very accepting of new ideas, adults can find it harder. When the Canadian couple David Stocker and Kathy Witterick announced that they would be raising their child, Storm, without revealing Storm’s sex, people delivered angry letters to their door and shouted at them through car windows.

Many parents raising their children gender-neutral feel that the most difficult part is managing other people’s reactions. Close relatives often feel left out if they are not told the child’s sex. Friends, neighbors, and even total strangers express concerns about how the child will develop. One common anxiety is that the child is being forced into a lifestyle that the child did not choose. Parents who elect gender-neutral parenting argue that they are doing just the opposite—providing their children with more rather than fewer opportunities, allowing them the freedom to explore and choose what is best for them, without social pressure. Critics also state that children raised this way will be confused about their sex, gender, or both. Parents who use gender-neutral parenting respond by emphasizing how important it is to have conversations with children about these concepts.

p. 156↵Despite the media attention, true gender-neutral parenting is still rare. However, many parents attempt to be as gender-neutral in their parenting as possible, even if they assign their child a gender at birth. They may encourage their child to try clothing and toys traditionally associated with different genders and allow their child to pick out their own clothing for school, even if it does not match gender expectations. They may talk with their child about sex and gender at an early age and stress the history of sexism and rigid gender stereotypes that lead to harm for people of all genders.

In some parts of the world, these approaches are broadening outside of individual families to enter into day care programs and schools. In Sweden, preschool teachers avoid the term “boys and girls,” calling children “friends.” A gender-neutral Swedish pronoun, hen, was introduced in 2012 and allows teachers to use one word for all children, instead of either he or she. These techniques seem to be making a difference. Children in schools that use gender-neutral language are less likely to make assumptions based on gender stereotypes and more likely to have friends of another gender. Whether or not a particular family chooses to use gender-neutral parenting, approaches to child-rearing that intentionally break down stereotypes can benefit all children.

How might new technologies shape our ability to modify the human body?

Technology has always aided the desire of humans to amplify gender-conforming aspects of the body, be it through the early use of make-up by the ancient Egyptians, the popularization of the corset throughout the 16th century, or access to breast augmentation in the 20th century. Compared to only a few decades ago, there has been significant medical and social progress in the arena of gendered body modification, particularly for transgender communities. Hormones have become more accessible and, in the United States, can often be obtained p. 157↵through informed consent models that allow people, as long as they are judged fit to make medical decisions for themselves, to start hormones when they feel they are ready.

In the past, most clinics that provided hormone therapies had strict criteria for prescribing medication, including that those seeking help provide stereotypical accounts of their childhoods and identify as straight after transition. This meant that far fewer people were able to medically transition, and many who did felt that they had to lie at least about some aspects of their experiences.

Since the beginning of the 21st century, one of the biggest breakthroughs in hormone treatment has been the use of puberty blockers to delay puberty in transgender youth. Puberty blockers have allowed some transgender young people to avoid experiencing an unwanted puberty and have eliminated their need for later body modifications they could require to reverse that puberty. Studies report few negative side effects from these medications.

Interestingly, it was not a medical discovery that led to this breakthrough, as puberty blockers had existed since the 1980s and were readily employed to treat children with conditions that activated early puberty. Instead, it was an increase in social recognition and acceptance of transgender youth that led to more physicians being trained in and willing to use puberty blockers, as well as a select group of insurance plans changing their policies to cover these medications.

While hormone treatment can have desired gendered effects on the body, such as changes in body fat and muscle distribution and body/facial hair, there are body parts for which surgery is the most effective method of change. Improvements in surgery techniques have led to results that are more aesthetically pleasing and preserve functioning, such as nipple and genital sensation. Like other medical treatments for transgender people, an increasing number of U.S. insurance companies are now also covering certain types of gender-affirming surgeries.

p. 158↵Breast augmentation for transgender women and chest reconstruction—or top surgery—for transgender men, are generally extremely effective surgeries. Facial feminization surgeries have advanced to the point where physicians are able to reverse many of the facial structure changes that occur with male puberty. Body contouring surgeries can enhance the fat located in certain areas of the body or remove it, helping achieve more or less curvy silhouettes that are more gender-typical based on cisnormative body ideals.

Genital surgeries for transgender individuals include a variety of approaches and options and continue to modernize as more complex techniques are developed to enhance circulation, sensation, and appearance. Vaginoplasty, the creation of a vagina, is performed by different surgeons using varied techniques and is generally successful aesthetically as well as in preserving urinary function and genital sensation. Phalloplasty, or the creation of a penis, is considered a more complex procedure as it requires tissue from another area of the person’s body to create the phallus and specific techniques to lengthen the urethra outside the body. While some trans men, as well as cisgender men whose genitals have been injured, do undergo full phalloplasties, there are many alternative methods available for men interested in genital surgery. Some transmasculine individuals opt for a metoidioplasty, which cuts the clitoral ligament so that the clitoris pushes farther outside of the body as a phallus. A special kind of metoidioplasty called a ring metoidioplasty extends the urethra through the elongated clitoris, allowing the person to stand and pee. Some people who undergo phalloplasties and metoidioplasties also have a vaginectomy, which closes the vaginal canal, while others do not.

In 2014, surgeons in South Africa performed the world’s first successful penis transplant, paving the way for the possibility of a new type of genital construction. Between 2014 and 2018, there were three other successful transplants, all on p. 159↵cisgender men, including a U.S. soldier whose genitals had been destroyed in combat.

Looking ahead, there is a world of possibilities for how new technologies could allow us to improve on existing gender-related body modifications. Surgical techniques, especially, are likely to change dramatically over the next decade or two. We might progress from using our own or donor tissue for transplantation to substituting more sophisticated synthetic materials, or growing the desired tissues from stem cells. Prosthetic hips and knees may make way for prosthetic genitals. Creating transferrable body parts from our own DNA may be as easy as 3-D printing an organ that can be attached to our existing nerves and function like any of our other organs. Will these technologies end up making us less human? Or will they allow us to be even more of ourselves?

What are the current frontiers in gender equality?

When we talk about frontiers, we generally have expansive ideas in mind. In terms of gender equality, we may picture women in positions of world power, such as presidents or prime ministers, or women as the pinnacles of success, making scientific discoveries and writing the next brilliant work of fiction. Women are pushing these boundaries every day.

Seventy of 146 nations studied by the World Economic Forum have now had a female leader. In recent years, almost 50% of the books on the New York Times Bestsellers list have been written by women. Nearly half of tenure track professors in the United States are women. In 2018, New Zealand passed legislation granting victims of domestic violence ten days paid leave, allowing them to leave their partners, protect themselves and their children, and seek out new housing. In January 2019, 5 million women in India formed a 385-mile human protest for gender equality. Across the globe, women, girls, and transgender people are organizing and advocating for change.

p. 160↵At the same time, women continue to live in starkly different economic conditions than men. Around the world, women are more likely than men to live in poverty. Sixty percent of chronically hungry people are women and girls. In the United States, women are only 5% of Fortune 500 CEOs, but 63% of those earning minimum wage. Globally, women are paid 23% less than men. Only 20% of the world’s landowners are women. Seventy-five percent of women in developing countries work in the informal economy, without access to legal rights or protections. Women do twice as much unpaid work, such as household chores and childcare. The United Nations Foundation estimates that unpaid work done by women across the globe, if paid, would add up to $10 trillion a year.

Despite many important changes in the status of women over the last two centuries, women and girls continue to live in some of the most miserable conditions in the world. Images of women in positions of power in governments and academic settings is inspiring, and the appearance of women astronauts and physicists makes for exciting news. However, many experts and aid organizations suggest that there is an urgent need to direct resources and attention to creating a more equitable society. With regards to economic parity, it is estimated that the gender gap will take 257 years to close. Today, there are 72 countries where women are barred from opening bank accounts or obtaining credit, and there is no country where men spend the same amount of time on unpaid work as women.

Two thirds of illiterate people in the world are women. Every day, millions of girls, especially in rural areas, watch as their brothers leave for school. This is despite the fact that we know that educating girls works. Every year of primary school increases a woman’s eventual wages by 10% to 20%. Women who have been educated have lower rates of early pregnancy, death in childbirth, and child malnutrition.

Feminists have argued for years that women having control over when and how to have children is essential to gender equality. Some have even suggested that until reproduction p. 161↵is separated from human bodies (e.g., through the use of artificial wombs), women will never have the same opportunities as men. While artificial wombs may be a long way off and may not be desirable for everyone, granting women the ability to control their own reproduction may have similar results. Studies show that access to contraception allows women to further their education and move forward in their careers. Access to safe abortions similarly allows for increased gender equity. However, in 2018, over 40% of women lived in countries with highly restrictive abortion laws.

Time out of work or school to have children greatly affects women’s economic potential. Once someone has decided to become pregnant, in many areas of the world, there is no such thing as maternity leave, and in those with this benefit, it is often unpaid. Opponents of comprehensive maternity leave argue that women choose to become pregnant and therefore should shoulder the burden themselves. This argument falls flat when we consider that no children would ever be born if no one gave birth to them.

In addition to the effects of maternity leave itself, women also take on the lion’s share of childcare and household work, often leaving them with time for part-time work only, or working long hours at paid work and then returning home to work even longer at home. Women who stay home with children while male partners work have little access to economic freedoms that would allow them to make their own choices about their lives. Some countries, particularly those with democratic socialist governments, have introduced reasonable lengths of paid maternity and paternity leave, as well as universal childcare so that women have improved access to education and career advancement.

A frontier that is less often considered, but could be key to reaching gender equity is the promotion of typically unpaid women’s work (including child and elder care, cooking, cleaning, and running errands) as a shared societal burden that is either spread out over both genders or monetarily p. 162↵compensated. Women perform about two and half times more of this kind of work globally than men do, and even in countries where social norms encourage men to be more involved, such as Sweden, women still perform a third more of the unpaid work. Making this type of work more equitable or receiving pay for it could drastically change household economics.

Healthcare access is stratified not only by geographic location and class, but also gender. The United States has the worst maternal mortality rate of any developed country. Despite global maternal death rates falling by more than one third from 2000 to 2015, outcomes for American mothers worsened. African American, Native American, and Alaskan Native women die of pregnancy-related causes at a rate about three times higher than those of white women. For transgender individuals, access to basic healthcare and gender-affirming interventions is often a laborious process marked by roadblocks, expense, and discrimination. The United States 2015 Transgender Health Survey, the largest of its kind, found that the combination of anti-transgender bias and persistent, structural racism was especially devastating to the health and wellness of transgender individuals. The survey found that transgender people faced higher rates of HIV infection, smoking, drug and alcohol use, and suicide attempts than the general population. For transgender and gender diverse individuals, limited access to safe housing and education, precarious legal protections, violence, and discrimination continue to threaten lives and livelihoods globally.

Although much progress has been made toward gender equality across the globe, major power disparities still exist today. Thinking optimistically about the future, we can imagine a world where gender inequality is a thing of the past—where individuals of all genders have equal rights, access to the same opportunities, and are treated with the same respect and autonomy. However, realistically, the work that remains would require monumental restructuring of institutions, the p. 163↵undoing of strongly entrenched biases, and the rethinking of long-standing cultural assumptions.

Could the future be genderless? Do we want it to be?

What would a genderless future look like? Some people might imagine a world where humans no longer have bodies that signify gender—one in which we are all androgynous. Medical technologies may one day advance to the point where this is possible. But is it probable?

With the myriad of varied gender identities and presentations that exist today, it seems unlikely that we would all soon conform to a standard androgynous body and more likely that definitions of gender and experiences of gendered bodies would instead expand. But what would it mean to expand our definitions of gender? How exactly would that work?

While we almost certainly cannot know the answers to these questions now, we can imagine what the future of gender might look like in different scenarios.

In the future, it is possible (although not probable) that anti-oppressive social forces would be so successful in fighting male privilege that masculinity would no longer be advantaged over femininity, men and women would have equal earnings, and gender inequality would cease to divide and disenfranchise entire swaths of the population. Our bodies would be the same as they are now, but birth certificates would not have genders because they would be useless. Children would be raised without particular expectations for boys or girls and would be supported in whatever styles of dress or activities they preferred. As adults, all people would have access to all kinds of careers and partners, regardless of gender.

Despite the many gains we have made, this scenario seems unlikely given the weight of ingrained social attitudes about gender. But what if technology changed the way we interacted?

In another future scenario, we could all become so integrated into cyber technology that we would live most of our p. 164↵lives online. Virtual worlds like Second Life that allowed people to create avatars and interact with each other through those avatars would become our primary modes of communication. In this kind of future, it is possible that we could all choose any kind of avatar we wanted, without concern for how our gendered bodies interfacing with our computers were actually configured. Our avatar bodies could be like ours, different from ours, transgender, cisgender, or intersex. In these virtual worlds, we could be whatever we wanted to be. What would it mean to communicate, work, and even develop relationships with others with identified genders untethered from our flesh and blood bodies behind the screen? Would that alter the way we think about our own identities? Could it change the amount of importance we place on gender and the assumptions we make based on gender?

Although we have access to virtual worlds now, most of us continue to spend the majority of our time interacting with others in the “real” world, so it would likely take a significant change in social norms or a consequential upgrade in virtual technology to bring us to the point where we interacted almost completely through virtual worlds. But what if the technology change involved our bodies and not our modes of communication?

Every day we move closer and closer to the ability to replace our body parts with either artificial parts made of metal or plastic or with human body parts grown from stem cells. At a certain point, it may become so normal to replace body parts that we may all essentially be cyborgs—part human and part mechanical. Technology may lead us to be almost immortal. Although it might be difficult to prevent accidents, when our organs began to fail, we would simply replace them. What would this mean for our gendered selves? One thing it might mean is that we would have the freedom to try out differently-gendered bodies. And if anyone could change the gender of their body, what would gender mean? Or would it become meaningless?

p. 165↵While the language, norms, and expectations around gender have shifted over the past century to expand our understanding of the vast nature of gender and gains in technology provide the potential for an even more limitless, variable experience of gender, the future of gender may not be as liberated and self-determined as some may hope. In 1985, Margaret Atwood published The Handmaid’s Tale, and, in 2017, Hulu released a television series based on the novel. The plot presents a dystopian future wherein stark lines around gender are reinforced by biology. Particular to this story is a focus on reproductive rights and the governing powers that regulate women’s bodies.

The novel and television show are fictional, but the depictions of gender-based violence, revocation of personal freedoms, and lack of access to education are common realities faced by women, girls, and other gender minorities across the world today. In 2017, Russia’s parliament voted 380–3 to decriminalize domestic violence in cases where it did not cause “substantial bodily harm” and did not occur more than once a year. In 2018, Tokyo Medical University marked down the test scores of young women applying to medical school, limiting women to just one third of the class to ensure more men than women became doctors. The reason given was that authorities were concerned with women’s ability to continue to work after starting a family, reinforcing a limit to women’s earning power and ability to self-determine their careers. In May 2019, Alabama’s state senate passed a near-total ban on abortion, making it a crime to perform the procedure at any stage of pregnancy, with no exception for rape or incest. Internationally, the global gag rule prohibits foreign nongovernmental organizations that receive funding from the U.S. government from providing abortion services or referrals, while also barring advocacy for abortion law reform, even if it’s done with the nongovernmental organization’s own, non-U.S. funds. These realities make it difficult to imagine a genderless world, p. 166↵particularly because gender and power are so dynamically related in our current societies.

It is possible that if we continue to make progress, we may be able to move toward freeing ourselves from the confines of gender oppression and gender-based violence, into a future where gender becomes less of a determinant of safety, success, and freedom. Technological advancements may render bodies more gender fluid than we have known to be possible, and body-based gender versus our online presence may reduce or eliminate the gendered focal point of identity. Advancements in reproductive technologies may change the biologically deterministic ideology of our global economy, health, education, and culture. Yet there exist many concerning trends today that call into question our ability to make the type of progress we would hope for. True, we could be moving toward the possibility of a genderless future, where more freedom exists to explore diverse gender experiences, aided by technology and medicine. However, this experience, at least at first, will likely be reserved for the most privileged. Technological advancements that could be shifting us toward a potential genderless future may not parallel social movements toward equality. A true genderless future may therefore only be an option once gender equality is achieved, necessitating ongoing dedication to education and advocacy.