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).
Family preservation: As concerns over illegitimacy began to decline in the early 1970s, social-welfare agencies began to emphasize that, if possible, mothers and children should be kept together.[156] In the U.S., this was clearly illustrated by the shift in policy of the New York Foundling Home, an adoption-institution that is among the country's oldest and one that had pioneered sealed records. It established three new principles including "to prevent placements of children...," reflecting the belief that children would be better served by staying with their biological families, a striking shift in policy that remains in force today.[157]
Some adoptees reject the idea of reunion. It is unclear, though, what differentiates adoptees who search from those who do not. One paper summarizes the research, stating, "...attempts to draw distinctions between the searcher and non-searcher are no more conclusive or generalizable than attempts to substantiate...differences between adoptees and nonadoptees."[169]

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]
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[83] about 51,000 or 40% were through the foster care system.[84]
Other studies provide evidence that adoptive relationships can form along other lines. A study evaluating the level of parental investment indicates strength in adoptive families, suggesting that parents who adopt invest more time in their children than other parents and concludes, "...adoptive parents enrich their children's lives to compensate for the lack of biological ties and the extra challenges of adoption."[94] Another recent study found that adoptive families invested more heavily in their adopted children, for example, by providing further education and financial support. Noting that adoptees seemed to be more likely to experience problems such as drug addiction, the study speculated that adoptive parents might invest more in adoptees not because they favor them, but because they are more likely than genetic children to need the help.[95]
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]
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]
Social workers and other professionals in the field of adoption began changing terms of use to reflect what was being expressed by the parties involved. In 1979, Marietta Spencer wrote "The Terminology of Adoption" for The Child Welfare League of America (CWLA),[184] which was the basis for her later work "Constructive Adoption Terminology".[185] This influenced Pat Johnston's "Positive Adoption Language" (PAL) and "Respectful Adoption Language" (RAL).[186] The terms contained in "Positive Adoption Language" include the terms "birth mother" (to replace the terms "natural mother" and "real mother"), and "placing" (to replace the term "surrender"). These kinds of recommendations encouraged people to be more aware of their use of adoption terminology.

The research says that the dysfunction, untruths and evasiveness that can be present in adoptive families not only makes identity formation impossible, but also directly works against it. What effect on identity formation is present if the adoptee knows they are adopted but has no information about their biological parents? Silverstein and Kaplan's research states that adoptees lacking medical, genetic, religious, and historical information are plagued by questions such as "Who am I?" "Why was I born?" "What is my purpose?" This lack of identity may lead adoptees, particularly in adolescent years, to seek out ways to belong in a more extreme fashion than many of their non-adopted peers. Adolescent adoptees are overrepresented among those who join sub-cultures, run away, become pregnant, or totally reject their families.[133][134]
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]
Identity is defined both by what one is and what one is not. Adoptees born into one family lose an identity and then borrow one from the adopting family. The formation of identity is a complicated process and there are many factors that affect its outcome. From a perspective of looking at issues in adoption circumstances, the people involved and affected by adoption (the biological parent, the adoptive parent and the adoptee) can be known as the "triad members and state". Adoption may threaten triad members' sense of identity. Triad members often express feelings related to confused identity and identity crises because of differences between the triad relationships. Adoption, for some, precludes a complete or integrated sense of self. Triad members may experience themselves as incomplete, deficient, or unfinished. They state that they lack feelings of well-being, integration, or solidity associated with a fully developed identity.[129]
Previous research on adoption has led to assumptions that indicate that there is a heightened risk in terms of psychological development and social relationships for adoptees. Yet, such assumptions have been clarified as flawed due to methodological failures. But more recent studies have been supportive in indicating more accurate information and results about the similarities, differences and overall lifestyles of adoptees.[125]
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[83] about 51,000 or 40% were through the foster care system.[84]

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]
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