Behind the international adoption journey

Susan Branco, PhD, has always had two birthdays. But until she reunited with her Colombian birth family in 2021, she and her adoptive parents did not know about the second one, the actual date of her birth, which falls about 6 weeks earlier. She also learned that she has two siblings, a shock for someone who was raised as an only child in suburban Philadelphia.

While her White adoptive parents were loving and supportive, Branco had yearned to know about her birth family since she was a little girl and started searching for them in her 20s. “It took 24 years of active searching,” said the 51-year-old, an associate professor of clinical mental health counseling at Palo Alto University in California, who studies transracial adoption.

The 2021 reunion at the airport in Bogotá, joyful with flowers and tears, proved to be the next stage in what researchers frequently describe as a lifelong journey for transracial international adoptees. Branco, who has conducted research involving Colombian adoptees while pursuing her own familial search, is still getting to know her birth mother and adjusting to her new status as the middle child with an older and younger sibling. Her therapeutic journey also has occurred in stages. When Branco sought therapy earlier in life, she was not asked about any adoption-related challenges—not an unusual omission, particularly years ago, she said. More recently, she found a psychotherapist trained in working with transracial adoptees. “You go through life with one identity for yourself and one understanding of what family is and what it means,” said Branco, who these days celebrates both her Colombian and U.S. birthdays. “And then all of the sudden, as a middle-aged adult who has their own family and is married and has parents who are aging, now I’m incorporating this whole other family into my life.”

While U.S. adults have long adopted children from other countries, with the initial surge occurring after the Korean War, psychological insights into the lived experience of these international adoptees have only begun to coalesce in the last few decades. Since international adoption rates peaked in 2004, many of these children are now well into their adult years, and researchers have continued to study the acculturation and other adjustment challenges that they may face.

International adoptees can be more vulnerable to some mental health difficulties compared with non-adoptees, including eating disorders, depression, and anxiety disorders (Strand M., et al., Epidemiology and Psychiatric Sciences, Vol. 29, 2020opens in new window). Other research indicates that mental health challenges may be related to color blindness—the myth that racism can be avoided by disregarding skin color—when exhibited by adoptive parents, as that can make adoptees feel isolated in managing society’s racial stereotypes (Wiley, M. O., American Psychologist, Vol. 72, No. 9, 2017opens in new window).

To provide effective therapy, psychologists must be prepared to assist adoptees as they strive to process the contradictory experiences that they may have encountered, according to psychologists who study international adoption, some international adoptees themselves. While they may love their adoptive parents, they may still grieve the loss of not only their birth family but their home country and language. They may require support with cultural and, in particular, racial socialization, as research indicates that White parents who adopt children transracially—children whose racial or ethnic background differs from their own—may be less able to discuss issues involving bias or racism.

In some cases, transnational, transracial adoptees of color may not grapple with what Minnesota counseling psychologist Richard Lee, PhD, describes as the “transracial adoption paradox” until they move farther away from their largely White home and community for college or other opportunities. At that point, they may recognize for the first time that being raised with the privileges of a largely White community has not prepared them for living in a culture where they are perceived based on their skin color, said Lee, a psychology professor who also directs the Asian American Studies Program at the University of Minnesota.

“You’re in a setting where people don’t know about your family history and experiences growing up in a White family,” Lee said. “So, they look at you and they see your brown skin and they make assumptions about your ethnicity and race and the experiences that you had that are often associated with your ethnic and racial background.”

Prior to 2000, most psychology researchers applied a more “color-blind” prism to international adoption, similar to the framing that adoption agencies used at that time, Lee said.

“They were really trying to make the case that the color of one’s skin, the cultural background of a child, whether it’s the same or different from the family, is less relevant than just growing up in a warm, nurturing home,” said Lee, who published one of the first reviews of ­transracial adoption research in 2003 (The Counseling Psychologist, Vol. 31, No. 6, 2003opens in new window).

But the lived racial and ethnic experiences of adopted children were largely missing from that earlier research, Lee said. He credits adoptive parents and earlier generations of adoptees with playing an influential role in highlighting the importance of cultural socialization by establishing cultural camps and building related communities in the 1980s and 1990s, particularly involving Korean adoptees.

In recent years, researchers have delved more into how much ethnic and racial socialization adoptive parents do provide to foster the adoptees’ ethnic identity and prepare them for bias and racism. Between 2007 and 2014, Lee and his colleagues followed 116 internationally adopted Korean American children and adolescents across the 7-year span. They found that the parents of the adolescents—who were ages 13 to 20 when the follow-up interview was conducted—reported higher levels of parental ethnic socialization than their children did. Researchers also learned that those parental ethnic socialization efforts decreased as their children entered adolescence (Developmental Psychology, Vol. 53, No. 11, 2017opens in new window).

Like Branco, many international adoptees are now adults, given the broader trends. Adoptions to the United States, which peaked at nearly 23,000 in 2004opens in new window according to U.S. Department of State data, have significantly declined as the primary sending countries—China, Russia, Guatemala, South Korea, and Ethiopiaopens in new window—made it more difficult to adopt, according to Pew Research Center data published in 2017. The reasons vary, ranging from concerns about fraud and corruption in Guatemala to a diplomatic rift with Russia. By 2019, prior to the COVID-19 pandemic, the total number of adoptions to the United States had dropped below 3,000.

As these children become parents themselves, psychologists have begun to study how they provide socialization to their own children. Parents who have biological children report that it can be a powerful experience, a step toward engaging with their birth roots, said Xiang Zhou, PhD, an assistant professor of counseling psychology in the College of Education at Purdue University. Zhou and colleagues have conducted 51 qualitative, in-depth interviews with Korean American adults who became parents biologically or through adoption (Family Relations, Vol. 70, No. 2, 2021opens in new window).

One participant described how having their own biological child “is almost like looking into a mirror backwards,” Zhou said. “By having a child, they can finally look into their ancestry, to their past.”

Most of the adults, though, reported feeling hampered in helping their children, having received limited cultural and racial socialization from their adoptive parents, the researchers found. Still, some reframed their new parenthood as providing a second chance, Zhou said. “Becoming a parent offered them another window, another opportunity to start learning about Korean culture that they may not have been able to as a kid.”

Psychologists may find that therapy enables adoptees to share their struggles with bias and discrimination, which they may not have felt comfortable broaching with adoptive parents and other family members. Children adopted transracially from countries outside of the United States likely have encountered another type of verbal assault as well, called an adoption microaggression, said Amanda L. Baden, PhD, a professor of counseling at Montclair State University in New Jersey who was adopted by White parents from Hong Kong in 1969. With transracial adoption, she said, “the adoption is visible to other people immediately,” given differences in facial and other physical features from other family members. “So, people are having adoption trigger questions as soon as they see that,” she said.

Baden developed and began to study adoption microaggressions after learning about research involving racial microaggressions (Sue, D. W., et al. American Psychologist, Vol. 62, No. 4, 2007opens in new window). Microaggressions of any type are rooted in some form of stigma or misunderstanding, including adoption microaggressions, Baden said. “Adoption is widely seen as a second, third, or last choice for forming a family,” she said, adding that “people have widely inaccurate assumptions about what adoption means and how it works.”

In her research, Baden described common themes involving adoption microaggressions, which can be directed at children adopted domestically or internationally as well as their adoptive parents. (Adoption Quarterly, Vol. 19, No. 1, 2016opens in new window). These microaggressions can persist well beyond childhood, according to other research that Baden was involved with, based on interviews with 11 transracial adult adoptees. One type of microaggression is rooted in the misperception that adoptees must be a “bad seed” in some way, with emotional or developmental traits that could cause strain within the adoptive family, she wrote. Another microaggression—that they should be grateful—places weighted expectations on the adoptee (Journal of Family Psychology, Vol. 36, No. 8, 2022opens in new window).

“It’s a complicated thing,” Baden said. “Adoptive parents don’t adopt someone because they want to hurt them.”

“But adopted children sometimes feel a lot of pressure to be very loyal,” Baden continued. “They get the message very clearly from family, from society, from every book and movie that has an adoption story … That they’re supposed to be grateful for their being rescued from this terrible situation.”

Baden also has introduced a new type of microaggression, called adoption microfiction. During the adoption process, the true circumstances around the adoption “can be altered purposefully, or even accidentally,” Baden wrote, resulting in inaccurate information. Or, some parents attempt to hide that the child was adopted (Adoption Quarterly, Vol. 19, No. 1, 2016opens in new window).

Meanwhile, efforts by White parents to understand racism and prepare their children for bias and discrimination may not be as robust as they perceive. In one study, involving 30 families with White parents and at least one child adopted from Korea, just nine of the families acknowledged that racial and ethnic differences had an influence on their family. Six rejected that premise and the remainder held a mix of views (Kim, O. M., et al., Journal of Adolescent Research, Vol. 28, No. 1, 2012opens in new window). Other work, based on interviews with 95 pairs of Asian American adolescent transnational adoptees and their parents, found that the parents underestimated their children’s personal exposure to racism compared with what the children themselves reported (Langrehr, K. J., et al., Asian American Journal of Psychology, Vol. 10, No. 2, 2019opens in new window).

For Kimberly Langrehr, PhD, one of the study’s authors, those findings resonate with her clinical experience, working with families who have adopted internationally, along with her personal perspective. When she was adopted in 1981 from South Korea by a family living in rural Wisconsin, she noted, her parents were given the guidance prevalent at the time—to raise her as though she were White.

In Langrehr’s clinical work, she’s noticed that parents are more prone to focus on building their child’s ties to their cultural heritage and less comfortable with exploring their vulnerability to racism. Thus, it can be quite painful when their child comes home talking about racial taunts and slurs, said Langrehr, an associate professor of psychology at Roosevelt University in Chicago. “A lot of times I feel like their shock speaks to the parents’ own lack of racial socialization themselves to know just the prevalence and pervasiveness of racism on a daily basis,” she said.

Doctoral student Inah Jeong, who grew up as Maggie O’Brien, described college as a pivotal turning point. During their childhood years in suburban Minneapolis, Jeong’s White parents tried to connect Jeong with Jeong’s Korean heritage, suggesting that they attend a Korean cultural camp one summer. But Jeong declined, preferring to remain at home and play soccer with friends.

Once in college, Jeong joined a Korean drumming group. They began to learn the language and identify more as Korean, including using Inah Jeong more frequently—the name listed in the Korean adoption papers.

“Still even to this day, it’s kind of hard for me to say ‘Korean American,’” said the 26-year-old, who is pursuing a doctoral degree in learning sciences at the University of Illinois Chicago. “Because I feel that holds with it the story of growing up in a Korean American family.”

Researchers are still sorting out why international adoptees experience more mental health difficulties. Some studies point to preadoption factors, such as neglect at adoption facilities and separation from early attachment figures, as potential contributors to later challenges (Palacios, J., et al., Research on Social Work Practice, Vol. 29, No. 2, 2019opens in new window).

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Amid the pandemic, Chinese transracial adoptees in the United States described how they were psychologically buffeted in various directions, according to a qualitative study involving interviews with 20 young adults who were born in China then adopted by White families. Like others with Chinese heritage, the young adults reported discrimination amid the fears over COVID-19. But they still lived in a primarily White culture, with parents who sometimes denied their pandemic-influenced racial experiences. Eight subthemes were identified, among them an increased sense of being a perpetual foreigner in the United States, a sense of in-betweenness amplified by sociopolitical tension, and increased thoughts of birth parents (Wing, H. M., & Park-Taylor, J., Asian American Journal of Psychology, Vol. 13, No. 3, 2022opens in new window).

Psychologists who want to better meet the psychological needs of international adoptees should first make sure that they are not overlooking them among their existing patients, Zhou said. As part of the intake process, psychologists should routinely ask patients to detail their relationship to their caregivers, whether it’s biologic, adoptive, or some other type of family structure, he said.

Therapists should not assume that someone is seeking counseling for reasons related to their adoption history, but they should keep that additional context in mind, Lee said. For example, an adolescent may seek help for depression, but over time it becomes apparent that their depression is influenced in part by strain within their adoptive family over their desire to seek out their birth family. Therapists should stay especially alert, Lee advised, to the rethinking of identity that can occur during life transitions, such as starting college or becoming a parent. For example, a Korean American parent may choose to reengage with their culture and ethnicity after having a child, which may change the dynamics within the partnership if the other parent is White.

Langrehr, who counsels young adult adoptees from China and Korea, said that these adoptees have traditionally tended to keep their experiences with racism to themselves, regardless of how strong their relationship is with their adoptive parents. But that’s changed somewhat, she said, amid more public discussions about microaggressions and more overt racism against Asian Americans during the pandemic. “I see a lot more adult adoptees wanting to have conversations with their parents and realizing that they have been sitting on some resentment over the years,” she said.

In this regard, therapists can serve as a sounding board, working through some of these emotions with the adoptee in advance, Langrehr said. What do they want to express and how? Also, what are they trying to achieve? While expressing one’s feelings is important, she added, it does not always lead to the critical conversations that adoptees crave. Instead, they can just end up feeling minimized and ignored as a person of color.

Psychologists also can provide guidance and support for the adoptive parents, who may initially be defensive as their color-blind perspective is disrupted, Langrehr said. “It can be absolutely heartbreaking for them,” she said. “What I often tell adoptive parents is, ‘This is not the end though. You also have the opportunity to still grow should you want to.’”

In a similar vein, Branco suggests that therapists talk with patients about what they want to achieve during a birth family search. Her research has identified strong emotions, including grief and loss, among individuals who have reunited with their birth families as they contemplate what they have missed out on by growing up so far away (Adoption Quarterly, 2023opens in new window).

Therapists should prepare patients for a range of outcomes if they decide to try to meet their birth parents or other family members, Branco stressed. The birth parents may no longer be living or may not be ready to connect with their biological child. The search can disrupt existing relationships, Branco found in her research. “Sometimes adoptive family members felt jealous or felt angry at them or wanted to be over-involved.” Moreover, there can be notable disconnects between the stories that the adoptees first heard and what they later learned.

In one study, involving interviews with 17 adult adoptees from Colombia, eight of them reported inaccurate information or challenges related to their birth family search. In one case, the birth mother described being coerced into adoption by family members. In another case, the search was delayed because the adoptive parents withheld the birth mother’s information for years (Branco, S. F., & Cloonan, V., Genealogy, Vol. 6, No. 4, 2022opens in new window). When adoptees learn about such a microfiction, Branco suggests that therapists set aside their own preconceived notions about international adoption to acknowledge and validate what the adoptee is sharing.

In Branco’s personal search, she felt supported by her adoptive parents. But she had little to work with because she did not know her birth mother’s name. It was not until a DNA match connected her to a cousin, who had also been adopted by a U.S. family, that they were able to piece together the genealogy. The cousin, adopted more recently, had the name and a government identification number for her birth mother, the sister of Branco’s mother.

The story that the orphanage told Branco’s adoptive parents proved to be a microfiction, she said, about her mother living in a home in the Andes mountains that cared for unmarried college students. “They had no reason to believe that it wasn’t true,” Branco said of her adoptive parents. “But it wasn’t the story at all.”

Branco declined to share more specifics, other than to say that her mother had been underage and not in college. “It was not a happy scenario,” she said. “I don’t think any of the scenarios are happy though, ever, in adoption.” But it gave her a lot of peace to know the truth, she said, and to reclaim her birth story.

As Branco gets to know her birth family on her mother’s side, her path has been eased by her proficiency in Spanish and familiarity with Colombia, which she had visited nine times prior to 2021. Although they do not yet have the degree of shared experiences and history that she has already built with her adoptive family, they are working on it.

“Our commitment is, we’re going to have to make memories,” she said. “And we’re going to commit to being in each other’s lives.”