A Complete Guide to Genogram Symbols and What They Mean

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Therapist Rebecca Tenzer, MA, LCSW, CCTP, CGCS explains how to read the symbols & relationships in a genogram

Co-authored by Rebecca Tenzer, MAT, MA, LCSW, CCTP, CGCS, CCATP, CCFP and Devin McSween

Last Updated: February 11, 2026 Fact Checked

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Basic Symbols

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Family Relationships

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Children

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Emotional Relationships

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Medical Symbols

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Building a Genogram

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What are genograms used for?

A genogram is a visual way to graph your family tree. It uses symbols to list gender, sexuality, age, date of birth, date of death, familial relationships (parents, children, siblings, etc.), and emotional relationships between family members. We’ll explain what all of the symbols on a genogram mean so you can read one with ease, plus provide a guide on how to build a genogram of your own, with professional insights from therapist Rebecca Tenzer, MA, LCSW, CCTP, CGCS.

What are genogram symbols?

An illustration of genogram symbols and their meanings.

Therapist Rebecca Tenzer, MA, LCSW, CCTP, CGCS says genograms are visual tools used to map familial structures and patterns. Each symbol represents a family member’s gender, sexuality, age, date of birth, marriages/divorces, familial relationships, emotional relationships, medical conditions, and date of death.

Section 1 of 7:

Basic Genogram Symbols

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Basic symbols include gender, sexuality, and life status. Building a genogram starts with describing the people in your family tree. This includes their gender, sexuality, birth date, age, and date of death if they’re deceased. There are also symbols for pets. Here’s what the basic genogram symbols represent:^{[1]
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- Male: Square^{[2]
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- Female: Circle^{[3]
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- Nonbinary: Arch (Rectangle with a semi-circle top)
- Transgender (female to male): Square with a circle inside
- Transgender (male to female): Circle with square inside
- Unknown gender: Question mark
- Gay or lesbian: Upside-down triangle inside the square or circle
- Bisexual: Dotted upside-down triangle inside the square or circle
- Deceased: “X” inside the square or circle
- Name: Written name inside the square or circle
- Age: Numerical age inside the square or circle
- Birthdate: Date (M-D-Y) above the left side of the square or circle
- Date of death: Date (M-D-Y) above the right side of the square or circle
- Pet: Diamond
Meet the wikiHow Expert

Rebecca Tenzer, MA, LCSW, CCTP, CGCS is a therapist with over 18 years of clinical and educational experience in the field of mental health.

Section 2 of 7:

Family Relationship Genogram Symbols

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Family relationship symbols include marriage, separation, and divorce. In a genogram, the family relationship describes a union between two people and is depicted by a horizontal line connecting them (if it’s a man and woman, the man is depicted on the left and the woman on the right). The type of line (solid vs dotted) and any symbols along the line describe the type of relationship the couple has. Common family relationship symbols include:^{[4]
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- Marriage (civil or religious): Solid line^{[5]
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- Committed relationship: Dashed line
  - This can refer to an engagement or simply a long-term relationship.
- Cohabitation/common-law marriage: Dashed line with house symbol in the center
- Separation: Backslash (\) in the center of the line^{[6]
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  - This indicates that the couple is not living together, but hasn’t started the legal separation process.
  - You can use the separation symbol for a marriage, committed relationship, cohabitation, or casual relationship.
- Legal separation: Forward slash (/) in the center of the line^{[7]
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  - This indicates that the couple is not living together and has started the legal separation process.
  - You can use the legal separation symbol for a marriage or a cohabitation relationship.
- Divorce: Solid line with two forward slashes (//) in the center^{[8]
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- Widowed: Solid line with an “X” in the center
- Casual relationship (dating): Dotted line
- Temporary sexual relationship: Dashed and dotted line

Section 3 of 7:

Children Genogram Symbols

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Genogram symbols for children include adoption, twins, and pregnancy. On a genogram, children are listed as vertical lines below their parents’ horizontal relationship line, says Tenzer.^{[9]
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Rebecca Tenzer, MAT, MA, LCSW, CCTP, CGCS, CCATP, CCFP
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Expert Interview} If there are multiple children, they’re listed with the oldest on the left and the youngest on the right. Here are the various children symbols:^{[10]
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- Biological child: Solid line
- Adopted child: Dashed line
- Foster child: Dotted line
- Fraternal twins: Two solid lines descending from the same point
- Identical twins: Two solid lines descending from the same point, and a horizontal line connecting the children
- Multiples (triplets, etc.): Three or more solid lines descending from the same point
- Pregnancy: Triangle
- Miscarriage: Triangle with “X” through the center
  - Some genograms list miscarriages as a small circle (open or filled)
- Abortion: Triangle with an “X” and a horizontal line through the center
  - Some genograms list abortions as an “X”
- Stillbirth: “X” through the center of a small square or circle
  - Some genograms list stillbirths as a forward slash through the square or circle

Section 4 of 7:

Emotional Relationship Genogram Symbols

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Emotional relationship symbols include close, distant, and cut-off relationships. Emotional relationship symbols describe the type of bond any two people on the genogram share, which includes positive and negative relationships. The type of relationship is depicted as a line connecting the two people together. The line is typically colored to make reading the genogram easier. Here are the most common emotional relationship symbols:^{[11]
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- Very close relationship: Double solid green line^{[12]
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  - Meaning: A positive, communicative, and respectful relationship.
- Friendship: Double-dashed green line^{[13]
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  - Meaning: A deep friendship with trust, understanding, and affection.
- Love: Solid green line with a circle in the middle
  - Meaning: A strong, positive, and loving relationship.
- In love: Solid green line with two overlapping circles in the middle
  - Meaning: A passionate and committed relationship.
- Indifferent or apathetic relationship: Dotted black line^{[14]
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  - Meaning: One or both people are indifferent to each other.
- Distant or poor relationship: Dashed black line
  - Meaning: Communication is limited between the two, often due to lifestyle differences.
- Estranged or cut off: Dashed red line with 2 vertical lines separating them in the middle
  - Meaning: There is no contact between the two.
- Repaired cutoff: Dashed green line with 2 vertical lines separating them, and a circle in the middle
  - Meaning: The two were previously estranged, but have since repaired the relationship.
- Hateful relationship: Triple-dashed red line
  - Meaning: The two individuals have an intense dislike and wish harm on each other.
- Conflictual or hostile relationship: Loose zig-zag red line^{[15]
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  - Meaning: The two individuals argue and have fights about major issues.
- Violent relationship: Tight wavy red line
  - Meaning: The two individuals have fights that result in physical force.
- Physical abuse: Tight blue zig-zag line, with an arrow pointing toward the victim
  - Meaning: One individual is physically abusive to the other.
- Emotional abuse: Tight and short blue zig-zag line, with an arrow pointing toward the victim
  - Meaning: One individual is emotionally abusive (yelling, name-calling, shaming, etc.) to the other.
- Sexual abuse: Double zig-zag blue line, with an arrow pointing toward the victim
  - Meaning: One individual is sexually abusive to the other.
- Neglect: Dashed blue line with an arrow pointing toward the victim
  - Meaning: The individual does not provide for their child or dependent’s basic needs (housing, food, clothing, medical care, supervision).
- Manipulative relationship: Solid red line with an “X” in the center
  - Meaning: One individual manipulates the other.
- Controlling relationship: Solid red line with a square in the middle that has an “X” in the center
  - Meaning: One individual controls the other.
- Fused relationship: Triple solid red line
  - Meaning: The two are inseparable and dependent on one another.
- Focused on: Solid black line with arrow pointing at the object of focus
  - Meaning: One individual is unhealthily focused on or obsessed with the other.
- Normal or plain relationship: Solid black line
  - Meaning: A neutral relationship. It’s not descriptive on its own, but may be used in genograms where there are many dysfunctional relationships.

Section 5 of 7:

Medical Genogram Symbols

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Medical symbols include cancer, heart disease, and depression. Many people use genograms to track hereditary conditions and illnesses in their families. These include physical illnesses, mental illnesses, and developmental conditions.^{[16]
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- Cancer: Purple sliver in the top right or left corner of the square or circle
- Heart disease: Red sliver in the top right or left corner of the square or circle
- Hypertension: Red sliver in the bottom right or left corner of the square or circle
- Obesity: Green sliver in the top right or left corner of the square or circle
- Diabetes: Dark purple sliver in the top right or left corner of the square or circle
- Alzheimer's disease: Blue sliver in the top right or left corner of the square or circle
- Depression: Dark blue sliver in the top right or left corner of the square or circle
- Mental illness: Gray sliver in the bottom right or left corner of the square or circle
- Arthritis: Gray sliver in the top right or left corner of the square or circle
- HIV/AIDS: Orange sliver in the top right or left corner of the square or circle
- Sexually Transmitted Infection: Yellow sliver in the top right or left corner of the square or circle
- Autism: Turquoise sliver in the top right or left corner of the square or circle
- Down syndrome: Dark blue sliver in the bottom right or left corner of the square or circle
- Alcoholism: Blue square or circle
- Drug abuse: Orange square or circle
- Gambling addiction: Pink square or circle

Section 6 of 7:

How to Build a Genogram

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Draw your genogram by hand, or use an online template. There are plenty of pre-made genogram templates you can use, such as ones by GenoPro and Canva. It’s also easy to make your own genogram, whether you draw it by hand or create it using a word processor, like Microsoft Word, or a graphic design platform, like Canva. Simply gather your family history and create your genogram by following these basic steps:^{[17]
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- Tenzer says to start by mapping the immediate family and expand to at least three generations, similar to a family tree.^{[18]
  X
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  Rebecca Tenzer, MAT, MA, LCSW, CCTP, CGCS, CCATP, CCFP
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  Expert Interview} So, start with the union between 2 people (grandparents, parents, etc.). List the man on the left, the woman on the right, and draw a horizontal line connecting them.
- Add any identifying details about the people, such as their sexuality, age, date of birth, and date of death.
- Customize the horizontal line to describe what sort of familial relationship the two people have, such as married, divorced, or widowed.
- Then, add any children or pregnancies they have as vertical lines extending from the horizontal line. List the oldest child on the left and the youngest on the right.
- Add any identifying details about the children, such as their sexuality, age, date of birth, and date of death.
- List any unions the children have with horizontal lines, and add vertical lines to designate any children they have.
- Add emotional relationship symbols, says Tenzer.^{[19]
  X
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  Expert Interview} Describe the emotional relationships any two people have by drawing colored lines between them (the lines can be horizontal, vertical, or diagonal to fit on the genogram). For instance, they can be close, estranged, or hostile.
- Add relevant health (diabetes, cancer) or mental-health patterns (substance use, bipolar, depression), Tenzer says.^{[20]
  X
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  Rebecca Tenzer, MAT, MA, LCSW, CCTP, CGCS, CCATP, CCFP
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  Expert Interview} Use these colored slivers to track hereditary illnesses.
- Create a key to reference what different symbols and lines mean. While most genograms use the same or very similar symbols, feel free to customize the symbols to your liking.
- Analyze the data and patterns. “Once complete, reflect on repeating themes such as attachment, boundaries, familial roles, trauma or communication styles to better understand how the past informs the present and how change can begin,” Tenzer says.^{[21]
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  - Tenzer notes that genograms can change over time. “Genograms evolve. They can be revisited as insight deepens, relationships shift, or healing occurs.”^{[22]
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Section 7 of 7:

What are genograms used for?

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Tenzer explains, “Genograms are visual tools used by therapists to map familial patterns to assist with understanding the complexities of family dynamics. [They] help to build a big picture of a client’s family structure and emotional relationships across generations.” She says that they’re more than just a family tree. “They highlight patterns such as closeness, conflict, caregiving roles, trauma, and resilience that influence how families and partners relate today.”^{[23]
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- “They are very powerful tools in psychotherapy to pinpoint relationship patterns and potential treatment planning,” Tenzer continues. “By seeing these dynamics on paper, individuals gain insight, empathy, and clarity, often discovering that past and present challenges are part of larger intergenerational patterns, genetics or products of their environment and not personal failures.”^{[24]
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