More gender options please
Answered
I know this has been brought up before, but I am very uncomfortable with the gender options provided. My preference would be that gender be a write-in field on the first page. In terms of insurance, I'd like to see the gender question say "what gender does your insurance record show?" and then just M or F, only on the page with insurance, and then displayed on the same page as insurance. While you're at it, it would sure be nice if the birthday was also on the same page as the other insurance info. This is significant enough to me that I am considering other practice management options. I specialize in alternative populations, and I feel terrible having a gender option that says "other." Yuck!!
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Hi Lara, thanks for sharing this feedback. I'm excited to say that SimplePractice is completely revamping the sex and gender entry on the Demographics Form. While we don't have a set release date for this new feature, it is coming to SimplePractice soon. Thank you for your patience as we work with clinicians like you to make your practice even more affirming.
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I am really happy to see this is changing. It was one of my main reason for thinking about choosing a different EHR. I see that you will be using "sex," only needing to fill out sex if using insurance and having a fill in gender identity and pronouns option. Is it possible to change "sex" to "sex assigned at birth?" and/or "sex according to your insurance carrier"? Sex is better than gender but trans folks may have changed and/or be in the process of changing their biological sex. "sex at birth" helps clarify and "sex according to insurance" helps those who are billing insurance.
Thanks!
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I like Katrina's suggestion, and I don't think the info being in the tooltip is enough. If somebody is triggered by binary gender designations, they will be triggered before even thinking about opening the tooltip. I'd like to see the sex drop down only with the insurance info, not in the regular intake document. I'd also like to see the client's birthday on the same page as the insurance info. That's the only time I ever need it is when I have to call an insurance company, and it's aggravating switching pages just for the b-day. Thanks,
Lara
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Hi Lara, thank you! Adding the client date of birth to the Billing page is a great idea and something we plan to do in the future. We're continuing to gather feedback to iterate on the new sex and gender identity feature, and appreciate your suggestions. This feature will be released next week after thorough testing and feedback from hundreds of clinicians in our community.
Depending on the population you work with, and the specific needs of your practice, you may consider creating your own customized Intake Form using our Note and Form Template Builder. While that doesn't populate information automatically into the client chart, it will allow you more control and flexibility over the intake process with your clients.
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I am pleased with the new option to provide pronouns/gender identity. I love Lara's suggestion to ask "what gender does your insurance record show"? In California it is now also possible to have "X" as the legal marker. Can this be added as an option for the sex drop down, in addition to M, F, and "prefer not to say"? "X" is specifically non-binary, and different from declining to identify. Thanks!
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Hi Paige, happy to help. We actually released a host of updates related to client Gender Identity, Sex, and pronouns in August 2019. Here's a post from our blog with more details: https://www.simplepractice.com/blog/whats-new-sex-and-gender-identity/
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I'm glad to see that others are concerned about this and that it is being looked at by SimplePractice. I'm on a trial account, right now, trying to decide if this is the EHR for me. I like so much of what I'm seeing, but this issue would be a deal-breaker for me. I guess my main question, at this point, is: Can I use my own custom demographics form in place of the existing one?
I'm not seeing how I can turn the default demographics form off completely. I'm very uncomfortable with the options for gender, as well. I don't take insurance, and so I have no need for that distinction to match insurance forms. If I do in the future, I will have that conversation with patients myself. In the meantime, I need to not traumatize or trigger people before they even get in the door. Thank you!
P.S. For what it's worth, I had only seen the post-August 28th version when I wrote this. The new one is better than the previous, but it's still not what I need. As long as I can override that one and use my own, I'm fine with that.
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Gillian, the above directions that you provided, do not disable the demographics form, it only provides you the option to remove fields of "nickname, insurance, and gender identity" Even when creating our own custom demographic form, SP does not allow you to remove its default demographic form.
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Hi Gillian and the SP Team,
I wanted to follow up on this thread because while the updates in August 2019 increased inclusivity somewhat, they did not address an important point raised by my colleagues above about the use of the potentially triggering term "Sex" in place of "Sex Assigned at Birth" or "Sex on Record with Insurance."
Likewise it did not address changing the full Male and Female to M, F or adding an X for those whose legal gender is recorded as such. I'm wondering why these change weren't made along with the others? Are there more updates scheduled in the near future to address this?
I would also like to offer the suggestion to separate "Gender Identity" and "Pronouns" into two different entries, as those are categorically two different things and are not necessarily correlated.
I know that there is the option to create custom demographics forms, but I don't think that the "standard" form should need to be altered to be affirmative and inclusive to all potential clients.
Thanks,
Anna
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I totally agree with Anna! The suggestions are spot on and don't sound too challenging technologically. I concur that the current fields are liable to be quite triggering for people. And yes - gender identity and pronouns ought to be separate. I was looking at that field and trying to figure out how someone might fill it in accurately as it is.
Thanks, all. I have officially jumped on the SimplePractice train. I'll create my own form, for now, but I'll probably switch to the default form if I can.
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Gillian -
If I choose to create my own demographics form, will it still populate the fields on the client info page? Or will I have to do this manually?
I agree with the comments above that there really need to be more options. I would also add that "sexual identity" would also be a helpful field to add.
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Hello! I am glad to see this thread. I also would like to echo the NECESSITY of the change to adjust "sex" and to include that only in the insurance portion and to be very cognizant of the need to label it "Sex on record with insurance" or "sex assigned at birth". Also, yes, please separate gender identity and pronouns.
Additionally, I would like to see more options for adding more than one relationship status. This continues to signal that the accepted answer is that there is only one relationship to note. I work with many polyam folx and continue to find this upsetting for clients.
We should not have to go to the effort of making a custom form as these should be standard. Also, it is unclear if this would auto populate in their chart or if we would have to spend more time on adding this info on our own.
Simple Practice, y'all are great. And I would like to keep my group practice of 4 therapists and growing continuing to use your service. When can we expect these changes to be made? You have received some great FREE consultation from my colleagues above. It should not take much more time for these changes to be made. The clients we work with shouldn't have to face this level of discrimination. Frankly, as a non-binary therapist, it also is upsetting to me that y'all have overlooked this very easily Google-able aspect of client/human care.
Now that you know better, please do better. And with urgency.
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Following up on Neathery Thurmond, the option for sex needs to be "Sex on record with insurance".
Reasons:
* The reason we need the M/F marker is for insurance billing.
* Legal gender marker may not match insurance records.
* Actual gender identity may not match insurance records.
* Sex assigned at birth may not match insurance records.
Also, now that states are allowing the "X" gender marker, it may be necessary to add make the options for "Sex on record with insurance" field include X as one of the options.
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To respond to Cora's question: yes, if you create your own form and choose not to send the default demographics form, you'd have to enter the info into the profile yourself.
As expressed by my colleagues above, it would be lovely not to have to do this. That being said, I'm willing to enter info by hand if it helps avoid triggering people during their intake process, which I believe is a very real possibility with the current form.
I want to emphasize that I appreciate the functionality and flexibility of SP! I also would like to suggest shifting the thought process about these questionnaires based on Kaye-Alisa's comments above. Also, try to think along these lines:
- People are assigned so many aspects of their identities before they have a chance to choose them (e.g., gender and their NAME).
- As a therapist, I want to be flexible about allowing people to identify however it suits them AND recognize that these identities may shift over time.
- Legal name changes and legally changing gender is sometimes difficult and sometimes not even possible. A lot of people learn to live with discrepancies between what shows up on paper and in legal documents and what their lived experience actually is, which is unfortunate that they should have to.
It is important to allow people the greatest degree of agency with regards to their own presentation and identities. The practicality of collecting data according to insurance requirements is necessary for those who take insurance, but shouldn't be at the expense of the rights of the individual. The insurance information is more or less a "necessary evil." Since this is an application focused on facilitating the work of doing therapy, it would be wonderful if the default questionnaires were crafted similarly to how therapists have to think in order to "do no harm."
I'm really not trying to be snarky. (It's hard to convey tone in a message. It probably sounds more sassy than I mean it to be!) We appreciate the hard work and that SP is listening. Thank you! We're trying to educate on behalf of clients/patients that are often less represented and/or misunderstood. I appreciate the ways in which SP makes my life a lot easier. It's getting better, and I believe it can be truly great with some changes.
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I appreciate that SP has changed information in demographics to be more inclusive of gender BUT...the newest change with creating claims has caused a significantly difficult work around for my practice.
For clients who choose "prefer not to answer" under the "Sex" demographic question I have been able to create a claim and then manually enter the gender markers that clients have on file with their insurance.
Now, it will not even create a claim until I go back to the demographics and change it. And, to respect clients' choice of "prefer not to say" I new have to go back after I've created a claim to return it to "prefer not to say." When clients look at their records and see that I have changed this to a binary marker that they do not identify with, it causes emotional harm.
SO... in order to actually serve the purposes that the gender marker fields are trying to serve, here are my suggestions.
The demographic question about Sex should say Gender Marker (instead of sex), ask the question What is the gender marker that your insurance has on file for you? And give only the options that need to go on the CMS-1500 form.
For now, I am fine with the gender identity line though it is not ideal...some thoughts on that:The line about gender identity should become two different questions
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what are your pronouns? and can have a drop down that says choose as many that apply:
they/them/theirs
she/her/hers
he/him/his
ze/zir/zir
ze/hir/hir
another pronoun not listed*
*then give a write in option - how do you describe your gender identity and have a line for clients to write something in
Maybe create a small committee of people who are expert in working with trans/gnc/nb clients to develop these with you??
For the gender identity line it
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what are your pronouns? and can have a drop down that says choose as many that apply:
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Thanks, everyone, for your continued thoughtful feedback on how to make the Demographics Form in SimplePractice even better. I'd recommend taking a look at our Ideas board, which is where our Product team goes to learn more about what our customers would like to see in SimplePractice, at simplepractice.uservoice.com.
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