My daughter is also 4 and has not had surgery.  She, has asked why she looks different than me and I tell her some girls have little clitorises and some have big clitorises.  She accepts this for now.  I believe that my daughter will need counseling and possibly your granddaughter with someone they trust.  Who knows?  Also, Margret thank you for posting.  Most of the time I know we made the right decision to let her decide on surgery, but every now and then I wonder.....but then seeing posts like Aimee’s on the controversy board let me know she’ll be okay.  (Aimee wrote something about the fact that she didn’t have surgery until 5 when her parents could tell her gender and that just because she had a large clitoris it didn’t make her feel any less a girl.)  I believe that with or without surgery there is the potential to be hurt and need counseling.  The difference is that with surgery the choice in gone forever and possibly lack of sensation.  Take care.  Julia