P3B080: The Role Healthcare Professionals Play in Supporting the Unique Ethnic Identity Developmental Needs of Transracial Adoptees

Background: From 2005-2019, transracial adoption in the United States increased from 23 to 28 percent of all adoptions. Transracially adopted children face unique challenges to developing ethnic/racial identity and psychological outcomes. Parents often lack the knowledge and resources to facilitate their child’s ethnic identity formation. Healthcare professionals have an opportunity to facilitate these children’s identity development. However, there is currently no accepted standard of practice or universal training when it comes to transracial adoption.

Methods: In order to address the clinician’s role in transracial adoption, we divided our literature search into 3 distinct categories. First, we reviewed 21 psychological case studies and cohort studies that conceptualized ethnic/racial identity through various theoretical models and ethnic socialization. Next, we reviewed 18 longitudinal, population-level outcome studies that tried to uncover relationships between experiences that promoted or rejected ethnic/racial exploration and psychological adjustment. Finally, we searched for articles pertaining to clinical management and treatment of transracial children and their families by healthcare providers ( n=6). Among the articles selected, 10 overlapped between the first and second categories, 2 between the first and third, 4 between the second and third, and 5 papers between all three categories.

Results: In support of Dr. Jean Phinney’s framework, our review found that a child’s ethnic development is largely dictated by parental and peer interactions. Positive forces include language courses and attending cultural events. Negative forces include racism and discrimination. Interestingly, there appears to be a discrepancy in the reported level of ethnic socialization between child and parent. This difference in ethnic awareness increases risk of familial conflict. In terms of psychological well-being, studies found a positive association between strong ethnic identity and positive psychological functioning, measured in terms of self-esteem and positive attitudes. Conversely, discrimination was associated with poor mental health. Notably, only a small body of literature exists for providing care for this demographic.

Conclusion: Transracial families have an opportunity to discuss race relations in modern American society, celebrate multiculturalism, and advocate for marginalized groups. However, due to lack of resources, most practitioners will not receive adoption medicine specific training to address the needs of transracially adopted children. Future research should be directed towards developing guidelines to provide culturally sensitive training for physicians, relevant pre-adoption connections, screening tools for healthy ethnic identity development, and psychological or community-based intervention resources. Currently, our team is developing the Routine Antiracist Conversations for Early Childhood (R.A.C.E. Worksheet) quality project to support in family discussions surrounding race and ethnicity.