In many jurisdictions the adopted person's full original birth certificate is cancelled and replaced with a fabricated post-adoption birth certificate which states that the child was born to the adoptive parents. This deception, when carried out, may continue with the adopted person for life and can be the cause for many well documented traumas experienced by the adopted person, including loss of identity, family history, culture, biological family (including not only biological parents but also siblings and extended family), family medical history and records, and increased risk of suicide, homelessness, incarceration, PTSD, depression, and anxiety.
Open records: Movements to unseal adoption records for adopted citizens proliferated along with increased acceptance of illegitimacy. In the United States, Jean Paton founded Orphan Voyage in 1954, and Florence Fisher founded the Adoptees' Liberty Movement Association (ALMA) in 1971, calling sealed records "an affront to human dignity.". While in 1975, Emma May Vilardi created the first mutual-consent registry, the International Soundex Reunion Registry (ISRR), allowing those separated by adoption to locate one another. and Lee Campbell and other birthmothers established CUB (Concerned United Birthparents). Similar ideas were taking hold globally with grass-roots organizations like Parent Finders in Canada and Jigsaw in Australia. In 1975, England and Wales opened records on moral grounds.
Adoption practices have changed significantly over the course of the 20th century, with each new movement labeled, in some way, as reform. 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, create confusion regarding genealogy, and provide little in the way of medical history.
Foster care adoption: this is a type of domestic adoption where a child is initially placed in public care. Many times the foster parents take on the adoption when the children become legally free. Its importance as an avenue for adoption varies by country. Of the 127,500 adoptions in the U.S. in 2000 about 51,000 or 40% were through the foster care system.
Externally focused theories, in contrast, suggest that reunion is a way for adoptees to overcome social stigma. First proposed by Goffman, the theory has four parts: 1) adoptees perceive the absence of biological ties as distinguishing their adoptive family from others, 2) this understanding is strengthened by experiences where non-adoptees suggest adoptive ties are weaker than blood ties, 3) together, these factors engender, in some adoptees, a sense of social exclusion, and 4) these adoptees react by searching for a blood tie that reinforces their membership in the community. The externally focused rationale for reunion suggests adoptees may be well adjusted and happy within their adoptive families, but will search as an attempt to resolve experiences of social stigma.