We first encountered adoption specialist Jane Aronson, also known as the Orphan Doctor, at a breakfast co-hosted by Mary-Louise Parker (interviewed by Babble here) for ErbaOrganics, the swank baby-product line whose purchase benefits Aronson’s Worldwide Orphans Foundation. The Brooklyn-born Aronson spoke with such conviction and intensity that she commanded the full attention of the crowd, no mean feat considering the radiant Parker was lounging nearby in four-inch heels. In fact, even next to Angelina Jolie, a friend and client of Aronson’s, the doctor is a captivating presence.
As clear a candiate as we’ve ever seen for living-sainthood, Aronson has treated thousands of pre- and post-adoption orphans through her private practice and her non-profit (which provides children in orphanages with check-ups, HIV treatment and other essential humanitarian services). Talk to her for any length of time and you may well find yourself suddenly considering adoption, or wanting to throw money at her foundation. We dare you to learn about her work and crack one more joke about Brangelina’s growing brood. – Ada Calhoun
How did you get into this field?
I’m a pediatrician by training, and I became an international health specialist at the beginning of the AIDS crisis. AIDS was defined in 1981. I entered medical school in the fall of 1982. In my life as a lesbian, I had many friends who were affected by HIV, and I became a pediatric AIDS specialist. I was very interested in international health, and it just sort of unfolded that I became interested in health issues of children living as orphans in institutions. And then I developed this practice for international adoption.
With the rise in attachment parenting, there’s been an emphasis on the ages zero to three. There’s this sense that if children don’t get nurturing during this crucial time that they are done for, emotionally speaking. It seems that parents are unwilling to adopt older children as a result.
People make their risk assessment of what they’re willing to deal with in the care of children adopted from abroad. It’s a real, conscious decision for parents who adopt. They kind of have a little algorithm. If you adopt an infant, there are less institutionalization effects and hopefully less issues around developmental delays and attachment disorder. But at the same time, when you adopt an infant, there’s not a lot of behavior or development that’s there to begin with, and so some people shy away from infants because they feel they don’t know the real character of the child, the personality.
So adopting an older child can be an advantage.
Some people just really prefer to adopt an older child, because they can really see who the child is. And they feel a sense of control that if the kid’s lasted a few years and is alive, he or she likely doesn’t have some god-awful disease. There are many people now who really want to adopt older children for more positive and pro-active reasons. These kids are growing up within a family and so they understand attachment bonding and intimacy. But they have lost their family to AIDS, like in Ethiopia. These children often come in sibling groups. Older parents feel much more comfortable with an older child because of their personal age, their advanced age. It fits them not to be taking care of a baby and staying up all night, and also to do a nice thing.
That’s great to know. That idea that zero-to-three is some kind of magic number has always seemed false.
No, there’s no magic number, Ada. That’s a silly thing. It’s like an artificial convention that’s used to organize things for people. Let me add something else, Ada. Attachment disorder is likely more based on brain chemistry and brain damage. And a lot of these magazines that you read aren’t tapping into research done by people who are at lofty universities who really study attachment from the basis of the physiology and anatomy of the brain. And attachment likely has more to do with brain damage that occurs during the pregnancy, due to malnourishment, exposure to toxins in the environment, infections during the pregnancy, exposure to alcohol and drugs and smoking. All of that conspires to cause damage to brain structures that are involved in the actual chemistry and physiology of attachment. So when people use this sort of artificial convention of saying, you know, “You gotta get ’em by three, or else they’re ruined,” I think that’s also not taking into consideration that attachment likely has to do with brain chemistry during pregnancy.
As for pregnancy today, there’s such madness around fertility right now-
I don’t think it’s right now, Ada. I think the madness about fertility has existed for thousands of years. You know, childless women have been viewed as “barren.” Terrible terms were applied to those sorts of couples. Divorces have occurred because people haven’t been able to reproduce. Judgments have been made and people have always felt bad and depressed about not being able to parent children. And that’s led to lots of bad judgments about adoption and foster care. The fervor around giving birth to a child at all costs has been fueled by the rise of technology and the media, for sure. And as more fertility technology is made available to people, people get their hopes up and then people’s hopes are dashed at the same time.
It’s true. The success rates of procedures like IVF are not high.
People need to understand all the options involved. There are wonderful education programs available through the American Fertility Association. There are fertility centers in all of the large medical centers, so people can go and have consultations with fertility experts. There are fertility social workers and therapists who actually specialize in dealing with families that are interested in having birth children. And they are also capable of helping parents transition to other ways of creating families, maybe adoption, maybe foster care.
What is the difference right now between domestic and international adoption?
As a domestic adoption and international adoption specialist, I would say that the trend at this point [in the U.S.] is that there have always been drugs, but right now crystal meth in the rural and remote areas of our country is very common. Also, babies up for adoption are exposed commonly to smoking, alcohol, drugs. The women are frequently depressed and have a history of clinical depression or other mental illness. And poor nutrition, poor pre-natal care and lack of education access. That’s kind of the profile.
One major thing that has changed [in domestic adoptions] is that more and more agencies have created policies requiring that families be open to “open adoption,” where in the birth family is involved, certainly the birth mothers. There’s a lot of emphasis psychologically about the birth triad, transparent openness, people understanding each other and knowing each other through the life cycle.
And international adoption?
International adoptions have changed a lot in the past few years. The countries that are open and very popular: Russia, China, Taiwan, Ethiopia, Vietnam, South Korea, Kazakhstan.
Russian adoption looked like it was going to blow up, because of changes in accreditation [whereby orphanages must conform to certain standards], but accreditation is once again on hold in Russia due to the recent resignation of officials in the Russian government.
China‘s adoption has changed. The process has been typically about a year to two years waiting for a healthy child. Now, there’s been the creation of a special needs track. Families opting for special needs adoption, the fast track program, likely wait less than a year. Regulation is going to change the rules for adoption based on weight and age: No one can adopt from China who is older than fifty years of age or has a body mass greater than forty. And no more single-parent adoption in China.
Ethiopian adoption is thriving.
Guatemalan adoption has grown hugely in the last three years, so there are three to four thousand adoptions in a year now, sort of supplanting the numbers that came out of China. Especially with the accessibility from Miami to Guatemala. But the problem in Guatemala now is that there are political forces regarding whether Guatemala will be a Hague Treaty country or will close adoption due to forces within the current government not favoring international adoption.
And, you know, there are still countries available for adoption in small numbers. There are children who come out of Taiwan in small numbers, and the care in Taiwan is just wonderful. Children come out of almost any country in the world in small numbers because people make arrangements, because they’re employed in the country or have some special connection to it.
You’ve adopted two children yourself. How did you find them?
My children were adopted from Ethiopia and Vietnam. I’ve had a love affair with Vietnam since the sixties, when I was a high school student. I worked against the war and I did a lot of reports and reading about Vietnamese culture, Vietnamese history, as a teenager. So I thought it was my destiny to adopt from that country. And then through my foundation, Worldwide Orphans Foundation, I got involved in HIV orphans in Ethiopia, and then the next step was I got interested in adoption there.
What is the difference in how much the process costs from country to country?
I think there are very specific differences in price that you could more or less get from talking to an agency. But I can give you a ballpark figure for international adoption: that would be between $10,000 and $30,000 now. You can probably do an international adoption in Ethiopia that’s between $10,000 and $15,000. And an adoption from China is $15,000 to $20,000. Vietnam is closer to $20,000. Guatemala is likely between $20,000 and $30,000. But you can do an adoption from foster care, where you get a newborn and then you have to wait two years till the adoption can be made official, for nickels and dimes. The cost in domestic adoptions is controlled by state regulations, very controlled. The families are responsible legally for medical costs for the birth mother and the birth mother can have certain living expenses free for a number of months. But it’s very controlled, because otherwise it becomes a buying spree.
You mentioned that China now has restrictions against single parents-
I wouldn’t word it “against single parents.” I would say that adoption in each country is regulated by the government, and they make distinctions about what kind of parent they want, and that falls into the category of age and gender and marital status, and also including obviously, which I just mentioned to you, weight and health Celebrities do not have an easier time adopting; they have a worse time adopting.issues. There are people who have cancer or underlying medical conditions who would have to meet the criteria for health requirements for medical clearing. And that’s on both sides, both with the social workers as well as through the country’s adoption regulators.
I’m just trying to get a sense of how the experience might be different for a single parent versus a gay couple versus-
Well, for single parents – nobody has to talk about their homosexuality when doing adoptions. But most of the states in the United States have open regulations for gays and lesbians to adopt. Outside the U.S., there are no countries internationally that [explicitly] allow gay people to adopt. There are single-parent adoptions, for males and females in some countries, but mostly it’s a married couple.
There’s a sense right now that international adoption is trendy, because of certain high-profile celebrity adoptions.
I don’t think that international adoption is trendy. I don’t think it’s trendy at all. I think that when somebody famous does something, then people look at it, and they decide for their own purposes media-wise that it’s trendy. But when you look at the numbers of famous people who have adopted: they’re not in the majority, number one, and I don’t think that they necessarily feed off of one another. I think that many celebrities are like many other people – they may have fertility issues, they may have humanitarian choices that they make. And they may have mental reasons for adopting, but it’s not motivated celebrity-wise because of the trend. But I think people are influenced by celebrities. I always say that celebrities and other famous people have become wonderful role models for adoption.
Another impression that I think a lot of people have is that celebrities have a much easier time adopting.
They do not have an easier time adopting; they have a worse time adopting. And they would all agree with me.
Why is that?
They have to do all the things that are regulated in any country. They follow the rules. It might be easier for them because they have a personal assistant to file the papers. But they still have to be fingerprinted, and they still have to meet the requirements of the home study. And they still have to appear in the country to pick up their child. And on top of it, the worst part is that then they have to be stalked by newspapers, magazines, radio and TV stations. And they are stalked by the people of the country where they go, as well. And they are expected to fork over a lot of money, to donate money, because they’re looked at as Mr. and Mrs. Moneybags. So I think they have a harder time and they can’t really enjoy their experience, because it’s not allowed to be private. And I feel bad for them.