When I was expecting my second child, my mother asked more than once: Couldn’t she simply call the doctor’s office to ask, girl or boy? She would keep it a secret. She promised.

As we did with our first pregnancy, my husband and I had chosen not to find out the sex of our baby, frustrating relatives who wanted to be able to buy pink or blue, to inscribe a name on a baby blanket, to begin picturing outings with a girl in a sundress or a boy in a baseball cap. We wanted the surprise at delivery. And we wanted the sex of our baby not to matter quite so much — not when it was in utero, and not later, either.

We were swimming against the tide, of course. The constant first question for any pregnant woman is, “What are you having?” And more families seem to be hosting “gender reveal” parties, with decorations that play on stereotypes (Guns or glitter? Ties or tutus?) and the baby’s sex revealed by the color of cake frosting or balloons released from a box or Silly String sprayed on expectant parents.

In a perspective piece published Friday in the journal Pediatrics, titled “The Gender Reveal: Implications of a Cultural Tradition for Pediatric Health,” Dr. Leena Nahata asks whether such parties -- though well-meaning -- are a symptom of society’s overemphasis on gender.

“Are these traditions truly harmless?” she writes. “By celebrating this single ‘fact’ several months before an infant’s birth, are we risking committing ourselves and others to a particular vision and a set of stereotypes that are actually potentially harmful?”

Nahata is a pediatric endocrinologist who trained at Harvard Medical School and for a year led the program on differences in sex development at Boston Children’s Hospital. She’s now part of the THRIVE program at Nationwide Children’s Hospital in Columbus, Ohio, focused on sex development and gender concerns.

Nahata works with families whose children are born with anatomic differences in sex development, which can mean that their sex is unclear at birth. Such variations are rare, occurring in roughly 1 in 5,000 births.

But her perspective on what can happen when families set their expectations based on gender has broader implications. Our conversation, lightly edited:

Chelsea Conaboy: When did gender reveal parties first raise a red flag for you?

I happened to be pregnant with my own first child at the same time as I was leading the differences of sex development program in Boston. We ultimately chose not to find out what we were having until my baby was born. It just clued me in a little bit more, because I realized how many people ask you, 'Do you know what you’re having?' That’s not wrong. That’s society. I probably did it all the time before, too. I think I’m just more conscious of it now.

Because I was so involved with families who had babies that were born where [the sex] just wasn’t 100 percent clear, it made me realize you have these 10 months of pregnancy where, if you choose to find out or not, it’s constantly being asked of you. You’re constantly thinking about that aspect of your baby.

The gender reveal has become a big thing. I have been struck by how elaborate these customs have become.

It’s very much a custom of our time, with videos of the big moment shared on social media.

What’s interesting to me is, when you have a baby shower, you’re just celebrating the birth of your baby. But when you’re having a gender reveal, the specific focus of that tradition is really the celebration of finding out whether this baby is a boy or a girl.

Having that experience of having people ask [about the baby’s sex] all the time, at the same time that you’re seeing these families in turmoil because they were expecting one thing and then it was something else, or they were told that it wasn’t clear – it just made me realize how much of a focus it really is.

There is an expectation that you should know and focus on gender from the very beginning.

That’s exactly the point. Even if you choose not to find out, it’s a constant topic of conversation. Nobody asks, 'Is the baby healthy?' It’s a suboptimal setup for situations when the baby is born and, as clinicians, we’re saying, 'You know, the most important thing is that your baby is healthy.'

What do you say to people who think you are just pooh-poohing something that is supposed to be fun and lighthearted?

One thing to keep in mind — and it’s easy to lose sight of this when you do this work — is that these conditions are rare. So they’re not going to affect the grand majority of people. But I just think, as a society, we just have to be a little bit more cognizant of -- you know, there are more people coming out with gender concerns. We want to be more sensitive to that. Maybe not everybody thinks that, but many people do and are not even realizing how these types of traditions may play in to that.

You talked about working with families in turmoil. What process do you go through with them when they have a baby who is intersex, or who has differences in development?

If you think about the delivery experience, the first statement about what that baby is will be made in the delivery room. Often there is an exclamation of, 'It’s a boy!' 'It’s a girl!' And then sometimes that exclamation isn’t made, because somebody feels like maybe it’s unclear.

So those conversations often start in the delivery room. Or in the newborn nursery when providers are examining the baby. By the time we as an interdisciplinary team see a family, they may have had multiple conversations with different people about the gender of their child, or sex -- different people will argue those terms differently.

Oftentimes, what we will say to them is, 'We need to undergo a thorough evaluation to really understand what’s going on.'

We use all the information we have to make the best [sex] assignment at birth, and that child grows up and, once they can express themselves, they may say, 'That’s not how I feel.' And we do tell families that that’s a possibility, with kids who are born with anatomic differences. We tell them, 'We are all coming together to make the best possible decision for your child. Your child can’t be part of that decision right now. Your child may grow up and feel differently, and we have to be open to that and we have to support them.' But that’s hard for families.

I imagine that can be a comforting message in some cases and a really discomfiting one in other cases, because there could be uncertainty for years.

Yes. And some people really struggle with that.

What do you suggest to parents-to-be who are aware that their child could fall somewhere on a gender spectrum and who want to be thoughtful about how they approach this topic?

The research shows that, for kids with any sort of gender concerns, if they have supportive families and supportive peer groups, they’re going to do so much better. I think that’s the bottom line. Any time your child has a medical condition or anything that makes them any bit different than the mainstream, you know there are battles that kid may face. All you can do is try to provide them as supportive an environment as possible.

I am in no way saying get rid of [gender reveal parties]. I just think if we look at how things have evolved, it is just getting more and more elaborate. And I think the more elaborate something gets, the more of a focus it is. We just, as a society, have to be careful about that.

People may have a gender reveal and still internally say, 'You know what? We realize that gender is one aspect of our child. And we’re going to do this party because this is what people do and it’s for fun, but we also recognize that sometimes it’s not going to be what we expect either at birth or at some point in life, and it’s just one aspect of our child.' I think that’s really the most important thing.

Chelsea Conaboy is a freelancer who writes often about health care. Find her at chelseaconaboy.com and on Twitter @cconaboy.