Circumcision and the Internationally Adopted Child

Upon arrival to your home, it is recommended to schedule an introductory medical evaluation with your pediatrician within the first week. This is to ensure there are no acute medical conditions that may require immediate care. A full post adoption evaluation is usually performed at a later date, once the child has become situated in his or her new environment. A frequent topic of discussion that may arise at one of these visits is the issue of circumcision and when to have it performed.

Like most internationally adopted boys, the majority may not have been circumcised in their country  of origin. Although the procedure itself is quite simple, the social, emotional, and religious aspects of circumcision can be often complex. It is commonly performed in American boys and in those from traditional Jewish and Muslim families. The procedure usually takes place at the hospital, within a few days of birth. It may also be performed later during a religious ceremony.

Reasons for circumcision generally fall into one of three categories: To address an immediate medical condition, prevention of future disease or as an act of religious dedication. Currently, approximately       80 percent of US males have been circumcised, mostly for non-religious reasons. Recent data shows that frequency of newborn circumcision has fallen in the USA from roughly 90 percent in the 1950s to about 55 percent today. Prevention of disease is the second most commonly given reason for circumcision after religious reasons, although the evidence that it has any beneficial effect on future health is uncertain.

Potential medical benefits of newborn male circumcision are a reduced incidence of urinary tract infections in the first year of life, reduced risk of penile infection, and possibly reduced incidence of penile cancer (all rare conditions, even in the uncircumcised male). Possible risks and complications of the surgery are those of other minor procedures; bleeding, infection, and scarring. Circumcision performed after the newborn period typically requires a general anesthetic and involves the risks of anesthesia. One major consideration is the potential effect of a traumatic experience, surgery, on the child’s ability to bond to his adoptive family.

In general, elective surgery should wait until your child is settled in your home. It is suggested that adoptive parents who are interested in circumcision consider the timing of such a procedure. It may be prudent to delay the operation for six to nine months after adoption. This waiting period encourages the adoptive family to work on attachment and bonding. It allows the child, in some cases, to develop the cognitive and language skills to understand what is happening to him. Furthermore, the risks associated with general anesthesia are somewhat decreased after a child’s first birthday.

To children, hospitals can be quite intimidating. Doctors perform blood tests and procedures which can be uncomfortable and sometimes painful. The adopted child may also become separated from his parents at times during the hospital stay. These stressful situations can negatively influence the newly adopted child and raise concerns over whether such non-essential procedures should be performed in the first place.

Many families choose to combine circumcision with other surgical procedures that their new child may require, for example; ear tubes, hernia repair or removal of tonsils and adenoids. Their patience may result in a safer and less stressful surgical experience for both adoptive parents and child.

Written By Nicholas Rogu M.D. of Adoptiondoctors.com and Adoptioneducationclasses.com.
Dr. Nick Rogu is a General Pediatrician that works at RBKPediatrics.com and has a special interest in children with developmental disabilities.

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