A survey of medical reporting on intersex surgeries in Islamic societies demonstrates that the majority of intersex children seen by medical professionals undergo surgical “correction” before puberty. In many cases, the assigned sex is simply the sex that is most easily achieved via surgery, or it is the sex the parents want. Preference for male or female sex varies by region and sex-based landholding patterns. Muslim physicians express anxiety that the children must be able to perform either male or female social roles, and that “Islam does not tolerate” non-binary gender. An “Islamic solution” must therefore be found. However, examination of premodern legal, medical, and biographical texts (Gesink 2018) demonstrates widespread awareness of intersex conditions and construction of multiple legal non-binary sex categories. This awareness shifted gradually after 1800 to favor mandating binary sex as a result of European discourse on homosexuality and indigenous scripturalist revivalism. A return to the “Islamic solutions” of the premodern period might alleviate some of the pressure on parents and surgeons to prematurely “correct” infant sex.