International Adoption, “Early” Puberty, and Underrecorded Age

Abstract

* Abbreviations: PP — : precocious puberty Internationally adopted children appear to reach puberty at a relatively young age1 and to have a high risk of early puberty including very early or precocious puberty (PP), that is, pubertal development at <8 years of age for girls and at <9 years of age for boys.2,3 However, there can be uncertainty over the chronological age of adopted children, raising the possibility that the seemingly elevated risk of early puberty is due to some children having a significantly underrecorded age, perhaps of up to 2 years or more. If a child’s birth date is unregistered and relatives are uncertain, or if the child is abandoned, an age will need to be determined to complete adoption formalities. There is no certain method of determining a child’s age, which makes errors in either direction possible. However, it may be suspected that underestimates are more likely than overestimates, either to facilitate placement with adoptive parents, who tend to favor younger children, or because neglected and malnourished children will be less advanced and smaller than the typical child of their age. Researchers into early puberty freely admit that there is an element of uncertainty over birth dates; 1 study reported that a child who entered the recipient state apparently aged 5 years and who later developed early puberty may have been 2 or 3 years older than his recorded age4; another classified 25.4% of internationally adopted girls as having an uncertain date of birth.1 Nonetheless, most researchers have tended to discount underrecorded age as a systemic explanation of the elevated risk of … Address correspondence to Peter Hayes, PhD, Faculty of Education and Society, University of Sunderland, Sunderland SR1 3PZ, UK. E-mail: peter.hayes{at}sunderland.ac.uk