social construction changed the management of ambiguous genitalia from determination of the baby's real sex (by checking gonads or chromosomes) to determination of what sex should be assigned. The most common intersex surgery offered in childhood was amputation of the clitoris and widening of the vaginal opening to make the genitals of a girl with CAH appear more conformed to the expectations. However, by the late 1950s surgical techniques for transforming an adult man into a woman were being developed in response to requests for such surgery from transsexuals. Rise of infant surgery and "nurture over nature" By the 1960s, the young specialties of pediatric surgery and pediatric urology at children's hospitals were universally admired for bringing infant birth defect surgery to new levels of success and safety. These specialized surgeons began to repair wider varieties of birth defects at younger ages with better results. Earlier correction reduced the social "differentness" of a child with a cleft lip, or club foot, or skull malformation, or could save the life of an infant with spina bifida. Genital corrective surgeries in infancy were justified by (1) the belief that genital surgery is less emotionally traumatic if performed before the age of long-term memory, (2) the assumption that a firm gender identity would be best supported by genitalia that "looked the part," (3) the preference of parents for an "early fix," and (4) the observation of many surgeons that connective tissue, skin, and organs of infants heal faster, with less scarring than those of adolescents and adults. However, one of the drawbacks of surgery in infancy was that it would be decades before outcomes in terms of adult sexual function and gender identity could be assessed. In North American and European societies, the 1960s saw the beginning of the "sexual revolution", characterized by increased public interest and discussion about sexuality, recognition of the value of sexuality in people's lives, the separation of sexuality from reproduction by increasing availability of contraception, the lessening of many social barriers and inhibitions related to sexual behavior, and social acknowledgment of women's sexuality. In this era, genes and hormones were thought not to have a strong influence on any aspect of human psychosexual development, gender identity, or sexual orientation. The 1970s and 1980s were perhaps the decades when surgery and surgery-supported sex reassignment were most uncritically accepted in academic opinion, in most children's hospitals, and by society at