Genogram Symbols Explained

Genograms rely on a standardised set of symbols that convey a great deal of information at a glance. Understanding these symbols is the first step to reading or creating a genogram correctly. This guide covers the most widely accepted notation, based on the system established by Monica McGoldrick, Randy Gerson, and Sylvia Shellenberger.

Symbols for Individuals

Each person in a genogram is represented by a geometric shape:

• Square — a male individual.
• Circle — a female individual.
• Triangle — a pregnancy (or non-binary / gender-unknown individual in modern usage).
• Diamond — a person whose gender is unknown or not specified.

The identified patient or the person who is the focus of the genogram is marked with a double border (a square within a square or a circle within a circle).

Status markers inside the shape

• An X or cross through the shape indicates the person is deceased.
• A small diagonal line indicates a miscarriage or stillbirth, depending on the convention used.
• A filled (solid) shape is sometimes used to indicate a diagnosed condition when colour coding is applied.

Symbols for Relationships Between Couples

Horizontal lines connect two individuals in a couple relationship. The type of line reflects the nature of the relationship:

• Solid horizontal line — a married couple. The date of marriage is often written above the line.
• Dashed line — a cohabiting (non-married) couple.
• Two slash marks on the couple line — separated.
• Three slash marks — divorced.
• A dotted line — a brief or casual relationship.

Symbols for Parent–Child Relationships

A vertical line descends from the couple line to a horizontal sibship line. From this sibship line, individual vertical lines drop down to each child. Adoption and foster care are shown with a dashed vertical line instead of a solid one.

Twins share the same attachment point on the sibship line: identical twins are connected by a horizontal bar, fraternal twins are not.

Relationship Quality Lines

Beyond structural connections, genograms use relationship lines to describe the emotional quality of a connection between any two people:

• Close / warm — two parallel lines running between the two individuals.
• Very close / enmeshed — three parallel lines (or thick parallel lines).
• Conflictual — a jagged or zigzag line.
• Estranged / cut-off — a line with two perpendicular bars crossing it.
• Fused and conflictual — a combination of parallel and zigzag lines.
• Distant — a single, thin dashed line.

Annotations and Labels

Standard annotations placed near each symbol include:

• Name — usually first name below the shape, last name above for the index generation.
• Birth year — inside or below the shape (e.g., b. 1952).
• Death year — beside the X mark (e.g., d. 2018).
• Diagnoses or conditions — abbreviated codes near the shape (e.g., HTN for hypertension, ALC for alcoholism).
• Occupation — sometimes noted below the name.

Colour Coding

Many practitioners extend the symbol set with colour coding to track a specific theme — for example, all family members who experienced depression are shaded blue, all who had cancer are shaded red. Colour is especially effective when presenting genograms to clients or in training contexts. Whatever scheme you choose, document it in a legend so the diagram remains readable by any colleague who reviews it.

Tips for Consistent Notation

The most important thing is consistency within a single genogram. If you choose to represent alcoholism with a specific code or colour, apply it the same way throughout. Inconsistent notation is the most common source of confusion when a genogram is reviewed by a colleague or supervisor.

When in doubt, add a legend to the genogram. A small key panel listing your colour codes and any non-standard symbols takes only a moment to prepare and makes the diagram immediately readable by anyone unfamiliar with your notation choices.

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