Breaking Down Barriers: Healthcare for Adopted Adults

Jade Wexler experienced her first medical conundrum as a teenager when she realized her adoption status made her health history incomplete at the doctor’s office. This personal experience sparked a journey that led her to a groundbreaking study on the challenges adopted adults face in healthcare.

The Personal and Professional Journey

When Wexler was young, sitting in her pediatrician’s waiting room, she faced a dilemma: how to fill out a medical intake form with questions about her family’s health history, something she couldn’t answer due to her adoption. Her experience was isolating and confusing.

Years later, as a medical student at Brown University, Wexler encountered similar challenges from the clinician’s perspective. She observed that there was little guidance for doctors on treating patients with limited family medical history, particularly those who were adopted.

Wexler’s curiosity led her to launch a study involving 23 primary care physicians. Through interviews and hypothetical clinical scenarios, she aimed to understand how clinicians cared for adopted adults.

Study Insights and Findings

The study, published in Annals of Family Medicine, revealed significant gaps in the training and awareness of healthcare providers regarding adoptees. These gaps can hinder preventive care and lead to adverse health outcomes, potentially alienating patients.

Many clinicians struggled with adjusting screening protocols and mental health assessments for patients without biological family history. One physician participant summarized the issue succinctly: “Until we had this discussion, I never even thought of this as something missing in our education.”

The Broader Impact

Adoption is not just a childhood experience; it affects health throughout life. According to the Adoption Network, an estimated five million Americans are adopted, and a 2022 survey by the Dave Thomas Foundation for Adoption found that one in ten adults in the United States was adopted as a child.

However, no standardized medical training or clinical guidelines exist for healthcare providers to address this population effectively. This lack of guidance can have serious consequences, including increased risk of mental health issues. One study in Pediatrics found that adopted adults were 3.7 times more likely to report attempted suicide compared to their nonadopted peers.

Without adequate family medical history information, adoptees often worry about screening for conditions like cancer and fret over the implications of unknown health risks. This anxiety can be particularly pronounced with the rise of direct-to-consumer genetic testing kits. Many adoptees seek genetic testing, but interpreting results accurately and providing appropriate counseling can be challenging for clinicians.

Jennifer Chambers, MD, a pediatrician and medical director of The Adoption and Foster Care Clinic in Hoover, Alabama, emphasizes the importance of genetic counseling. She notes that genetic testing can reveal birth relatives or uncover family health information, adding layers of complexity to the process.

Improving Care for Adoptees

Several small changes can significantly improve healthcare for adopted adults. For instance, electronic health records should include options to indicate a patient’s adoption status or indicate unknown family history. This simple update could normalize the experience for adoptees and make it easier for clinicians to understand and address their specific needs.

Clinicians should also modify how they ask about family health history. Instead of assuming biological connections, they can start with open-ended questions like, “What do you know about your biological family’s medical history?” This approach avoids making adoptees feel like outliers.

Training modules for medical residents, like those developed by Wexler, can help integrate best practices for treating adoptees. These efforts can lead to broader reforms in medical school curricula and continuing education for practicing physicians.

Conclusion

Adopted adults deserve thoughtful, informed care, and the healthcare system is slowly recognizing the need for specific training and guidelines. By implementing small changes and emphasizing the importance of identifying and addressing unique healthcare needs, clinicians can significantly improve the quality of care for adopted adults.

As a society, we must continue to advocate for these changes. Adoptees are an integral part of our communities, and their health and well-being should be a priority.

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