Most U.S. citizens raised by their biological parents never question whether the information on their birth certificates is accurate. With the evolution of adoption and alternate means of conceiving a child, “accurate” is an increasingly subjective term.

Is the purpose of a birth certificate to portray a biological account of a person’s birth parents, or is it an account of one’s “legal” parents — the ones responsible for raising them?

The US Census Bureau created Birth Certificates in the beginning of the 20th Century as a means of tracking the effects of disease and urban environments on mortality rates. The task of issuing birth certificates was transferred to the Bureau of Vital Statistics, a division of the Department of Health and Human Services. In 1946, the recording births was decentralized into today’s varied state systems (and in reality, based on my parents births in the 1930s, this existed well before the 1940s). This has caused there to be 50 different sets of regulations concerning how, when, why and if access to original birth certificate information can be obtained.

The document has become an important (if not our sole) means of identification when we obtain anything from a driver’s license to a passport. It is an indispensable tool for genealogical researchers.

For adoptees as well as donor-conceived persons, there is oftentimes a clear distinction between one’s genetic parents, those with whom you share DNA, and one’s legal parents, the ones who have rights and responsibilities attached to their parenthood, and most-times, the ones who are raising them.

Our birth certificate practices concerning non-biological parents began with adoption. In the mid-20th Century, there was rising concern that adopted children’s birth certificates read “illegitimate.” In response, states began to issue adoptees amended birth certificates, listing the adoptive parents as if they were the genetic parents, thus hiding the shame of the child’s illegitimacy and the adoptive parents’ infertility. The originals containing the biological parents’ names were sealed and not available to anyone (including the adoptee) except by court order. The new birth certificates showed no indication that they had been amended, which gave adoptive parents an easy way to not tell their children of their adoption. In about half of the US states (including large population ones like California and Virginia as I personally found with my two parents adoptions), adoptees original birth certificates remain sealed.

Women who use donor eggs to become pregnant are listed as mothers on birth certificates. When our donor informed me she had her DNA tested at 23 and Me, I made the decision to provide my children with the information and private access to her (with her consent) that DNA testing and that site’s design make possible. It is unsettling to see someone else listed as my two sons “mother” even though they grew in my womb, nursed at my breast and have been cared for and nurtured by me 24/7 for almost every day of their entire lives. Yet, I knew this was the proper path to establish for my own children their personal reality.

There are a whole host of concerns raised by adoptees and the donor-conceived, including the right to identity, ongoing medical history, biological heritage, and the right to know their genetic parents and I for one believe these issues are valid and should receive transparent answers.

The US Surgeon General reports 96% of Americans believe that knowing their family history is important. It certainly has made a world of difference for me as the offspring of two adoptees. I suppose this has given me a broader perspective on the importance of a person knowing from where their genes originated. The United Nations has acknowledged the right of the child to preserve his or her identity, including nationality, name and family relations.

I believe that all people have a moral right to know the truth about their personal history. Where the state has custody of relevant information it has a duty not to collude in deceiving or depriving individuals of such information. Growth, responsibility, and respect for self and others develop best in lives that are rooted in truth.

There has been a recommendation made that the Standard US Birth Certificate be revised to expand upon the “two parent only” format to include categories for Legal Parents, Genetic Parents and Surrogates. In the case of adoptees, the child’s birth name and parentage should be recorded along with his or her legal/adoptive name.

The time for birth certificate reform is now. Unfortunately for many, it should have happened decades ago.