Recommendations for PCPs
| Ask open-ended questions.31 |
| Avoid assumptions or judgement. |
| Assess how much information the patient wishes to know. |
| Normalize adoption and LFMH in health care settings including when reviewing patient questionnaires, interviewing.16,28,31 |
| Reflect the terminology used by the adopted patient.28,31 |
| Avoid unnecessary qualifiers (refer to adoptive parents as parents). |
| Avoid using terms like “real” or “natural” parents, instead use “biological” parents. |
| Do not assume reunion with biological family or “going back to [country]” is desired by or feasible for the adoptee. |
| Recognize the diversity in adoption processes (public vs private, open vs closed, domestic vs international).16,28,31 |
| Be transparent about unknowns and offer to discuss what LFMH might mean for care.28,31 |
| Use shared decision making regarding screening.31 |
| Set realistic expectations, particularly regarding genetic testing and limits to interpretation.69 |
| Refer to medical genetics counselor if possible.69 |
| Recognize the relationship between adoption, mental health, and trauma.16,31 |
| Screen for depression and anxiety, and refer to adoption-competent mental health providers.28,31 |
| Listen to patients with LFMH, including adopted people.28,31 |
LFMH = limited family medical history; PCP = primary care physician.
Note: Some find the term “birth parents” offensive, with the perception that it minimizes preadoption parenting and decreases their role only to labor.