Several factors affect the decision to release or raise the child. White adolescents tend to give up their babies to non-relatives, whereas black adolescents are more likely to receive support from their own community in raising the child and also in the form of informal adoption by relatives.[118] Studies by Leynes and by Festinger and Young, Berkman, and Rehr found that for pregnant adolescents, the decision to release the child for adoption depended on the attitude toward adoption held by the adolescent's mother.[119] Another study found that pregnant adolescents whose mothers had a higher level of education were more likely to release their babies for adoption. Research suggests that women who choose to release their babies for adoption are more likely to be younger, enrolled in school, and have lived in a two-parent household at age 10, than those who kept and raised their babies.[120]
Adoptions can occur either between related family members, or unrelated individuals. Historically, most adoptions occurred within a family. The most recent data from the U.S. indicates about half of adoptions are currently between related individuals.[78] A common example of this is a "stepparent adoption", where the new partner of a parent may legally adopt a child from the parent's previous relationship. Intra-family adoption can also occur through surrender, as a result of parental death, or when the child cannot otherwise be cared for and a family member agrees to take over.
Concerning developmental milestones, studies from the Colorado Adoption Project examined genetic influences on adoptee maturation, concluding that cognitive abilities of adoptees reflect those of their adoptive parents in early childhood but show little similarity by adolescence, resembling instead those of their biological parents and to the same extent as peers in non-adoptive families.[114]

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.[167]
The adoptee population does, however, seem to be more at risk for certain behavioral issues. Researchers from the University of Minnesota studied adolescents who had been adopted and found that adoptees were twice as likely as non-adopted people to suffer from oppositional defiant disorder and attention-deficit/hyperactivity disorder (with an 8% rate in the general population).[135] Suicide risks were also significantly greater than the general population. Swedish researchers found both international and domestic adoptees undertook suicide at much higher rates than non-adopted peers; with international adoptees and female international adoptees, in particular, at highest risk.[136]
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 another study that compared mothers who released their children to those who raised them, mothers who released their children were more likely to delay their next pregnancy, to delay marriage, and to complete job training. However, both groups reached lower levels of education than their peers who were never pregnant.[124] Another study found similar consequences for choosing to release a child for adoption. Adolescent mothers who released their children were more likely to reach a higher level of education and to be employed than those who kept their children. They also waited longer before having their next child.[122] Most of the research that exists on adoption effects on the birth parents was conducted with samples of adolescents, or with women who were adolescents when carrying their babies—little data exists for birth parents from other populations. Furthermore, there is a lack of longitudinal data that may elucidate long-term social and psychological consequences for birth parents who choose to place their children for adoption.
In another study that compared mothers who released their children to those who raised them, mothers who released their children were more likely to delay their next pregnancy, to delay marriage, and to complete job training. However, both groups reached lower levels of education than their peers who were never pregnant.[124] Another study found similar consequences for choosing to release a child for adoption. Adolescent mothers who released their children were more likely to reach a higher level of education and to be employed than those who kept their children. They also waited longer before having their next child.[122] Most of the research that exists on adoption effects on the birth parents was conducted with samples of adolescents, or with women who were adolescents when carrying their babies—little data exists for birth parents from other populations. Furthermore, there is a lack of longitudinal data that may elucidate long-term social and psychological consequences for birth parents who choose to place their children for adoption.

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As the idea of institutional care gained acceptance, formal rules appeared about how to place children into families: boys could become apprenticed to an artisan and girls might be married off under the institution's authority.[19] Institutions informally adopted out children as well, a mechanism treated as a way to obtain cheap labor, demonstrated by the fact that when the adopted died, their bodies were returned by the family to the institution for burial.[20]
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.[167]
These differences in development appear to play out in the way young adoptees deal with major life events. In the case of parental divorce, adoptees have been found to respond differently from children who have not been adopted. While the general population experienced more behavioral problems, substance use, lower school achievement, and impaired social competence after parental divorce, the adoptee population appeared to be unaffected in terms of their outside relationships, specifically in their school or social abilities.[117]
Family plays a vital role in identity formation. This is not only true in childhood but also in adolescence. Identity (gender/sexual/ethnic/religious/family) is still forming during adolescence and family holds a vital key to this. The research seems to be unanimous; a stable, secure, loving, honest and supportive family in which all members feel safe to explore their identity is necessary for the formation of a sound identity. Transracial and International adoptions are some factors that play a significant role in the identity construction of adoptees. Many tensions arise from relationships built between the adoptee(s) and their family. These include being "different" from the parent(s), developing a positive racial identity, and dealing with racial/ethnic discrimination.[130] It has been found that multicultural and transnational youth tend to identify with their parents origin of culture and ethnicity rather than their residing location, yet it is sometimes hard to balance an identity between the two because school environments tend to lack diversity and acknowledgment regarding such topics.[131] These tensions also tend to create questions for the adoptee, as well as the family, to contemplate. Some common questions include what will happen if the family is more naïve to the ways of socially constructed life? Will tensions arise if this is the case? What if the very people that are supposed to be modeling a sound identity are in fact riddled with insecurities? Ginni Snodgrass answers these questions in the following way. The secrecy in an adoptive family and the denial that the adoptive family is different builds dysfunction into it. "... social workers and insecure adoptive parents have structured a family relationship that is based on dishonesty, evasions and exploitation. To believe that good relationships will develop on such a foundation is psychologically unsound" (Lawrence). Secrecy erects barriers to forming a healthy identity.[132]
The next stage of adoption's evolution fell to the emerging nation of the United States. Rapid immigration and the American Civil War resulted in unprecedented overcrowding of orphanages and foundling homes in the mid-nineteenth century. Charles Loring Brace, a Protestant minister became appalled by the legions of homeless waifs roaming the streets of New York City. Brace considered the abandoned youth, particularly Catholics, to be the most dangerous element challenging the city's order.[26][27]

Taken together, these trends resulted in a new American model for adoption. Following its Roman predecessor, Americans severed the rights of the original parents while making adopters the new parents in the eyes of the law. Two innovations were added: 1) adoption was meant to ensure the "best interests of the child;" the seeds of this idea can be traced to the first American adoption law in Massachusetts,[16][23] and 2) adoption became infused with secrecy, eventually resulting in the sealing of adoption and original birth records by 1945. The origin of the move toward secrecy began with Charles Loring Brace who introduced it to prevent children from the Orphan Trains from returning to or being reclaimed by their parents. Brace feared the impact of the parents' poverty, in general, and their Catholic religion, in particular, on the youth. This tradition of secrecy was carried on by the later Progressive reformers when drafting of American laws.[44]
The language of adoption is changing and evolving, and since the 1970s has been a controversial issue tied closely to adoption reform efforts. The controversy arises over the use of terms which, while designed to be more appealing or less offensive to some persons affected by adoption, may simultaneously cause offense or insult to others. This controversy illustrates the problems in adoption, as well as the fact that coining new words and phrases to describe ancient social practices will not necessarily alter the feelings and experiences of those affected by them. Two of the contrasting sets of terms are commonly referred to as positive adoption language (PAL) (sometimes called respectful adoption language (RAL)), and honest adoption language (HAL).
In the 1970s, as adoption search and support organizations developed, there were challenges to the language in common use at the time. As books like Adoption Triangle by Sorosky, Pannor and Baran were published, and support groups formed like CUB (Concerned United Birthparents), a major shift from "natural parent" to "birthparent"[182][183] occurred. Along with the change in times and social attitudes came additional examination of the language used in adoption.
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.
The research literature states adoptees give four reasons for desiring reunion: 1) they wish for a more complete genealogy, 2) they are curious about events leading to their conception, birth, and relinquishment, 3) they hope to pass on information to their children, and 4) they have a need for a detailed biological background, including medical information. It is speculated by adoption researchers, however, that the reasons given are incomplete: although such information could be communicated by a third-party, interviews with adoptees, who sought reunion, found they expressed a need to actually meet biological relations.[167]

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]
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