I am a father with an adopted child and you are correct. Medical treatments should always be the first option and adoption only the last resort. Sometimes medical science can't help. Our reason for adoption was infertility that could not be helped with in vitro methods.

Many people like the person you replied to seem think that adoption is easy or inexpensive option. It's neither. It's far more expensive than in vitro fertilization and it takes years (in our case 5 years with constant running costs, training, and bureaucracy). Even then it's not certain that you get to adopt a child.

Because I have an adopted child (she's now 8, but was 5 when adopted by us) I've done a lot of research on the problems in adopted children. Typically the severe psychological problems directly related to the trauma of adoption (i.e. not inherent psychological issues which may occur due to abuse before adoption or naturally like in any child) are a result of poor handling of the child's care in the first couple of years after adoption.

It's a very delicate situation and it is imperative that the parents get well trained to recognize the signs of real trouble but at the same time don't burden the child with e.g. psychologist after perfectly normal reactions.

There is no cookie-cut solution as each child is different. Some kids fully embrace their new life from the start and don't even want to talk much about their pre-adoption life. You need to respect the child's wishes in this respect or you're hurting him.

Our child was the former. She eagerly and voluntarily preferred her new Finnish name over her original Indian name (still one of her legal names), learnt perfectly good Finnish in 7 months (quite a feat considering how difficult our language is), and refuses to talk in her native tongue which we know she still can do. She wanted to make a clear cut between her former and new lives. The only thing she misses is her former friends in India (now also adopted abroad), but fortunately we were able to contact one of the families and the kids are in contact over the net.

On the other hand, some kids need to process the transition fully and in depth with parents and/or professional help. In this case, the role of the parents is critical and the long lasting trauma results from botching this process.

The parents may not see the need for professional help, or they just don't recognize the special needs of an adopted child. For instance, they overload the kid with too many new things at the same time (too early to school, too many hobbies, too many new friends, too irregular daily schedule,...). You can't raise an adopted child in the same way as his/her peers. There is always a delay in the child's development, but they will catch up later on.

Above all the child needs is to feel SAFE and LOVED. Unexpected events are bad. The adopted children don't initially deal well with surprises, because routine is safety. Feeling safe also includes unlimited food, shelter and unconditional love even when misbehaving.

The child needs be given enough time to process his new life, so overstimulating the child is bad. Both parents need to be present, so a family where both parents are working is a very bad scenario. My wife is a housewife, but I still took months of unpaid leave to make sure our child gets to start her new life with her new father.

The parents should also be willing to swallow their pride and ask for help if in doubt. The early years as a family are critical. If you screw that up, you are going to end up with long term psychological problems. Many parents are blind to the problems, even as severe as the child hurting him/herself, and refuse to acknowledge them and ask for help. That's where the trouble often begins.