the structuredefinition is derived from FHIR Core genderIdentity extension but does not use FHIR Core's fixed  Extension.url

{}http://hl7.org/fhir/StructureDefinition/patient-genderIdentity

using 

http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity

instead.

This is a technical correction that is superseded by a completely rewritten extension in US Core Version 6.1.0.

This is a patch request for version 5.1.0 to allow both URLs in the extension, although one is technically nonconformant.