When I wrote my memoir and critical study of the U.S. adoption experience, I deleted a chapter where I highlighted divisions among many of the millions of adoptees, notably those who want to focus mainly on their personal feelings about this experience and those who focus more on making systemic changes to end inequities to many.
This is a long debate, and I strategically dropped this section because I thought it would become a distraction. There are many ways this plays out, and I am choosing not to amplify works and ideas that I do not think will lead to change. Nor do I want to tell others how to navigate meaning in their lives. Those decisions remain with the individual, and no one but the person has the ability to confront those realities.
Making systemic change requires a focus on upstream advocacy, to fix the root issues and problems.
Since publishing my book, I have had some modest successes, including calling attention to how the United States fails to even count adoptees, which would be one step forward. This ongoing and intentional failure by the U.S. Census reveals larger issues of bias to adoptees and how the power dynamics of the interconnected institutions and interests co-mingle with sustaining modern adoption while not reforming it.
I would love to see more fellow adoptees, especially among those who advocate for systemic changes—what public health folks call upstream advocacy—talk about the intersection of public health, adoption, and adoptee rights issues.
Adoption is and will remain a public health concern, since the public health systems at the local, state and federal level in this country helped build this system and sustain it, for domestic and inter-country adoptions.
I am fortunate that I have a background in public health, so I can make these connections much more easily. As I wrote in what I call my first of its kind public health memoir on adoption: “I use public health concepts that focus on laws and systems that have an impact on large groups of people. A public health lens lets one look at outcomes, including the health of adoptees and those born illegitimately. This approach points out flaws that can be fixed, particularly if we look at evidence and science as well as how adoption systems work best.”
The Centers for Disease Control and Prevention provide this model to explain how a public health approach addresses problems and promotes population health.
Unfortunately, I have found few adoptees with this formal education, and that may be one reason why this method and lens have not been widely shared by them as a means to highlight the root issues and show a path to change with institutions that wield unhealthy power over the lives of millions of adoptees because of laws and policies.
As I have written before, health and public health groups have a moral obligation to advocate for the wellbeing of all adopted Americans as a population. Both also have a responsibility to correct their past historic roles creating a system that denies adoptees rights and also health information that could potentially be life-saving for some.
I am still confident that the approach I outlined in my book will gain traction, among journalists who continue to ignore root issues and also among adoptees themselves.
I also know this journey will be long. I have not given up hope because the goal remains to fix the larger problems, and changing laws and systems will help the greatest number of people who continue to be denied basic legal rights and knowledge of who they are.