Madonna has attacked claims she and Angelina Jolie are adopting children from developing world countries as part of a "fad".
The stars have been criticised for overlooking needy orphans from their own countries, and accused of starting a dangerous trend.
A British child psychologist recently dubbed it "the Madonna effect".
But Madonna refuses to accept she is setting a bad example.
She says, "If I was challenging people to open their minds and their hearts then I had to be willing to stand at the front of the line.
"And I can appreciate and understand how people could be cynical. That's fine, I accept that. Because I think that we live in a society where people are naturally suspicious of acts of altruism or generosity.
"I don't see how anyone who understands how complicated it is to adopt a child could say that someone chose to do that as a fad. It's just too difficult. It's too traumatic."