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  1. FHIR Specification Feedback
  2. FHIR-44710

Sex Extension's value set is too restrictive

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Core (FHIR)
    • current
    • Cross-Group Projects
    • US Core Sex Extension
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      Non-Binary has been added to the value set: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1240.3/expansion to include SNOMED CT code: 33791000087105 | Identifies as nonbinary gender (finding) | Has a synonym that seems to align with the defintion for "X" as described by gov't orgs: "Fluctuating between male and female, or identifying as either having a gender that is in-between or beyond the two categories or as having no gender, either permanently or some of the time." |

      Add guidance that this particular term coorelates with the federal and many states concepts of "X"

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      Non-Binary has been added to the value set: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1240.3/expansion to include SNOMED CT code: 33791000087105 | Identifies as nonbinary gender (finding) | Has a synonym that seems to align with the defintion for "X" as described by gov't orgs: "Fluctuating between male and female, or identifying as either having a gender that is in-between or beyond the two categories or as having no gender, either permanently or some of the time." | Add guidance that this particular term coorelates with the federal and many states concepts of "X"
    • Brett Marquard/Eric Haas: 17-0-0
    • Enhancement
    • Compatible, substantive

    Description

      The Sex Extension profile is designed to implement the [Sexhttps://www.healthit.gov/isa/taxonomy/term/731/uscdi-v3] data element in USCDI v3, where it can be any instance of sex info: birth sex, legal sex, you name it.

      However, the value set that it's bound to is super tightly constrained. The sex has to be one of four values (male, female, unknown, or "asked but declined") and nullFlavors aren't allowed--if you can't map a sex to one of those four, you can't send it at all!

      But if we truly want this template to capture the full spectrum of USCDI v3 Sex, then we need to broaden it. In particular, it doesn't work with legal sex right now--if the sex on your drivers license is "X" or "nonbinary" or anything to that effect, there's no way to send it!

      I think we need to expand the value set, but we should probably discuss with Gender Harmony and/or CGP.

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            Unassigned Unassigned
            mszczepa Matt Szczepankiewicz
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              Updated:
              Resolved: