The sexual genogram explained

A sexual genogram adds messages about sex to a family genogram

The drawing is an ordinary genogram. Belous and colleagues, who revisited the method in 2012, describe it as structurally no different from a traditional genogram, with a further layer about sex and sexuality. That layer records what each person was told, what was never said, how affection was shown and how each person describes their gender and attraction.

Hof and Berman wrote for therapists treating couples. Belous and colleagues extended the method to individual clients, and their paper appears as course material on a sexuality counselling course at East Carolina University.

Hof and Berman build the chart in five steps

Belous and colleagues summarise the original method in five steps. The questions of the third step can be answered at home or in the session, and the genogram interview questions cover the family history of the first two.

Six areas of questions decide what goes on the chart

The third step asks about six areas, each linking what the family passed down with what the client or couple brings now. That link is why the chart records these things and leaves the rest out.

The 2012 update records identity in the person’s own words

Belous and colleagues give every person an orientation or attraction, written as a letter the person chose, such as L for lesbian, G for gay, B for bisexual, P for pansexual, Q for queer or questioning, A for asexual and H for heterosexual. The letters record how people describe themselves, never what the therapist assumes.

The editor draws the inverted triangle of McGoldrick, Gerson and Petry (2020) instead, and the teaching chart shows both. Mari, Helen’s wife, has neither, because she was not asked, and a partner’s gender does not answer the question.

The teaching chart follows two fictional families

Nina Calder, the index person, and Theo Moreau are in couple therapy because they find it hard to talk about intimacy. Nina’s grandparents treated sex as a risk to avoid until marriage. Ruth was pregnant with Ian when she married Graham in 1968, a secret the family kept, and she stopped speaking to Helen for four years after Helen came out in 1995.

Ian and Clare left the subject to a book, and Nina’s aunt Helen answered her questions. On Theo’s side, Anne answered questions as they came and Luc left the room. Each partner brings a different family habit to the same difficulty, which is the comparison the fifth area of questions invites.

Consent and anonymity come before the first line is drawn

A sexual genogram holds private facts about the person and about relatives who never agreed to appear on it. These rules apply in therapy, in supervision and in a class.

Draw a sexual genogram in the editor with marks and fields

Draw the family first. Then select a person, open Identity and marks, type the person’s own words in Gender identity, and switch on LGBTQIA or Secret where they apply.

For the sexual layer, click Add a field under Notes and name it Messages or Identity, so that the value is written under the name. A custom line records who answered a child’s questions, and the Clinical switch in the bottom strip replaces the names with numbers.