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Adoptions in the United States may be either domestic or from another country. Domestic adoptions can be arranged either through adoption agency or independently.
Adoption agencies must be licensed by the state in which they operate. The U.S. government maintains a website, Child Welfare Information Gateway, which lists each state's licensed agencies. There are both private and public adoption agencies. Private adoption agencies often focus on infant adoptions, while public adoption agencies typically help find homes for waiting children, many of them presently in foster care and in need of a permanent loving home. To assist in the adoption of waiting children, there is a U.S. government-affiliated website, AdoptUSKids.org, assisting in sharing information about these children with potential adoptive parents. The North American Council on Adoptable Children provides information on financial assistance to adoptive parents (called adoption subsidies) when adopting a child with special needs.
Independent adoptions are usually arranged by attorneys and typically involve newborn children. Approximately 55% of all U.S. newborn adoptions are completed via independent adoption.
The 2000 census was the first census in which adoption statistics were collected. The estimated number of children adopted in the year 2000 was slightly over 128,000, bringing the total U.S. population of adopted children to 2,058,915. In 2008 the number of children adopted increased to nearly 136,000.
The United States foster care system enables adults to care for minor children who are not able to live with their biological parents. In fiscal year 2000, 150,703 foster children were adopted in the United States, many by their foster parents or relatives of their biological parents. The enactment of the Adoption and Safe Families Act in 1997 has approximately doubled the number of children adopted from foster care in the United States. If a child in the U.S. governmental foster care system is not adopted or returned to the custody of their birth parents by the age of 18 years old, they are aged out of the system on their 18th birthday.
Adoption is changing the way people form families, as well as affecting the way society perceives the fundamental concepts of life such as nature and nurture and the role of biological relations with an adoptive family member. Because of changes in adoption over the last few decades – changes that include open adoption, gay adoption, international adoptions and trans-racial (racial transformation) adoptions, and a focus on moving children out of the foster care system into adoptive families – the impact of adoption on the basic unit of society and the family, has been enormous.
The adoption of children of one race by parents of another race, which began officially in the United States in 1948, has always generated controversy. The argument often comes down to opposing views as to who gets to decide what is the "best interest" of children. Critics of transracial adoption question whether white American parents can effectively prepare children of color to deal with racism. Others wonder where the children raised by white parents will find social acceptance as adults. Testimony from many transracially adopted adults who grew up in white families illustrates the "in-between" status many adoptees feel, not belonging to or feeling comfortable in communities of color or among white society. Another source of controversy is the history of the widespread removal of children from families and communities of color, which has been shown by historians to have been a tool to regulate families and oppress communities, dating back to slavery times and during the now-discredited Indian Boarding School movement of the early twentieth century. Given this history of child removal, the National Association of Black Social Workers (NABSW) condemned transracial adoptions in 1972 in their historic Position Statement. In that paper, the NABSW equated the removal of African American children from their families of origin—and their placement in white homes—with "cultural genocide."
Pro-transracial adoption advocates argue that there are more white families seeking to adopt than there are minority families; conversely, there are more minority children available for adoption. For example, in 2009, 41% of children available for adoption were African American, 40% were white children, and 15% were Hispanic children. This disparity often results in a lower cost to adopt children from ethnic minorities - usually through special adoption grants rather than fee discrimination. Many critics decry the exchange of money for children, whether as "fees for service" or otherwise, arguing that no children of any race should ever be for sale. Proponents point out practicality in the current systems. This situation is morally difficult because the adoptive families see adoption as a great benefit to trans-racially adopted children, while some minorities see it as an assault on their culture. In 2004, 26 percent of African-American children adopted from foster care were adopted trans-racially. Government agencies have varied over time in their willingness to facilitate trans-racial adoptions. "Since 1994, white prospective parents have filed, and largely won, more than two dozen discrimination lawsuits, according to state and federal court records." There is also a great need to place these children; in 2004 more than 45,000 African-American children were waiting to be adopted from foster care.
Americans have adopted more than 200,000 children from overseas in the past 15 years, half of whom come from Asia. This trend has helped lower the resistance to trans-racial adoptions in the United States, at least for Asian and Hispanic children, although there is still high demand for Caucasian children, who usually come from Eastern Europe.
As the children adopted in the early days of the transracial adoption experiment have reached middle age, a growing chorus of voices from adult transracial adoptees has emerged. Their collective experience can be found in films, scholarly articles, memoirs, blogs, and numerous books on the subject.
No sooner were US adoptions made secretive with original birth records sealed, than those adopted began to seek reform. Jean Paton, author of Breaking Silence and founder of Orphan Voyage in 1954, is regarded as the mother of adoption reform and reunification efforts. Jean Paton mentored adoptee Judith Land, "Adoption Detective: Memoir of an Adopted Child" during her adoption search. Florence Fisher organized The ALMA Society (Adoptees Liberation Movement Association) in 1972, Emma May Vilardi created International Soundex Reunion Registry (ISRR) in 1975, Lee Campbell and other birthmothers joined the fight for Open Records forming Concerned United Birthparents (CUB) in 1976, and by the spring of 1979 representatives of 32 organizations from 33 states, Canada and Mexico gathered together in DC to establish the American Adoption Congress (AAC). The Triadoption Library began keeping records in 1978 showing 52 search/support/reform organizations, by 1985 there were over 550 worldwide.
Adoption Reform encompasses family preservation, adoptees' access to original birth certificates, birth and adoptive families having direct access to each other (open adoption) and all related records (open records).
The Adoption Triangle by Annette Baran, Reuben Pannor and Arthur Sorosky; Twice Born and Lost and Found by Betty Jean Lifton; I Would Have Searched Forever by Sandra Musser; The Adoption Searchbook: Techniques for Tracing People by Mary Jo Rillera; The Politics of Adoption by Mary Kathleen Benet; all published in the 1970s and still in print, were instrumental in examining and defining the foundation of reform.
As of February 2009, 24 U.S. states have legal provisions for enforceable open adoption contact agreements. Each year additional states consider law changes that give persons separated by adoption access to information about themselves and each other. As of 2013, over 85% of adoptions in the US are either semi- or completely open.
Many adopted people who were separated from their birth parents by adoption have a desire to reunite, and most would like family medical history information and access to any documents where they are mentioned. Often, birth parents who placed their infants want to reunite as well. In states which practice or have practiced confidential adoption, this has led to the creation of adoption reunion registries, and efforts to establish the right of adoptees to access their sealed records (for example, the American Adoption Congress, Concerned United Birthparents, and Bastard Nation). Others join search and support groups, most of which are non-profit, or some hire investigative companies to locate birth families and adopted children.
Prospective American adoptive parents may use international adoption (also called intercountry adoption) to adopt a child from another country. American citizens, including American citizens who have emigrated from countries they wish to adopt from, represent the majority of international adoptive parents, followed by Europeans and those from other developed nations such as Australia. The laws of different countries vary in their willingness to allow international adoptions. Some countries, such as China, Korea and Vietnam, have very well established rules and procedures for foreign adopters to follow, while others, the United Arab Emirates (UAE) for example, expressly forbid it. International adoptions by Americans became much more common after the Korean War when American servicemen fathered interracial children with Korean women. China is the leading country for international adoptions by Americans.
The U.S. Department of State has designated two accrediting entities for organizations providing inter-country adoption services in the United States that work with sending countries that have ratified the Hague Adoption Convention, which specifies by international treaty requirements for adoption between countries that have ratified the treaty. They are the Council on Accreditation and the Colorado Department of Health and Human Services.  The U.S. Department of State maintains a list of all accredited international adoption providers.
There are also individuals who act on their own and attempt to match waiting children, both domestically and abroad, with prospective parents, and in foreign countries provide additional services such as translation and local transport. They are commonly referred to as facilitators. Since in many jurisdictions their legal status is uncertain (and in some U.S. states they are banned outright), they operate in a legal gray area.
Where the law does not specifically allow them to, all they can do is make an introduction, leaving the details of the placement to those legally qualified to do so. But in practice, their role as gatekeepers can give them a great deal of power to direct a particular child to a particular client, or not, and some have been accused of using this power to defraud prospective adoptive parents.