Background

Currently, the core gender element in the Patient, Practitioner and RelatedPerson resource types (hereinafter referred to as just 'the gender element') is simply a single 'code' value with no further defining machine-processable semantics about the value (e.g. the source of the gender/sex value).

It is well-understood that the gender element may reflect a Recorded Sex or Gender (RSG) values (i.e. not reliably representing an individual's gender identity, nor a sex parameter for clinical use) as defined in the Gender Harmony - Sex and Gender Representation, Edition 1 HL7 Cross Paradigm Implementation Guide.

Change request

This change request proposes adding a boolean sub-element to the Person Recorded Sex Or Gender extension which may be used to assert that an RSG instance provides the definition of the semantics of the gender element. The proposed sub-element would be defined as follows in the RSG:

1. Additional subelement

• Name: definesGenderElement
• URL: Fixed value "definesGenderElement"
• Cardinality: 0..1
• Type: boolean

2. Additional constraint

• One one instance of the RSG extension may include the definesGenderElement sub-element with a value of "true" in a single instance of Patient, Practitioner, or RelatedPerson.

Scheduling

Owing to this functionality being sought in Australia, it is requested that this change request be considered for the 2024 release of the FHIR Extensions Pack.