Gender discrimination

Is a fertility treatment test being misused to select male embryos? Yes, alleges one Mumbai woman

Shubhangi Bhostekar has complained to the Maharashtra child rights panel after a surrogate hired by her husband gave birth to a boy.

A complaint received by the Maharashtra State Commission for Protection of Child Rights early this year has raised concerns that fertility clinics might be misusing technology meant for screening genetic disorders to guarantee the birth of boys.

It is illegal in India to use any technology to select the gender of a foetus. But activists suspect that medical professionals have been using Preimplantation Genetic Diagnosis, or PGD as it is commonly known, to selectively implant male embryos. The PGD technique allows doctors to test an embryo for genetic abnormalities before transferring it to the uterus. It was introduced in India roughly two decades ago. A woman’s complaint to the child rights commission has only strengthened this suspicion.

Shubhangi Bhostekar, 35, said that a surrogate hired by her businessman husband, Prakash Bhostekar, 41, without her knowledge had in September 2016 delivered a male child. Shubhangi Bhostekar claimed the birth of the boy was made possible by sex selection at preconception. The couple have two daughters aged 5 and 14.

Mumbai’s Jaslok Hospital, where the surrogacy procedure was performed, has refuted the allegation of sex selection. A hospital spokesperson said the embryo was implanted into the surrogate’s uterus on the second day of its formation. “At this stage, embryo biopsy for PGD is not possible and hence there has been no misuse of a technology,” the spokesperson said.

The Maharahstra child rights body has asked the Mumbai police to investigate Shubhangi Bhostekar’s allegation. The police have referred the matter to a medical board, consisting of government doctors, for expert opinion, Senior Police Inspector at Mulund station Shripad Kale said.

The Pre-Conception and Pre-Natal Diagnostic Techniques Act of 1994 requires that every “Genetic Counseling Centre, Genetic Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centre shall maintain a register showing, in serial order, the names and addresses of the men or women given genetic counseling, subjected to pre-natal diagnostic procedures or pre-natal diagnostic tests, the names of their spouses or fathers and the date on which they first reported for such counseling, procedure or test”.

The Indian Council of Medical Research also maintains a national registry of fertility clinics.

To help couples who are unable to conceive naturally bear children, doctors take reproductive germ cells called gametes from them or donors to create an embryo. The embryo may be screened for genetic abnormalities using the PGD technique before it is implanted into the uterus of the mother or the surrogate. The technique can also be used to determine the gender of the embryo. In fact, a study conducted in Iran, where PGD is widely used for gender selection, found that it was “100% successful in achieving the desired sex”.

This is what worries activists in India. Specifically, such procedures are difficult to monitor and, thereby, regulate, making them prone to misuse. “These clinics are offering such sophisticated treatments but are not being monitored effectively,” said Varsha Deshpande, founder of Lek Ladki Abhiyan, a non-profit that campaigns against sex selection. “It is not a mere coincidence that celebrities and rich people opting for surrogacy are only having sons.”

In 2013, Deshpande filed a case against the actor Shah Rukh Khan and Jaslok Hospital for allegedly predetermining the sex of his third child, who was born through surrogacy. Her petition was eventually dismissed by the Bombay High Court.

Suspicious case

On January 12, 2016, Shubhangi Bhostekar and her daughters were allegedly evicted from their home. In her complaint to the Mulund police, she said her husband had forced her to undergo multiple abortions following the birth of her second daughter because he wanted a male child. “He even took me to Jaslok Hospital in 2014 as he wanted me to undergo infertility treatment,” she told Scroll.in. “He told me treatment at the hospital will ensure the birth of a boy. I was tired of the harassment and decided not to undergo it.”

Jaslok Hospital confirmed the couple had visited infertility specialist Dr Firuza Parikh on August 6, 2014, but had not registered as patients or paid a fee. They wanted to plan for another child but the patient came with a history of having two daughters, two miscarriages and the husband had high blood sugar level, the hospital said. They were told to come back when his sugar levels were under control. Prakash Bhostekar returned after about 17 months, but as a single man who wanted a child through surrogacy. At that time, Parikh did not recall his previous visit, the hospital added.

On March 21, 2017, Shubhangi Bhostekar complained to the child rights commission, alleging that her husband, in pursuit of having a boy, had hired a surrogate through Jaslok and entered into an agreement with her on January 15, 2016, three days after throwing Shubhangi Bhostekar and their daughters out of his home.

Jaslok, however, told the commission they were not aware Prakash Bhostekar was married with two daughters since he had furnished an affidavit saying he was single. The Indian Council of Medical Research’s guidelines require a married person to take spouse’s consent before commissioning surrogacy.

The surrogate delivered a baby boy on September 28, 2016. A month later, Shubhangi Bhostekar approached the police after learning her husband had brought an infant home.

Her lawyer, Siddh Vidya, claimed the police investigated her complaint only after she filed a Right to Information application about the status of the case. “There is enough circumstantial evidence indicating that Prakash opted for surrogacy to have a boy,” said Vidya.

The child rights commission agreed. After receiving Shubhangi Bhostekar’s complaint, it directed the Maharashtra government to “take appropriate action against Prakash Bhostekar and [his mother] Laxmi Bhostekar for sex selection, forceful abortion, for giving false affidavits to the effect that the [marital] status of Prakash Bhostekar is single and for obtaining a male child through surrogacy.”

Pravin Ghuge, chairperson of the commission, said Prakash Bhostekar has violated the rights of his daughters and newborn son. “We are not a medical body but from the submissions made to us it appears the surrogacy was opted for the sole purpose of having a male child,” he said.

Need for regulation

In 1998, Dr Anniruddha Malpani, who runs an infertility clinic in South Mumbai, argued in an article in the Indian Journal of Medical Ethics for allowing the PGD technology to be used for sex selection.

Twenty years later, Malpani said that the bannon the use of technology for sex selection was to be blamed on cases like the Bhostekars. “The ban has driven the operations underground,” he said. Malpani said that instead of a blanket ban, there could have been a regulatory mechanism to allow couples to select the gender of the child. “What if the couple just wants to balance the sex-ratio in the family?” he asked.

Infertility specialist Dr Kamini Rao, who practises in Bangalore, said discussions around using the PGD technology for sex selection were unwarranted. “The law does not permit it and we have to follow it,” she said.

Still, many couples do ask her to conduct sex selection procedures – “especially couples who are opting for infertility for a second child inquire about sex selection,” she said. “But it is not necessarily only for having a boy. Many couples want a girl.”

Amar Jesani, a researcher specialising in bioethics and public health, said artificial reproductive technologies have made it possible for doctors and couples to select several aspects of the foetus. “It is a well known fact that selection takes place and gender is only one part of it,” he said.

Both Jesani and Rao said legislative regulation of assisted reproductive technologies was required. “The Bill to regulate assisted reproductive technology was never introduced in Parliament,” said Jesani. “And without regulating the ART industry, having a bill for regulating surrogacy is not enough.”

Gita Aravamudan, author of Baby Makers: The Story of Indian Surrogacy, said it was not surprising that doctors were selecting the gender of embryos. “During my research, I learnt of cases where couples chose the gender of the child they bore using infertility treatment,” she said. “The entire industry needs to be regulated.”

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Swara Bhasker: Sharp objects has to be on the radar of every woman who is tired of being “nice”

The actress weighs in on what she loves about the show.

This article has been written by award-winning actor Swara Bhasker.

All women growing up in India, South Asia, or anywhere in the world frankly; will remember in some form or the other that gentle girlhood admonishing, “Nice girls don’t do that.” I kept recalling that gently reasoned reproach as I watched Sharp Objects (you can catch it on Hotstar Premium). Adapted from the author of Gone Girl, Gillian Flynn’s debut novel Sharp Objects has been directed by Jean-Marc Vallée, who has my heart since he gave us Big Little Lies. It stars the multiple-Oscar nominee Amy Adams, who delivers a searing performance as Camille Preaker; and Patricia Clarkson, who is magnetic as the dominating and dark Adora Crellin. As an actress myself, it felt great to watch a show driven by its female performers.

The series is woven around a troubled, alcohol-dependent, self-harming, female journalist Camille (single and in her thirties incidentally) who returns to the small town of her birth and childhood, Wind Gap, Missouri, to report on two similarly gruesome murders of teenage girls. While the series is a murder mystery, it equally delves into the psychology, not just of the principal characters, but also of the town, and thus a culture as a whole.

There is a lot that impresses in Sharp Objects — the manner in which the storytelling gently unwraps a plot that is dark, disturbing and shocking, the stellar and crafty control that Jean-Marc Vallée exercises on his narrative, the cinematography that is fluid and still manages to suggest that something sinister lurks within Wind Gap, the editing which keeps this narrative languid yet sharp and consistently evokes a haunting sensation.

Sharp Objects is also liberating (apart from its positive performance on Bechdel parameters) as content — for female actors and for audiences in giving us female centric and female driven shows that do not bear the burden of providing either role-models or even uplifting messages. 

Instead, it presents a world where women are dangerous and dysfunctional but very real — a world where women are neither pure victims, nor pure aggressors. A world where they occupy the grey areas, complex and contradictory as agents in a power play, in which they control some reigns too.

But to me personally, and perhaps to many young women viewers across the world, what makes Sharp Objects particularly impactful, perhaps almost poignant, is the manner in which it unravels the whole idea, the culture, the entire psychology of that childhood admonishment “Nice girls don’t do that.” Sharp Objects explores the sinister and dark possibilities of what the corollary of that thinking could be.

“Nice girls don’t do that.”

“Who does?”

“Bad girls.”

“So I’m a bad girl.”

“You shouldn’t be a bad girl.”

“Why not?”

“Bad girls get in trouble.”

“What trouble? What happens to bad girls?”

“Bad things.”

“What bad things?”

“Very bad things.”

“How bad?”

“Terrible!!!”

“Like what?”

“Like….”

A point the show makes early on is that both the victims of the introductory brutal murders were not your typically nice girly-girls. Camille, the traumatised protagonist carrying a burden from her past was herself not a nice girl. Amma, her deceptive half-sister manipulates the nice girl act to defy her controlling mother. But perhaps the most incisive critique on the whole ‘Be a nice girl’ culture, in fact the whole ‘nice’ culture — nice folks, nice manners, nice homes, nice towns — comes in the form of Adora’s character and the manner in which beneath the whole veneer of nice, a whole town is complicit in damning secrets and not-so-nice acts. At one point early on in the show, Adora tells her firstborn Camille, with whom she has a strained relationship (to put it mildly), “I just want things to be nice with us but maybe I don’t know how..” Interestingly it is this very notion of ‘nice’ that becomes the most oppressive and deceptive experience of young Camille, and later Amma’s growing years.

This ‘Culture of Nice’ is in fact the pervasive ‘Culture of Silence’ that women all over the world, particularly in India, are all too familiar with. 

It takes different forms, but always towards the same goal — to silence the not-so-nice details of what the experiences; sometimes intimate experiences of women might be. This Culture of Silence is propagated from the child’s earliest experience of being parented by society in general. Amongst the values that girls receive in our early years — apart from those of being obedient, dutiful, respectful, homely — we also receive the twin headed Chimera in the form of shame and guilt.

“Have some shame!”

“Oh for shame!”

“Shameless!”

“Shameful!”

“Ashamed.”

“Do not bring shame upon…”

Different phrases in different languages, but always with the same implication. Shameful things happen to girls who are not nice and that brings ‘shame’ on the family or everyone associated with the girl. And nice folks do not talk about these things. Nice folks go on as if nothing has happened.

It is this culture of silence that women across the world today, are calling out in many different ways. Whether it is the #MeToo movement or a show like Sharp Objects; or on a lighter and happier note, even a film like Veere Di Wedding punctures this culture of silence, quite simply by refusing to be silenced and saying the not-nice things, or depicting the so called ‘unspeakable’ things that could happen to girls. By talking about the unspeakable, you rob it of the power to shame you; you disallow the ‘Culture of Nice’ to erase your experience. You stand up for yourself and you build your own identity.

And this to me is the most liberating aspect of being an actor, and even just a girl at a time when shows like Sharp Objects and Big Little Lies (another great show on Hotstar Premium), and films like Veere Di Wedding and Anaarkali Of Aarah are being made.

The next time I hear someone say, “Nice girls don’t do that!”, I know what I’m going to say — I don’t give a shit about nice. I’m just a girl! And that’s okay!

Swara is a an award winning actor of the Hindi film industry. Her last few films, including Veere Di Wedding, Anaarkali of Aaraah and Nil Battey Sannata have earned her both critical and commercial success. Swara is an occasional writer of articles and opinion pieces. The occasions are frequent :).

Watch the trailer of Sharp Objects here:

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This article was published by the Scroll marketing team with Swara Bhasker on behalf of Hotstar Premium and not by the Scroll editorial team.