International adoption, rise and fall

Back when my readers numbered a small fraction of the small number of people who now read this blog, I wrote a handful of posts about international adoption. This link should bring them up. It had recently become apparent that international adoption was declining worldwide, and there was a debate over whether this was good or bad.

Someday I’ll update the posts with new information and read up on the state of the issue, but in the meantime here’s my updated figure on the trend, which shows international adoptions to the United States have dropped more than a third just since 2010, and more than two-thirds since the peak in 2004:

Source: The data back to 1999 are here. I can’t find the link to the 1990-1999 numbers.

I should go pull some countries out of “other” now that the composition has shifted (For example, Ukraine is in the top 5 now, and more kids come from Haiti than from S. Korea).

One obvious pattern is that the decline in adoptions from China has slowed or stopped. After about 2008 virtually all of the children adopted from China have medical needs (see, e.g., this agency page).

In 2004 I figured a child adopted from China would be on the leading edge of a large, if not growing, wave. I wonder how the experience would be different if that had been the case.

Thankful for families, or not

Hunger is unequally distributed around the world, as we know. And in the places where hunger is a serious problem, it also is unequally distributed within families.

Around the world, populations range from almost no systemic undernourishment to more than 35% undernourished (click for the full PDF map):

How do families help? Naturally, parents feed their children when they’re young, and when necessary children feed their parents when they’re old. When parents or children are too poor to feed each other, governments, others in the community, or aid agencies may help. And when there is no government or other aid, the people without families are especially vulnerable.

Within families, though, nutrition flows unevenly.

The tendency of parents to give girl children less food has been observed in studies from India, Bangladesh and others, but it is not universal – varying between regions and across family types and children’s ages, for example. Local variability offers insights into how this works: Indian communities in which adult women have relatively higher status show less discrimination against girls.

These things are never quite as simple as they seem, though. For example, in some parts of South Asia fertility has fallen but there is still strong son preference. One implication is sex selective abortion — because the stakes are higher when they’re only having a couple children, parents may get desperate for one of them to be a son. The other thing that happens is people are more likely to stop bearing children after they have a son – not after they have a daughter. Math-wise, that means daughters have more siblings, on average. And that brings us back to boys getting more food — which is especially the case in larger families.

Personally

I hate child hunger, a subject painful enough that I exercise my tenure-given right to choose a different research topic. Disparities in educational opportunity or gender socialization are one thing, but gross differences in mid-upper arm circumference (representing malnutrition) are something else. But charitable giving is easier than research.

If you’re fortunate enough to be able to give some charity this year, consider adding the right international targets into your giving mix. Our family’s non-systematic review of charitable options has produced two leading targets: Love Without Boundaries which provides humanitarian aid, including medical care, to Chinese orphans and poor children; and Doctors Without Borders, which provides medical aid to those most in need in many countries. In addition to their reputations for sound financial management and good ethics (check Charity Navigator or another evaluator), these organizations help provide for people when their families can’t or won’t.

Mother no more?

North Carolina’s Supreme Court voids “second-parent” adoptions by homogamous couples.

Related Topics, by Julie Shapiro, calls my attention to a very aggressive anti-gay-parent ruling by the N.C. Supreme Court, which retroactively voided the adoptions of same-gender spouses. The decision, in the case Boseman v. Jarrell, went beyond the couple at hand to undo existing adoptions in which an adoptive parent joined a biological parent and shared parental rights, much like step-parents may do.

The public profile of the case is elevated by the fact that Boseman is Julia Boseman, the state’s “only openly-gay state senator,” the only one to vote against honoring Jesse Helms when he died, and a key supporter of anti-bullying and comprehensive sex education programs.

Shapiro writes:

The case begins with a familiar if sad scenario. Julie Boseman and Melissa Jarrell, a lesbian couple, decided to raise a child together. Jarrell became pregnant via insemination with sperm from an anonymous provider. Their son, Jacob, was born in October, 2002.

Jarrell and Boseman lived together with Jacob until 2006, at which point they separated. There’s no doubt that each of the women acted as Jacob’s mother before their separation, sharing the responsibilities and obligations of parenting. … In order to secure Boseman’s rights, the two women [had gone] to court in 2005 and requested that Boseman be recognized as an adoptive parent of Jacob [without terminating Jarrell’s parental rights]. The court complied with this request.  … With the adoption in place, when the women split up, you end up with an ordinary custody fight between parents.

But to get a leg up in that custody fight, Jarrell sued to have Boseman’s rights revoked, and that’s what the Supreme Court did — as if the adoption never happened, which is very rare in adoption cases so long after the fact. Not only that, Shapiro explains:

The North Carolina court’s opinion doesn’t just apply to Jacob. It applies to all the other second-parent adoptions that have been conducted there–or so it would appear. All the second-parent adoption completed in NC, even those where the two parents are perfectly happy raising their kids in a unitary family, are void. With the stroke of the pen, the NC court deprived all those families of the legal security that the adoptions provided.

It was just this scenario that those in favor of second-parent adoption rights were afraid of. In its explanation of why it filed an amicus brief on behalf of Boseman, the American Psychological Association said that “about 250 lesbian and gay couples have used the second parent procedure in adoptions in North Carolina. These adoptions, as well as future adoptions, would be at risk if the challenge is successful.”

Revoking the parental rights from stable families could be devastating, as Shapiro explains:

Well, suppose the adoptive mom is injured or killed. If she was a parent, her child might well be eligible to receive various benefits via Social Security. But as of a couple weeks ago, she’s not a parent any more and the child won’t be eligible. Or perhaps the child is eligible for health insurance because of the adoptive mother’s employment? Not any more. Not a legal parent, no more health insurance. …[T]here are probably a number of people in North Carolina who don’t realize that they aren’t legal parents anymore. … They may only find out they aren’t legal parents when it really matters most–when they try to make a claim on insurance and the insurer challenges the child’s eligibility, say.

According to media reports, the only recourse now is a change in state law enabling second-parent adoptions — or, of course, legalize homogamous marriage. That didn’t happen before 2010’s election, and it seems less than likely now that Republicans control both houses of the legislature.

Citizenship: Because I said so

Birthrights, “anchor babies,” and shameless politics.

For a parent, “because I said so” is the ipse dixit‘s justification. For a patriot, there are substantive explanations for the moral chasm between them and us, but they all seem to be variations on the OED‘s definition of “selfish”: Devoted to or concerned with one’s own advantage or welfare to the exclusion of regard for others. The modern state’s reasons for granting or denying citizenship are a mix of “because I said so” and “because we matter and you don’t.”

Birthrights

Democracy is a living monument to individual rights. Except not in real life, where nationalism protects the patriot’s political shenanigans from the shame of selfishness. Today’s example: citizenship. For a newborn baby, yet to commit its first sin, what is the moral principle that lets the citizenship of it parents determine its rights?

“Birthright citizenship” — by which a baby born in the US is as American as POTUS himself — is a welcome case of legally treating children as individuals with their own rights. The rarely-mentioned fact that an “anchor baby” can’t sponsor its parents’ immigration until it turns 21 confirms that it is not the parents who have benefited from a “loophole.” Rather,  the child is itself a citizen — who may act on that privilege (or not) upon reaching the age of majority. (Aside: but shouldn’t that age be 18?)

By one conservative estimate, there are about 4 million U.S.-born children with at least one parent who is an unauthorized immigrant.

But if all those pregnant women without immigration papers think their babies will be anchors — helping them stay in the country after they “swim across the river” and give birth on U.S. soil — they’re wrong. I knew that suburban legend rang a bell, and then I remembered my own post from last year:

Over the 10 years up to 2007, the U.S. deported 108,434 adults whose children were U.S. citizens, according to a Department of Homeland Security report. The exact number of citizen children left behind in these deportations is unknown, because no one in the government cared to count them. … Either keeping your parents from being dumped over the border isn’t a right Americans enjoy, or someone in power doesn’t really think these kids are American. Or both.

Litigating exclusion

The principle of “settled law,” or stare decisis, is mutable. And when it comes to anti-immigration-election-year politics, ignorance of the law is the only excuse some people need. In the case of birthright citizenship, which some Republicans say they want to eliminate by amending or reinterpreting the 14th Amendment, the principle may be worth refreshing.

Wong Kim Ark was born in San Francisco around 1870 — after the adoption of the 14th Amendment, which reads in part, “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States.”

In 1894, having previously traveled to China and back as a U.S. citizen, he attempted to return from another visit there. This time, however, the authorities blocked his return on the logic that, under the Chinese Exclusion Act of 1882, he could not be a citizen because his parents were Chinese. In an 1898 decision, the Supreme Court declared that citizenship by birth was guaranteed under the 14th Amendment.

It is fashionable among anti-immigrant groups to claim that the 14th Amendment is not clear, or that the courts haven’t spoken directly to this issue. (Practically, this isn’t likely to change right away. But in the meantime, some suggest, maybe the U.S. should deny pregnant women visas.) I am especially incensed by those who pretend that undocumented immigrants are not “subject to the jurisdiction” of the US. Tell that the undocumented immigrants executed here.

What is “jurisdiction,” anyway? Change “and subject to the jurisdiction thereof” to “or subject to the jurisdiction thereof,” and you’d have to let at least the people of Afghanistan and Iraq vote here as well.

On the other hand

While some people are trying to gain citizenship — or at least access — others become U.S. citizens involuntarily after being declared orphans and getting adopted by American parents. A recent NY Times report highlights the scrambling confusion — followed by limbo-citizen status — for some children adopted from Haiti and granted “humanitarian parole.” (Aside from the Haiti situation, intercountry adoption has become less common, but it’s too early to tell if it’s era has ended.)

And then there are the citizens who aren’t. Being a U.S. citizen doesn’t mean the CIA can’t wage an undeclared war on you and blow you to smithereens with a drone — while your lawyer sits in jail for attempting to represent you. Such political de-Americanization was immortalized in the Phil Ochs song “The Ballad of William Worthy,” about the Black journalist convicted of traveling without a passport on his return from Cuba — having had his passport seized after a trip to China: “You are living in the free world and in the free world you must stay.”

(Aside: In the category of arbitrary citizenship rules, maybe for comparison, consider Israel. Because its national identity is religiously-defined, “Essentially, all Jews everywhere are Israeli citizens by right.” Unlike in some religions, children of Jewish parents [mothers] are assumed to be Jews, too. But, like in other religions, people can also convert to Judaism, and after ironing out a few details, those who have converted may also claim their right to Israeli citizenship. If fact, Jewish American parents who adopt children may convert them to Judaism, and then, I suppose, move them to Israel as citizens — giving them two new citizenships and one birthright religion before they’re old enough to speak for themselves. [So, what if the whole world converted to Judaism?] This automatic citizenship for some comes at the expense of those denied access to what is now Israel, including of course some people who were born there.)

So?

There is no way — and no reason — to avoid the underlying tension of citizenship politics, which is the mind-bending level of global economic inequality, largely expressed as between-country disparities. This creates the unbearable pressure that builds along the borders between rich and poor, and fuels the politics around them. That background reality urges me toward an ends-justifies-the-means attitude regarding citizenship, in which I simply root for the policies that favor more open borders in order to increase access by the poor to a better life.

I read somewhere that, “Height variations within a population are largely genetic, but height variations between populations are mostly environmental.” Metaphorically, opportunity and the myth of meritocracy work similarly. Within some populations (say, countries), those who work hard or have better raw material may out-compete their peers and rise to the top (call that genetic). But the inequality between countries is essentially insurmountable by individual effort or ability (call that environmental).

Such are the accidents of birth — and the selfishness of the politics that covets citizenship.

Addendum: The Pew Hispanic Center has updated their report on Unauthorized Immigrants and Their U.S.-Born Children.

Russia’s institutionalized children

Writing in the Washington Post’s Outlook, Darshak Sanghavi uses the tragic case of Justin Hansen / Artyom Savelyev, sent back to Russia by his American adoptive mother, Torry Hansen, to discuss the unique case of orphans living in Russian institutions.

Sanghavi’s essay mentions the paper Rose Kreider and I wrote in Pediatrics last year, which reported higher than average rates of disabilities among children adopted from Russia and Eastern Europe, among other places. As I told Dr. Sanghavi (who is chief of pediatric cardiology at the University of Massachusetts medical school), mental disabilities in this population are often attributed to fetal alcohol exposure, the result of drinking patterns among poor Russian mothers.

However, Sanghavi believes the main problem is the caregiving model that prevails in Russian institutions.

These facilities offer a time capsule of a medicalized approach to child-rearing that was popular in the Unites States decades ago, before the critical importance of children’s attachment to their caregivers was widely recognized and before we realized how damaging orphanages can be.

Rather than neglect, these children suffer from over-medicalization and under-nurturing, he argues.

I’m not well aware of the research on this phenomenon, but I did hear a compelling presentation by Harvard’s Charles Nelson at this year’s Adoption Policy Conference. He shows convincingly — based on experimental data — that a group of Romanian children randomized into foster care from orphanages developed much better, and the effects were larger the earlier they left the orphanage. The presumption that family care is preferable was behind the U.S. transition to a foster care system decades ago.

Although my initial reaction was more or less like this one, I’m not really in a position to offer much on the Hansen family situation. But I did find Sanghavi’s piece to be an interesting way to widen the lens on the story.

International adoption under siege?

After a day at the 2010 Adoption Policy Conference.

I’m not an adoption expert, but I know more today than I did yesterday. Spend a day in a room full of legal experts, advocates and activists devoted to promoting and facilitating international adoption, and you’re bound to learn something. But these days you’re also bound to get a feeling that the whole enterprise is under siege.

What had looked like a tidal wave of adoptions into the U.S. just a few years ago now looks like a roller coaster whose ride is coming to an end:

One of the most articulate versions of the siege story came in the talk by Elizabeth Bartholet from Harvard Law School, which mostly drew from this recent paper:

International adoption is under siege, with the number of children placed dropping in each of the last several years, and many countries imposing severe new restrictions. Key forces mounting the attack claim the child human rights mantle, arguing that such adoption denies heritage rights and often involves abusive practices. Many nations assert rights to hold on to the children born within their borders, and others support these demands citing subsidiarity principles. But children’s most basic human rights are to grow up in the families that will often be found only through international adoption. These rights should trump any conflicting state sovereignty claims.

The forces of siege were not well represented at today’s conference, which revolved around the crisis in Haiti. Many advocates have been frustrated with UNICEF in particular, which sounded the alarm about the potential for abuse and trafficking in the aftermath of the earthquake. To the critics’ minds, this just follows UNICEF’s historically negative attitude toward international adoption. UNICEF’s statement on the practice in general lists international adoption as “one of a range of care options,” not as good as being raised in their families of origin but better than staying in an orphanage. In practice, however, UNICEF seems to treat international adoption as a failure of the domestic system, rather than as a necessary response to the needs of parentless children.

On the other hand, one of the heroes in the room was Whitney Reitz, the representative from U.S. Citizenship and Immigration Services who was credited with engineering the “humanitarian parole” of more 900 Haitian children after the earthquake. These were children whose adoptions were already approved and matched to American parents before the earthquake, but whose final paperwork had not been completed. Reitz and her colleagues, with explicit support from above in the Obama administration, jury-rigged a system to approve their entry into the U.S., which required a signature from Haiti’s prime minister in each case. That system is imperfect — for example, they are not U.S. citizens yet, as orphan adoptees normally are upon arrival — but considering the building with their files in it collapsed, that is to be expected.

On the other hand, I wasn’t sure I was happy to hear Reitz say, “The idea was to help the kids. And if we overlooked Hague, I don’t think I’m going to apologize.” That’s a reference to the Hague Adoption Convention, which the U.S. ratified, and the principles of which the U.S. “strongly supports.” (To clarify this, since Haiti is not a signatory to the Convention, its rules don’t apply to adoptions to the U.S.) Of course, everyone was against corruption and abuse anywhere in the adoption process, under the oft-repeated triple mandate: “ethical, legal, and transparent.”

Anyway, I can’t resolve the battle of competing rights — the right to a family, your original family, a loving home, a secure permanent setting, etc. Everyone seems to agree explicitly that “there is no right to adopt, only the right of the child to be adopted,” but the reality is that the demand generated by adoptive parents is one of the driving forces in this arena — and that includes their money. (As Bartholet points out, of course, that also means international adoption is a way of helping children without government spending.)

Ironically, although many advocates for children are adoptive parents, I am starting to get the feeling that if policy is going to be true to that premise — children’s rights, not adoptive parents’ rights — then the adoptive parents shouldn’t be in the room when the policy is written. In other words, the humanitarian impulse, at least ideally, could be the foundation of public policy — but we can’t expect it to be the motivation for adoptive parents any more than it is for birth parents.

W(h)ither intercountry adoption?

I’m off to the Adoption Policy Conference sponsored by the Center for Adoption Policy and New York Law School’s Center for Children and Families. There I’ll present my paper with Rose Kreider on disability rates among internationally adoption children, in Pediatrics last year. I’ve posted slides from the paper here, and pasted a few of the highlights below, beginning with this chart showing the dramatic drop in immigrant adoptions since the peak in 2005 – a drop of nearly one-half.

With the Haiti earthquake shaking up intercountry adoption, the organizers have retooled the agenda to address the crisis.

Faced with extremely bad situations for children in Haiti, as well as both child trafficking and legitimate adoptions, I tried to do a little reading on the issues. That led me to several legal scholars. Harvard’s Elizabeth Bartholet believes intercountry adoption “serv[es] the most fundamental human rights of the most helpless of humans.” She discusses the issue from a human rights perspective in several papers on her website. On the other hand, Stanford’s David Smolin has several recent papers on the implications of corruption and child trafficking, the most recent of which “looks to the future, and describes the kinds of reforms that would be necessary to make the intercountry adoption system meet the goals of the Hague Convention.” The current situation seems to provide plenty of fodder for both the ethically critical and humanitarian perspectives.

As for our paper, the gist of it is that we analyzed data from the 2000 Census for the presence of disabilities among internationally adopted children ages 5-15 (so, mostly adopted in the mid-1990s or before), and compared them with those adopted domestically. We found no major differences between domestic and international adoptees — though they all have disability rates about twice the national average.

We also compared them by country of origin, and here the differences were quite large.

Some, but not much, of these differences were attributable to other things we could identify — such as the very large proportion of girls among those adopted from China. We didn’t speculate much about the cause of the remaining differences, which could reflect specific conditions affecting poor women in the various countries, the type of care the children received before adoption, and lots of historically specific features of the moments. (These results should not interpreted as predictions about the health or disability of children adopted in the future.)

Anyway, the conference will feature some health experts, as well as immigration and state department folks, so I expect an interesting exchange.