Because modern Western European culture treats the anatomical sex of the body at birth as the basis for assigning social gender (boy or girl), intersex conditions represent a crisis for contemporary notions of sex, gender, and identity.

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Since the mid-twentieth century, most intersex individuals with significantly ambiguous genitalia who are born in industrialized countries have been subjected to neonatal surgeries designed to make their genitals approximate cultural norms of either male or female embodiment. By the late twentieth century, however, some adult intersex people who received these surgeries as children began to organize politically to end the practice. They claimed that the nonconsensual surgeries did more harm than good, and were intended to calm the anxieties of parents and doctors rather than improve the health and well being of intersex individuals.

The political intersex movement has always had close ties to activism. The pioneering Intersex Society of North America (ISNA), the first intersex advocacy group to link intersex issues to feminist and queer critiques of biomedical science and gender ideology, was founded in 1993 in San Francisco by Cheryl Chase.

Chase worked closely with activists in particular to articulate a framework within which intersexuals could acknowledge their sense of violation, claim their own moral agency, resist medical colonization, seek appropriate healthcare, work to educate the public, change harmful practices, and celebrate rather than hide their differences from most other people.

ISNA champions a radical new treatment protocol for intersexuality. It advocates assigning intersex infants as either boys or girls, depending on which gender would most likely be least problematic for each particular individual, without performing irreversible surgery.

They advocate that parents and children alike receive counseling and peer support to help with any emotional difficulties arising from stigma associated with the perception of intersexuality. If the intersex child later desires to change social genders, or seeks surgical intervention, that desire should be supported. The central concern is to preserve the widest range of options for the intersex person to exercise consent over what happens to his or her body.

In response to ISNA's activism, a new body of intersex scholarship began to emerge in the 1990s. Historian Alice Dreger, psychologist Suzanne Kessler, and biologist Anne Fausto-Sterling have all written important works that support ISNA's positions. This intellectual foundation, coupled with the activism of intersex people and their allies, has already resulted in significant changes in the medical management of intersex conditions.

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