Change Request
Subject to FHIR-43834 (AU Base: Adoption of Gender Harmony Recorded Sex or Gender (RSG) data element) being added to the version of AU Base which AU Core R1 is based upon, this change request proposes the following:

•  AU Core R1 to make RSG with a type value of "Sex Assigned at Birth" a Must Support element in the AU Core Patient profile. This support to be implemented as follows:
  • Defining a Sex Assigned at Birth profile of the individual-recordedSexOrGender FHIR extension ​
    • Must Support on Extension.extension(type) 1..1 Fixed to 1515311000168102 | http://snomed.info/sct​
    • Must Support on Extension.extension(value) 1..1 Binding: Biological Sex (extensible)​ 
    • Must Support on Extension.extension(acquisitionDate)​
  • Add a Must Support slice to Patient.extension for RSG (individual-recordedSexOrGender) profiled by Sex Assigned at Birth (0..*)​
  • In the Gender Identity and related concepts subsection on the profile page (see AU  Core Patient) add the following statement
    • *Sex Assigned at Birth​*
    • By making Patient.extension(recordedSexOrGender/sexAssignedAB) a Must Support data element, this profile explicitly supports representation and exchange of the Sex Assigned at Birth data element (as defined in the Australian Core Data for Interoperability (AUCDI) Release 1 Draft for Comment and HL7 Cross Paradigm  Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1).

Background

• HL7 Gender Harmony Project: https://hl7.me/GHP 
• HL7 Gender Harmony – Sex and Gender Representation, Edition 1 Implementation Guide: https://hl7.org/xprod/ig/uv/gender-harmony/
• GH Recorded Sex or Gender (RSG) logical data element: https://hl7.org/xprod/ig/uv/gender-harmony/model.html#recorded-sex-or-gender-rsg
• Exchanging Recorded Sex or Gender (RSG) in HL7 FHIR: https://hl7.org/xprod/ig/uv/gender-harmony/fhirgenderharmony.html#exchanging-recorded-sex-and-gender
• FHIR-43834 proposed adding the GH RSG FHIR extension to the AU Base Patient, AU Base RelatedPerson and AU Base Practitioner AU Base profiles with 0..* cardinality.
• RACGP Standards for general practices (5th edition) — Collecting and recording information about patient sex, gender, variations of sex
  characteristics and sexual orientation fact sheet: link

NOTE: This change request was updated on Tuesday, 20 February 2024 to reflect feedback received and accepted by the reporter.