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  1. FHIR Specification Feedback
  2. FHIR-44895

It may really need a breaking change in the AdminGender code system to allow any expansion of the normalized administrative-gender valueset.

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Highest Highest
    • FHIR Core (FHIR)
    • R5
    • Patient Administration
    • Patient
    • Terminologies
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      We fully agree that the Patient.gender property and the associated value set (and binding) are not useful for many real-world business needs in the area of sex and gender.  There is the [Gender Harmony Implementation Guide|https://hl7.org/xprod/ig/uv/gender-harmony/] that has guidance on how various sex and gender concepts can be represented in FHIR.  

       

      Also, there is guidance in the Patient page in the core spec on sex and gender concepts:  https://build.fhir.org/patient.html#gender

       

      While we do not plan to update the value set or binding for Patient.gender, we do want to make our Sex and Gender section more visible to readers of the spec, and so we will update the Short Display to include a "See also" link to the Sex and Gender section, so that the link to that section will show up in the tree view of the resource.

       

      Short Display male | female | other | unknown   See also: Sex and Gender
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      We fully agree that the Patient.gender property and the associated value set (and binding) are not useful for many real-world business needs in the area of sex and gender.  There is the [Gender Harmony Implementation Guide| https://hl7.org/xprod/ig/uv/gender-harmony/ ] that has guidance on how various sex and gender concepts can be represented in FHIR.     Also, there is guidance in the Patient page in the core spec on sex and gender concepts:   https://build.fhir.org/patient.html#gender   While we do not plan to update the value set or binding for Patient.gender, we do want to make our Sex and Gender section more visible to readers of the spec, and so we will update the Short Display to include a "See also" link to the Sex and Gender section, so that the link to that section will show up in the tree view of the resource.   Short Display male | female | other | unknown   See also: Sex and Gender
    • Brian Postlethwaite / Ming Dunajick : 7-0-0
    • Clarification
    • Non-substantive

    Description

      The normative valueset of the admin gender in Patient is really a big headache for implementers due to the current business requirements of the expansion of the code values.
      After looking through the whole valueset chain, the codesystem might be the weaker link with less impact to break. Please consider relaxing the code system of 
      https://hl7.org/fhir/codesystem-administrative-gender.html
      Therefore, the implementer could just add in new values in the CodeSystem to expand the AdminGender Valueset.

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            thomas_zhou1 Thomas Zhou
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