In 1981 and 1983, Shaykh al-Azhar ‘Ali Jad al-Haqq issued fatwas in which he advised that sex-change operations were permitted for intersexuals. In 1990, Saudi Arabia’s Scientific Committee for Research and Ifta’ ruled that sex-changes were permitted with the recommendation of a doctor. In 1999, Ayatollah Khamina’i issued a fatwa permitting the same for intersexuals and MTF transsexuals. Previous scholarship on the legal treatment of intersexuals in Islamic societies (Bouhdiba 1975, Sanders 1991) suggests that these rulings protect the dominance of men within a legal system that demands absolute binary sex identities. My paper analyzes rulings and descriptions of the khuntha (hermaphroditic intersexual) in medieval and early modern legal manuals, dictionaries, and medical texts, including but not limited to al-Khalil ibn Ahmad’s 8th century Kitab al-‘ayn, Ibn Sina’s 11th-century Qanun fi al-tibb, an 11th-century Shi‘i legal text by al-Tusi, an 11th-century Hanafi commentary from the Transoxianian jurist al-Sarakhsi, an 11th-century Hanafi manual from al-Quduri of Baghdad, al-Marghinani’s 12th-century legal manual al-Hidaya, Ibn Qudama’s 13th-century Hanbali legal manual, Ibn Manzur’s 14th-century dictionary from Mamluk North Africa, al-Halabi’s 16th-century legal manual from Syria, and al-Muhibbi’s 17th-century history of the Ottoman empire. Read within a legal discourse of compassion for believers, rather than the twentieth-century discourse of gender hierarchy, these diverse texts display consistent rhetoric: concern for intersexuals’ physical and emotional comfort, sexual satisfaction, and ability to obey gendered rules governing prayer and social behavior. In stark contrast to Europe, where hermaphrodites were subject to arbitrary medical examination, juridical assignment of gonadal sex contrary to gender identity, and dissolution of marriage (Dreger 1998), Muslim authors respected the hermaphrodite’s human dignity and equality in submission to God’s law. This study thus provides a historical context with which to frame contemporary discussions of gender ambiguity and so-called “Islamic intolerance.”