By Julie Ryan McGue
My twin sister and I were adopted during the Baby Scoop Era—post–World War II through the early 1970s—when closed adoption was the only option available to birth moms. Back then, adoption agencies matched babies with adoptive parents without any input from birth parents. Birth parents were promised anonymity, and future contact with their birth child was prohibited. This arrangement granted adoptive parents’ full autonomy to raise their adopted children as they deemed fit. But what all parties––birth parents, adoptive parents, adoption agencies, state lawmakers, and even civil liberties organizations––failed to do was provide for the long-term health and well-being of the adopted child.
For most of my life, I gave little thought to the fact my twin sister and I were adopted, something we seemed always to have known. Did I ponder the “big three” questions–– who are my birth parents, where are they, and why was I adopted––details about which most closed adoption adoptees admit to ruminating?
You bet I did.
But as much as I dwelled on the big three as a child, I did not consider how my lack of family medical history would affect me as an adult. I also didn’t understand that adoption meant I had two birth certificates: the OBR (original birth record) that was sealed with my closed adoption, and a redacted one that contained my adoptive parents’ details. It would be years before I comprehended the difference, and a lifetime until I appreciated the role my OBR played in my long-term health.
In our formative years, my adoptive parents would periodically bring up our adoption, quizzing my sister and me about whether we wanted to seek information. “No, we’re fine” was our standard reply. In truth, we were quick to dismiss our folks because we feared our curiosity would be misinterpreted as disloyalty. As an adult––and a parent myself––I wish that instead of asking how we felt about searching, that our folks would have taken a proactive role, advocating and securing information that might keep us healthy as we aged.
Besides those adoption chats with my parents, the only other time I was confronted with the realities of closed adoption were during routine doctor appointments. When asked to fill out my medical history, it was with deep shame that I admitted my status.
“I’m adopted. I don’t know anything.”
Even as I child, I was aware that if a doctor was asking about ailments, medical conditions, allergies, and sensitivities that ran in my bloodline, it wasn’t good to come up lacking. As I matured, I developed a burning anger around what closed adoption had denied me. I’d sit in a doctor’s waiting room, the stack of intake forms filling my lap, and scrawl in large letters across the entire form, “Adopted. N/A.”
As a young woman going into marriage, I was athletic and healthy. I was blessed with four normal pregnancies. Then at forty-eight, suddenly I wasn’t fine. “Six areas of concern” appeared on a routine mammogram. I was sent for a biopsy. My twin sister and I agreed it was time to claim what everyone else who isn’t adopted has the right to know: family medical history.
Since our adoptive parents still possessed our adoption papers, the first step began with them. Dad was quick to say, “We will help you in any way we can,” but Mom was quiet. Her stunning silence and downcast gaze meant she was disturbed and unhappy. The idea of us contacting, and possibly getting to know our birth relatives, had rocked her world. Just as I had as a child, I felt caught between loyalty to my parents and my “need to know.”
My sister and I moved forward, petitioning our adoption agency for the non-identifying information in their files. We were hopeful that the secrets it held would assist my doctors in managing my care. But despite learning fascinating facts about our birth parents––their careers, education, interests, how they met, and why they didn’t marry––there were only a few measly lines about family health: birth mother says birth father wore glasses and everyone in her large family was in good health.
Shortly after my biopsy, the adoption statutes in Illinois changed and I petitioned the state for my original birth record (OBR). Emboldened with false hope, I gave a copy of my OBR to the search firm my sister and I had hired. Their response was quick. “Your birth mother used an alias on the OBR. We can’t help you.” This was something, I later learned was entirely legal in those days. This highlighted the other problem. Where our birth father’s name should have been, were the words: Legally Omitted. This meant that to find our birth dad and get his family health background, we had to find our birth mom first.
Because our OBR was useless, I applied to the Illinois Confidential Intermediary Service (CISI), requesting that the Circuit Court of Chicago assign an intermediary to my case, someone who could legally access the identifying information in our adoption file. We got lucky. Besides the alias, our birth mother’s true identity was in the adoption file. Within weeks the intermediary sent an outreach letter to her.
But three days shy of our fifty-first birthday, my birth mother returned a curt note to the intermediary, denying all contact with my sister and me. Devastated, I appealed to the judge, asking permission to send a second outreach letter to her, requesting family health details. She complied, and we learned that one of our six aunts had survived uterine cancer. Another had beat breast cancer. With these confirmed health risks, my doctors sent me for additional testing. For months, I wondered if this was all the family history I’d ever possess.
Months later, our birth mother surprised us. Nine months after our initial request for contact, she changed her mind. We entered a full reunion. During our first phone conversation, she provided my birth father’s name, and my sister and I launched a search for him. Once we located him, I sent a carefully worded letter. His response stunned my sister and me. His only sibling, an older sister, had died of breast cancer at age thirty-nine.
A few days later, the phone rang. The brother I didn’t know existed weeks before wanted to talk. In that conversation, we discovered an amazing synchronicity, one that compelled us to meet right away. He was married to someone I knew; we figured our paths had crossed many times during the previous decade. Because of this connection, he agreed to DNA testing, proving that the threat of breast cancer was real. My doctors scheduled me for breast cancer gene testing.
Now that I am in reunion with birth relatives, I believe if the “open” adoption process––one that came into vogue in the early 1980s and provides for an exchange of information between members of the triad––had been in place, I might have been spared the angst of searching for years for relatives. People that closed adoption offered protection at the expense of my long-term health.
Should the future health of all closed adoption adoptees have been given a higher priority back in its founding years? Absolutely. Could some kind of provision have been made for adoptees to access birth family health updates at say age 18, 21 or 30? Why haven’t the best interests of adoptees been taken as seriously as the rights of the birth and adoptive parents when ratifying and updating state adoption laws? And why is it that access to this information is still prevented in most states despite the very real health needs of aging adopted children like me?
There are an estimated six to eight million adoptees in the US, people whose “right to know” is still deemed insignificant compared to the “right to privacy” for both sets of their parents. It’s time for the practices of the past to come out of the shadows of secrecy, to shed the misplaced shame of the adoption journey, and to allow access to medical information that’s essential knowledge for future adoptees. Every state, not just a dozen or so, must revamp antiquated adoption statutes and provide compassionate and responsible legislation allowing for easy access to vital information.
Julie Ryan McGue is an American writer, a domestic adoptee, and an identical twin. Her first memoir, Twice a Daughter: A Search for Identity, Family, and Belonging, was released in May 2021, winning multiple awards. Her work has appeared in the Story Circle Network Journal, Brevity Nonfiction Blog, Imprint News, Adoption.com, Lifetime Adoption Adoptive Families Blog, Adoption & Beyond, and Severance Magazine. Her personal essays have appeared in several anthologies, including Real Women Write: Seeing Through Her Eyes (Story Circle Network) and Art in the Time of Unbearable Crisis (She Writes Press). Her collection of essays, Belonging Matters: Conversations on Adoption, Family, and Kinship (Muse Literary), released in November 2023. She writes a biweekly blog and monthly column (The Beacher Newspapers), in which she explores the topics of finding out who you are, where you belong, and making sense of it. McGue splits her time between Northwest Indiana and Sarasota, Florida. Twice the Family: A Memoir of Love, Loss, and Sisterhood is her third book. Visit her website for more information.