"The losses in adoption are a big thing," said study author Jones.
Although Kempf said her children have had their share of medical challenges, they are emotionally well adjusted. She credits that to many factors, including keeping them close to their cultural roots, maintaining a network of supportive friends and being open about their adoptions.
"We're really lucky we live near a Chinese immersion school, so they're immersed in Chinese culture every day," said Kempf, who is white. "They have Chinese nationals as teachers and celebrate Chinese holidays."
The family stays in touch with the adoptive families of her daughters' orphanage roommates in China too. She occasionally talks with her girls about being adopted, and speaks positively about their birth parents.
"We talk about their birth mom now and then," she said. "I just kind of drop it into conversation. I say, 'You are getting so tall. Oh, I bet your birth mom was tall.' Or, 'I bet she is thinking of you today.'"
Read more about adoption resources at the U.S. Department of Health and Human Services.
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