Opinions
My visit to Inova hospital marred by binary intake form
‘M’ or ‘F’ excludes trans, non-binary patients from affirming care
When Inova opened its Pride Clinic in Falls Church last year, an official hailed the new center as an inclusive space where LGBTQ+ patients would be welcomed at the door with the questions, “What are your pronouns? How do you prefer to be addressed?”
But that was not at all my experience when I visited the emergency room of an Inova hospital just a few miles away.
At Inova Alexandria Hospital, intake forms listed only two boxes — M or F — for me to be able to disclose my gender. I did not know how to answer. I am transgender. I am non-binary.
On forms and in life, it is very hard when you can’t find a box that fits you to be able to say who you are. I know this from hard experience.
So I took the intake form to the hospital intake employee who had asked me to fill it out. I pointed to the “X” marker on my gender on my driver’s license.
“The DMV has a box for me to say who I am, but Inova doesn’t,” I said.
The employee was empathetic, but told me she doesn’t make the forms and that I could refuse to answer the question. The point is, I want to be able to answer. I want to be able to say who I am. But the forms did not let me.
“If folks can’t get in the door and be called their proper name and proper pronouns and get their information collected, it doesn’t surprise me they’d be reluctant to come in the door and it doesn’t surprise me that disparities exist,” Alex Waad, health equity manager in ChristianaCare’s Office of Health Equity in Delaware, said in a telephone interview.
Waad, who could not comment on the practices of Inova or other hospitals, was part of a team of researchers at ChristianaCare and the University of Delaware who published a study after surveying dozens of hospital registrars about how they seek and record information on gender.
The researchers found, in some cases, electronic healthcare record systems just did not allow for reporting on nonbinary patients. That affects thousands of would-be patients. According to the Virginia Mercury, more than 5,000 Virginians have recorded their gender marker as nonbinary with the DMV since a 2020 law allowed the designation.
Despite large, unwieldy electronic health systems, change is possible. In January, after all, the nation’s largest healthcare provider, the Department of Veterans Affairs, announced its own medical record system would change to include transgender options for gender.
“All veterans, all people, have a basic right to be identified as they define themselves,” VA Secretary Denis McDonough said at the time. “This is essential for their general well-being and overall health.”
Luckily, my bicycling accident left me scraped and sore but without any broken bones. The clinical care I received at Inova was prompt and professional. Still, a few days later, I told hospital officials about my concerns.
“Your forms have only a male and female box and solicit no information at all to indicate preferred pronouns or any trans existence at all,” I wrote in an email. “I understand it can be important from a clinical perspective to understand somebody’s (assigned) gender at birth, but it’s equally important to understand the entirety of somebody’s identity and experience.”
This goes far beyond hurt feelings. It’s about respect and accuracy. What’s more, after this sort of experience, the next time a trans person has to decide whether they will go to the hospital, they might opt to stay home instead, at a time when they could need critical and life saving care.
In response to my inquiry, a hospital spokeswoman said Inova would, indeed, be updating its forms and training across its system. More than 2 million patients visit Inova’s hospitals, primary and specialty care practices and other medical offices each year.
“We strive to provide a welcoming and safe environment for all of our patients from the moment they walk through the doors,” Inova spokeswoman Tracy Connell wrote in an email.
Connell also said the nonprofit health system had updated its patient electronic medical records (EMR) back in 2020 to let patients note their affirming gender identity, along with pronouns, legal sex, sex assigned at birth and other inclusive values.
However, she added, “unfortunately, our paper forms do not yet align with our EMR.”
This news of updated, inclusive forms is welcome, if belated.
I asked Connell to send me a copy of any new intake forms, and I’ll be sure to follow up when that happens.
In the meantime, slow down motorists and keep a watchful eye for bicyclists, because I’m not looking to return to the ER anytime soon.
A former newspaper reporter, Jamie McElhatton is a private investigator and organic grocery store worker. They live in Alexandria, Va.
A right does not need to be banned to be restricted. Sometimes it only needs to be made uncertain.
That is what emerges from a closer examination of adoption access for same-sex couples across different countries. There is no broad legal rollback. What appears instead is a more subtle pattern: rights that remain on paper but become fragile, conditional, and uneven in practice.
Italy provides a clear example.
Since 2023, under the government of Giorgia Meloni, administrative decisions have limited the automatic recognition of both mothers in female same-sex couples, particularly in cases involving assisted reproduction abroad. In practice, many families have been forced into additional legal proceedings to validate relationships already established.
At the same time, Italy has intensified its opposition to surrogacy, extending penalties even to those who pursue it outside the country. Human rights organizations have warned that these measures disproportionately affect LGBTQ families, particularly male couples.
The judiciary, however, has pushed back.
In 2025, the Constitutional Court ruled that a non-biological mother cannot be excluded from legal recognition when there is a shared parental project. It also removed a long-standing restriction that prevented single individuals from accessing international adoption.
Italy has not eliminated these rights. But it has made them unstable.
When a right depends on litigation, judicial timelines, or shifting interpretations, it is no longer fully guaranteed.
In the United States, the structure differs, but the outcome converges.
At the federal level, same-sex couples can adopt. Yet the system varies widely across states.
Data from the Movement Advancement Project show that while some states explicitly prohibit discrimination in adoption, others provide no clear protections. In several states, licensed agencies can refuse to work with same-sex couples based on religious objections.
Access, therefore, is shaped not only by law, but by geography, institutions, and applied standards.
Research from the Williams Institute further complicates the narrative. Same-sex couples adopt and foster children at higher rates than different-sex couples.
The contradiction is clear.
Child welfare is invoked, yet the pool of available families is reduced. Faith is cited, yet it is used as a filter within publicly funded systems.
The consequences are tangible
children remain longer in care
processes become more complex
families face unequal scrutiny
What is happening in Italy and the United States is not isolated. Across parts of Europe, conservative governments have advanced legal frameworks that reinforce traditional definitions of family while limiting recognition of diverse ones.
Adoption is not always addressed directly. But the impact accumulates.
Options are restricted while the language of protection is used to justify it.
There is no need to soften it.
This is not only a debate about family models. It is a decision about who is recognized as family and who must continue asking for permission.
That is not neutral.
It is political.
And when a right depends on where you live, who evaluates you, or how hard you are willing to fight for it, that right is already being weakened.
Opinions
ROSENSTEIN: Chavous for Democratic D.C. Council-at-Large
Committed to fighting for statehood for our 700,000 residents
Kevin Chavous said, “I’m running for D.C. Council At-Large because Washingtonians deserve leadership focused on improving their everyday quality of life. Throughout my career, I’ve worked on the practical business of city government, and public policy, focused on solving real problems, and making government work better for the people it serves.”
Kevin’s experience spans safer streets, affordable housing, early education and school readiness, workforce and economic opportunity, support for seniors, and the day-to-day operations of city government. The knowledge he brings to the office is grounded in experience, clear-eyed oversight, and a commitment to delivering results. His platform outlines his priorities and approach, but as he has said, “it’s not the end of the conversation. I believe the best solutions come from listening and working together.”
Kevin believes safe streets are the foundation of strong neighborhoods. He is committed to having Washingtonians feel secure in their neighborhoods, and working to ensure all public safety efforts are smart, fair, and effective. To Kevin that means an approach focusing on enforcement that works, prevention that matters, and a range of services to stop crime before it happens. Kevin supports smart, effective policing, with a focus on violent crime, and getting repeat offenders off the streets. To do this he will work to strengthen community policing with the aim of rebuilding trust in every community, which will improve neighborhood-level safety. He will introduce legislation to expand targeted mental health and crisis-response services. The goal again, to prevent violence before it occurs. He will work to see government coordinates youth diversion, workforce, and support programs, which can intervene early, and reduce recidivism.
Kevin understands housing stability is essential for families, seniors, and workers, to stay and thrive in D.C. His housing priorities focus on increasing the supply of affordable housing, helping people build long-term stability in the neighborhoods they call home. He will work to increase the affordable housing supply through zoning updates, ADUs, and adaptive reuse of vacant properties. He will submit legislation to strengthen programs that help first-time, and longtime homeowners, buy and then stay in their homes. He will work to expand permanent supportive housing and targeted rental assistance for vulnerable residents, and protect tenants ensuring housing laws are enforced clearly, and consistently.
Kevin believes “every child should enter school ready to learn, with the support needed to succeed from day one. Early investment pays lifelong dividends – for families and for the District.” He will work on the Council to expand early childhood education, and school-readiness programs, citywide. He supports quality and affordable childcare for all children, birth to three, including seeing students begin the school year healthy, by supporting access to medical and dental screenings for all children.
Kevin knows economic opportunity allows families and communities to thrive. He will fight to see D.C.’s growth creates real pathways to good jobs, strong local businesses, and long-term stability for residents in every ward. His approach connects workforce training, worker protections, and neighborhood investment, so that growth benefits the people who live here. He will work to expand job training, apprenticeships, and career pipelines tied to high-demand fields, including construction, healthcare, and infrastructure. He will fight to strengthen First Source and local hiring requirements, so D.C. residents benefit directly from major development projects such as the new RFK site. He will demand the government protect workers by enforcing wage, safety, and labor standards, and holding bad actors accountable. He will introduce legislation to invest more in neighborhood-based economic development, including small businesses, BIDs, and commercial-to-residential revitalization.
Kevin has spoken out for the seniors in our city saying, “seniors built this city – and D.C. must ensure they can age with dignity, security, and independence.” Kevin will work to expand property tax relief and housing supports, so seniors can age in place. He will work with the AG to strengthen protections against fraud, exploitation, and predatory practices targeting seniors. He will support and work to expand nutrition, transportation, and community-based programs, that reduce the isolation many seniors face.
Kevin’s experience working for the Council, in the oversight role he had, gives him a practical understanding of what works, what doesn’t, and how to fix it – without delay. He will use that experience as he works to strengthen agency oversight to ensure laws are implemented as intended, and to improve service delivery by fixing bottlenecks, and outdated processes. Ensuring clear standards and accountability in inspections, enforcement, and permitting. Kevin will demand government use technology responsibly to improve efficiency, while protecting residents from fraud and abuse.
For all these reasons and more, I support Kevin Chavous. The more includes the fact Kevin has spoken out clearly, about the need to fight the antisemitism, Islamophobia, racism, sexism and homophobia, all once again rearing their ugly heads in our society. He will fight to keep ICE out of our city, and to keep immigrants safe. He is committed to fighting for statehood for the 700,000 residents of the District of Columbia, while fighting for budget and legislative autonomy as we work toward statehood.
Again, I urge the voters of D.C. to cast their ballot for Kevin Chavous for DC Council-at-Large.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
The state of Tennessee has a long history of political discrimination against its 225,000 LGBTQ citizens. In 2019, a district attorney remarked that gay people should not receive domestic violence protections, and in 2023, for five months in Murfreesboro, homosexual acts in public were illegal, prompting a federal judge to have the ordinance removed.
In 2022, I briefly lived in Tennessee and played rugby with the LGBTQ-inclusive Nashville Grizzlies, who welcomed me with open arms as an ally, teaching me that rugby isn’t always about winning or losing – it’s about creating a safe, inclusive, and joyful space for people looking to feel welcome.
In Tennessee, where 87% of the LGBTQ community has experienced workplace discrimination, and where, each year, countless bills that target their identities are introduced, it can be difficult to feel welcome. The Nashville Grizzlies played rugby with the exuberance of newly liberated people who were finally able to be their authentic selves. I was inspired by their brotherhood.
When I read about the Charlie Kirk Act being passed last week, I felt a visceral need to write about it.
While the bill is presented as legislation that strengthens free speech and encourages greater public discourse on campuses, it would effectively allow a school to expel a student who felt compelled to walk out on a speaker with hateful views, forcing marginalized groups to sit through existentially harmful rhetoric.
And ironically, it doesn’t seem like free speech goes both ways — a Tennessee University administrator lost their job last year for sharing negative views on Charlie Kirk, and countless LGBTQ books have been banned not only in schools, but even in adult libraries.
We like to think that as time moves forward, progress is inevitable, but this isn’t always the case. In a 2023 study, 27% of LGBTQ Tennesseans and 43% of transgender people in the state have considered relocating, forcing them to reckon with leaving home in pursuit of a better life. Nashville Grizzlies Captain Ethan Thatcher told me, “I’ve thought about leaving Tennessee. Hard not to when the government does not want you here. What has kept me here is the Grizzlies community, and the thought that existence is resistance.”
Everybody in our country deserves to feel safe. I thought that was a core value of the American ethos, but apparently, in some states, certain groups are welcome while others are ostracized.
Tennessee Gov. Bill Lee should reject the Charlie Kirk Act.
Tyler Kania is a 2025 IAN Book of the Year nominated author and civil rights activist from Columbia, Conn.
