A total of 6,441 International, or Intercountry, adoptions were processed in the 2014 fiscal year.   Although the Child Citizenship Act of 2000 allows internationally adopted children of U.S. citizens to acquire citizenship automatically, the process of acclimating to life with a new family in a new country is not always smooth.

Some adopted children have experienced significant early trauma that has affected their physical and emotional development. This can include: abuse or neglect, substance exposure in utero, multiple transitions in caregivers, and/or poor institutional care (Fujimura, 2005; Gleitman & Savaya, 2011; Nickman, et al., 2005). Although much has been written about poor pre-adoption conditions in orphanages abroad, and the lack of available foster families in the child’s home country, some advocates and researchers question whether or not adoptees ultimately benefit from placement with families in the United States (Jones, 2010; Fujimura, 2005).

At one end of the debate, some adoptees and advocates have spoken out against the forced racial and cultural assimilation they feel that they are subjected to with their American families, while others assert that children adopted internationally lead better, healthier lives than those in institutional care (Lee, Seol, Sung, & Miller, 2011). As mental health professionals and parents, how can we better understand adoptees’ multifaceted identities and unique cultural context?

In her book on transracial adoption Sandra Patton writes, “The situation of adoption- regardless of whether we know our birth families or not- locates adoptees in a curious position in relation to assumptions about kinship, culture, and where one belongs…Our origins are somewhere else… We don’t so much belong to one family or the other, as to both our ‘native’ and ‘foreign’ cultures. Yet our lives elude traditional definitions of self, family, and culture.

These eloquent words speak to the conflicts and ambiguity faced by international adoptees as they develop a sense of identity and belonging. One factor that may impact sense of self is the subjective feeling of rejection or loss. These feelings can be triggered when children are made aware of the existence of their biological parents and mourn the loss of their adoptive parents as their “natural” parents (Leon, 2002). Grieving may be an important facet of the adoption experience. For children it could include grieving the loss of past caregivers, their birth country, their culture of origin, or the idea that their current parents are their birth parents. As children develop more sophisticated cognitive capacities, they may begin to ruminate on the decisions made by their biological parents, which can stir up difficult feelings of abandonment, self-criticism, and low self-worth (Brodinsky, 2011). During childhood and adolescence, building identity can be a complicated process of understanding one’s biology, parenthood, kinship, and culture. This may be difficult for adopted children, as they must learn to appreciate and define these ideas within a society that views them as innately connected rather than multidimensional.

Research suggests that adopted children benefit from openly discussing identity, race, culture, and discrimination with their parents. This is believed to assist children in building a strong sense of identity and helping them develop the skills needed to cope with societal prejudices. Research and clinical work also suggests that children who are exposed to positive cultural role models and positive messages about their heritage develop more secure and cohesive identities (Brodinsky, 2011). Clinicians can help support children and families by encouraging parents to be open, honest, and emotionally available to discuss difficult topics (Brodinsky).  It is also important for both children and parents to understand that there is not one correct or “healthy” way for a child or family to identify themselves or circumstances of their adoption. As families navigate their way through this difficult process, they may find it helpful to seek outside support. Many children and families benefit from individual therapy, family therapy, or support groups. Although adoptive parents cannot change the stressful aspects of their child’s history, they can be a loving, stable, and accepting part of their future.


Brodzinsky, D. M. (2011). Children’s understanding of adoption: Developmental and clinical implications. Professional Psychology: Research and Practice, 42, 200-207.

Fujimura, C. K. (2005). Russia’s abandoned children: An intimate understanding. Westport, CT: Praeger Publishers.

Gleitman, I., & Savaya, R. (2011). Adjustment of adolescent adoptees: The role of age and exposure to pre-adoption stressors. Children and Youth Services Review, 33, 758-766.

Jones, S. (2010). The ethics of intercountry adoption: Why it matters to healthcare providers and bioethicists. Bioethics, 24, 358-364.

Lee, R. M., Seol, K., Sung, M., & Miller, M. J. (2011). The behavioral development of Korean children in institutional care and international adoptive families. International Perspectives In Psychology: Research, Practice, Consultation, 1(S), 3-18. doi:10.1037/2157-3883.1.S.3

Leon, I. G. (2002). Adoption losses: Naturally occurring or socially constructed? Journal of Child Development, 73, 652-663.

Nickman, S. L., Rosenfeld, A. A., Fine, P., Macintyre, J. C., Pilowsky, D. J., Howe, R. A., et al. (2005). Children in adoptive families: Overview and update. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 987-995.

Patton, S. (2000). Birthmarks: Transracial adoption in contemporary America. New York: New York University Press.