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This is the set of working definitions that enumerate named context of use for sex and gender that specifies concept content and other required information. This page captures the working output of the project.

The set of Gender Harmony context definitions will be focused on identities but it will also note that there are associated observations that are used to record clinical information that can be used as a basis for determining the clinical sex identity.  For example chromosomal allosomes, genotype, hormone levels, secondary sex characteristics.

It may be that we will need to name some contexts for typical known uses because this context name will be used to clarify for what use a member value is meant to represent. For example Organ-based clinical sex would indicate that the included member concepts - M, F, Intersex - describe the patients sex organ characteristics. 


DescriptionDefinitionSynonymAllowed valuesUNK allowed?Open/ClosedExisting known implementations
Gender identityA self-characterization of identity that is reflective of sexual phenotype but is not restricted to standard binary male or female. This is not a characterization of the preference for sexual partnership (ie: sexual orientation.)Sexual identity



Sex identityA characterization of identity that defines allowed values and context of use based on what is typically called biologic, phenotypic or genetic characteristics. This is not a characterization of the preference for sexual partnership (ie: sexual orientation.)Sexitems below this row


Organ-based clinical sexA characterization of identity that defines allowed values and context of use based on objective characteristics related to sexual reproduction. Biologic sexM, F, IntersexUNKClosed
Phenotypic sexA characterization of identity that defines allowed values and context of use based on objective visually observable characteristics related to sexual reproduction. 




Chromosomal sexA characterization of identity that defines allowed values and context of use based on chromosomal findings for the patient.




Binary administrative sexPhenotypic biologic sex identity for use in administrative situations allowing only binary results.Administrative gender, Administrative sexM, F
Closed
Binary with UNK administrative sexPhenotypic biologic sex identity for use in administrative situations requiring only binary results.
M, FUNKClosed
Unrestricted binary administrative sexPhenotypic sex identity for use in administrative situations requiring binary results or OTH.
M, F, OtherUNKClosed
Open administrative sexUnrestricted phenotypic gender identity for use in administrative situations
M, FUNKOpen
Birth sexSex identity assigned at birth.
M, F, UndiferentiatedUNKClosed
Birth certificate sexSex identity recorded on the birth certificate.
M, F, Non-binary, Intersex
Closed





















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6 Comments

  1. AdministrativeGender is always just that in contexts I know. It is called AdministrativeSex in this list with AdministrativeGender as synonym.

    I don't see how "Unrestricted binary administrative sex" with value "Other" could be marked as a Closed set. Other by default means Open in my mind. So I don't see how it is different from "Open administrative sex"

    AdministrativeGender for The Netherlands is defined by the national person registry BRP/GBA. The logical design (Dutch) may be found here on page 247:

    Element 04.10 Geslachtsaanduiding (Indication of Gender)

    M = male, V = female, O = unknown

    Definition: An indicator that determines that the registered party is a male or a female, or that the gender is (still) unknown.

    The Dutch BRP/GBA also procedures in place to change the administrative gender over time, so it is not just gender at birth.

  2. LOINC has an answer list for GenderIdentity: https://s.details.loinc.org/LOINC/76691-5.html?sections=Comprehensive

    SNOMED CT has 429019009 Finding related to biological sex that has some overlap with LOINC

  3. I believe the current definition of "Gender identity" is not correct. It is not (necessarily) connected to phenotypical facts, but according to at least wikipedia it is:

    Gender identity is the personal sense of one's own gender.

    I believe the current definition of "Sex Identity" is not correct. It is not (necessarily) connected to phenotypical facts, but according to wikipedia it is:

    Sexual identity is how one thinks of oneself in terms of to whom one is romantically or sexually attracted

  4. Alexander Henket Appreciate these contributions. We will work through these comments during our quarter (Wed Q4). One note on the Sex Identity versus Sexual Identity. In short, we don't have enough words in English for this and the word Sex was chosen to explicitly not mean Sexual. In fact it is an attempt to make the meaning of Sex Identity to be something distinct from Sexual Identity and from Gender Identity. 

  5. Patient Administration has done a write-up of this in the FHIR Patient Resource

    http://hl7.org/fhir/patient.html#gender