Sexuality scholarship demonstrates the historical production of the male/female sexual binary in scientific discourse. While some scholars have applied the insights of this scholarship to modern Islamic contexts, studies on intersex persons (khuntha) in premodern Islamic societies often underestimate the nonjudgmental character of legal and medical discourse. Based on analysis of medical, lexicographical, and juridical discourse from the eighth to the eighteenth centuries, this article argues that the dominant strand of this discourse tolerated ambiguity and flexibility regarding nonbinary sex embodiments. This discourse widely recognized three to five sexual categories, including khuntha mushkil, a “medial sex” with intersex physical characteristics difficult to categorize as predominantly male or female. Jurists and physicians treated such persons as indeterminate or complex, even when assigning them a “provisional” legal sex. Premodern Islamic experts largely understood intersex as ambiguous and mutable when addressing inheritance, prayer, burial, dress, travel, and marriage.