Adoption Informed Counseling and the Chinese Adoptee

Adoption-Informed Counseling

Systematized intercountry adoptions to the US have been a part of family creation since World War II from countries such as Greece. Approximately 4,000 Greek children left their country for adoption in the United States after 1950. Greece ended its overseas adoption programs around 1975 (Van Steen, 2023) The Korean War, however, led South Korea (to be) the world's largest diaspora of intercountry adoptees, with more foreign adoptions overall than any other nation (Cho, 2023). Mainland China opened its doors to intercountry adoptions in 1992 with an estimated 160,000 children having been adopted to US parents. According to China's Children International, about 29% of the adoptee population in the United States were born in Mainland China. At the time of this practice brief, China ceased its intercounty adoption program (US Department of State, 2024a) rendering the estimated 160,000 Chinese adoptees a finite community of individuals whose personal narratives are impacted by intercountry adoption. While most of the children were female at birth, they were not exclusively one gender.

Research and academic writings on the outcomes of the lives of intercountry adoptees have been growing, especially from those with lived adoption experiences. As early as 1998, researchers such as Kathleen Bergquist, an adoptee from South Korea, examined the longitudinal effects on identity in the Korean adoptee community (Bergquist, 1998). Today, Chinese adoptee scholars are examining how “technologies demonstrate the ways in which Asian American family and kinship have been endowed with narrative fantasies of identification, intimacy, and belonging that define racial categorization” (Johnson, n. d., para 2).

I am an intercountry adoptee mental health clinician serving the adoption community. I have over two decades of experience working within adoption agencies, preparing and counseling adopting parents. I am also actively in private practice working with intercountry adopted adults as they navigate their adoption identity. While I do not identify as an adoptee from China, my identity as an intercountry adopted person from South Korea informs the way I approach the work with my fellow adoptees in counseling. This practice brief will share ways counseling adoptees from China can be a unique experience all the while providing recommendations that may serve the intercountry adoptee community more broadly.

Adoptive parent demographics

Adopting a child from outside of the US is dependent on many factors, primarily dictated by the requirements of the sending country. According to Kane and Choi (1999), the geopolitics of the availability of children from China was initiated primarily by the country's stringent one-child policy of 1979. Over the last 30 years, the requirements of who China would allow to adopt their children have varied, but in general, China was more open to diverse applicants in terms of age and marital status. This allowed for adopting parents to be married or single (female only), over the age of 50, have at least a high school diploma, “have a history of honorable behavior and good moral character” and have an annual net worth of $80,000–$100,000 (US Department of State, 2024b). Adoptive parents of Chinese children are of mostly middle to high socioeconomic status to meet the net worth requirements and afford the steep expense of international adoption. In addition, most adoptive parents achieved a high educational status and were mostly White identifying. While China does not permit adoption to same-sex couples, the children, now adults, who are participating in counseling have identified as being raised by two same-sex parents. While the pervading narrative around adoptions from China was the one-child policy, the specifics of why US parents adopted from China are consistent with many of the reasons US parents adopted from Asia in general, “…all noted that they preferred China because of how transparent the process appeared for foreigners…” (p. 33). Sparkman reported that adoptive parents “participants used the words ‘reliable,’ ‘predictable,’ ‘standardized,’ ‘regimented,’ ‘appealing,’ ‘and transparent’…” (2021, p. 33).

Chinese adoptee demographics

The general demographics of the now-adult children adopted from China are consistent with their adoptive families. In my clinical counseling setting, the adoptees present as mostly female with the foundation narrative of the one-child policy in Mainland China. Their adoptive parents are older than their horizontal peers, and these adoptees are highly educated, pursuing education beyond high school. More specifically, the areas of interest in pursuing higher education, the Chinese adoptees are majoring in women's studies, gender studies, and American or East Asian studies in addition to their intended major. In assessing their presenting issues, the adoptees from China, while only in their 20s and early 30s, invariably contend with having aging parents and the reality of the wider generational gap between parent and adult child. Counseling topics include conversations around earlier parental loss than their typical, mostly nonadopted, cohort.

While this may reflect growing trends in the general population, many of the Chinese adoptees have identified having had to overcome educational challenges that had required an Individual Education Plan or 504 accommodations or labeled as having “special needs” during their early school years. Many, in my practice, reported previous experiences with therapy in their youth and were prescribed psychotropic medications to address depression, anxiety, and attention-deficit/hyperactivity disorder. In recent years, there have been more adoptees from China coming to counseling with either a visible or nonvisible disability. This is consistent with the program “China's Waiting Children” established in 2000 by the Chinese government, specifically centering on the adoption of children with disabilities (Sparkman, 2021). In addition, there seems to be more fluidity in their sexual identity, identifying as queer or nonbinary and more equitable in dating and relationships with both White and non-White partners.

Lastly, the lack of transparency in a formulaic method of search and reunion for the intercountry adoptee continues to be a challenge (Darnell et al., 2017). The adoptees from China are mostly in emergent and young adulthood and the pursuit and discovery of biological relatives is still a surprising event. However, more and more adoptees are finding relatives through DNA testing and social media. The notion that intercountry adoptions eliminate the possibility of biological connections remains a myth. Specifically, the notion that China and its governmental structures would prohibit any possibility of finding biological connections remains a myth. However, given the new change in policy to discontinue intercountry adoptions, it remains unknown as to how or if the Chinese government will provide any resources toward the preservation of documentation and historical acknowledgment of this community of adoptees.

Themes in counseling

In 1982, Roszia introduced the concept of the seven core issues that impact the life of an adopted person and other members of the adoption constellation (Roszia, 2020). In 2019, Roszia and Maxon updated the cores to include loss, rejection, shame and guilt, grief, identity, intimacy, and mastery and control, all under the framework of trauma (Roszia & Maxon, 2019). Throughout the developmental phases of an adopted person, they may experience any one or a combination of these issues as they apply to life transitions and decisions.

The ambiguity of loss is also another framework that can be effectively applied to intercountry adoptees. Dr. Pauline Boss conceived the idea of ambiguous loss in the 1970s as a “relational disorder caused by the lack of facts surrounding the loss of a loved one. It is not an individual pathology because the problem emerges from the outside context and not from the psyche” (Boss, 2024, para 3). Working with intercountry adoptees as they examine their relationship with unknown birth parents, unknown birth culture, and unknown information on their origins as well as connect with a community of others who are holding those same unknowns is an essential aspect of counseling.

Lastly, the Adoptee Consciousness Model has become an effective resource for adoptees to visually internalize the development of self. Through its nonlinear pathways, an adoptee “can and often do move between these touchstones” (Branco et al., 2023, p. 57) of status quo, rupture, dissonance, expansiveness, forgiveness, and activism. Adoptees from China are consistent in processing these persistent themes of exploration.

Implications for Individual and Family Counselors and Therapists

As with any marginalized community, adoptees from China are not a monolith. The themes expressed in this practice brief are general, but the stories of the adopted person are specific. With consideration of the common themes in working with the intercountry adopted person, I recommend some salient clinical guidelines when collaborating with Chinese adoptee clients.

The importance of ongoing conversations on issues of grief and loss, attachment and adoption trauma, and the exploration of not having a genetic biological history. Some of the symptomatology of depression or anxiety may be masks for grief and disordered attachment.

Conclusion

Adoption-informed counseling practices can support emergent, young adult, and adult intercountry adoptees to navigate adoption-related developmental tasks including grief and loss; search and reunion; and racial and ethnic identity questions. This practice brief described clinical work with one intercountry subpopulation, adoptees from China. I provided demographic information about Chinese adoptees and their adoptive families in my practice, described clinical themes effective in understanding this community, and shared adoption-informed interventions unique to this group. These broad concepts can serve as a framework to create a more cohesive counseling experience for the intercountry adopted person.