ORLANDO, Fla. — A patient’s family medical history can help providers identify their risks for certain diseases and chart a course of treatment or screenings for hereditary illnesses like heart disease, cancer and diabetes.

Family history can be so consequential the American Medical Association recommends that patients collect health records for the prior three generations of family members and present it to all of their health care providers. But for people adopted, that kind of information can be challenging, if not impossible, to come by. 

In 2017, Lia Epps began researching her biological family. However, in Florida, adopted people do not have an automatic legal right to their birth records — only limited, non-identifying information about their birth parents. She considered petitioning a judge, which may start the release of her records.

“The thing about petitioning a judge is it’s not guaranteed,” Epps said. “You have to have a compelling reason, and me wanting to know my medical history, which is really important — that’s not enough.” 

The state of Florida is required to provide some information about the health history of an adoptee's birth parents, but that only accounts for parents’ health at a certain period. Epps wanted to know more about her biological siblings, grandparents and broader family tree. So she hired a private investigator who tracked down some family members in North Carolina. 

Epps learned that her biological parents had died many years before. She spent time with living relatives, including siblings, who helped her fill in the gaps about her family, including their medical history. 

“Whenever I found my bio family and as I got to know them more, I started to learn that there was a history of cancer in my family,” she said. “One sister had ovarian cancer when she was 19 and the other sister had breast cancer.”

Her siblings informed her that her biological father had died of lung cancer. 

Epps is considered a high-risk patient because of her family’s medical history. Since sharing these partial family health records with her primary care physician and OBGYN, she has received genetic screenings for cancer and is recommended for regular breast MRIs and ultrasounds. Epps received her first mammogram at age 28, about 25 years earlier than most. 

Advocates for the rights of adopted people said states should allow them to access their legal records.

Florida is one of 18 states where adopted people are not legally entitled to their birth certificates. According to Florida’s Department of Children and Families, over 12,000 people have registered to reunite with their birth families. The department reported that it conducts fewer than 10 reunions a month.

“We should have access to this information,” Epps said. “Because sometimes it truly can be a matter of life or death.”