The most recent adoption attitudes survey completed by the Evan Donaldson Institute provides further evidence of this stigma. Nearly one-third of the surveyed population believed adoptees are less-well adjusted, more prone to medical issues, and predisposed to drug and alcohol problems. Additionally, 40–45% thought adoptees were more likely to have behavior problems and trouble at school. In contrast, the same study indicated adoptive parents were viewed favorably, with nearly 90% describing them as "lucky, advantaged, and unselfish."[144]
Adoption practices have changed significantly over the course of the 20th century, with each new movement labeled, in some way, as reform.[152] Beginning in the 1970s, efforts to improve adoption became associated with opening records and encouraging family preservation. These ideas arose from suggestions that the secrecy inherent in modern adoption may influence the process of forming an identity,[153][154] create confusion regarding genealogy,[155] and provide little in the way of medical history.
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There are many ways in which the concept of identity can be defined. It is true in all cases that identity construction is an ongoing process of development, change and maintenance of identifying with the self. Research has shown that adolescence is a time of identity progression rather than regression.[127] One's identity tends to lack stability in the beginning years of life but gains a more stable sense in later periods of childhood and adolescence. Typically associated with a time of experimentation, there are endless factors that go into the construction of one's identity. As well as being many factors, there are many types of identities one can associate with. Some categories of identity include gender, sexuality, class, racial and religious, etc. For transracial and international adoptees, tension is generally found in the categories of racial, ethnic and national identification. Because of this, the strength and functionality of family relationships play a huge role in its development and outcome of identity construction. Transracial and transnational adoptees tend to develop feelings of a lack of acceptance because of such racial, ethnic, and cultural differences. Therefore, exposing transracial and transnational adoptees to their "cultures of origin" is important in order to better develop a sense of identity and appreciation for cultural diversity.[128] Identity construction and reconstruction for transnational adoptees the instant they are adopted. For example, based upon specific laws and regulations of the United States, the Child Citizen Act of 2000 makes sure to grant immediate U.S. citizenship to adoptees.[128]
Who are the children who wait? The children who wait are the survivors of abuse and neglect. They are school aged children, siblings, children of color and children with disabilities. Each of them waits for adoption and there are more than 114,000 of them across the country. These children live in a series of foster and group homes for an average of three years. There they wait while they hope for the stability of an adoptive family.
"Honest Adoption Language" refers to a set of terms that proponents say reflect the point of view that: (1) family relationships (social, emotional, psychological or physical) that existed prior to the legal adoption often continue past this point or endure in some form despite long periods of separation, and that (2) mothers who have "voluntarily surrendered" children to adoption (as opposed to involuntary terminations through court-authorized child-welfare proceedings) seldom view it as a choice that was freely made, but instead describe scenarios of powerlessness, lack of resources, and overall lack of choice.[187][188] It also reflects the point of view that the term "birth mother" is derogatory in implying that the woman has ceased being a mother after the physical act of giving birth. Proponents of HAL liken this to the mother being treated as a "breeder" or "incubator".[189] Terms included in HAL include terms that were used before PAL, including "natural mother," "first mother," and "surrendered for adoption."
There are supporters of various lists, developed over many decades, and there are persons who find them lacking, created to support an agenda, or furthering division. All terminology can be used to demean or diminish, uplift or embrace. In addressing the linguistic problem of naming, Edna Andrews says that using "inclusive" and "neutral" language is based upon the concept that "language represents thought, and may even control thought."[190]
In Spain under Francisco Franco’s 1939–75 dictatorship the newborns of some left-wing opponents of the regime, or unmarried or poor couples, were removed from their mothers and adopted. New mothers were frequently told their babies had died suddenly after birth and the hospital had taken care of their burials, when in fact they were given or sold to another family. It is believed that up to 300,000 babies were involved. These system – which allegedly involved doctors, nurses, nuns and priests – outlived Franco’s death in 1975 and carried on as an illegal baby trafficking network until 1987 when a new law regulating adoption was introduced.[180][181]
The stigmas associated with adoption are amplified for children in foster care.[149] Negative perceptions result in the belief that such children are so troubled it would be impossible to adopt them and create "normal" families.[150] A 2004 report from the Pew Commission on Children in Foster Care has shown that the number of children waiting in foster care doubled since the 1980s and now remains steady at about a half-million a year."[151]
This system of apprenticeship and informal adoption extended into the 19th century, today seen as a transitional phase for adoption history. Under the direction of social welfare activists, orphan asylums began to promote adoptions based on sentiment rather than work; children were placed out under agreements to provide care for them as family members instead of under contracts for apprenticeship.[21] The growth of this model is believed to have contributed to the enactment of the first modern adoption law in 1851 by the Commonwealth of Massachusetts, unique in that it codified the ideal of the "best interests of the child."[22][23] Despite its intent, though, in practice, the system operated much the same as earlier incarnations. The experience of the Boston Female Asylum (BFA) is a good example, which had up to 30% of its charges adopted out by 1888.[24] Officials of the BFA noted that, although the asylum promoted otherwise, adoptive parents did not distinguish between indenture and adoption; "We believe," the asylum officials said, "that often, when children of a younger age are taken to be adopted, the adoption is only another name for service."[25]
Evidence about the development of adoptees can be supported in newer studies. It can be said that adoptees, in some respect, tend to develop differently from the general population. This can be seen in many aspects of life, but usually can be found as a greater risk around the time of adolescence. For example, it has been found that many adoptees experience difficulty in establishing a sense of identity.[126]

Private domestic adoptions: under this arrangement, charities and for-profit organizations act as intermediaries, bringing together prospective adoptive parents and families who want to place a child, all parties being residents of the same country. Alternatively, prospective adoptive parents sometimes avoid intermediaries and connect with women directly, often with a written contract; this is not permitted in some jurisdictions. Private domestic adoption accounts for a significant portion of all adoptions; in the United States, for example, nearly 45% of adoptions are estimated to have been arranged privately.[83]
His solution was outlined in The Best Method of Disposing of Our Pauper and Vagrant Children (1859) which started the Orphan Train movement. The orphan trains eventually shipped an estimated 200,000 children from the urban centers of the East to the nation's rural regions.[28] The children were generally indentured, rather than adopted, to families who took them in.[29] As in times past, some children were raised as members of the family while others were used as farm laborers and household servants.[30] The sheer size of the displacement—the largest migration of children in history—and the degree of exploitation that occurred, gave rise to new agencies and a series of laws that promoted adoption arrangements rather than indenture. The hallmark of the period is Minnesota's adoption law of 1917 which mandated investigation of all placements and limited record access to those involved in the adoption.[31][32]