Young Adults: Postadoption Issues

This article has been taken directly from Child Welfare Information Gateway.

Adopted persons may deal with a range of issues at different points in their lives.

Loss and Grief


The loss of birth parents as a result of adoption may set the stage for feelings of grief for many adopted persons. The loss experienced by adopted persons may be characterized as ambiguous loss, or the loss of someone who still is (or who may be) alive (Powell & Afifi, 2005). This type of loss also may increase the feelings of uncertainty (e.g., “Do I resemble my biological parents?”) an adopted person feels. Adopted persons who feel secure in their adoption and have open adoptive family communication may be better able to manage their uncertainty and grief (Powell & Afifi). Additionally, adopted persons may have difficulty finding an outlet because their grief may not be recognized by others.

Feelings of loss and grief, as well as anger, anxiety, or fear, may especially occur during emotionally charged milestones, such as marriage, the birth of a child, or the death of a parent.

Adopted persons may also suffer secondary losses. For instance, along with the loss of their birth mother and birth father, adopted persons may experience the loss of brothers and sisters, grandparents, aunts and uncles, and cousins. There also may be a loss of cultural connection or language (in cases of intercountry or transracial adoption). For those who were adopted as older children, there may be a loss of friends, foster families, pets, schools, neighborhoods, and familiar surroundings.

Identity Development

Identity formation begins in childhood and takes on increased importance and prominence during adolescence (Grotevant, 1997). Adoption is a significant aspect of identity for adopted persons, even when they are adults (Evan B. Donaldson Adoption Institute, 2009). The task of identity development may be more difficult for an adopted person because of the additional issues related to adoption, such as why he or she was placed for adoption, what became of the birth parents, does he or she have siblings, and whether he or she resembles the birth parents in looks or in other characteristics. Adoption remains an important aspect of identity throughout adulthood, and one study described the development of adult adoptive identity as having five phases:

  1. No awareness/denying awareness: The adopted person does not overtly acknowledge adoption issues.
  2. Emerging awareness: The adopted person views adoption as a positive influence and recognizes some issues, but he or she is not ready to explore these issues.
  3. Drowning in awareness: The adopted person has feelings of loss, anger, and sadness about the adoption.
  4. Reemerging from awareness: The adopted person recognizes the issues related to the adoption, but also sees the positive aspects and is working toward acceptance.
  5. Finding peace: The adopted person has worked through his or her issues with the adoption and is moving toward peace and acceptance (Penny, Borders, & Portnoy, 2007).

Self Esteem

Often accompanying these issues of identity are issues of self-esteem—that is, how the adopted person feels about him or herself. A number of studies have found that, while adopted persons are similar to nonadopted persons in most ways, they often score lowers on measures of self-esteem and self-confidence (Borders, Penny, & Portnoy, 2000; Sharma, McGue, & Benson, 1996). This result may reflect the fact that some adopted persons may view themselves as different, out-of-place, unwelcome, or rejected. Some of these feelings may result from the initial loss of birth parents and from growing up away from birth parents, siblings, and extended family members. They also may be caused by an ongoing feeling of being different from nonadopted people who know about their genetic background and birth family and who may be more secure about their own identity as a result. Additionally, some adopted persons report that secrecy surrounding their adoption contributes to low self-esteem.

Thinking About the Adoption

The amount and degree of thought an adopted person devotes to his or her adoption may change over time and may vary based on each person’s circumstances. For example, the birth of a child to an adopted person, which may be the first experience with a biological family member, may cause the adopted person to revisit earlier issues of identity. The new parent may also be prompted to think about what his or her birth mother experienced in giving birth and what the birth mother and father may have experienced in making the adoption placement decision. Adopted adults who become new parents may be sympathetic to the difficulties of their birth parents, or they may wonder how their birth parents could ever have placed them for adoption. In a study of adopted adolescents’ thinking about adoption, 13 percent never thought about adoption, 54 percent thought about their adoption once a month or more, and 27 percent thought about their adoption once a week or more, with males thinking about their adoption more frequently than females (Kohler, Grotevant, & McRoy, 2002). Adolescents in closed adoptions were no more likely to have increased frequency of thought about their adoption than those in open adoptions

Genetic Information

Adopted persons often lack birth family genetic and medical history. This information can be vitally important to the diagnosis and treatment of genetically based medical conditions (Evan B. Donaldson Adoption Institute, 2010). In addition, being asked to supply medical history information at a doctor’s appointment may make adopted persons acutely aware of how they differ from those who were not adopted. Finding out later in life that they were adopted as infants puts adopted persons at risk of misdiagnoses or other medical issues due to their long-held assumption of a family medical history that they later find is incorrect. Additionally, when adopted persons plan to get married or become a parent, they may want to know about genetic characteristics their children may inherit.

In many cases, nonidentifying information, such as medical history, may be placed in the adoption file by the birth parents or agency at the time of the adoption. Adopted persons are allowed access to this nonidentifying information, which is usually at least as old as the adopted person. In some States, adopted persons can petition a judge to have their adoption records opened, and some judges will agree to do so in order to provide urgently needed medical information.

However, obtaining access to information provided by the birth parents at the time of the adoption may not be sufficient to provide a full medical history. For example, a birth parent, sibling, or grandparent may later develop or be diagnosed with a genetic disease or condition. It is more useful if birth parents regularly update the file that is kept with the adoption agency or attorney. Additionally, those in open adoptions may be able to get this information directly from their birth parents.

For more information about the collection of and access to birth family information, see the following Child Welfare Information Gateway factsheets:

Other Behavioral Health Issues

A review of the research on the mental health of adopted adults shows there is a divide about whether adopted adults’ psychological well-being is comparable to their nonadopted peers. Many studies report that adopted adults have a higher degree of mental health issues, but some researchers view these differences as minor while others view them as substantial (Baden & Wiley, 2007). Additionally, the studies are not always in agreement about what the differences are. For example, some studies cite higher rates of depression among adopted individuals than their nonadopted peers (Borders et al., 2000; Cubito & Obremski Brandon, 2000), while others have found similar levels of depression within both groups (Feigelman, 2005).

Even with the split in research conclusions about adopted adults’ psychological wellbeing, most of the literature points to adopted adolescents and adults being more likely to receive counseling than their nonadopted peers (Borders et al., 2000; Miller et al., 2000). Studies comparing adopted persons to their nonadopted peers also indicate that adopted adults have similar rates of antisocial behaviors (Grotevant et al., 2006), and that adopted persons are at an increased risk of substance use disorders during their lifetime (Yoon, Westermeyer, Warwick, & Kuskowski, 2012).

Return to Adoption Parenting

Young Adults: Openness, Searching, and Access to Family History

Young Adults: Managing Adoption Issues

Young Adults: Additional Resources


Baden, A. L., & O’Leary Wiley, M. (2007). Counseling adopted persons in adulthood: Integrating research and practice. The Counseling Psychologist, 35, 868–901.

Borders, L. D., Penny, J. M., & Portnoy, F. (2000). Adult adoptees and their friends: Current functioning and psychosocial well-being. Family Relations, 49, 407–418.

Child Welfare Information Gateway. (2013a). Openness in adoption: Building relationships between adoptive and birth families. Retrieved from

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Corder, K. (2012). Counseling adult adoptees. The Family Journal, 20, 448–452.

Cubito, D. S., & Obremski Brandon, K. (2000). Psychological adjustment in adult adoptees: Assessment of distress, depression, and anger. American Journal of Orthopsychiatry, 70, 408–413.

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Evan B. Donaldson Adoption Institute. (2010). For the records II: An examination of the history and impact of adult adoptee access to original birth certificates. Retrieved from pdf.

Feigelman, W. (2005). Are adoptees at increased risk for attempting suicide? Suicide and Life-Threatening Behavior, 32, 206–216.

Grotevant, H. D. (1997). Coming to terms with adoption: The construction of identity from adolescence into adulthood. Adoption Quarterly, 1, 3–27.

Grotevant, H. D., Miller Wrobel, G., Von Korff, L., Skinner, B., Newell, J., Friese, S., & McRoy, R. G. (2007). Many faces of openness in adoption: Perspectives of adopted adolescents and their parents. Adoption Quarterly, 10, 79–101.

Grotevant, H. D., van Dulmen, M. H. M., Dunbar, N., Nelson-Christinedaughter, J., Christensen, M., Fan, X., & Miller, B. C. (2006). Antisocial behavior of adoptees and nonadoptees: Prediction from early history and adolescent relationships. Journal of Research on Adolescents, 16, 105–131.

Howard, J. A. (2012). Untangling the web: The Internet’s transformative impact on adoption. Retrieved from

Kohler, J. K., Grotevant, H. D., & McRoy, R. G. (2002). Adopted adolescents’ preoccupation with adoption: The impact on adoptive family relationships. Journal of Marriage and Family, 64, 93–104.

Miller, B. C., Fan, X., Grotevant, H. D., Christensen, M., Coyl, D., & van Dulment, M. (2000). Adopted adolescents’ overrepresentation in mental health counseling: Adoptees’ problems or parents’ lower threshold for referral? Journal of American Academy of Child & Adolescent Psychiatry, 39, 1504–1511.

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Penny, J., Borders, L. D., & Portnoy, F. (2007). Reconstruction of adoption issues: Delineation of five phases among adult adoptees. Journal of Counseling & Development, 85(1), 30–41.

Powell, K. A., & Afifi, T. D. (2005). Uncertainty management and adoptees’ ambiguous loss of their birth parents. Journal of Social and Personal Relationships, 22, 129–151.

Sharma, A. R., McGue, M. K., & Benson, P. L. (1996). The emotional and behavioral adjustment of United States adopted adolescents: Part I. An overview. Children and Youth Services Review, 18(1/2), 83–100.

Siegel, D. H. (2012). Growing up in open adoption: Young adults’ perspectives. Families in Society: The Journal of Contemporary Social Services, 93, 133–140.

Siegel, D. H., & Livingston Smith, S. (2012). Openness in adoption: From secrecy and stigma to knowledge and connections. Retrieved from

Yoon, G., Westermeyer, J., Warwick, M., & Kuskowski, M. A. (2012). Substance use disorders and adoption: Findings from a national sample. PLoS ONE, 7. Retrieved from


Child Welfare Information Gateway. (2013). Impact of adoption on adopted persons. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.