Medical intake forms and letters

I went to the mammogram, and they have a form. They want to know when I had my first period, about pregnancies and menstruation, and a bunch of questions you ask non-trans women. But they’re irrelevant questions to me, and so I found that to be a real barrier. I was uncomfortable and annoyed. I thought about walking out of the office, and then I decided, well, they sent me for this test, it must be important. I said to the technician, “You know that form, it really doesn’t work for me. As a trans woman, those questions don’t make sense to me. I can’t answer them.” And she said, “All the regular women fill them out.”
That didn’t help. After that point, she was terrific, but that wasn’t a very good start. There must be a better way to try to get this information. Debbie

Filling out an intake form gives LGBTQ clients one of their first and most important impressions of your office. The experience sets the tone for how comfortable they will feel being open about their sexual orientation or gender identity/expression.

Here are some tips for developing or revising intake forms so that they include and respect LBGTQ clients:

• When asking about gender, leave a blank space rather than having clients check a box for “male” or “female.”
• Ask clients their preferred pronouns (again, leave a blank space rather than having clients check off “he” or “she”).
• Ask about the name a client prefers to be called (if different than the name on their health card).
• Instead of using terms such as “husband” or “wife,” use gender-neutral terms, such as “spouse” and “partner(s)”; use the term “relationship status” instead of “marital status.” Questions about families should allow for families that include two parents of the same sex and more than two parents. Use the term "parent/guardian" rather than "mother" or "father."
• Intake forms should include an explanation about how confidentiality will be protected and who has access to medical records. Offer the client the option to refuse to answer a question on the intake form if he or she is concerned, knowing you can discuss it in your office.
• If a client leaves blanks on the intake form, this may indicate he or she feels uncomfortable being open in writing — giving you a chance to create trust during the initial interview. You can ask about the blanks, explain your office’s confidentiality policy, and let the client know that he or she has the right to choose which questions to answer.
• Trans men and women may find questions about menstruation, menopause and childbirth problematic.
  • Many trans men will not menstruate because they take testosterone or have had a hysterectomy. Rather than assuming a person menstruates, include a preface question that asks, “Do you menstruate (have monthly bleeding)?”
  • Trans men on hormones or not may find discussion of menstruation upsetting and may prefer alternative terms, such as “monthly bleeding.”
  • Trans women do not menstruate and may find questions about menstruation, menopause and pregnancy/childbirth at best irrelevant and at worst offensive or off-putting. Again, it can help to preface questions about menstruation with a general, “Do you menstruate)?”  or a prompt to skip non-applicable questions.
  • Rather than ask the assumptive, “Number of pregnancies/births?” you can ask “Have you ever been pregnant?”