"Birth sex" instead of just "Sex" feels extremely exclusionary and not in a bad design way, unfortunately.

It's possible the culprit is the company that provides their EHR, too. However, the "Birth sex" form is not in the sample templates they show on their site, so it doesn't appear to be them. Presumably it's a field the eye doctor added.

Again, it's honestly reasonable to ask for assigned sex, but the fact that they are forcing trans people to ONLY enter that, wording it in such a way...and forcing people to hand over the birth sex of a partner (thus potentially outing them) is definitely something which needs to be addressed.