Abstract
The internalisation of stigma by adoptive parents has been related to depressive symptoms and dysfunctional family behaviour. This study investigates stigma internalisation and perception, and their relationships with social support from family, friends and the broader community. The aim is to determine the extent to which adoptive parents feel that societal attitudes are stigmatising and how social support influences stigma. Data were collected using an online survey and semi-structured interviews. Participants (n = 43) reported that the motivation to adopt and the nature of the adoptive family are poorly understood by non-adopters and that the media portrays parents in an unrealistic manner, as either ‘heroes’ or ‘desperate’. Location was found to be significant, with people living in cities perceiving lower stigma than those in towns, suburbs and rural areas. Social support came from an extended ‘family’ made up of close friends, other adopters and religious communities. The findings point to a need for more extensive education on adoption in schools and the media, for increased support services in less urbanised areas and for earlier support for parents adopting from outside their local authority.
Introduction
In recent decades the profile of children needing adoption in the UK and Ireland has drastically changed: contemporary adoptees are likely to have experienced abuse or neglect and have specific physical, emotional, developmental and educational needs (Selwyn, Wijedasa and Meakings, 2014). The task of social workers is to find a family with the skills and resources to deal with, for example, sibling groups, disabled children, minority ethnic children or children exposed to drugs or alcohol (Thomas, 2013). In recognising the increasing challenges facing adoptive parents, existing literature has highlighted the influence of friends and family support on their well-being (Rosnati, Ranieri and Barni, 2013), while also stressing the importance of taking into account societal attitudes and their impact on mental health and family functioning (Miall, 1996). Yet little is known about the relationship between societal attitudes towards adoption as perceived by adoptive parents and their experiences of social support. Thus, this article seeks to explore whether attitudes towards adoption are perceived as stigmatising and whether social support ameliorates this situation.
Societal attitudes towards adoption
Society’s attitudes towards adoption are salient to the self-perceptions of adoptive parents because such attitudes are likely to affect how they talk about adoption and, consequently, how they perceive themselves. One observed attitude, arising from the idea that adoptive parenthood is ‘second best’ to biological parenthood, is known to influence parents’ unwillingness to share experiences for fear of being judged as ‘failures’ for not being able to biologically conceive, together with a concern that their child will be seen as ‘different’ (Miall, 1987). Matching children and parents on the basis of their physical appearance increases the likelihood of being seen as the ‘real parent’ but in doing so emphasises the importance of the biological background by trying to give the appearance of shared genes (Herman, 2002; Wegar, 2000).
Another significant attitude is linked to the necessity of proving that applicants will be good parents before being able to adopt (Hartman and Laird, 1990) and the view that it is they who should solve problems originating from the time before the child was placed with them (Grotevant, McRoy and Jenkins, 1988). Adoptive parents allocate more resources to their children than other family types, a phenomenon traditionally explained by their older ages, relatively high incomes and pressure to be ‘perfect’ (Hamilton, Cheng and Powell, 2007; Hartman and Laird, 1990).
Several researchers (e.g. Kirk, 1964; March, 1995; Miall, 1987) have investigated the ways in which society’s attitudes towards adoption might be perceived as stigmatising by adoptive parents. Stigma has been recognised as one of the ‘most serious and devastating psychosocial issues’ (Chronister, Chou and Liao, 2013: 583) and has been related to lower self-esteem, poor quality of life and depression (Link, et al., 2002). Stigma can be understood as two related but distinct processes. One, called ‘stigma perception’, is the awareness that many people in society have negative beliefs towards adoption; the other, known as ‘stigma internalisation’, is the extent to which one feels that such beliefs apply to oneself and one’s family. The two are not necessarily related as being aware that others hold stigmatising beliefs about one’s family does not necessarily mean internalising them (Goldberg, Kinkler and Hines, 2011), but such attitudes can lead adoptive families to feel marginalised and devalued (Kline, Karel and Chatterjee, 2006).
Stigma arises when an individual or a group threatens the norms of the majority (Goffman, 1968), which in the case of the family concern fertility and kinship. It originates from the childless status of the adoptive couple: the fertility norm is that couples should reproduce and want to do so; childlessness, whether voluntary or not, is seen as a form of deviant behaviour, leading mothers to perceive infertility as a ‘failure’ (Miall, 1987; Whiteford and Gonzalez, 1995).
Adoption also contradicts the kinship norms prevalent in western societies (March, 1995) according to which bonds should be based on blood relations. Adoptive mothers have mentioned that people see adoption as the ‘second best’ option and that adopted children are ‘second rate’ because of their unknown genetic past, hence, society conveys the message that they are not ‘real parents’ (Miall, 1987). Adoption does not feature very often in the media and when it does, popular culture continues to fuel its stigmatised status, for example, with programmes on adoptees looking for their biological parents (Wegar, 1997).
Stigmatising beliefs and social support
Many adoption support groups provide meaningful emotional assistance for parents to discuss personal matters in a safe environment and exchange information (Bryan, Flaherty and Saunders, 2010). But the availability of support services varies geographically across the UK, with more on offer to people in large cities (Rushton and Dance, 2002). However, there is less recognition that adoption can potentially be stigmatising, leading to situations where there are no post-adoption services specifically providing help to adoptive families facing stigma in their communities (Wegar, 2000). The mismatch between the support needed and that received is due not only to parents not knowing which services they are entitled to but also to their reluctance to ask for help from a fear that their request might be attributed to some fault of their own (Rushton, 2003; Sturgess and Selwyn, 2007), which links back to the impact of widespread attitudes on parental behaviours.
Outside of formal services, social stigma can be countered by a strong social support network. The knowledge that one will receive support if needed is identified in the literature as ‘perceived support’ and has been found to predict well-being (Bristol, 1984; Osofsky and Thompson, 2000) and to act as a buffer against stressful life events (Wills and Shinar, 2000). Thus, social support is an important protective factor ‘in facing challenging transitions such as that of adoption’ (Rosnati, Ranieri and Barni, 2013:12).
Support from family and friends is not always forthcoming. This may be due to wider social stigma but also to individuals in the parents’ network struggling to understand the motivations behind adoption, as discussed in Selwyn and colleagues’ (2014) study of adoption disruption. Additionally, they might stop helping because of the difficulty in coping with the demands of rearing an adopted child (Sturgess and Selwyn, 2007). Whatever the reason, adopters can become isolated and be deprived of potential ways of easing stress. In compensation, some find support from their religious community in the form of a ‘family surrogate’ (Glock, Ringer and Babbie, 1967), so altering traditional perceptions of ‘family’.
Study aims
In the light of this situation, the study aims to provide a comprehensive picture of adoptive parents’ support networks and how social support relates to negative and potentially stigmatising attitudes towards adoption in the UK and Ireland. The overarching research questions used to guide the data collection and analysis were:
How much support from family or friends do adoptive parents perceive, and how much importance do they attribute to this? What are the factors influencing these perceptions? Who do adoptive parents see as providing informal support? What are the levels of stigma perception and stigma internalisation in this sample, how do they relate to support and what are the significant factors? What are adoptive parents’ experiences of other people’s attitudes to adoption and to what extent can they be seen as ‘stigmatising’?
Methods
Participants
The participants comprised adoptive parents in the UK and Ireland. Information about the study was posted on the website www.adoption.uk, shared on Twitter and re-posted by adoptive parents, forwarded to CoramBAAF and emailed to the manager of the adoptive parents Buddy Scheme in the authors’ local authority. Forty-three adoptive parents responded. They were aged between 30 and 70 years (M = 44.55, SD = 8.93); 76% were female and 81% in a heterosexual relationship, 12% in a same-sex one and 7% single. Forty-five percent said they lived in a city, 24% in a suburb, 21% in a rural location and 10% lived in a town or other location. The mean time since placement/adoption was five years and the mean age of the first adopted child was eight. Fifteen respondents out of 43 had adopted a second child whose mean age was seven. Eighty-six percent of the participants reported not having biological children.
Design and ethics
A mixed-method approach was used to address the research questions. All consenting participants completed a secure online survey consisting of social support and stigma scales and provided background data on their family circumstances. A subsample of survey participants took part in semi-structured interviews to examine the issues of support and stigma in greater depth. Ethical approval for the study was granted by the University of Oxford’s Education Department Research Ethics Committee.
Measures
The family and friends support scale
Social support was measured using a family and friends support scale, based on the instrument created by Bonds and colleagues (2002). To give participants a wider choice of responses to describe the extent of perceived social support, the instrument’s four-point scoring system was transformed into a five-point Likert scale. The 38 items of the original scale covered the categories of practical support (e.g. ‘My friends would babysit, if I needed them to’), informational support (e.g. ‘I get good ideas about parenting from my friends’), esteem support (e.g. ‘My family members express confidence in me as a parent’) and venting support (e.g. ‘I have family members I can talk to when I just want to blow off steam about parenting issues’). A higher score on the items represents a higher level of support. 1
The Feelings About Adoption Scale
Social stigma was measured using the Stigma Perception Scale and the Stigma Internalisation Scale, grouped together in the Feelings About Adoption Scale (FAAS) (Goldberg, et al., 2011). This eight-item scale has a five-point Likert scale scoring system. Five items constitute the Perceived Stigma Scale (e.g. ‘People have indicated to me that they feel that as an adoptive parent, I’m not a “real” parent’); the other three items define the Internalised Stigma Scale (e.g. ‘I have felt that being an adoptive parent is second rate (to being a biological parent)’. Higher scores indicate higher levels of perceived and internalised stigma. 2
Interviews
As part of the online survey participants were asked to take part in an interview, either by phone or in person. Of the 20 people who indicated an interest, seven semi-structured interviews were arranged, two were conducted in person at the authors’ university and five by phone. The themes covered were: family’s and friends’ support and child’s integration; reactions to the decision to adopt by family, friends and other people (e.g. at school); and perceptions about society’s view of adoption. Interview transcripts were analysed using thematic analysis (Braun and Clarke, 2006).
Results
Survey responses
Mean (and SD) of support and stigma scales, by gender and living area.
In terms of actual help received, a dependent-samples t-test showed that adoptive parents perceived more support from their friends than from their families (t(40) = 3.06, p = .004), but in terms of the importance attributed to that support, no significant difference was found in the ratings. Respondents reported significantly more stigma perception than internalisation (t(40) = 12.60, p < .001).
In terms of background factors, parents’ gender was not related to perceived support from families or friends or to either perceived or internalised stigma. However, there were gender differences in the importance of both family and friends support (p = .057 and p < .001, respectively). As Table 1 shows, women rated the importance of support from family and friends highly whereas men tended to rely more on relatives. 3
A further analysis using a one-way ANOVA showed that living area had no significant effect in five of the six support and stigma subscales. But, there were statistically significant differences between parents living in different areas in terms of perceived stigma (F(3,37) = 5.99, p = .002). Post-hoc tests revealed that parents living in cities or rural areas perceived significantly lower levels of adoption stigma than those living in suburbs or other locations (ps < .030).
All the other demographic variables were unrelated to the measures of support and stigma.
Correlations between support and stigma scales.
p < .05, **p < .01, ***p < .001
Finally, four multiple regression models were created using a forced-entry method to identify the significant predictors of perceived family and friends support and perceived and internalised stigma. In each model, the remaining three support and stigma subscales were entered as predictors, along with parents’ living area, since this had been shown to be significant in the earlier analyses.
The models for perceived family support and internalised stigma were non-significant. However, the model for perceived friends support significantly predicted 19% of the variance in outcome, and showed that greater perceived stigma still predicted lower friends support, even after controlling for other factors. Notably, the model for stigma perception significantly predicted 46% of the variance in outcome, showing that lower friends support, greater stigma internalisation, living in a suburb and living in a town or other location were all unique predictors of greater perceived stigma.
Interview themes
An aim of the survey was to determine whether negative attitudes towards adoption were perceived as stigmatising by parents, given that the results of the FAAS showed that they recognised the negative attitudes held by many people. Crucially, both the measurement scales and the interviews revealed that lack of knowledge and misunderstandings of adoption did produce feelings of stigma. Negative attitudes also affected parents’ willingness to share about adoption. These findings will be elaborated in discussions of the seven themes emerging from the interviews.
Blood ties
A major issue arising in the interviews concerned the ways in which society emphasises the importance of blood ties in creating a family and relegates adoptive parents to a second rate status. Parents were often asked: ‘Who are the child’s real parents?’: People who we didn’t bring closely to our decision process took a while to visit us, I think they were sort of, ‘I don’t know, it’s so sudden, it’s a family from nothing, I am not quite sure how I should react to that.’ […] Other people are kind of surprised if they call me mummy and I am like, ‘Well that’s what I am.’ (Miriam)
Matching the child with the parents on the grounds of appearance is one way of emphasising biological ties and adoption agencies often try to match the child with the parents so as to resemble, in as far as possible, biological kinship (Herman, 2002). Ellen gave an example of this: Some people are surprised when I say that she is [adopted] because she looks so much like me that you wouldn’t know, so that was very good when they matched her, that she doesn’t look totally different to me. (Ellen) If it is covered in the media it is covered in the aspect of adoptive children as victims or parents as heroes or desperate. Talking about infertility treatments, you never get parents who are seeking to become adoptive parents: they are always ‘desperately seeking’. (Martha)
Misconceptions about adoption
Parents gave several examples of misconceptions about adoption, which seen in the light of the scores on the FAAS, can be assumed to be perceived as stigmatising. Paradoxically, if at times adoptive parents were depicted as ‘desperate’, just as often they were called ‘heroes’. One interviewee reported a common reaction as ‘Weren’t you wonderful to do this?’ Martha had the feeling that what other parents actually meant was, ‘Gosh, I wouldn’t do it but you are very brave to do that.’ Sven was struck by people’s inability to see the reality rather than the idealisation of why a couple unable to have children would want to adopt: ‘They never say how lucky you are, it’s always how lucky the child is'; and, ‘Aren’t you good for doing this?’, which is not how most adoptive parents feel at all. This lack of knowledge about adoption can lead parents to feel the pressure to be ‘perfect’ and cause them to feel isolated. As one interviewee said: Sometimes you just don’t want to tell people things are not going well […]. One of the concerns is that if you say, it’s not going well, or I am fed up with my children today, you feel that people are going to go, ‘Well, it’s your choice, you wanted them.’ It is my choice, I am happy I made that choice, but actually today it feels pretty bad. And yesterday it felt great and tomorrow it will probably be great, but today it felt rubbish! (Miriam)
Although adoptive parents should not have to be perfect, they do often need to approach their children’s behaviour with specific parenting styles and may be required to have a deeper understanding of children’s development than the average parent. Ellen stated that ‘you can’t parent an adopted child the same way you would a birth child […], their emotions are totally different’. Along the same lines, Gabriella was disappointed that adoptive parents need to have training about brain development and the consequences of early neglect, but that biological parents do not seem to have such knowledge: What they see is a child behaving a certain way and they look at you like, ‘What are you doing wrong? Why are not doing something about it?’
When parents spoke about non-adoptive parents, they portrayed them as empathetic but unable to truly understand adoptive parenthood. This is especially reflected in the tendency to over-simplify an adopted child’s behaviour: People with biological children don’t always understand where you are coming from. I think there is always a tendency to say, ‘It’s normal for children of this age’ when actually you might be thinking, ‘It might be normal or there might be something else going on here.’ (Gabriella) ... there is still a belief that [adoption] happens not because of the horrible things [my daughter] had to put up with, but because the parents split up or one of them can’t manage or they have died.
Openness about adoption
In response to these misconceptions, adoptive parents varied in terms of their openness to sharing the adoptive status of their children. Some decided that it was something to celebrate, while others preferred to keep quiet to avoid turning it into the characterising feature of their child. Jonas followed the latter approach: We don’t want the fact that she’s adopted to be what identifies her, the label that is attached to her. That’s why we did not explain that she was adopted to people, unless it was necessary. On their adoption day, we have a much bigger party than when it is their actual birthday. When they were little, they’d have a party, they’d have presents, and even now, they still want to celebrate it.
Internalisation of stigma
The interview questions were not designed to directly investigate the extent to which participants had internalised stigma in their self-concept as parents or the view of their families. Nonetheless, some responses showed how they had dealt with the perception of stigma. Jonas’s wife, for example, felt the psychological pressure of having to be a ‘therapeutic’ parent. This may be down to adoptive parents perceiving that they should be able to solve problems originating from before the placement. On the other hand, Martha actively countered the stigmatising view that she was not her daughter’s real parent by correcting people who would call her daughter’s biological parents ‘real’.
Social support
The survey results showed that the degree of social support from family and friends was well above the midpoint of the measurement scale. Most participants had previous experiences of adoption or fostering and having relatives who already adopted or fostered was a way of normalising adoption for the new parents as well. The importance of family support was pointed out by Martha: We didn’t have any adoption models in the family and I think it would have helped having someone who had actually been through the adoption process to talk to. All the people in [county] do their best to support everyone, but no one there has adopted a child or has been adopted. […] they haven’t got first-hand knowledge of what is like to adopt. (Ellen)
Jonas gave an example of the degree to which his support network had been a source of strength and how the lack of it had been an issue for his wife: I think my wife finds [some] questions that I mentioned […] quite hard to discuss with people. For me the support networks meant that anything embryonic like that you can discuss it before it becomes a big issue.
Making your own support
The interviews suggested a possible explanation for the survey finding that friends were perceived to offer more support than family, but that the importance attributed to them did not differ. This is summarised in the following quotation: My family aren’t local; […] my mum is one and a half hours away. We rely quite a bit on friends that we’ve got here. We have made quite a few friends who have adopted children as well […] but one thing that I have learnt after all these years is that it’s very important to have a family nearby. (Ellen)
The national policy that the local authority in which parents live is not allowed to offer support until three years after the adoption was an issue discussed by the participants. Many of them found themselves in need of help but had trouble obtaining it because the local authority their children came from was too far away: Our daughter came from somewhere about two to three hours north of us, and we found that we needed support from them and it was very hard to access it because we were not in the same county, but [county] was not allowed to offer support until three years later. (Martha)
The church community was mentioned as a source of emotional and practical support by four out of seven interviewees. Through these functions, the church acted as a family surrogate, especially when the interviewees spoke about their own family living a long way off. Emotional support was embodied in the ability to discuss problems without feeling judged: We have a lot of people within the church who understand our situation and help us in a confidential way. Just the ability to discuss […], they can pray for you and you can share problems. (Jonas)
There were other ways of creating a surrogate family: One of our friends, she has adopted her as her grandmother. There has been a bit of adopting like that, so we can create an extended family of sorts, some of our friends are really extended family to [our daughter]. (Sven)
Discussion and conclusions
The study has highlighted the ongoing stigmatisation of adoption in the UK and Ireland, and the role that adoptive parents’ social support networks can play in countering it. Adoption is still the object of misunderstanding, as shown by the astonishing 93% of this study’s sample agreeing or strongly agreeing with the statement ‘people in society do not understand adoptive families’. The view that adoption is not equated to ‘real’ biological parenthood was highlighted by the fact that friends and family were often unsure how to react to the news of the adoption and the various examples given of misunderstandings. The media play a role in this by portraying adoptive parents as either ‘heroes’ or ‘desperate’. This suggests that more public education is needed, especially in light of the finding that the adoption experience is ‘normalised’ when family or friends already have experience of it. The public discourse on adoptive parents as ‘heroes’, the feeling that they are being judged by non-adopters when their children are acting out in public and the reticence to share when things are not going well at home perpetuate unrealistic expectations of ‘perfect parenthood’, which can be hard to live up to. Willingness to share frustrations around parenting requires a non-judgemental outlet, such as a peer or religious group, but is less likely if this discourse has been internalised, as appeared to be the case for one interviewee’s wife. The pressure to be ‘perfect’ constitutes a serious issue in that it might prevent parents from asking for help and might contribute to the idea that it is their own fault if the child is experiencing difficulties. Further research is needed to understand gender differences in the way adoptive parents deal with the pressure of having to be ‘perfect parents’ and the role that support groups might play in mitigating this.
Further misunderstandings arise due to a lack of public awareness around the backgrounds and potential long-lasting consequences for adopted children. Unlike foster carers, adoptive parents may face less empathic and more judgemental responses to children’s behaviour. This can discourage parents from revealing children’s adoptive status. One finding of the study was that location can determine the levels of adoption stigma that parents perceive, with those living in towns, suburbs and rural areas more likely to notice public stigma around adoption than those residing in cities. Diverse family structures are more common in urban areas, which would partly explain why families in cities perceive lower stigma. Future research could explore this further, taking into account the links between perceived stigma and adoption disruption.
Although higher perceived stigma was related to greater internalisation of it, the parents who participated were less likely to internalise than to perceive stigma. This is an encouraging finding, but may be a reflection of our sample. Future research should extend the recruitment procedure to include those adopters whose voices are rarely heard.
Levels of support from family and friends were related but distinct experiences and parents do not receive equal amounts from both. In our sample, more support was received from friends, possibly because adopters spoke of having become friends with fellow adopters who were said to be able to offer appropriate help. The interviews revealed that some grandparents lived too far from their children to be closely involved, even if this was offered. Moreover, they showed that participants’ conceptualisations of ‘family’ and ‘friends’ were flexible, with interviewees often building their own ‘family’ from a close group of friends or a religious community. Next to the religious examples, one interviewee offered a secular illustration of an artificially constructed family by explaining how his whole family had been committed to ‘create an extended family’ for their daughter. Each of these examples highlights how families, and their concomitant networks of support, can be created by choice.
The interview findings might suggest that this sample experienced high levels of both support and stigma, but the survey showed that support from friends and the perception of stigma were negatively related, even after controlling for other factors. Either those with more friend support were less likely to notice any public stigma or those noticing more stigma were less likely to have supportive friends. One possible explanation for this finding is that adopters in this sample surrounded themselves with other adoptive parents. If so, this offers a promising avenue for the use of adoption support groups in countering stigma. However, the potential role of friends' support as a buffer against stigma needs to be tested in a longitudinal design. Particularly significant here is the finding from friendship studies that women are more prone to share emotional experiences with their friends while men tend to share activities (Wright, 1982). Indeed, some parents questioned the instrument used to measure support from friends as they were unsure whether they should average out the amount of support they felt they received from all their friends; they suggested that having a measure that focused first on close friends and then on more distant ones would have been more sensitive to differences in the degrees and types of support. Implementing these changes in a future study with a larger sample might help to explain this.
Implications for practice
The findings of this study have some practical implications for social workers and policy-makers. Offering support services outside of cities would be an important step for parents living in less diverse and less populated areas. Wherever such services are currently unavailable, provision of local and online support groups could buffer against social stigma. Parents who have adopted from a local authority different from the one in which they live would also benefit from alternative support services tailored around the specific regulation that requires them to wait for three years to get help. Attempting to bridge the experiences of adoptive and non-adoptive parents could decrease the former’s perceived need to be with fellow adopters to feel understood and less isolated. Public education around adoption would play an essential role in not only bringing these two groups closer to one another but also in increasing understanding, altering unrealistic and idealised portraits of adoptive parents and reducing stigma. Information on adoption should extend beyond campaigns such as National Adoption Week into regular media and school curricula.
Footnotes
Acknowledgements
We would like to thank John Simmonds, Director of Policy, Research and Development at CoramBAAF, and the local authority adoption team for their assistance in spreading the word about this research and finding participants. Special thanks also to Aoife, Vânia and Mariela from the Rees Centre at the University of Oxford for their comments on an early draft.
We are also immensely grateful to the parents who took part in the study.