Tips for Adoptive Parents

In response to our Tips for Parents, one woman wrote to say that she was adopting a child who had already had cosmetic genital surgery, and could we write guidelines for people in her position?

First off, we want to thank all parents—adoptive, foster, biological, and other—who provide love and care to children with intersex conditions. Good, open love is what all children need.

Now, take a look at our Tips for Parents. We would recommend that you follow the same basic idea: avoid being subject to the concealment-centered approach (which features incomplete information and uninformed decision-making) and insist that your child receives a patient-centered approach, one featuring honestly and openness. More specifically:

Recommendations 1-6 of the “Tips for Parents” apply to all situations:

  1. Get the exact diagnosis (and keep checking to make sure they and you have it right).
  2. Get copies of all medical records, including lab results and images.
  3. Limit examinations of your child to those necessary for the child’s well-being.
  4. Get names of other parents to talk to.
  5. Get referrals to psychologists, psychiatrists, and social workers who can act as resources to you and your child.
  6. Sort out medical concerns from psycho-social concerns. Address the medical concerns as necessary.

Recommendation 7 still applies to you; just because your child had genital surgery doesn’t mean the gender assignment (as boy or girl) that the doctors gave will be the one the child feels. Be open to the possibility that the child will need to have his or her gender label changed in order to get his or her public gender to match what she or he feels. Talk with your medical provider about this.

Recommendations 8-11, which talk about surgical options, may still apply to you, because you may find that your medical providers are suggesting more surgery. (This is pretty common; you’ll often hear “We can make things look a little better.”) So go back to those recommendations as necessary; ask about why surgery is necessary, what evidence there is that it works, why you can’t wait for the child to decide for herself or himself, what the particular surgeon’s outcomes are for such surgeries, and ask to be introduced to adults who have had and not had the interventions recommended.

Most importantly: Be open and honest with your child about what has happened and what you know and don’t know.

Here’s something interesting: As we’ve done our work at ISNA in the last 10 years, a lot of social workers have pointed out to us that the central mistake made in adoption over the last many years is the same mistake made in cases of intersex: an assumption that children would be better off if they didn’t know the truth. So lying, deceiving, and withholding of information has been used because it was mistakenly believed to be beneficial for children. The truth is, people are better off knowing the truth about what has happened to them. It gives them the ability to take control of their histories and their bodies, to feel like they are their own.

We hope this is of help. Please feel free to write to us to give us feedback.