The Lifelong Trauma of Adoption Relinquishment

Mirah Riben, author and activist
14 min readAug 22, 2021

The general public sees adoption as an act of altruistic love — a “win-win” wherein an otherwise “unwanted” child is “saved” by parents seeking a child who are admired.

Such is the dominant narrative about adoption: a fairy-tale story about children being “chosen” by their “forever” families as seen through the lens of, and told by, those for whom adoption is the joyous culmination of longings — a dream come true — a positive event that is celebrated.

But adoption is not a win for everyone involved.

Excerpted from a blog post by the same name by Elle Cuardaigh at

The truth is far more complicated. Most who adopt would prefer to have a child related to them. Most who are adopted would prefer to be related to those who raise them. And most who lose a child to adoption would prefer to have been able to raise their child. For all adoption, is at best — second best.

Adoption is a Two-Step Process

Adoption is defined as “taking as one’s own.” However, every adoption begins with a relinquishment or termination of parental rights and a separation of a child from their biological parents or gestational mother. This occurs in infant adoption, international adoption and adoption from foster care, regardless of the age of the infant or child or their cognitive memory of the separation.

Every adoption — whether resulting from an untimely pregnancy, abuse, neglect, parental death, war, political policy, addictions, mental health issues, poverty or whatever — relies on a failure of a mother or family to receive the resources they needed to remain intact. The result is a traumatic maternal/child severance that likewise occurs in surrogacy and has neurological and psychological implications for the life of child.

Every adoption and surrogate birth has its roots in such a traumatic separation; a loss. This aspect of adoption is less known and seldom discussed perhaps because as Catherine Moor, an adoptee and an adoptive parent says: “Loss is never an easy topic” despite the fact “the very nature of adoption comes with a plethora of it.” It’s also ignored because it’s bad for the business of adoption.


Every day adoptees write on their blogs, in memoirs and on social media some version of: “I love my adoptive parents, BUT…” or “I know my adoptive parents love me, BUT…” No matter how loving, there remains the underlying loss and unrecognized grief many are unable to consciously grasp especially when they are told how lucky they are to have been adopted.

While adoption is driven by a longing, those who are adopted have no choice and would in many cases prefer to be raised in an immediate and extended family they see themselves reflected. There is a void in place of being surrounded by kin with whom they share talents and traits and are left to wonder who they look like and why they were given away. Likewise no one wants to live in a medical history void. Additionally, many adoptees, at some point, feel that they are stand-ins for the child their adopter(s) wanted and couldn’t otherwise have.

Adoption is not just a loss for the adoptee who loses his entire family, and in many cases, his culture . . . it is also a loss for both his family of origins and for the adopting family.


There is no win for the families of origins of adopted children. No little girl grows up thinking: “I’d love to have a baby and give it to someone more deserving.”

For natural (aka birth) mothers and fathers the relinquishment or termination of parental rights required for adoption is a crisis not a choice. It’s a loss; a permanent “fix” of a temporary problem such as age, marital status, or finances. Studies have found that time, rather than heal the loss and the grief, actually intensifies it. There is a higher rate of secondary infertility among mothers who have lost a child to adoption, making the lost child their only child.

In the past, pregnancy outside of marriage carried the weight of the shame of one’s family and women were cast away and given no choice but to relinquish their child for adoption. Today, while the shame and disgrace are no longer prevalent, many women facing unintended pregnancy are still told that adoption is a “loving choice.”

Today baby brokers, adoption attorneys, agencies and facilitators often move the mother-to-be out of state away from any support and have her expenses paid by prospective adopters locking her in with indebtedness and fear of having to repay such expenses if she finds she is able to raise her child. Mothers today are promised open adoption beleiving that open adoption will be like being a non-custodial parent in a divorce or like an aunt. They are not provided legal counsel (other than that paid for the adopters) and so are not informed that all promises of ongoing contact, beyond the parties initially meeting one another, are unenforceable promises and are often and easily broken leaving today’s birth mothers in the dark as much as those of past generations.

Every adoption — open or not — begins with the mother and father relinquishing or being stripped of all parental rights. The adopters become the sole legal parents with all rights thereof, including a right to deny any contact even when agreed to.

Some natural parents get updates and photos. For those lucky enough to have an adoption that remains open with visitation, it’s a double-edged sword seeing the joys they missed.


Adoption begins with — and is driven by — a desire; a powerful longing for a child by those who cannot have one naturally. The majority of those who adopt do so after trying long and hard to have had a child of their own genetics. Adoption is a fall back — a second or even third choice for most when unable to have a child naturally even with the help of interventions such as IVF or considerations of surrogacy in order to still have a child that is genetically “theirs.” “Adopting” a frozen embryo is another option to traditional adoption that, while it provides an unrelated child, enables one to experience pregnancy.

Adoption is thus not all joy, but rather a last resort that arises from a loss of what might have been — what was truly desired leaving many who adopt wondering what their “own” child might have been like at each stage of life, just as the addoptee wonders about his origins.

Parenting is challenging and adoptive parenting adds an extra challenge. Most adopters are loving and caring and try their best, but are often unprepared for the fact that all adoptees suffer a primal wound, a trauma of separation — no matter at what age they are adopted — that can make forming attachments difficult. False expectations and claims of lack of support can lead to disrupted adoptions and a practice called rehoming. Despite assurances given expectant moms that adopters are highly motivated and well vetted, there are no guarantees of a “better life” — other than materially. While, not the norm, adopters are in fact not exempt from neglecting, abandoning, emotionally, physically and sexually abusing and even murdering children entrusted to them.

Adam Pertman author of Adoption Nation: How Adoption Is Transforming America, former Executive Director of the renowned Donaldson Adoption Institute and current President, CEO and Founder of the National Center on Adoption and Permanency, recognizes that it was via “grief and loss” that he became an adoptive father.

Unlike loss by death, neither adoptees nor the mothers they were born to have any ritual for mourning or grieving and are often expected to be grateful or simply forget their loss as if it never happened. Adopters need real solutions to help the children they are caring for recognize and acknowledge the loss aspect of adoption.

An excellent panel discussion presented by the OLLIE Foundation entitled “The Unacknowledged Grief of Adoption” offers just that.


Note that all of the losses described herein as “adoption” relate to the separation at the time of relinquishment/termination that precedes adoption and apply equally to children gestated by a surrogate.

Kittens and puppies are given 6–8 weeks before they can be taken from their mothers. Current infant adoption practice, however, encourages prospective adopters to be in the delivery room and they are handed babies wet from the womb. It is alleged that doing so will provide healthy attachment despite any evidence that is in the best interest of anyone other than the adopters. This now commonplace practice, in fact, denies babies the immunities of their mothers’ colostrum.

The North American Council on Adoptable Children’s (NACAC) , whose mission is to promote adoption from foster care recognize that:

“Loss is one of the core issues in adoption. Every child and parent in adoption has experienced loss of some kind — whether the loss of their birth family or loss of a control of what a child experiences in their early life.”

The Child welfare Information Gateway echoes these views of adoption, stating in a paper entitled: Helping Adopted Children Cope with Grief and Loss:

“Loss is a central theme to adoption, and it is experienced by all constellation members. Losses must be acknowledged, validated, and grieved in order to heal and move forward. If losses are not grieved, the ongoing hurt and pain will negatively impact one’s ability to function and form healthy attachments. Children grieve differently than adults, so it is important for adoptive parents to understand and identify how loss and grief manifest developmentally, behaviorally, and emotionally and learn strategies for helping children heal. Resources in this section can help children and families identify their losses and focus on building a secure attachment that will help both heal.”

The American Academy of Pediatrics’ publication, Helping Foster and Adoptive Families Cope with Trauma, says that we need to: “Assume that all children who have been adopted or fostered have experienced trauma.”

None of this is New

>> As early as 1937, psychiatrist David Levy presented case histories showing that adoptees suffered from what he called “primary affect hunger” — what is now called attachment disorder — which is not a disorder but a normal reaction to maternal/child separation and deprivation. At the same time John Bowlby and Mary Ainsworth reported findings establishing that the attachment bond between a biological/gestational mother and her child is formed in the womb, where fetuses develop preferential responses to maternal scents and sounds that persist after birth.

>> During the 1940s and 1950s other American and British clinicians continued to report the powerful negative consequences of growing up “without genealogy.” Marshall Schechter, a psychiatrist in private practice in California, reported that adoptees were 100 times more likely than non-adoptees to present a range of serious emotional problems. While criticized for using too small a sample, a follow-up report presented empirical data confirming that adoptees showed up in clinical populations everywhere at much higher than average rates. Povl Toussieng, a child psychiatrist at the Menninger Clinic, likewise found that up to one-third of all children seen as outpatients at the clinic were adopted.

>> Schechter, Toussieng and others found that first and closest ties formed between infants and the adults who care for them were crucial determinants of personhood. Children had difficulty coping with feeling rejected by birth parents and no amount of reassurance that their adoptive parents loved and wanted them could make up for the “severe narcissistic injury” that adoption inflicted. Schechter’s account of the damage that adoption does to children is widely accepted by parents and professionals who agree that attachment and loss are at the heart of what makes adoption a distinctive and difficult experience. This consensus comprise the book, The Psychology of Adoption (1990) by Schechter and developmental psychologist David Brodzinsky.

>> Between 1998 and 2015, psychologist Nicholas Zill documented the behavior of 19,000 kindergarten and first-grade students for the National Center for Education Statistics. His research involved having teachers test and evaluate the behavior of children who were in permanent homes, but separated from their primary biological families prior to entering Kindergarten. The report concluded these children “tend[ed] to have worse behavioral and academic outcomes in kindergarten and first grade” than their peers and were also “more likely to get angry easily and to fight with other students” (Zill, 2015, p. 4).

>> Cook et al. (2005) reported: “When [loss of] the [primary] caregiver relationship is the source of the trauma…80% of these children [will] develop insecure attachment patterns” and this “manifests itself in survival-based behaviors that are rigid, extreme, and dissociative…revolving on themes of helplessness (abandonment, betrayal, failure, dejection) or coercive control (blame, rejection, intrusiveness, hostility). This also creates a lifelong risk of physical disease and psychosocial dysfunction”.

>> Today, it is generally accepted that mother-child separation — even immediately after birth and even with a constant substitute primary caregiver — causes neurobiological vulnerability into adulthood. Perry’s (1995) findings — supported by Myron Hofer (2006), Schore (2001), and Sunderland (2015) — report the trauma of early separation “determines the organizational and functioning status of the mature brain” and how emotional “dissociation become [s] a [permanent] maladaptive trait” that alters the “the limbic area responsible for attachment and affects regulation, and aspects of emotion” (p. 274).

>> Paul Sunderland, who came at the subject of adoption after noting the higher than expected percentage of adoptees in his work in addiction recovery, discovered and uncovered the early psychological wounds of relinquishment and adoption and has presented his findings at adoption conferences worldwide.

>> Nancy Verrier found that roughly 90% of adoptees are diagnosed with ADD/ADHD, as well as various anxiety conditions. Sunderland says that is because they are constantly living on red alert, hypervigilant, due to the levels of chemicals they experienced from the trauma of separation at birth.

>> Adoptees of all ages are significantly over-represented in all mental health facilities and programs and have a four-times greater experience of attempted suicide than their non-adopted peers.

>> Silverstein and Kaplan (1982) found that: “Adoption triggers seven lifelong or core issues for all triad members, regardless of the circumstances of the adoption or the characteristics of the participants

  1. Loss

2. Rejection

3. Guilt and Shame

4. Grief

5. Identity

6. Intimacy

7. Mastery/control”

>> MRI imaging done by Dr. Shore at UCLA and the PET scans done by The Harvard Department of the Developing Child both detected differences in the brains of children separated from their gestational caregiver and those not separated.


With all we have long known of the overwhelming and irrefutable studies of lifelong effects of the loss and grief of the relinquishment or termination of parental rights that precedes every adoption and surrogate contract, we cannot in good conscience continue to encourage and promote either.

Adoption in the past was about finding homes for babies and children in need. Throughout the 1940s, 50s and 60s — The Baby Scoop Era — lack of birth control and the stigma of single parenthood led to an abundance of babies placed for adoption. The public nostalgically holds onto this old idyllic version of adoption wherein a child in need is “rescued” by those longing to be parents and they all live happily-ever-after.

Nowadays, however, it is the total opposite. The entire process has been turned totally on its head. It has morphed from starting with the needs of children putting those first and foremost and turned instead into a marketplace driven by demand for babies. Adoption today is a mega-billion-dollar industry driven and financed by those willing to pay tens of thousands of dollars to adopt a child, which creates corruption, exploitation and the commodification of children with prices based on race.

The inability to have children is painful and drives adoption loss and separation. Thus part of the solution is a major educational project aimed reducing preventable infertility, in particular, that childbirth cannot be delayed without making it more difficult and increasing risks.

Promoting stranger adoption results in children being “8 times more likely to die of maltreatment” than children in households with biological parents, which in turn is likely a contributing factor in adoptee suicides.

Promoting relinquishments results in large numbers of children needing special education classes and adolescents and young adults in mental health and substance abuse rehabilitation facilities is cruel and inhumane as well as financially counter-productive. As a society, we put limitations on the tobacco industry’s cigarette sales for the health and safety of our citizens and to reduce related health care costs. We are likewise working to curb the pharmaceutical industry’s role in opioid addiction. Many nations have halted their transnational adoption programs because of corruption and are finding ways to provide for children in need within their borders. Surrogacy is illegal in most of the world. We need to likewise curtail an industry that commodifies children and creates lifelong trauma at great cost to society.

Opposition is strong. The adoption industry has powerful lobbyists and huge PR budgets to keep promoting the redistribution of children to meet a demand which now includes same-sex couples who have made adoption and surrogacy part of their agenda and attack the fact that no one has a “right” to adopt or utilize surrogacy as homophobic.

Simultaneously, there is a misperception that there are children languishing in orphans and foster care that need to be adopted. The truth is that 90% of children in orphanages worldwide have families who want them. Additionally, while there are half a million children in state care who cannot be reunified with families, those eager to adopt compete for newborns believing they are free from the damage of foster care or overseas orphanages.

We can never totally eliminate the need for alternative care for children but we must listen to the researchers and to adult adoptees who articulate the challenges of their lived adoption experience. We must listen to the teachers and clinicians who work with adopted children, adolescents and adult adoptees.

We must put the needs of children before the wants of adults and work to prevent as many maternal separations as possible by providing support for mothers and families in crisis. It is imperative to get the money out of adoption and put far more government resources into the prevention of familial loss and separation through family preservation programs, such as those enacted on February 9, 2018 as a part of the Bipartisan Budget Act (HR. 1892).

Family First includes long-overdue reforms to help keep children safely within their families and avoid traumatic separations. The law gives states and tribes the ability to access federal resources for prevention and early intervention services to keep children safe, strengthen families and reduce the need for foster care whenever it is safe to do so and provides support for kinship (relative) caregivers. In passing the law, Congress recognized that too many children are unnecessarily separated from parents who could provide safe and loving care if given access to needed mental health services, substance abuse treatment or improved parenting skills.

We need to do more to put these goals in place to protect children from the harm of loss of continuity. We need to put the rights of infants and children over a money-making industry that exploits the wants — not needs — of adults.


· Grief and Loss in Adoption, PACT

· Adoption & Loss: The Hidden Grief

· Coping With the Grief of Adoption in a Healthy Way, American Adoptions

· Adoptee Issues: The Impact of Adoption Trauma, Loss and More

· Grief and Loss in Adoption by Meg Roetta, MSW, LMSW, Lutheran Family and Children Services

· Adoptees “Flip the Script” on National Adoption Month

· But I adopted my child at birth. What do you mean trauma?

· Is Adoption Trauma?

· Adoption-Related Trauma and Moral Injury

· How Mother-Child Separation Causes Neurobiological Vulnerability into Adulthood

· The Effect of Early Trauma on Adopted Adolescents

· Trauma, Trust, and Academic Achievement Stories Shared by High School Dropouts

· Lecture on Adoption by Paul Sunderland