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The media’s representation of multiracial and multicultural families formed by adoption has become much more visible during the past 10 to 20 years. TV shows such as This Is Us and The Fosters show transracial adoptive families, and movies such as the Kung Fu Panda series shed light on adoption. Celebrities and even members of the Supreme Court, namely Supreme Court Justice Amy Coney Barrett, have transracial adoptees in their families. 

Counselors who treat transracial and transnational adoptees and study the practice of adoption say it warrants scrutiny. People who are unfamiliar with these types of adoption may view them as an act of altruism to “rescue” a child from unfortunate circumstances, says Amanda Baden, PhD, a professor of counselor education at Montclair State University in New Jersey.  

“But if you ask the adoptee community, they would say there are a lot of abuses in transracial and transnational adoption and there needs to be much more careful and ethical oversight of the practice,” says Baden, a transracial and transnational adoptee from Hong Kong who works with transracial and transnational adoptees in her private practice in New York City. “There needs to be some awareness that adopting a child across race and across culture is a very serious action that can have repercussions.” 

According to the 2022 U.S. Adoption Attitudes Survey, about 1 in 10 adults in the U.S. are adopted, with about 13% through foster care and about 4% from other countries. The survey notes that most adoptions are private, meaning that the child’s birth parents work directly with the adoptive family. 

“Transracial adoption” is the adoption of a person across race, while “transnational adoption,” also known as “intercountry adoption,” is when adoptive parents adopt a child from another country. While adoptions from foster care are a small percent, statistics from the U.S. Department of Health and Human Services showed that the number of transracial adoptions from foster care increased in the U.S. by 58% between 2005–2007 and 2017–2019. This increase outpaced same race adoptions from foster care, which increased by 24%. Black children comprised 23% of all children in foster care in 2019, but during this time period, adoption of Black children from foster care declined, while adoption of white and Hispanic children increased.  

Although it is important not to pathologize adoptees, research has found that relinquishing a child from their birth mother or birth family — at any age — is a traumatic life event. On social media, specifically TikTok, adult international adoptees have been sharing their personal stories about the heartbreak and pain they have experienced through adoption. 

Lauren Fishbein, LPC, owner of Lauren Fishbein Counseling LLC in Boulder, Colorado, says it is important to recognize that media depictions “may not always reflect the nuanced experiences” of transracial and transnational adoptees. “It is essential to listen to the voices and perspectives of adoptees themselves to gain a more comprehensive understanding of their experiences and challenges.”  

Challenges can include adoptees being raised without any racial or cultural mirrors to provide an accurate reflection of their heritage, adoptees having difficulty claiming the racial or cultural identity of their birth parents and having white adoptive parents who are clueless about their own implicit biases.  

While the emotional complexities involved in adoption may contribute to the mental health and identity issues these clients can present, the good news is more transracial and transnational adoptees are entering the counseling profession, says Susan Branco, PhD, LPC, LCPC, a transracial and transnational adoptee from Colombia who counseled adoptees for more than a decade. Branco is an associate professor in the counseling department at Palo Alto University in California and co-developer of the Adoptee Consciousness Model.  

Branco says these counselors have the clinical skills and lived experience to study, treat and support transracial and transnational adoptees as they come into their own consciousness about the impact of adoption on their life journey. 

Racism and Corruption 

Racism is entwined in U.S. history, and this is also true when it comes to the adoption of children of color. Marginalized communities still wrestle with the effects of abusive practices. “We’ve had significant problems in the U.S. with transracial adoption that mirror and reflect the problems we’ve had with race in general,” Branco says.  

The federal government’s Native American adoption program removed Indigenous children from their tribal lands to be adopted by white people for the purpose of assimilation. This is the first example of racist and discriminatory adoptive practices involving Black, Indigenous and people of color, she says. 

In the early 1970s, the adoption of Black children by white families prompted the National Association of Black Social Workers to issue a statement referring to the practice as “akin to genocide,” Branco says. The organization voiced its concern because “the children were losing their cultural connections to their communities,” she says.  

The overrepresentation of children of color in the nation’s child welfare system and foster care also reflects the “systemic inequalities in how families of color are policed regarding child rearing and caretaking,” Branco says.  

The practice of transnational adoption began in the U.S. after the Korean War with Korean orphans being adopted by white parents. The practice grew in the mid-2000s, when children were being adopted from countries such as China, Russia, Colombia and Guatemala. In the past decade, however, transnational adoption has decreased around the world because more countries “are discovering significant corrupt practices and ethical violations,” Branco says, including child trafficking in Guatemala. 

In 2007, the U.S. stopped transnational adoptions with Guatemala because of the country’s corrupt adoption system. Globally, corrupt adoption practices in Ethiopia and Vietnam led to closing transnational adoption. In her research, Branco has found corrupt practices evident in Colombia as well. 

The U.S. is “terribly behind” other Western countries in investigating the harm that has been done in transnational adoptions, she says. Switzerland, France and Sweden have investigated the practice to root out criminal activity.  

Trauma and Grief 

To be effective in counseling this population, Baden stresses that clinicians must approach clients with an adoption-informed lens, noting that clients should not have to teach counselors about the adoption process. 

Counselors should refer to the Competencies for Counseling the Multiracial Population: Couples, Families, and Individuals; and Transracial Adoptees and Families, which were endorsed by ACA’s Governing Council in 2015. 

Part of being adoption-informed is also being wary of trying to establish a direct cause for mental health disorders in clients who have been adopted because of the way they have been stigmatized. For example, Branco says children of color in the foster care system often carry the stigma of being over-diagnosed for reactive attachment disorder and being overmedicated.  

“To be fair, many children who are in foster care have experienced abuse, neglect or trauma, so it makes sense that they may have challenges in response,” she says. However, Branco says it’s important to be cautious when talking about mental health disorders in this population and that counselors should not overlook the social problems that may also be a cause or contributing factor.  

Baden, whose research specialty is transracial adoption and adoption-related issues, says there is evidence that shows that adoptees may present a need for mental health services at a higher rate than non-adoptees. However, mental health professionals don’t yet fully know whether this is because of problems in the practice of transracial adoption or if it’s because there is a lower threshold of referrals for adoptive families who seek mental health services. 

Fishbein, a transracial and transnational adoptee from Chile, says transracial adoptees often report “feeling ostracized and experiencing microaggressions and blatant racism.” This can cause adoptees to “feel utterly misunderstood and not supported by the adults around them,” she explains. “All of this is extremely damaging and traumatic to a person of any age. This can leave adoptees feeling depressed, lonely or even suicidal.”  

Lillian Jiwoo Hexter, a master’s-level clinician with Boston Post Adoption Resources (BPAR) in Brookline, Massachusetts, says in her practice, adoptees present with mental health issues regarding attachment, anger, anxiety and perfectionism. 

“It is difficult to pinpoint whether their mental health issues are related specifically to being adopted or to the life experiences they’ve had before the adoption placement,” says Hexter, a transracial Korean American adoptee. “Research has definitely shown that the experience in utero of intergenerational trauma transmitted through epigenetics has an impact on most people, including adoptees.” 

The counselors at BPAR consider all adopted clients to have been affected by the experience of separation from their biological family, regardless of their age at placement or whether they have conscious memories of life before they were adopted. 

Branco points out that there is now evidence that the cumulative effects of living life as a transracial or transnational adoptee can be traumatic for some clients and that the effects can include trouble sleeping, avoidance behaviors and even complex post-traumatic stress disorder. 

It is essential for counselors to recognize that relinquishment and abandonment are a part of the adoption process and that these clients are likely to have been affected psychologically, Baden stresses. Branco and Baden say the most common emotional responses from being adopted are feelings of grief and loss. 

Regardless of the age that adoptees are placed with their new families, these clients may grieve their birth family and, if they are transnational adoptees, they may also grieve their home country. If their adoptive family has not shared any details about their birth and adoption, these clients may also feel that they have lost access to their past and the possibility of reaching out to their birth family in the future, Fishbein says.  

Fishbein uses a mindfulness exercise to help clients process feelings of grief and loss. This guided exercise encourages clients to get in touch with their inner child to access their true self that lies beyond their grief and loss. Fishbein says the goal is for clients to gain a sense of relief from the pain and a deeper insight into the experience of being adopted.  

“What we’re doing is acknowledging the part of them that was unfulfilled and giving them a chance to get what they needed, to fill the void and soothe their feelings, which helps with grief and loss,” Fishbein says.  

Searching for Identity 

Difficulties in naming and claiming one’s racial or ethnic identity is also a major theme that many adoptees struggle with from childhood to  
later adulthood. 

“Experiencing difficulties with one’s identity is often because transracial and/or transnational adoptees are often raised in isolation from their birth heritage communities, which is something that they cannot control as children,” Branco says. 

Sometimes adult transnational and transracial adoptees feel they are in between cultures. “They may look like they belong to their birth culture from the outside, yet feel like their adoptive culture, which is often white dominant, on the inside,” Branco explains. “They may feel like they do not belong to either culture.” 

This sense of not belonging can lead adoptees to wonder about their own worthiness, Fishbein says. “Adoptees might have feelings that something isn’t quite right, but they can’t put their finger exactly on what it is,” she explains, noting that this can lead them to feeling “less than,” which can affect their self-esteem.  

Becoming Adoption-Informed 

Baden says the most important act therapists can do if they want to treat transracial and transnational adoptees is to educate themselves about the adoption process.  

Unfortunately, Baden says most counseling students go through their graduate program and hear nothing about adoption. “When they go into practice, everything they’ve learned comes from movies, books and TV shows,” she explains, noting that these sources can be inaccurate and perpetuate stereotypes and misconceptions. 

Branco recommends that counselors review the Adoptee Consciousness Model that she co-developed to learn how adoptees might process their experience with the practice. She also encourages counselors to become familiar with the work of the Multiethnic, Multiracial and Transracial Adoptee Concerns Group, part of the Association of Multicultural Counseling and Development, which is a division of ACA. 

Becoming better informed about the challenges transracial and transnational adoptees face can help counselors recognize and affirm the tenacity of this population. Fishbein says adoptees develop strengths that guide them through life. Rather than crumble under the weight of painful experiences, adoptees “learn how to tackle grief and hardship,” she says. “It helps to make us resilient.”