She was born and raised in Phoenix, Arizona as the daughter of wealthy beer distributor Jim Hensley. After receiving bachelor's and master's degrees from the University of Southern California, she became a special education teacher. She married John McCain in 1980, and the couple moved to Arizona in 1981, where her husband was elected to the United States Congress the following year and reelected five more times. The couple had three children together, in addition to adopting another. From 1988 to 1995, she founded and operated a nonprofit organization, the American Voluntary Medical Team, which organized trips by medical personnel to disaster-stricken or war-torn third-world areas.