PSA: ‘Transgender’ Is Not A Sexual Orientation

When Medical Intake Forms Don’t Quite Get It Right

Twelve minutes had passed. As I sat in the waiting room with the electronic intake forms (conveniently located on an iPad, inside of what appeared to be a dog-proof case), I began sinking further into the corner of the comfy leather couch. I yawned. It was too warm in this doctor’s office, and I was feeling sleepier by the second. I glanced at my phone. 8:45 a.m.

“I’ve been completing forms for 15 minutes,” I thought. “There’s nothing else left to cover.”

As I continued straining to remember which family member — paternal grandmother, paternal grandfather, maternal grandmother, maternal grandfather — had which type of heart condition, cancer, or cholesterol, or thyroid problems, my name was finally called, as always, last name mispronounced.

“Martha…” (they always use my birth name, even though I’ve never been called Martha a day in my life and I always write “MARTIE” over where the chart says Martha, they still never call me by my actual name, Martie.)

What followed “Martha” was a question-like pause. I usually get up at this point and spare them the agony of butchering my last name, but this morning I was too tired and I was moving too slow.

“Sir…OH…sis?” she asked with hesitation.

“sir-ROY,” I corrected, with a friendly smile.

I know my last name acquired by marriage is odd-looking and difficult. Sirois. It has too many vowels in close proximity to one another, as is the nature of some French-Canadian names. But by now, at age 43, I think I’ve heard every possible pronunciation. I usually try to help people out by explaining, “it’s like ‘Illinois…’ the final ‘s’ is silent.” Or, “the ‘ois’ part at the end is the same as the ‘ois’ in Illinois. See? They rhyme: Illin-ois, Sir-ois.” Or, “just think, ‘sir’ like a knight, and ‘Roy,’ like the boy’s name. Accent on the second syllable: Sir-ROY.”

It seems simple enough a concept to me when put in perspective. Still, even with this explanation, I’ve heard them all:








“Psoriasis;” etc.

Once, my husband got “sir-ILL-ee-us” — seriously, where did four syllables come from — let alone the letter L?!

(But, as usual, I digress. Language & pronunciation: that’s a whole other tangent.)

Before I was called back to the doctor’s office, I read something on part of the intake form that made me chuckle, then roll my eyes, then feel a bit perplexed, then just plain irritated. Which is why I’m writing about it now. It was this section that read Please enter the patient’s sexual orientation:

At first glance I thought, “how nice to see the word transgender on a medical intake form. Progress–“ But before I could finish my thought, the next thought surfaced: (facepalm) “Wait… OMG. Gender is not sexual orientation! Are you freaking kidding me? If anything, ‘transgender’ should appear as an option on the page that says ‘sex.’ Furthermore, there should be a section with pull-downs for at least the following:

  • Sex Assigned At Birth: Male/Female/Intersex
  • Gender Identity (circle as many as apply): Male/Female/Transgender/Non Binary/Genderqueer/Gender Nonconforming/Gender Fluid/Agender/Two-Spirit/Other (please specify): __________
  • Prounouns: He/him/his, She/her/hers, They/them/their(s), Ze/Hir, no pronouns, Other (please specify) __________

Then I thought, “Okay, calm down, Martie. Someone, somewhere is trying. This is progress.”

And ultimately I just got irritated, because even if this is progress, it’s incorrect, so it’s not really progress.

Why does it matter?

Because gender (and by default, gender identity) are not the same thing as sexual orientation. They are worlds apart. Gender is a social construct that is arbitrary, stereotypical, and changes over time. Gender identity is the internal perception of one’s gender, and how they label themselves, based on how much they align or don’t align with what they understand their options for gender to be. In other words, gender identity is someone’s deeply innate sense of being male, female, some combination of both, neither, or something else altogether, like a third gender. (There are many cultures and religions that recognize more than two genders.)

Sexual orientation, however, is the type of sexual, romantic, emotional, and/or spiritual attraction (or lack thereof) that one feels for others, often labeled as the gender-based relationship between the person and the people they are attracted to, i.e. lesbian, gay, straight, etc. This is often mistakenly referred to as sexual preference. Just like gender identity and a person’s pronouns, it’s not about a “preference,” but simply, what comprises a person, how they’re hard-wired, and/or who someone is at their core. Someone may choose to come out as gay, but they don’t choose to be gay — any more than someone chooses to be straight, or bi, or asexual. Simply, we are who we are.

To conflate gender identity with sexual orientation is to perpetuate false narratives and misinformation. And, it’s very reckless and dangerous. Because it’s exactly that type of misconception that fuels transphobia (the intense dislike, sense of disgust, hatred, and/or fear that someone feels in response to seeing or hearing about a transgender person), and transphobia is what fuels acts of hatred and violence against the transgender community.

Transphobia is almost always the underlying cause of the brutal murders of trans women — black trans women, especially.) *HRC has long reported that fatal violence disproportionately affects transgender women of color, and that the intersections of racism, sexism, homophobia and transphobia conspire to deprive them of employment, housing, healthcare and other necessities, barriers that all make them vulnerable.

In addition to the trans community already being largely misunderstood, people who are transphobic hate or fear trans people mainly because they can’t seem to separate words like “sexual deviant” and “pervert” from “transgender person.” Transphobic people (or even people who may not *hate* trans people, but certainly don’t understand them) are typically the ones who think the mere presence of a trans person in public restrooms is a dangerous threat, or a serious violation of privacy (as if they’d even know a trans person in the bathroom if they saw one; as if trans people haven’t already been using public restrooms next to us all along before “bathroom bills,” and no one was the wiser).

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Janet Mock, trans activist

Conflating sex offenders with trans folks is a dangerous myth that just won’t go away. No one should be looking through the stall cracks or sneaking a peek at the next urinal over to see anyone else’s genitals for any reason. And, despite what extreme, fear-mongering Trumpeteers would like you to believe, there hasn’t been a single case in the U.S. of a transgender person sexually harassing or assaulting anyone in a public restroom. Ever. Moreover, protecting transgender people does not compromise safety in public restrooms at all.

Many people also don’t understand that peeping, and other forms of perverted public behavior like indecent exposure, public urination, and — God forbid — child grooming for sexual abuse are all crimes regardless of who’s doing them. The mere presence of a trans person in a public restroom facility poses no more threat than your best friend in the next stall over.

Additionally, people who tend to buy into the “transgender predator in the bathroom” myth are also the same people who fail to understand that the biggest threat to their children is someone they know and trust, not a stranger in the public bathroom. 93% of child sexual abuse is committed by someone the child knows, like a family member, a family friend, and/or someone in a position of authority. Trans folks in public restrooms want nothing more than to pee and exit the facility unharmed, for the threat of violence towards them (due to transphobia) is far more greater than the threat of violence towards cisgender people in public facilities.

Probably the reason why people tend to conflate trans folks with the concept of sexual orientation is because of the acronym — LGBT. Lesbian, Gay, and Bisexual are all sexual orientations. “T” is the only letter in that particular acronym that does not refer to a sexual orientation. It refers to how one identifies, sees, and experiences their own gender — their sense of self, whereas the “L,” “G,” and “B” refer to how someone identifies, sees, and experiences their physical or romantic attractions towards others.

So, the reason why distinctions like this are important — like not putting gender labels under sexual orientation labels, and vice versa — is because when we put out misinformation, we not only mislead others, but we perpetuate existing myths that are extremely dangerous and harmful, and can even lead to someone losing their life.

I was just one person in the doctor’s office that day, checking in and filling out intake forms for the first time. Countless others will have their hands on that iPad, answering all those questions, tomorrow, and the next day, and the next day, and so on. Chances are, no one will even notice that “transgender” appears as a selection on the screen asking about “sexual orientation.” However, chances are, someone else will notice.

Chances are, someone who doesn’t know anything about transgender people and their issues will glance at that screen, and without even thinking about it, have the “sexual predator” myth reinforced somewhere in the crevices of their brain, because a subconscious connection that somehow, slightly rings true is being made. Chances are, someone who’s transphobic will see the word “transgender” under the “sexual orientation” category, and feel a sense of rage that they may act on in some way.

Chances are, also, that someone who knows better will see it and feel compelled to take that iPad right back up to the front desk and report the error. But this particular morning in the waiting room, that person wasn’t me. Though in hindsight, I wish it was. It’s great that inclusiveness is finding its way — trickling down to even the boring, mundane medical intake forms, but I think it’s fair to say that accuracy is crucial at this moment. Maybe I’ll call about it, after having some time to reflect on the matter. And hopefully, hopefully, someone will care enough to take on the challenge of getting it right.

Originally published at on May 27, 2018.

Written by

Seen in HuffPost, Scary Mommy, etc; heard @ NPR, SiriusXM, TIFO podcast & more. Gender dismantling trailblazer. Political news junkie. TikTok aficionado. Mom.

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