"A lot of activists are concerned that what the German rule will do is encourage parents to make quick decisions and give the child an 'undetermined,'" she said. "We are afraid it will encourage intervention. We think a better process is assigning male or female sex, then waiting. But we haven't seen how the law will play out, so all we can do is speculate."
Tamar-Mattis said that her organization supports the Australian law because "it allows adults to choose to be recognized in a third gender."
"Adults should be able to make their own decisions about legal gender," she said. "German law is about assigning it at birth. That is not a battle young children should have to take up at this point. When they are grown, they can make decisions about their own bodies."
But Dr. Arlene Baratz, a Pittsburgh breast radiologist who has a daughter with a disorder of sexual development and helps hundreds of others in a support group, said the German law will "empower" both parents and children.
Baratz's daughter Katie was born with male chromosomes, but has a DSD called complete androgen insensitivity syndrome (cAIS). Because her androgen receptors are faulty, Katie developed female characteristics. She has a vagina, but no uterus or ovaries. When she was 6, doctors discovered small testes in a hernia sac.
Today, at 29, Katie is married and at the University of Pennsylvania, a resident in child psychiatry. Though she is infertile, she hopes to become a parent through adoption or gestational surrogacy.
"The law gives parents some space not to have to rush into making decisions themselves," said Baratz. "It gives them the time to do some tests and figure it out and a period of time before they write 'male' or 'female.' This way, you are OK -- raise the child, love the child. You have a wonderful baby and enjoy the fun. We don't have to rush into surgery that is irreversible."
"It brings the children into the decision and takes away the anxiety that motivates parents because they don't feel they are doing the right thing," she said. "Ultimately, the child will decide which sex he or she feels more comfortable with -- and that's a wonderful thing. It empowers children to make the decision for themselves."