Wealthy couples are coming to the U.S. from nations around the world in order to avoid legal restrictions on child gender selection in their native countries. The fact that gender selection is legal in the U.S. has created a global marketplace for a small number of fertility clinics which advertise in airline magazines and aim to attract international clientele. Opponents of gender selection call this “medical tourism” and believe legislators should become aware of its existence.

Dr. Jeffrey Steinberg of the Fertility Institutes of Los Angeles and Las Vegas believes the method of embryo selection is not akin to playing God, but rather providing a wanted service. He believes people will become more comfortable with the idea in time saying, “It’s new. It’s scary. We understand that.” He charges $20,000.

On the issue of international advertising “we basically want them to know it’s available,” Steinberg said. His clinic treated eight patients in a recent week and consulted with 12 more. Most couples are wealthy; however, one Australian couple has spent their yearly income in order to make gender selection possible. They have two boys already and want a girl. Gender selection is only legal in Australia for preventing gender-specific diseases.

The procedure which Steinberg provides has an added benefit for couples with fertility problems discover the sex of a group of fertilized eggs and implants embryos of the desired gender. This is called pre-implantation genetic diagnosis, or PGD, and is more often used to scan for genetic diseases.

Many countries ban gender selection without a specific medical purpose and seek places, like the U.S., that allow such procedures. The American Society for Reproductive Medicine says gender selection is clearly only ethically proper in an instance where the motivation is disease prevention. The group says they run the risk of reinforcing sexism as well as utilizing resources that would otherwise go to more pressing medical purposes.

The Johns Hopkins center is directing a study collecting data on gender selection statistics. The Center for Genetics and Society is pushing for practices marketing to become regulated by the government. “Right now the market is driving practices rather than social and ethical concerns,” said Sujatha Jesudason. “People who have the money to pay for it are getting the children of their choice.”

Steinberg requires the couple to remain in the country for only five short days. His office works with a clinic in whatever country the couple is from to provide the drugs that cause egg production before they come to the States. The technician removes one cell from every embryo to analyze and then implant them in the womb with one of two others all gender specific, to increase the chance of pregnancy. The Chinese and the Canadians are most interested in gender selection, of which Canadians want girls and the Chinese want boys.