We will allow both approaches: Update the base standard 2.9.1 to indicate that the existing guidance (with a pointer) can continue to be used to convey Sexual Orientation and Gender Identity as previously described. Pronouns will be indicate as an addition to the original scope as valid for sending in an OBX follow a PID segment. Update the existing guidance to remove the "short-term" modifier and indicate that the approach described is valid for use with any base version. And update the guidance to include how to send Pronouns (specifying the LOINC for OBX-3 and some comment on the value set for OBX-5 (e.g. give the example value set used by FHIR but indicate values are like to vary by location)) Gender Harmony IG would describe how to pre-adopt the GH segment approach When pre-adopting need to make sure folks use the applicable profile component (MSH-21)