According to the U.S. Department of Health and Human Services, the process of adoption affects children in a multitude of ways, influencing their sense of identity, self-worth, self-esteem and many other social and emotional areas. Adopted children may have trouble forging meaningful, trusting relationships and may also have difficulty articulating and controlling emotions.
Children are on a constant quest to create their own identities, and adopted children must struggle to reconcile the identities and histories of two different families (or the lack of identity and history from an unknown biological family). Adoption can also bring up major questions of self-worth in children. Those who feel "special" or "chosen" because they were adopted may come to realize as they grow older that another parent or family "not choosing" them is inherent in the process of adoption.
A child's history before being adopted can also have a strong effect on his emotional life after adoption. A child from an orphanage, group home or chaotic home life may not have had adults present to provide healthy emotional interactions. These children can struggle to make friends, to express their emotions productively and to effectively empathize with others. Children separated from caretakers in the past may suffer from attachment issues or alternately may struggle to develop bonds with new primary caregivers.