Disorders of sex development (formerly known as intersexuality), or DSDs, are congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical. The statistics of DSD incidence vary widely, depending on which conditions are included in the calculation. One incident in 2,000 births seems to represent a moderately inclusive estimate. DSDs have often been treated with genital surgery and both the timing and type of surgery have caused controversy. Many of these surgeries are medically unnecessary and have been carried out because of societal anxieties about marriage, heterosexuality, and the insistence on normative bodies. Those with atypical genital anatomies have had their bodies reshaped to look more typical, even though evidence suggests that many of those who have undergone such surgeries have not had more successful outcomes and happier lives than those who have avoided surgery. The accusation that physicians are continuing to perform surgeries that are not medically necessary but only cosmetic, with significant risk to the patient, is a real concern. Most recently, however, pre-implantation diagnosis and the ability to sequence fetal nucleic acids in maternal blood at as early as five weeks may render such considerations moot. Some bioethicists are calling for such an approach in order to reduce or even remove the incidence of DSDs in the population, as it has already decreased the incidence of other mutations such as Down syndrome. There is presently a challenge for bioethicists to critically appraise the use of prenatal genetic diagnosis to decrease diversity in our populations where scientists are using the term “eugenics“ in a positive rather than pejorative way. The bioethics community must address the clinical, ethical, religious, and social challenges of PGD so that we might make the arguments clearly to the public.