Stream: implementers
Topic: Data items in support of the LGBT community
Dave Barnet (Sep 16 2019 at 11:46):
I've been asked about some data items that are used in support of the LGBT community, and just wanted to check my modelling (and whether there's any thoughts of addressing some of these in later FHIR versions)
title - is OK as this is just a string on HumanName
sexual orientation - an Observation
sex - an Observation
gender - a bit trickier, as the values are male, female, other & unknown - which may not be broad enough (and they are Required)
any flag to indicate gender change - an Observation? - or might this be better served as an extension?
Sam Sayer (Sep 16 2019 at 12:05):
@Dave Barnet if you're not already familiar, you may be interested in the Gender Harmony project https://www.hl7.org/special/Committees/projman/searchableProjectIndex.cfm?action=edit&ProjectNumber=1533
Noemi Deppenwiese (Sep 16 2019 at 12:21):
https://www.hl7.org/fhir/patient.html#gender already contains suggestions about modelling clinical/legal sex/gender ect. .. for example a genderIdentity extension.
Michele Mottini (Sep 16 2019 at 13:25):
US Core has a birth sex extension - https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html
Lloyd McKenzie (Sep 16 2019 at 13:31):
Gender change should be an Observation - there are more abilities to manage sensitive information at the resource level than there are at the element level.
Cooper Thompson (Sep 16 2019 at 13:34):
I'm curious about the meaning of "gender change" in this context. Is this meant to be an update of the social concept of gender identity? In that case, I'd expect it to be tracked in the genderIdentity extension, where change is denoted via history. Or this about a clinical change in sex properties such as hormone therapy or affirmation surgeries? Those would normally be more substantive that just a single observation.
Grahame Grieve (Sep 16 2019 at 13:44):
it would be interesting to get a full record of the whole process and try and represent it in FHIR and see if there's any gaps
Dave Barnet (Sep 16 2019 at 14:21):
I have a meeting tomorrow to go over the requirements - so I'll document the full list of requirements & post here. The genderIdentity extension is useful.
Tim Berezny (Oct 30 2019 at 16:03):
It seems to me that patient.gender is notionally aligned with birth sex, and that the genderIdentity extension can be used for capturing the broader gender data. Is this an accurate interpretation?
Tim Berezny (Oct 30 2019 at 16:05):
Also, why does US Core have birth sex when it's essentially the same valueSet as Patient.gender?
Lloyd McKenzie (Oct 30 2019 at 16:13):
Patient.gender is used for searching and categorizing the patient as they are now. If someone currently identifies/presents as female, then that will be their Patient.gender, regardless of how they were classified at birth.
Tim Berezny (Oct 30 2019 at 17:27):
Isn't the valueset for gender much too narrow then to restrict to male | female | other | unknown, as there are many others?
https://young.scot/get-informed/national/gender-identity-terms. Technically "other" covers a bunch of that... what is the intention for keeping it to these 4 values?
Lloyd McKenzie (Oct 30 2019 at 18:35):
Did you read the usage notes towards the bottom of the Patient resource that talk about gender? :)
Last updated: Apr 12 2022 at 19:14 UTC
