Gender and Sex Inclusive Approaches for Discussing Predicted Fetal Sex: A Call for Reflection and Research

Abstract

BACKGROUNDTechnology has rapidly transformed the centuries-old practice of fetal sex prediction, and significant social and medical progress is changing the way prenatal health care providers (HCPs) address the often-asked question, "Am I having a boy or a girl?" Access to prenatal cell-free fetal DNA (cfDNA) screening is expanding broadly, and medical societies recommend cfDNA screening for all pregnancies. 1,2 Prenatal cfDNA screening offers sex chromosome assessment for sex chromosome aneuploidy (sex chromosome complements other than XX or XY), along with other aneuploidy screening (for trisomies 13, 18, and 21), as early as 10 weeks' gestation. Patients may have a limited understanding of the prevalence of aneuploidy in the general population, the implications of these differences, and the purpose of screening for them. This gap in understanding could lead patients to believe the test is solely about gender determination.There is increased awareness that gender and sex diversity are essential components of health, health care, and social reality. 3 In this commentary, we posit that many prenatal HCPs are currently underprepared to talk to parents about fetal sex prediction and sex chromosome variation during the course of prenatal care in a manner that is accurate and inclu-