[MonikaT]

I don't understand the line, either! As far as I can tell, he's just repeating himself!! How can one be unethical and the other be extremely unethical when they're both the same thing??

I think you misunderstood.

He said "Not Surgically Assigning a Binary Gender" is Unethical and "Allowing the child to remain as they are until they decide for themselves" (In Addition to not surgically altering them) is Extremely Unethical.
(Per his Opinion at least)

In simplest terms, the doctor is saying, "You're damned if you do, and you're damned if you don't." However, I think he may have the level of gravity backwards. While I'm led to believe they can now do all kinds of genetic testing to better determine which direction to go, I think it is worse to assign a gender than it is to allow the child to grow up and choose or not choose. After all, we do live in a gender binary though society is beginning to accept that it is more of a spectrum than a binary.

Please understand I am not trying to be hurtful, but what happens in the school locker room? A child is born with ambiguous genitalia. The parents give their child a unisex name like Taylor. Little Taylor grows up wearing clothes that aren't distinctly female or male, though most "male" clothing is sort of unisex in that females wear jeans and T-shirts, too. When Taylor starts pre-school or kindergarten, everyone wants to know if Taylor is a boy or a girl. How does Taylor answer? About the time puberty kicks in, the school starts making kids get naked in front of each other in the locker room. Girls use one locker room, boys the other. Which one does Taylor use? Kids are incredibly cruel. Teenage girls are the worst. Taylor's life is going to be hell if there is always a special locker room, a special rest room, a special shower for Taylor.

From the perspective of always being a special case that doesn't fit in either category, Taylor could suffer great psychological harm, thus the statement it is unethical to let the child decide. Conversely, given that doctors only guess right 15% of the time, it is also unethical to choose for the child at birth, or at least before school age. There's no inherently right answer, but of the options, one is least worst. I would argue that with adequate counseling and lots of family support, the best choice is to let the child decide. It's not ideal, but it is better than surgically-induced GID. So, the doctor got it backward, in my opinion. Who knows? The child may decide to remain as is, and that is certainly acceptable, too.