For medical experts, the appearance of external genitalia tends to be considered more important than chromosomes in determining sexual identity. Current medical protocols, for example, indicate that newborn boys should have a penis that is at least 2.5 centimeters long and newborn girls should have a clitoris that is no larger than 1 centimeter (Ben-Asher, 2006). Children who do not conform to these norms are designated for medical treatment, including hormone therapy and surgery, to help them more closely approximate the traits of either a male or female classification.

Although ambiguous genitalia pose no physical health risk, the birth of a child with ambiguous genitalia is deemed by medical experts to be a “social emergency” requiring immediate medical attention (American Association of Pediatrics [AAP] Policy, 2000). As a practical matter, it is much easier to construct an artificial vagina than an artificial penis. Because of this, it remains standard practice within the medical profession to perform a sex change operation on children with unusually small penises and other “under-masculinized” traits, even if the chromosomes fit the XY classification as male. XX babies with enlarged clitorises, on the other hand, are not converted into “boys” but undergo surgery to either remove or alter the clitoris to conform to medical expectations for girls.