THE announcement last week that two London doctors are opening a gender clinic, where parents will be able to choose the sex of their children, was greeted by a predictable outcry at the dubious ethics of 'off-the-shelf babies'. But what about children who grow up with the anguish of thinking that their parents would have loved them more had they been of a different sex?

Parents may feel strongly about gender for a variety of reasons: if they already have children of one sex they may want a mixed family; in some cultures the pressure to have boys is very strong; dynastic types want to pass on the family name; people who have got on badly with either one of their parents may be nervous of a pattern repeating itself and prefer to have a child of the other sex; parents who have lost a child may want to 'replace' their dead baby.

Juliet Hopkins, a child psychotherapist at the Tavistock Clinic in London, says in her work it is common to see children whose parents were disappointed by their gender at birth. In most cases, the parents recover and soon fall in love with the child, but sometimes parents and child have to work with a therapist to examine the role of gender in their relationship.

Mrs Hopkins says it is important to distinguish between children whose parents wished they had been a different sex and those who were brought up as the opposite sex: 'In the backgrounds of transvestites there is often, but not always, something like that. A boy whose mother doesn't complain when he tries on her shoes or make-up, but encourages it as being rather charming, may grow up feeling confused about his sexual identity.'

According to Mrs Hopkins, how children are treated in their first 18 months to two years is crucial in the development of their sexual identities. Some are born with anomalous genitals, a boy may have a retracted penis and testes hidden in his abdomen. The discovery at the age of four that he is a boy is often followed by a difficult adolescence. 'Despite a normal adolescent development, he doesn't feel comfortable as a man,' she says. These cases suggest that early learning and culture are more powerful even than biology.

From this evidence it is possible to see how parents' strong desire to have a child of a particular sex could have a similar psychological effect: if parents desperately want a boy, buy all the blue clothes, and produce a girl, even if they do not carry on treating her as a boy, a very early awareness of parents wanting a different child can leave its mark. Such children often grow up imitating the behaviour of a child of the preferred sex.

Mrs Hopkins says that as adults these children often have difficulty forming sexual relationships. 'A woman who tried to please her parents by trying to be like a boy may grow up envious and resentful of men, because they have what she ought to have had.'

She sees this phenomenon particularly with 'replacement children'. One 10-year-old girl came to her because her parents were worried that she was displaying extreme tomboyish behaviour - she would only wear trousers and play with boys. In the therapy sessions, she drew pictures of graveyards.

It transpired the parents had had a son who died but they never talked to their daughter about him. She had picked up the fact of his death, maybe from her parents talking before they thought she could understand, and she was trying to please them by being the dead boy. Mrs Hopkins encouraged the parents to tell their daughter what she already knew and to talk about their feelings. Quite soon the little girl dropped her tomboyish behaviour.

So what are the risks of childhood psychodramas for children chosen by sex selection? Claims of effectiveness for the technique used by the London Gender Clinic range between 70 and 80 per cent for male babies and 60 to 70 per cent for female, which leads some to fear an increase in abortions. For children who may grow up knowing that their parents paid pounds 650 for them to be sex-selected and they turned out the wrong way, there may be a higher risk of psychological problems. And will those whose chromosomes turn out according to plan think: 'My parents only love me because I'm the right sex?'

Mrs Hopkins thinks this will depend on whether there are other sources of insecurity. 'They may grow up feeling particularly wanted, like children born through in-vitro fertilisation who know their parents have gone through hell to have them.'

But in essence the message on sex selection from the professionals who have to pick up the pieces seems simple: have your children for who they are, not what sex they might have been.