Suggestions for Intake Forms for Intersex Clients or Patients

Suggestions for Intake Forms for Councilors Seeing Clients Who have Intersex Bodily Variations or Intersex Trait(s)

Before asking these intake questions, here is the definition of intersex according to the United Nations’ Intersex Fact Sheet:

What is Intersex?

“Intersex people are born with sex characteristics (including genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies.

Intersex is an umbrella term used to describe a wide range of natural bodily variations. In some cases, intersex traits are visible at birth while in others, they are not apparent until puberty. Some chromosomal intersex variations may not be physically apparent at all.

According to experts, between 0.05% and 1.7% of the population is born with intersex traits – the upper estimate is similar to the number of red-haired people.

Being intersex relates to biological sex characteristics, and is distinct from a person’s sexual orientation or gender identity. An intersex person may be straight, gay, lesbian, bisexual or asexual, and may identify as female, male, both or neither.

Because their bodies are seen as different, intersex children and adults are often stigmatized and subjected to multiple human rights violations, including violations of their rights to health and physical integrity, to be free from torture and ill-treatment, and to equality and non-discrimination.”

Questions about Bodily Autonomy and Chromosomes:

For the sake of these intake questions, I will use “intersex bodily variation” or “intersex trait(s)” to describe being born outside the norms of an endosex male or female body. Note: Endosex means born within the definition of male and female bodily anatomy.

Which would you consider yourself:

A. I am aware that I am Intersex and accept the word “intersex” to describe myself.

B. I am aware that I am not endosex but rejecting the word “intersex” to describe myself.

C. I am aware I am not endosex but use a different word to describe “Intersex,” “Intersex traits,” and “intersex bodily variations”. Please share what terms you feel comfortable with.

D. I am questioning if I have an intersex trait(s) and would like to investigate.

Now please explain more:

How did you figure out you were not born endosex (not intersex)?
Please describe your intersex traits(s). They can be chromosomal, hormonal, or involve your genitals or reproductive system.
Do you have a formal medical report or diagnosis describing your variation of intersex from a physician, and if so, what does it say?
Are you okay calling your bodily variations “intersex,” or “intersex traits”, or do you prefer a different language to be used?
Do you feel that you have had sex assigning surgery as a non-consenting child? How did you find out if you did?
Are you happy with the medical treatment you have received since birth and so far? Please share why you are unhappy.

Questions about Gender Identity and Anatomical Sex:

Do you look at Anatomical Sex and Gender Identity as separate or the same?
Do you agree with your birth assignment, and does your gender identity match it?
Are you happy with your Birth Certificate, or would you like it changed?
If you do not agree, have you considered emancipating your true gender identity through social and/or medical transition?
If you disagree with your birth assignment, do you feel you were medically, surgically or psychiatrically violated when assigned the wrong sex and gender?
How do you feel about the label transgender if you need to go against your birth assignment in emancipating your authentic self?
Would you like to change your legal documents (birth certificate, passport, and social security)?
How do you feel about intersex being considered your sex?
Would you want an intersex birth certificate?

Questions about Sexual Orientation, Gender identity, and Gender Expression:

What is your sexual orientation: Heterosexual, Gay, Lesbian, Bi-Sexual, Pansexual, Asexual, and any other ways to describe this.
Are you a part of LGBTQIA+ Pride Groups, or do you consider yourself a “Straight” outsider?
If you are a heterosexual and agree with your birth assignment, do you consider yourself an LGBTQIA+ Ally?
Do you have bias or prejudice against LGBTQIA+ people?
Have you ever suffered from genital exposure trauma or body shame, due to being born intersex? This genital exposure trauma could include past sex partners, or even harm brought to you by medical professionals.
How would you describe your real lived gender: Man/boy, Woman/girl, Both or neither?
Please share your label to describe your gender identity if you have one.
Please share how you would describe your gender expression: How you dress, act, or appear as man/boy, woman/girl, both or neither.
Do you like what you see in the mirror, or would you like to change things?

Questions about Family and Peer Support Questions:

Do you have family support, or do you feel isolated and alone?
Do you have peer/friend support, or do you feel isolated and alone?
Are you married or in a steady relationship?
Are you the parent of children biological or adopted?
Have you ever suffered prejudice for being born different?
Were you ever kicked out of a school, church, or organization for being different?
Do you belong to a Church or Fellowship?
Do you belong to any support groups?

Questions about Medical and Psychological Professionals:

Do you feel unhappy in any way with the way professionals in the medical complex or psychological complex have treated you?
Do you feel medically violated, sexually harassed, or disrespected by any medical or psychological professionals?
Have you ever find someone that understood you in the medical or psychological complex?
Do you have ongoing health concerns that are related to being born with an intersex bodily variation or intersex traits(s)?
Do you have a doctor that taking care of your medical needs?
Would you need a reproductive endocrinologist to transition from one gender to the other?

Questions about Family Dysfunction, Past Self Harm, Societal Harms, and Substance Abuse:

Have you ever attempted suicide? If so, how many times, and why?
Do you feel you were raised in a dysfunctional family? If yes, please explain how.
Did/do you ever self-harm in the form of eating disorders or cutting?
Are you the survivor of incest?
Are you the survivor of rape?
Are you the survivor of a hate crime due to your sexual orientation, gender identity, or gender expression?
Did/do you feel you depend on prescription drugs, street drugs, or alcohol to make it through the day?
Do you consider yourself an alcoholic or an addict?
If you do consider yourself an alcoholic or addict, are you in recovery? If so, explain what type.
Did you ever run away from home or became homeless? If yes, please explain at what age, and why.
Have you ever worked as a sex worker?
Have you ever been forced into the sex trade or child pornography?