Actions by intersex civil society organizations aim to eliminate harmful practices, promote social acceptance, and equality.

[5] When deciding whether to assign the intersex infant "male" or "female," the factors typically considered are potential for fertility and sexual penetration.

The Intersex Society of North America (ISNA) was a non-profit advocacy group founded in 1993 by Cheryl Chase to end shame, secrecy, and unwanted genital surgeries.

She states that the pair went to deliver an address, "on long-term outcomes and to challenging their still-prevailing opinion that cosmetic surgery to "fix" intersexed genitals was the best course of action", but were "met, officially, with hostility and were escorted out of the conference by security guards".

Scholars and activists, such as Georgiann Davis,[32] and Morgan Holmes,[33] Esther Morris Leidolf,[34] and clinical psychologists like Tiger Devore[35] regarded this shift as a retrenchment of medical authority over intersex bodies.

[39] The hospital found that "disorders of sex development" terminology may negatively affect care, give offence, and result in lower attendance at medical clinics.

[39] In 2013, Pidgeon Pagonis testified for interACT before the Inter-American Commission on Human Rights about the medical interventions they were subjected to as an intersex child,[41] alongside Latin Americans Mauro Cabral, Natasha Jiménez and Paula Machado.

[15][44] In June 2017, Joycelyn Elders, David Satcher, and Richard Carmona, three former Surgeons General of the United States published a paper at the Palm Center,[45][46][47] citing a State Department statement[48] and developments in Germany, Switzerland, Australia, Chile, Argentina, and Malta, and calling for a rethink of early genital surgeries on children with intersex traits.

Many of these procedures are done with the stated aim of making it easier for children to grow up "normal" and integrate more easily into society by helping them conform to a particular sex assignment.

[52] In a 2017 interview for Harper's Magazine, Laurence Baskin, chief of pediatric urology at University of California, San Francisco, told journalist Sarah Topol "that he would recommend early surgery not just for 5-alpha but for 95 percent of known D.S.D.

[54] interACT states that they are "unaware of any jurisdiction in the U.S. that enforces its own FGM laws in cases where the girl undergoing clitoral cutting has an intersex trait".

[60][61][62][63] The child in the case was born in December 2004 with ovotestes, initially determined as male, but subsequently assigned female and placed in the care of South Carolina Department of Social Services in February 2005.

"[61][65] The defendant in the case, Dr Ian Aaronson, had written in 2001 that "feminizing genitoplasty on an infant who might eventually identify herself as a boy would be catastrophic".

In January 2015, the Court of Appeals for the Fourth Circuit reversed this decision and dismissed the complaint, stating that, "it did not "mean to diminish the severe harm that M.C.

"[69] In May 2016, the United States Department of Health and Human Services issued a statement explaining Section 1557 of the Affordable Care Act stating that the Act prohibits "discrimination on the basis of intersex traits or atypical sex characteristics" in publicly funded healthcare, as part of a prohibition of discrimination "on the basis of sex".

The submission stated that the Gloucester County School Board held a "simplistic view of "physiological" sex [that] is demonstrably inaccurate as a matter of human biology.

[76] On September 26, 2016, California resident Sara Kelly Keenan became described as the second person in the United States to legally change her gender to non-binary.

Keenan had applied for a "non-binary" birth certificate but the City Department of Health and Mental Hygiene required a biological term.

Robert Sparrow has stated that the genetic elimination of intersex traits might be permissible, despite "uncomfortable" implications for "other nonpathological human variations" that do not affect physical health.

[82] Jason Behrmann and Vardit Ravitsky state that: "Parental choice against intersex may ... conceal biases against same-sex attractedness and gender nonconformity.

Notable advocates include Eden Atwood, Max Beck, Cheryl Chase, Cary Gabriel Costello, Georgiann Davis, Tiger Devore, Alice Dreger, Betsy Driver, Pidgeon Pagonis, Anne Tamar-Mattis, Hida Viloria, Sean Saifa Wall, Alicia Roth Weigel, Kimberly Zieselman and Dana Zzyym.

Personal testimonies are detailed in the San Francisco Human Rights Commission report, and also in a 2015 issue of Narrative Inquiry in Bioethics,[84] and a Lambda Literary Award winning book, Intersex (For Lack of a Better Word), by Thea Hillman.