Gender Identity

STATUS: proposal , NOT IMPLEMENTED - UNDER DISCUSSION

Definition

An individual's personal sense of being a man, woman, or other gender, regardless of the sex that person was assigned at birth or administrative gender.

Based on term https://loinc.org/76691-5/

Resource affected	Patient
Approved by	Interdepartmental Metrics Working Group 10 Aug 2023 (provided by @Wycliffe Waweru
Initial implementation	Expected early Q4 2023

Initial standard values [July 2023]

Based on LOINC Answer List https://loinc.org/LL3322-6 for term https://loinc.org/76691-5/

Code	Code system	Display	AKA	LOINC	SNOMED CT 285116001	In LOINC ValueSet LL3322-6

Code	Code system	Display	AKA	LOINC	SNOMED CT 285116001	In LOINC ValueSet LL3322-6
F	FHIR gender	Female	Woman, girl	LA22879-3	446141000124107	X
M	FHIR gender	Male	Man, boy	LA22878-5	446151000124109	X
F2M		Transgender Female-to-male	Female-to-male transsexual	LA22880-1	407377005	X
M2F		Transgender Male-to-female	Male-to-female transsexual	LA22881-9	407376001	X
NBN		Non binary	non-conforming	LA22882-7	33791000087105	X
OTH	null flavor	Other		LA46-8		X
ASKU	null flavor	Asked but unknown	Person asked and does not know or is not sure	LA20384-6		X
???		Decline to answer (see note)	Refused to answer Prefer not to say Did not disclose	LA31066-6
UNK	null flavor	Unknown		LA4489-6

SNOMED CT codes sourced from CDC | verified with SNOMED BROWSER

Note: FHIR does NOT plan to add an option for “decline to answer”

Values that we will add when the request is validated

We don’t foresee the need to extend the value set for Gender Identity further.

Code	Answer	Code Ref	LOINC	SNOMED CT	ICD-10/11

Code	Answer	Code Ref	LOINC	SNOMED CT	ICD-10/11

Value sets considered on July 2023

LOINC 76691-5

Identifies as male
Identifies as female
Female-to-male transsexual
Male-to-female transsexual
Identifies as non-conforming
Other
Asked but unknown

UK NHS

1 - Male (including trans man)
2 - Female (including trans woman)
3 - Non-binary
4 - Other (not listed)
X - Not Known (not recorded)
Z - Not Stated (person asked but declined to provide a response)

CALIFORNIA

Male
Female
Genderqueer or non-binary
Identity not listed
Trans female/Transwoman
Trans male/Transman
Unknown

Declined to answer

WASHINGTON COUNTY

Man or Boy
Woman or Girl
Agender or No Gender
Feminine leaning
Masculine leaning
Non-binary
Questioning
Not listed, Please Specify
Don't know
I don't know what this question is asking
I don't want to answer

NYC

Man
Woman
Transgender woman
Transgender man
Non-binary person
Genderqueer person
A gender identity not listed above
Unknown
Prefer not to answer

MASSACHUSETTS

Male
Female
Nonbinary, Genderqueer, not exclusively male or female
Transgender (If you identify as transgender, please check this box in addition to any others.)
I am questioning/not sure of my gender identity
I don’t understand what this question is asking
I prefer not to answer

OH

Male
Female
Transgender man/trans man
Transgender woman/trans woman
Genderqueer/gender nonconforming neither exclusively male nor female
Additional gender category (or other);
Decline to answer

WASHINGTON STATE

Male
Female
Transgender Male
Transgender Female
Transgender non-specific (New value being proposed)
Non-binary (New value being proposed)
Gender-queer
Two-spirit (New value being proposed)
Questioning/not sure (New value being proposed)
Choose not to disclose
Other, please describe
Unknown

Release history

Version	Date	Released as

Version	Date	Released as
1.0		Deployment of XXXX

References

ValueSet: Gender Identity (from HL7)
ValueSet: Gender Identity (from HL7). Present in FHIR v4 but not in FHIR v5
ValueSet from LOINC Answer Lishttps://loinc.org/LL3322-6t for term https://loinc.org/76691-5/: https://fhir.loinc.org/ValueSet/LL3322-6 [canonical URL: http://loinc.org/vs/LL3322-6]