Need to update the text in Terminology page section 13.3 Gender Identity first paragraph  clarifying that the GI value set as a minimum set with preferred binding, should serve as the starter set of gender identity concepts needed for dependent guides or implementation. Jurisdictions and implementers may make their own set of concepts.

Original:

Gender Identity minimum value set is built using concepts from the SNOMED CT International edition code system. SNOMED International has put significant effort into improving the representation of gender concepts and while that work is not complete, the concepts included in the gender identity value set represent affirming and useful representations of gender concepts. In addition the value set includes the HL7 null flavor UNK to be used if the gender is not known. We encourage comments on the use of the null flavor code system in this situation versus the Data Absent Reason (DAR) code system used in FHIR. Of particular interest is the difficulty for implementers moving from prior use of null flavor value sets to DAR.

New

Gender Identity minimum value set is built using concepts from the SNOMED CT International edition code system. SNOMED International has put significant effort into improving the representation of gender concepts and while that work is not complete, the concepts included in the gender identity value set represent affirming and useful representations of gender concepts. This universal realm value set is a minimum set of commonly used values and it is expected and encouraged that specific jurisdictions or communities will use additional gender identity concepts that are relevant within their community. In addition the value set includes the HL7 null flavor UNK to be used if the gender is not known. We encourage comments on the use of the null flavor code system in this situation versus the Data Absent Reason (DAR) code system used in FHIR. Of particular interest is the difficulty for implementers moving from prior use of null flavor value sets to DAR.