He and other doctors said medical centers are increasingly involving psychologists and other specialists in handling intersex cases because of their complexity.
"There's no good scientific data, and more and more we're leaning toward waiting," he said.
The Intersex Society of North America, a group representing intersex adults founded in 1993, advocates that children with anomalous genitals be raised in a specific gender even without surgery, but not be regarded as "a social emergency," as pediatric guidelines have called these cases in the past.
Cheryl Chase, the group's executive director, said its efforts are now focused on influencing how medical schools teach the intersex subject; she said that if doctors learned alternatives to early genital surgeries, including a treatment model that incorporates psychological support for families, they would in turn help parents see their children's condition more as a natural variation than a cause for panic.
In many cases, opponents of the surgery say, parents have hidden the medical history from their children. Betsy Driver, 40, a television news freelancer from Easton, Pennyslvania, who runs an online support group, Bodies Like Ours, said she underwent an extreme form of clitoral surgery as an infant because of congenital adrenal hyperplasia but did not fully learn the details of her condition until her 30s.
"I felt my parents could not love me the way I was," she said. "There was nothing wrong with the genitals. They just looked different."
It took her years of therapy to come to terms with her intersex condition, said Driver, who said she was left with no clitoral sensation. "Dating was exceptionally difficult," said Driver, who is gay and said she did not start dating until her 20s. "It was body image, fear of rejection and not being able to explain why I was different. Now, because I can explain, it's no big deal."
But she added, "Not doing the surgery is not a magic bullet." Parents need to talk openly about their children's bodies and teach self-esteem, she said.
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