Sex at Birth and Current Gender Identity


#1

Hi.

Our system will need to collect Sex at Birth and Current Gender Identity. Which data elements in the Patient resource is best to capture this (if any - i.e. does AdministrativeGender map to any of these two concepts)?

Thanks


#2

Neither Sex at Birth nor Current Gender Identity map exactly to Administrative Gender. For most patients, obviously, these are the same things, but once transgender issues come into play, they may be different. Administrative Gender is what the patient officially is - typically for billing/reporting purposes. Typically, this lags behind the current gender identity, and is not fluid like gender identity can be, though it may eventually be reconciled, depending on culture and jurisdication. Sex at Birth is different thing again.

Typically, current gender identity is an observation, with LOINC code like 76691-5 (Gender Identity). You can use an observation Sex at Birth (say 76689-9 “Sex assigned at birth”, though note that’s not quite the same thing). If you’re in USA, see http://hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html


#3

Thanks Graham… Not sure what is meant by “patient officially is” - i.e. how is that determined?


#4

Is there a reason that birthsex is US-core? It seems like it’s a concept that should apply world-wide, even if not everyone will necessarily care…


#5

I agree. And we may even need to consider/review how it is different from administrativeGender. Should I open a tracker item?


#6

It’s absolutely different from administrative gender. That reflects “now” - and for some individuals in some jurisdicitions will differ from birth gender. (And the birth gender extension would really only be relevant in those cases where it was different.) I’d be happy for a change request.


#7

Done. Here is the link to tracker item: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13603