In 2006, the official journal of the American Academy of Pediatrics published a consensus statement on the medical management of intersex traits. Like the profession's first statement, the revision advised against unnecessary surgical modifications. Yet, such surgeries continue in contemporary US society, despite the professional stance and public critiques from intersex activists. Relying on sixty-five interviews with medical professionals, individuals with intersex traits, and parents of intersex children, this article examines why the practice continues. It then analyzes how medical professionals justify their medical interventions and shows that these justifications convey a "covert necessity" to the parents of intersex children. Intersex bodies, situated on the threshold of the gender structure, are treated as "states of exception" where unnecessary medical interventions serve to uphold the sex binary. The article argues that medical interventions aimed at eliminating intersex traits will continue until society disentangles sex from gender, embraces gender fluidity, and no longer constructs intersex bodies as deviant or abnormal in order to disallow or erase them.