Most pages of genogram symbols are a grid of small pictures with one-word captions. That works until you need to know whether a dashed line means "distant" or "living together," whether a diamond is a pet or a nonbinary relative, or how to show a miscarriage your client still grieves. This reference describes every common genogram symbol in words: people, gender, pregnancy and loss, adoption, foster care and twins, partner lines, households, relationship lines, abuse, and the shading used for illness and substance use. It says where published keys disagree, covers the newer inclusive conventions, and ends with a symbol key you can copy into a note or document.
For two complete genograms built with clients, and the interview that produces them, see our genogram examples. This page is the dictionary that goes with them.
Every person and family in this article is invented. Any resemblance to a real person is a coincidence.
Where genogram symbols come from
The genogram grew out of Murray Bowen's family systems theory, and the notation most therapists learn comes from Monica McGoldrick and Randy Gerson's 1985 book Genograms in Family Assessment. Its current edition is Genograms: Assessment and Treatment by McGoldrick, Gerson and Sueli Petry (fourth edition, W. W. Norton, 2020), the standard reference for the format.
The drawings described on this page follow the Standard Symbols for Genograms sheet from the Multicultural Family Institute in Highland Park, New Jersey, which McGoldrick directs (Guilford Press author page). Where other keys draw a symbol differently, this page says so. The main ones:
- Genogram software. GenoPro, for example, defines 22 types of partner relationship and 34 types of emotional relationship, each with its own colored line (GenoPro).
- Agency and training legends, such as the Dovetail genogram legend used in youth alcohol and drug services in Queensland, which adds a nonbinary symbol.
- Medical pedigrees, the family trees genetic counselors and physicians draw, which follow the National Society of Genetic Counselors (NSGC) standard. They share the squares and circles but differ in several places (University of Iowa guide).
No key is official, and no reader can be sure what your symbols mean unless you tell them. The single most useful habit is to put a key on every genogram you draw.
Genogram rules: how the layout works
Before the symbols, the grid they sit on. Most keys agree on these rules:
- Generations sit in rows, oldest at the top. Three generations (the client's, their parents' and their grandparents') is the usual minimum.
- Partners sit side by side. A line drops from each partner and runs across beneath them. In the traditional layout the man is on the left and the woman on the right.
- Children hang from their parents' partner line in birth order, oldest on the left, each on their own short vertical line.
- Each person's facts sit in fixed places. Age goes inside the symbol, the birth year above it on the left, the death year above it on the right, and the name or initials below. The Multicultural Family Institute sheet adds location above the birth year, and occupation and education near the name.
- More than one partner: number the partnerships (1st, 2nd, 3rd) so the order is clear whatever the layout. The Multicultural Family Institute sheet draws former partners, and the siblings of the main people, smaller than the main people.
- Two kinds of line. Structural lines (partners and children) run down and across. Relationship lines (close, distant, conflict and the rest) run straight from one symbol to the other, often in another color, so nobody mistakes a relationship line for a partner line.
- Where lines cross, let one hop over the other with a small bump, so it's clear they don't join.
People symbols: the basic genogram symbols
- Square: a man or boy.
- Circle: a woman or girl.
- Double outline (a square drawn inside a slightly larger square, or a circle inside a circle): the index person, the client the genogram is built around. Medical pedigrees mark that person differently, with an arrow at the lower-left corner of the symbol.
- Number inside the symbol: the person's age now, or their age at death.
- Year above the symbol, on the left, followed by a dash (for example "1958-"): the birth year.
- An X drawn through the symbol, corner to corner: the person has died. The age at death goes inside the symbol, and the birth and death years above it ("1943-2002"). Write the cause of death beside the symbol in words. Some software draws a single diagonal line through the symbol instead of an X.
- Question mark inside the symbol, or in place of a fact: unknown. Use it for a person whose gender, age or name the client doesn't know, and for single missing facts.
- Small filled (solid black) triangle: a family secret, on the Multicultural Family Institute sheet. It sits beside the person or line the secret belongs to.
- Small rectangle joined to a person by a line: a significant connection to an institution, such as a treatment program, a faith community or the person's own therapist. Write the name inside or beside it.
- Diamond: a pet, on the Multicultural Family Institute sheet and in GenoPro. Other keys use the diamond for a nonbinary person or for unknown sex, so read the next section before you draw one.
Gender, gender identity and sexual orientation
This is where keys differ most, and where the conventions have changed most since the format was first published.
- The older two-shapes symbol.The Multicultural Family Institute sheet, an older version of the key, draws a transgender person as one shape inside the other: a square inside a circle for a transgender woman, a circle inside a square for a transgender man. The outer shape is the person's gender. The Dovetail legend uses the same pair. The sheet's own captions ("man to woman," "woman to man") are older wording that many people now find inaccurate.
- Gender first.In 2022 the NSGC revised its pedigree standard around sex and gender inclusivity (Bennett and colleagues, 2022). The approach is gender first: a square for a man, a circle for a woman and a diamond for a nonbinary or gender-diverse person. Where sex assigned at birth matters, it is written under the symbol as AMAB (assigned male at birth), AFAB (assigned female at birth) or UAAB (unassigned at birth) (summary in HGG Advances, 2024).
- The hexagon.A 2023 UK consensus for cancer genetics services agreed that transgender men and women should be drawn with the shape that matches their gender, with sex assigned at birth noted beneath, and recommended a hexagon for nonbinary and other gender-diverse identities until more research is done. Participants felt a diamond wasn't validating, because the diamond is widely used when gender is unknown (Giblin and colleagues, BJC Reports, 2023).
- Nonbinary as a diamond.The Dovetail legend draws a nonbinary person as a diamond and unknown gender as a square with a question mark inside.
- Unknown gender.GenoPro uses a question mark. Medical pedigrees use a diamond for unknown sex, which is also how they draw a pregnancy before the baby's sex is known (University of Iowa guide).
- Sexual orientation markers.The Multicultural Family Institute sheet marks a gay man or lesbian woman with an upside-down triangle drawn inside the square or circle, and a bisexual person with the same triangle in dotted lines. The same sheet shows a same-sex couple's committed relationship as a partner line labeled "LT" and the year.
What this means in practice:
- Sex assigned at birth is mainly a medical pedigree question, where it can bear on inherited risk. On a therapy genogram it's rarely needed. Record it only when it matters to care and the client agrees.
- Draw each person in the shape for their gender, and write their gender and pronouns beside the symbol in the words the client uses.
- Use each person's current name, and for relatives who have died, the name they last used.
- Pick one shape for nonbinary people (diamond, hexagon or a labeled square or circle) and say which in the key. If you use the diamond for nonbinary people, write "pet" for animals rather than drawing a second diamond.
- A relative's sexual orientation is their information, not just the client's. Mark it only when it matters to the work, only as the client reports it, and never as a guess.
Pregnancy, miscarriage, stillbirth and abortion symbols
Pregnancies hang from the parents' partner line in birth order, like children. Here keys disagree a lot.
On the Multicultural Family Institute sheet:
- Pregnancy:a triangle on its own vertical line, with the year.
- Miscarriage:a very small circle at the end of a short vertical line, with the year.
- Abortion:a small X at the end of a short vertical line, with the year.
- Stillbirth:a small square or circle, depending on the baby's sex, with an X through it, and the year written as a birth and death year ("1997-1997").
In other keys:
- GenoPro draws all three as triangles: a plain triangle for a pregnancy, a triangle with a diagonal cross over it for a miscarriage, and the same cross plus a horizontal line for an abortion. A stillbirth is a half-size square or circle with the cross (GenoPro).
- The Dovetail legend draws a miscarriage as a triangle with the letter M inside, and a stillbirth as a full-size square or circle with an X.
- Medical pedigrees draw an ongoing pregnancy as a diamond (or a square or circle once the sex is known) with the letter P, and use a triangle for any pregnancy not carried to term, labeled SB (stillbirth), SAB (spontaneous abortion, meaning miscarriage), TOP (termination of pregnancy) or ECT (ectopic pregnancy), with the weeks of pregnancy (University of Iowa guide).
What this means in practice:
- Because the shapes conflict, write the event in words beside every pregnancy symbol: "miscarriage, 2019, 10 weeks."
- Ask the client what word they use. A baby who was stillborn, or a pregnancy they still grieve, may have a name, and the client may want it on the genogram.
- Reproductive history is some of the most sensitive information in a record. Include an abortion or a pregnancy loss only when it matters to the work and the client agrees, and check your state's rules on reproductive health information.
Children: birth order, adoption, foster care and twins
- Birth child:a solid vertical line from the parents' partner line down to the child.
- Birth order:oldest on the left, each child's birth year above their symbol.
- Adopted child:on the Multicultural Family Institute sheet, a dashed line from the adoptive parents' partner line, labeled "A" and the year of the adoption. When the birth family is known, the child is also drawn in that family, with an arrow pointing from the birth family to the family the child moved into.
- Foster child:on the same sheet, a dashed line labeled "LW" (lived with) and the years the child lived with the family.
- Other keys for adoption and foster care:the Dovetail legend draws a foster child with a dotted line and an adopted child with a solid line and a dotted line side by side. Some software uses long dashes for adoption and short dashes for foster care. Medical pedigrees put brackets around an adopted person, with a dashed line to the family they were adopted into and a solid line to the birth family. Since the line styles conflict, write "adopted" or "foster" on the line.
- A child raised by relatives:draw the child in their birth family and add an arrow to the family that raised them, with the year (the Multicultural Family Institute sheet's example is a child raised from birth by a great-uncle and aunt).
- Twins:two child lines that start from a single point on the parents' line and spread apart, like an upside-down V.
- Identical twins:the same upside-down V with a short horizontal bar joining the two lines, which makes a small triangle.
- Triplets or more:three or more lines from the one point.
- Half siblings:each child hangs from the partnership they were born to, so half siblings share one parent's symbol but not a partner line.
- Stepchildren:there's usually no direct line between a stepparent and a stepchild. They connect through the stepparent's partner line, and the household line shows they live together. Some software adds its own line for step relationships.
- Donor conception and surrogacy:the Multicultural Family Institute sheet draws a sperm or egg donor as a small square or circle joined to the child's line with a dashed line, and a surrogate as a small labeled circle. There's no single standard, so label each one.
Partner lines: marriage, cohabitation, separation and divorce
- Marriage:a solid line dropping from each partner and running across beneath them, with "m." and the year written on it ("m. 1990"). Same-sex marriages use the same solid line.
- Living together, or a committed relationship without marriage:the same shape drawn with a dashed line, labeled "LT" (living together) and the year. The Multicultural Family Institute sheet also writes "Rel" and the year the relationship began.
- Affair:a dashed partner line. The Multicultural Family Institute sheet adds a small filled triangle for a secret affair.
- Separation:one slash across the partner line, with "s." and the year.
- Divorce:two slashes across the partner line, with "d." and the year. The Multicultural Family Institute sheet writes the whole history along the line: "m. 1990, s. 1995, d. 1997."
- Back together after a separation or divorce:the Dovetail legend crosses out the two divorce slashes with an X and writes "remar." and the year.
- Widowed:no extra mark is needed; the X on the partner who died shows it.
- Engagement, dating and other unions:software keys have their own lines for these (GenoPro's 22 union types include engagement, dating, legal cohabitation and annulment) (GenoPro). On paper, use a dashed line and write the word.
- Partners who are related to each other:medical pedigrees draw a double partner line for partners who are blood relatives. On a therapy genogram two parallel lines mean "close," so if you mark related partners, write it in words.
Households
- A dotted line drawn around everyone who lives together now marks the household. Pets that live there can go inside it.
- A child who lives in two homes, for example on alternate weeks, can sit inside both household lines, or have two loops drawn around them.
- People who live in an institution, such as a care home, a hospital or a prison, can be joined to the small institution rectangle instead.
Relationship lines: close, distant, conflict, cutoff and fused
Relationship lines (also called emotional or interactional lines) run straight from one person's symbol to the other's. These are the Multicultural Family Institute versions:
- Close:two parallel lines.
- Fused:three parallel lines. Fusion is Bowen's term; many therapists call the same pattern enmeshed, and most keys draw both with the three lines.
- Distant:a dashed line. Some keys use a dotted line.
- Hostile or conflictual:a zigzag line.
- Close and hostile:two parallel lines with a zigzag running between them.
- Fused and hostile:three parallel lines with a zigzag woven through them.
- Cutoff:a straight line broken in the middle by a small gap, with a short upright bar on each side of the gap.
- Cutoff repaired:the same broken line with the two bars enclosed in a small circle.
- Focused on:a single line ending in a filled arrowhead that points at the person who is the focus, for example a parent whose worry centers on one child.
- Caretaker:a single line ending in two open arrowheads, one behind the other, pointing at the person being cared for.
- Spiritual connection:a wavy line.
Where other keys differ:
- Some online keys draw "close" as a single line and "fused" as two lines, and some draw a cutoff as a line with one slash through it. If you read a genogram someone else drew, check their key before you count the lines.
- Software keys add many more lines, usually in color: harmony, love, best friends, distrust, jealousy, manipulation, control, indifference, and "never met," which GenoPro suggests for an adopted person and a birth parent who have never been in contact (GenoPro). Use them only with a key.
- Triangles have no symbol of their own. Bowen theory describes a triangle as a three-person relationship system (Bowen Center); on a genogram you see one through the lines among three people, for example a mother and son joined by three fused lines, the father distant from both, and a zigzag between the parents. Name the triangle in your notes rather than inventing a symbol for it.
A relationship line records someone's view at a point in time. Add the year and the source ("per client"), and expect two family members to draw the same relationship differently.
Abuse and violence symbols
On the Multicultural Family Institute sheet, abuse lines are relationship lines with an arrowhead, and the arrow always points at the person who was harmed:
- Physical abuse:a zigzag line ending in a filled arrowhead at the person harmed.
- Emotional abuse:a zigzag line ending in an open (outline) arrowhead at the person harmed.
- Sexual abuse:two parallel lines with a zigzag running between them, ending in a filled arrowhead at the person harmed.
- Neglect:the sheet has no symbol for neglect. GenoPro does, defined as failing to provide for a dependent's physical needs. On paper, draw a line with an arrowhead at the person neglected and write "neglect."
- Violence:software keys add violence lines combined with distance, closeness or fusion. The arrow rule still applies: draw harm in one direction, from the person who caused it to the person harmed.
Before you draw any of them:
- Ask privately. Never ask about abuse in front of the person who caused it, or in a joint session where a family member could be put at risk by the answer.
- Think about who will see the genogram. In a couples or family session, especially if you share your screen, consider keeping abuse lines on a version only you and the client see.
- Don't draw harm as mutual because two people "fought." A two-way conflict line can hide who was hurt. Draw what the client describes, in their words.
- Date it and source it: the years, and "per client."
- Know your reporting duty. If what you hear suggests a child or a vulnerable adult is being harmed now, your state's reporting law applies, whatever you draw. The Child Welfare Information Gateway summarizes mandatory reporting laws by state.
Medical genogram symbols: illness, mental health and substance use
On the Multicultural Family Institute sheet, health and substance use are shown by filling in parts of the person's symbol. Imagine the square or circle split into halves and quarters:
- Physical or mental illness:the left half filled in solid.
- Alcohol or drug problem:the bottom half filled in solid.
- Suspected alcohol or drug problem:the bottom half filled with diagonal stripes.
- Illness in remission:a vertical line divides the symbol, a short horizontal line divides only its left half, and only the lower-left quarter is filled. The vertical line is a reminder of the illness half.
- In recovery from alcohol or drug use:a horizontal line divides the symbol, a short vertical line divides only its bottom half, and only the lower-left quarter is filled. The horizontal line is a reminder of the substance half.
- In recovery from substance use and from a mental or physical illness:both lines cross the whole symbol, dividing it into four quarters, and only the lower-left quarter is filled.
- Serious mental or physical illness and substance use together:three quarters filled. Only the upper-right quarter is left white.
- A capital letter at the lower right of the symbol:S for a smoker, O for obesity, L for a language problem.
Where other keys differ:
- The Dovetail legend shows a past alcohol or drug problem with the bottom half shaded in gray rather than a quarter.
- Software often uses colors and patterns, and lets you assign them to any condition you choose.
- Medical pedigrees fill in the symbol of anyone "affected" by the condition being studied, use quarters or different shading when there is more than one condition, and always include a key to the shading (University of Iowa guide).
What this means in practice:
- Shading never stands alone. Write the condition beside the symbol in words, with the age it started if known: "type 2 diabetes, 50," "depression, per client," "alcohol use, sober since 2015, per client."
- Write cause of death in words, including suicide ("died by suicide, 2010, age 45"). The quarter-fill symbols have no way to show it.
- Relatives' conditions are the client's report, not your diagnosis. "Per client" belongs beside each one, and a label like "alcoholic" belongs nowhere. Older keys say "abuse" for alcohol and drug problems; describing the use, or using the client's words, is clearer.
- A therapy genogram isn't a genetic risk assessment. If a family pattern of illness worries you or the client, suggest they take it to their doctor.
Culture, migration and other context
The Multicultural Family Institute sheet has a few context symbols that many keys leave out:
- Someone who has lived in two or more cultures:a single wavy mark on the short line above the person's symbol.
- Immigration:a double wavy mark in the same place.
- Ethnicity and religion:written as words above each side of the family, or beside the person.
- Location and income:written above the birth year.
- Military service and other important experiences:written beside the symbol, with an arrow if space is tight.
Two adaptations go further:
- The cultural genogram.Kenneth Hardy and Tracey Laszloffy described the cultural genogram as a tool for training family therapists in cultural awareness and sensitivity (Journal of Marital and Family Therapy, 1995). In practice it means adding culture, migration, language and faith to the map, along with what they meant to each generation.
- Chosen family.When Mary Swainson and Fiona Tasker asked six lesbian couples to draw their family trees, the couples found genograms useful but needed to redraw them, for example with tiers and circles rather than the traditional symbols (Journal of GLBT Family Studies, 2005). Close friends, godparents and others who function as family can go on the genogram, joined by a labeled line or placed in their own ring around the client.
Where genogram keys disagree
The conflicts that cause the most misreadings, in one list:
- The diamond:a pet (Multicultural Family Institute sheet, GenoPro), a nonbinary person (Dovetail legend, the 2022 NSGC pedigree standard), or unknown sex and a pregnancy whose sex isn't known yet (medical pedigrees).
- Pregnancy loss:a very small circle or a small X (Multicultural Family Institute sheet), a triangle with a cross (GenoPro), a triangle with M (Dovetail), or a triangle with SAB or TOP (medical pedigrees).
- Adoption and foster care:dashed, dotted, long-dashed, short-dashed or bracketed, depending on the key.
- Death:an X through the symbol in most therapy keys, a single diagonal line in some software.
- Close and fused:two and three lines in the McGoldrick format, one and two lines in some online keys.
- Two parallel lines between partners:"close" on a therapy genogram, partners who are blood relatives on a medical pedigree.
- The index person:a double outline on a genogram, an arrow on a medical pedigree.
- Recovery and remission:a filled quarter (Multicultural Family Institute sheet) or a lighter half (Dovetail).
- Transgender people:two nested shapes on older sheets, the shape for the person's gender in the newer guidance.
Reading genogram symbols: a short example in words
Here is one small, invented genogram read symbol by symbol, the way you might describe it to a supervisor or write it in a text-only record. The client is Sam, 29.
- A diamond with a double outline, 29 inside, "nonbinary, they/them" written beside it: Sam, the client. Sam chose the diamond, and the key says the diamond means nonbinary.
- A dashed partner line from Sam to a square with 31 inside, labeled "LT 2023": Sam lives with their partner, Riley.
- A dotted loop around Sam and Riley: their household.
- One row up, a square with 58 inside, divided by a horizontal line, with only the lower-left quarter filled, and "alcohol use, sober since 2015, per client" beside it: Sam's father, Mark, in recovery.
- A circle with 56 inside: Sam's mother, Lynn.
- Mark and Lynn's partner line with two slashes, labeled "m. 1993, d. 2006": they divorced.
- A dashed partner line from Lynn to a circle with 55 inside, labeled "LT 2010": Lynn's partner, Dana.
- Hanging from Mark and Lynn's line, left to right: Sam's line; a short line ending in a very small circle, "miscarriage, 1999"; and a circle with 26 inside: Sam's sister, Kate.
- Top row: a square with an X through it, 66 inside, "1938-2004, heart attack" above it, the bottom half filled and "drank heavily, per family stories" beside it: Sam's grandfather, Joe. A circle with 84 inside, the left half filled, "depression, per client": Sam's grandmother, June. Their partner line reads "m. 1962."
- Relationship lines: a line broken by two bars between Sam and Mark, "since 2019": a cutoff. Two parallel lines between Sam and Lynn: close. A zigzag between Mark and Lynn: hostile. Two parallel lines between Sam and June: close.
Read together, the symbols show drinking in two generations of men with recovery in the second, a cutoff between the client and the parent in recovery, and closeness running through the women. Those are questions to explore with Sam, not conclusions: what happened in 2019, and what Mark's recovery means to them. Our genogram examples show how patterns like these turn into treatment goals and progress notes.
A genogram symbol key you can copy
Paste this under any genogram you draw, delete the lines you don't use, and fill in the brackets. It works on paper, in a word processor and in a text-only note.
A few notes on using it:
- Make one choice for the diamond and write it in the key. If it means nonbinary, write "pet" for animals.
- Keep the key with every version. A key that lives in a separate file gets lost.
- Save it as a template in your documents, and paste it under the genogram each time. Printing this page or saving the key as a PDF works too, if you prefer paper.
Common mistakes with genogram symbols
- No key on the page. Your reader can't tell which convention you used, and in six months you may not remember either.
- Mixing conventions in one genogram, for example GenoPro's pregnancy triangles with the Multicultural Family Institute sheet's stillbirth.
- Shading with no words. Half-filled symbols get misread. Write the condition beside every shaded symbol.
- Diagnosing relatives. "Bipolar" next to an uncle's symbol reads like your finding. "Per client: diagnosed with bipolar disorder" is what you actually know.
- Guessing gender or orientation. Use a question mark, or ask.
- Drawing harm as two-way conflict. Abuse lines point at the person harmed.
- Leaving out dates. A cutoff, a divorce or a move means more when you can see what else happened that year.
- Leaving out strengths. Long marriages, recovery, caretaking and repaired cutoffs are symbols too.
- Treating the genogram as finished. Date each version and add to it as you learn more.
Genogram symbols in the clinical record
- The genogram is part of the record when you use it for assessment or treatment planning, and clients can generally ask to see their record. Our genogram examples article covers privacy, minimum necessary and storage in detail.
- Keep a text version. A list like the example above can sit in the note, reads on any screen and works with a screen reader, which a scanned drawing doesn't.
- Record only what serves the work. Abuse, sexual orientation and reproductive history in particular: include them when they matter to treatment and the client agrees.
- Use the symbols in your case conceptualization. A shaded symbol in the grandparents' row is a predisposing factor; a cutoff the client keeps alive may be a perpetuating one; recovery and closeness are protective. Our case conceptualization examples show the 5 Ps for two full cases.
- Name the intervention in your note. "Constructed three-generation genogram" is the usual wording; our progress notes cheat sheet lists it with other family therapy terms.
How this works in TranqBay
TranqBay is practice software for therapists in private practice: a practice website, online booking, video sessions and session notes in one place. It doesn't draw genograms. Here is where the work around the symbols fits:
- The facts you need for the symbols, before the first session.The form library has ready-made templates you send a client for a session. The general intake asks what pronouns the client uses and their relationship status, which tells you how to draw and label them. In the family therapy intake, each person joining fills in their own copy, and it asks who they feel closest to, who they find hardest to get on with, whether they feel safe at home, and whether there's anything they want you to know that they wouldn't say in front of the family. Those answers give you the first relationship lines to check, and a private route to anything that might become an abuse line. There's also a couples intake and an AUDIT-C alcohol screen. Clients fill in forms online and the answers wait with the session; forms aren't scored automatically.
- Video sessions for couples and families.You can invite others to a session, and share your screen so the client watches the genogram take shape. Video sessions are HIPAA-ready, and TranqBay signs a Business Associate Agreement with you.
- The key and the text version in your notes.Paste the key and the symbol-by-symbol list into a blank note, or into the Data section of a BIRP, DAP, SOAP or GIRP note. Structured formats are part of the advanced note templates, which some plans include.
If you work with families or couples, practice.tranqbay.health shows a website design made for a child and family therapist, and how individual and couples sessions each get their own length and fee on your booking page.
Frequently asked questions about genogram symbols
What do the symbols in a genogram mean?
Squares are men, circles are women, and a double outline marks the client. An X through a symbol means the person has died. Lines that run down and across show partners and children; lines drawn straight between two people show how they relate (close, distant, conflict, cutoff). Filled-in halves and quarters of a symbol show illness and substance use. Keys differ, so always read the key first.
What are the basic genogram symbols?
A square for a man, a circle for a woman, a double outline for the client, an X for a death, a solid partner line for marriage, a dashed one for living together, one slash for separation, two for divorce, children hanging below in birth order, and a dotted loop around the household. The relationship basics are two lines for close, three for fused, a dashed line for distant, a zigzag for conflict and a broken line for cutoff.
What does a zigzag line mean on a genogram?
A hostile or conflictual relationship. A zigzag between two or three parallel lines means close and hostile, or fused and hostile. A zigzag ending in an arrowhead means abuse, with the arrow pointing at the person harmed.
What do two lines and three lines mean on a genogram?
In the McGoldrick format, two parallel lines mean a close relationship and three mean a fused, or enmeshed, one. Some online keys use one and two lines instead, and on a medical pedigree a double line between partners means they are blood relatives, so check the key.
How do you show a cutoff on a genogram?
A straight line between the two people, broken in the middle by a gap with a short upright bar on each side. If the cutoff has since been repaired, the two bars are enclosed in a small circle. Write the year it began.
How do you show a miscarriage or stillbirth on a genogram?
On the Multicultural Family Institute sheet, a miscarriage is a very small circle at the end of a short line from the parents' line, and a stillbirth is a small square or circle with an X through it. Other keys use triangles for pregnancy losses. Because the shapes conflict, write the event and the year beside the symbol.
How do you show adoption on a genogram?
Most keys draw the line to an adopted child as broken rather than solid. The Multicultural Family Institute sheet uses a dashed line labeled "A" and the year of the adoption, with an arrow from the birth family when it's known. Medical pedigrees add brackets around the adopted person. Write "adopted" on the line so nobody reads it as foster care.
How do you show a transgender or nonbinary person on a genogram?
Newer guidance draws each person in the shape for their gender: a square for a man, a circle for a woman. For nonbinary people there's no single standard: a diamond in the 2022 NSGC pedigree standard and some therapy legends, a hexagon in a 2023 UK consensus. Write the person's gender and pronouns beside the symbol and say in your key which shape you used.
What does shading inside a genogram symbol mean?
On the Multicultural Family Institute sheet, the left half filled means a physical or mental illness, the bottom half filled means an alcohol or drug problem, stripes mean a suspected problem, a single filled quarter means remission or recovery, and three quarters filled means both illness and substance use. Software and medical pedigrees often use colors instead, so write the condition in words beside every shaded symbol.
Is a genogram the same as a medical pedigree?
No. A medical pedigree maps who has a condition, to assess inherited risk, and follows the NSGC standard. A genogram adds how people relate and what happened to them. They share squares and circles but differ on pregnancy loss, adoption, the index person and the meaning of double lines.
Is there a genogram symbols PDF?
You can print this page, or paste the key above into a document and save it as a PDF. Whatever you use, keep the key on the same page as the genogram.
Who created the standard genogram symbols?
The format most therapists use comes from Monica McGoldrick and Randy Gerson's 1985 book Genograms in Family Assessment, building on Murray Bowen's family systems theory. The current edition, Genograms: Assessment and Treatment (2020), adds Sueli Petry as an author.
Before your next session
Copy the key, decide what your diamond means, and put the key under the next genogram you draw. Then write one short line in words beside every shaded symbol and every pregnancy symbol, so the genogram still makes sense to someone who learned a different key.
If you also want booking, video sessions and session notes in one place, see how TranqBay works for private practice: you can look at a website design made for a child and family therapist and the booking page a couple or family would use. If you're deciding whether to join, this page explains how joining TranqBay works.
Sources
Books 2proceduresonline.com 1thebowencenter.org 1genopro.com 3dovetail.org.au 1humangenetics.medicine.uiowa.edu 1Research 4eprints.bbk.ac.uk 1Federal 1988 Lifeline 1
Books and publishers2
proceduresonline.com1
thebowencenter.org1
genopro.com3
dovetail.org.au1
humangenetics.medicine.uiowa.edu1
Research4
- 10Bennett, R. L., French, K. S., Resta, R. G., and Austin, J. (2022). Standardized pedigree nomenclature update centered on sex and gender inclusivity. Journal of Genetic Counseling, 31(6), 1238-1248pubmed.ncbi.nlm.nih.govhttps://pubmed.ncbi.nlm.nih.gov/36106433/
- 11Queering genomics: How cisnormativity undermines genomic science. HGG Advances (2024)pmc.ncbi.nlm.nih.govhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11129102/
- 12Giblin, J., and colleagues (2023). UK recommendations for the management of transgender and gender-diverse patients with inherited cancer risks. BJC Reports, 1pmc.ncbi.nlm.nih.govhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11523990/
- 13Hardy, K. V., and Laszloffy, T. A. (1995). The cultural genogram: Key to training culturally competent family therapists. Journal of Marital and Family Therapy, 21(3), 227-237doi.orghttps://doi.org/10.1111/j.1752-0606.1995.tb00158.x