Public Policy, Chromosomes, Genes, and Societal “Cures”

Thanks to everyone who read my previous blog post, “Iceland 'Cures' Down Syndrome, Should America Do the Same?” and a deepest expression of gratitude to all who took the time to comment. A recent response to this article was particularly striking: "Comparing people with Down's—a chromosomal abnormality—to women, who do not have any chromosomal abnormality, and implying the reason for wanting to terminate either type of pregnancy is the same is asinine…”

I whole-heartedly concur with this reader’s comment: It is absurd and asinine to view being female (or any other gender) as a “condition” to be “cured” using genetic testing, counseling, and pregnancy termination. Indeed, there is credible and compelling scientific evidence, including mountains of data and at least thousands of studies showing that having two X chromosomes can be quite advantageous. Risk of autism, ADHD, speech and language disorders, dyslexia and many many other conditions such as heart disease (but not Down Syndrome, which occurs about equally in males and females) are much higher in people—like me—who do not have two X chromosomes. My own research (coauthored with Richard Woodcock) shows that females have some cognitive advantages as well[1]. Perhaps the most compelling data are for life expectancy—which is significantly higher for “two Xers.”

But some societies have viewed having two X chromosomes as a non-preferred genetic trait, despite the obvious asininity and unscientific nature of this perspective—leading to policies that reduced the number of female births in those places.

Therefore, I wish to make one point crystal-clear: In my view, societies and public policy should never target any genetic or chromosomal trait for “cure” for any reason whatsoever. The fundamental thesis herein is that both history and recent programs such as those in Iceland to “cure” any condition, whether it be Down Syndrome or being female—or any other “condition” a society deems “non-preferred”—are misguided and downright dangerous to the citizens of that state.

The relative advantage—or disadvantage—of any genetic trait should never be used by governments or societies as a basis for discrimination, oppression or any other “cure.” The word “genocide” broadly means killing on the basis of genetic traits— which is an eerily accurate definition when used to “cure” two X chromosomes—or Down Syndrome.

Candidly, because I have so many friends with Down Syndrome whose lives have so enriched my own, I find the idea that society should be “cured” of these wonderful people to be every bit as shocking, wrong-minded, and asinine—as the reader’s perspective on terminating females.

Why would anyone wish to “cure” our society by “terminating” Herbie, Jeannie, Molly, Rob, Robert, Andrew, and Will because they have non-preferred genes or chromosomes? I feel precisely the same way about my mother, sister, wife, daughters, daughters-in-law, granddaughters, aunts, professors and former professors, students, scientific colleagues, friends—and everyone in society who are “two Xers.” It should be inarguable that no society—or person—should ever devalue females for any reason, including chromosomes or genes.

This conversation is of the upmost immediate urgency because genetic testing continues to make rapid advances. Current technology is not infallible, but there is a high degree of accuracy for identifying sex, Down Syndrome, and a panoply of traits—such as Type 1 diabetes—that some may view as “undesirable.” But the situation could become even more dire as new scientific discoveries are made: It is likely that genetic markers for autism, ADHD, speech and language disorders, dyslexia and many other traits, including cancer, type 2 diabetes, heart disease and so on will become more fully understood.

It is also not unlikely that there will be new discoveries on the genetics of sexual orientation. The original meaning of a hateful slur of gay people is a stick of wood gathered for burning. This should serve as a clear warning about how differences in sexual orientation have been treated in some societies. And this is by no means limited to the distant past: Homosexuality is still a capital crime in some modern societies[2}. What are the implications in these places if genetic markers for homosexuality are discovered in the future? Does anyone doubt there would be a push for a “cure” using genetic testing, counseling, and pregnancy termination?

So, should our society strive to “cure” ANY condition using genetic testing in the way that Iceland is “curing” Down Syndrome? The answer must be a resounding, proactive, and unambiguous no.

Medical decisions, including all treatments and cures, must be private and exclusively between a physician, the patient, and their families. Family decisions, including whether or not to have children, should be the exclusive province of the family—and not the state. All citizens, regardless of their chromosomes and genes, should have explicit legal protection. Active moral and legal barriers are needed to prevent well-meaning—but potentially misguided—governmental or societal policies that deem any genetic or chromosomal conditions undesirable so as to be targeted for “cure.” History teaches us that such policies inevitably will end horrifically—no matter how high minded the original rationale.

Bear in mind that not one of us—or our genes—are perfect. Like people with Down Syndrome, and “two Xers,” we are all people and deserve to be treated as such by society—despite any genetic and chromosomal variability we may possess.