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It’s just an empty field — a small, mundane feature of a form that someone designed, probably years ago, without thinking about who would eventually be sitting in a plastic chair trying to fill it out. And yet there you are, your kid in a hospital bed next to you, nurse waiting, and the form in your hands asking for “Mother” and “Father” like it’s 1987 and as if those two options cover everyone.
They don’t, and they never did. It’s just that the people who built the system were never sitting in that chair.
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This isn’t about paperwork.
Or it is, but only in the way that a symptom is about the disease that caused it. What a form communicates, beyond its practical function, is who the people who designed it imagined would be filling it out. And for most of the history of American medicine and bureaucracy, that person was not a lesbian mom or a gay dad, was not a nonbiological parent, and was not a woman trying to explain — for the third time in 20 minutes to three different people — that yes, she is the child’s parent, no, there isn’t a father, yes, she has legal authority to make decisions, and could someone please just update the chart and move on.
The frustration isn’t new. What’s shifted is that more people in the LGBTQ+ community are naming it out loud, and loudly enough that some people are finally starting to listen.
The Nonbiological-Parent Problem
If you’re the biological parent, the form is an annoyance. It’s something you roll your eyes at and work around, writing “N/A” in the mother or father line and moving on. If you’re the nonbiological parent, it can be pretty frightening, because without the right legal documentation — a second-parent adoption, an updated birth certificate in a state that allows two same-*** parents to be listed, a carefully prepared folder of paperwork that you’ve been told to always carry and probably left in the car — you are, in the eyes of the hospital, functionally nobody. Not on paper, anyway. You’re a person who loves this child more than you love your own life, who has been at every appointment, every school play, and every 2 a.m. fever, and who is nonetheless being asked by a nurse with a clipboard what her relationship to the patient is.
This is the part that doesn’t make headlines — the Dobbs coverage, the fights over anti-trans legislation, the visibility battles happening in courtrooms and school board meetings. Those are all extremely important issues. But there’s a more systemic kind of invisibility that same-*** families navigate on an almost daily basis, and it doesn’t have a dramatic news hook.
It’s a form, a school registration packet, an insurance card that only has one parent’s name because there wasn’t a spot for the second one. It’s a doctor who walks into the room and addresses only the biological mother without seeming to register that there are two adults here who both belong to this child.
It’s Gotten Better, Depending On Where You Live
Some hospitals have updated their intake forms, and some electronic health record systems now include fields that accommodate two mothers, two fathers, a nonbinary parent, or a family structure that doesn’t fit into the postwar template. And following a 2017 Supreme Court ruling, every state in the U.S. is required to list married same-*** parents on birth certificates — with states like California, New York, Vermont, and Colorado going further, extending protections to nonbinary and unmarried parents and clarifying rights around surrogacy. The progress is real, and it matters, and the people who fought for it deserve credit.
It’s also uneven in ways that track almost perfectly onto geography and resources, which is its own particular kind of injustice. A well-funded urban hospital is far more likely to have modernized its processes than a rural clinic operating on fumes, which means the families who already have the least — less access, less money, less proximity to legal resources and LGBTQ-affirming care — are also the ones most likely to still be handed a form with a mother or father line and have to figure out what to write in it. And even in the places that have updated the form, the culture doesn’t automatically follow. A new field on a form doesn’t mean the staff knows what to do with the answer, doesn’t mean the doctor addresses both parents without hesitation, and doesn’t mean a well-meaning nurse won’t ask which one of you is the real parent.
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For what it’s worth, “we both are” seems to be the best response that elicits no follow-up questions (in my same-*** parent experience, at least).
What Actually Needs To Change
The form itself is fixable. Instead of just “father” and “mother” with two blank fields for names, there could be options like “legal guardian 1” and “legal guardian 2 (if applicable).” Advocacy groups like GLMA (Health Professionals Advancing LGBTQ+ Equality) have already laid the groundwork for this — their culturally responsive care guidelines tell hospitals to ditch the standard Mother/Father lines on intake forms in favor of “Parent 1/Parent 2” or “Parent/Guardian.”
Hospitals, schools, insurance companies and pediatric offices have all proven they can update their systems when they want to. The information is there — it’s just a matter of whether anyone in charge cares enough to use it.
But the form is also a symptom of something larger, a system that was built around a version of family that was never actually universal. And updating it, while necessary, doesn’t undo the accumulated experience of being asked to justify your own family to strangers who are just doing their jobs and have no idea they’re doing anything wrong.
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What all queer parents actually need is to stop being treated as an afterthought requiring special accommodation, and to start being assumed into existence the way straight nuclear families always have been. To walk into a hospital with a sick kid and have the form account for them without explanation, or three different staff members who each need to be caught up separately.
That’s not a radical thing to want. And yet here we are, still writing our names in the margins.
Jill Layton is a writer based in Long Beach, California, who has been covering lifestyle, parenting and commerce for over a decade. Her work has appeared in outlets including People, Scary Mommy, Bustle, Romper, Best Products, Runner’s World, The Dodo and Popular Mechanics, where she blends thoughtful reporting with a candid, relatable voice. She writes about the realities of everyday life — from parenting and relationships to shopping to the small moments that often go overlooked — with an eye for what resonates and what’s actually worth talking about.
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