AU Base Implementation Guide
6.0.0-draft - Draft

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## : Patient - as transgender person with sex and gender - TTL Representation

Page standards status: Informative

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix loinc: <https://loinc.org/rdf/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix sct: <http://snomed.info/id/> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

    # - resource -------------------------------------------------------------------

     a fhir:Patient ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "example-sex-and-gender"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://hl7.org.au/fhir/StructureDefinition/au-patient"^^xsd:anyURI ;
    fhir:link <http://hl7.org.au/fhir/StructureDefinition/au-patient>     ] )
      ] ; #    This purpose of this example is to demonstrate the use of sex and gender elements:
    #    - Gender Harmony Gender Identity (Individual Gender Identity extension)
    #    - Gender Harmony Pronouns (Individual Pronouns extension)
    #    - Gender Harmony Recorded Sex or Gender (Person Recorded Sex Or Gender extension)
    #    - Gender Harmony Sex Assigned at Birth (Person Recorded Sex Or Gender extension)
    #   This example is taken and adapted from the R5 Transgender Person Example
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Patient example-sex-and-gender</b></p><a name=\"example-sex-and-gender\"> </a><a name=\"hcexample-sex-and-gender\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-au-patient.html\">AU Base Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Patricia Roth  Male, DoB: 1974-12-25 ( Medical record number (use: usual, ))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td colspan=\"3\">false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-example1.html\">Organization Albion Hospital</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The pronouns to use when referring to an individual in verbal or written communication.\">Individual Pronouns:</td><td colspan=\"3\"><ul><li>value: <span title=\"Codes:{http://loinc.org LA29519-8}\">she/her/her/hers/herself</span></li><li>period: 2001-05-06 --&gt; (ongoing)</li><li>comment: Patient transitioned from male to female in 2001.</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth.  When exchanging this concept, refer to the guidance in the [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).\">Person Recorded Sex Or Gender:</td><td colspan=\"3\"><ul><li>value: <span title=\"Codes:{http://snomed.info/sct 248153007}\">Male</span></li><li>type: <span title=\"Codes:{http://snomed.info/sct 1515311000168102}\">Biological sex at birth</span></li><li>effectivePeriod: 1974-12-25 --&gt; (ongoing)</li><li>acquisitionDate: 2005-12-06</li><li>sourceDocument: <span title=\"Codes:{http://loinc.org 71230-7}, {http://snomed.info/sct 444561001}\">Scan of birth certificate</span></li><li>sourceField: Sex</li><li>jurisdiction: <span title=\"Codes:{https://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1 QLD}\">Queensland</span></li><li>comment: Patient transitioned from male to female in 2001, but their birth certificate still        indicates male.</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth.  When exchanging this concept, refer to the guidance in the [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).\">Person Recorded Sex Or Gender:</td><td colspan=\"3\"><ul><li>value: <span title=\"Codes:{http://hl7.org/fhir/administrative-gender female}\">Female</span></li><li>type: <span title=\"Codes:{http://loinc.org 46098-0}\">Sex</span></li><li>effectivePeriod: 2024-12-25 --&gt; (ongoing)</li><li>sourceDocument: <span title=\"Codes:{http://terminology.hl7.org.au/CodeSystem/rsg-source-document-type passport}\">Passport</span></li><li>sourceField: Sex</li><li>jurisdiction: <span title=\"Codes:{urn:iso:std:iso:3166 AU}\">Australia</span></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else. This represents an individual’s identity, ascertained by asking them what that identity is. \n In the case where the gender identity is communicated by a third party, for example, if a spouse indicates the gender identity of their partner on an intake form, a Provenance resource can be used with a Provenance.target referring to the Patient, with a targetElement extension identifying the gender identity extension as the target element within the Patient resource.  When exchanging this concept, refer to the guidance in the [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).\">Individual Gender Identity:</td><td colspan=\"3\"><ul><li>value: <span title=\"Codes:{http://snomed.info/sct 446141000124107}\">Identifies as female gender</span></li></ul></td></tr></table></div>"^^rdf:XMLLiteral
      ] ; #
      fhir:extension ( [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity"^^xsd:anyURI ] ;
        ( fhir:extension [
    fhir:url [ fhir:v "value"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a sct:446141000124107 ;
    fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "446141000124107" ] ;
    fhir:display [ fhir:v "Identifies as female gender" ]         ] )       ]     ] )
      ] [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/individual-pronouns"^^xsd:anyURI ] ;
        ( fhir:extension [
    fhir:url [ fhir:v "value"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a loinc:LA29519-8 ;
    fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "LA29519-8" ] ;
    fhir:display [ fhir:v "she/her/her/hers/herself" ]         ] )       ]     ] [
    fhir:url [ fhir:v "period"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:Period ;
    fhir:start [ fhir:v "2001-05-06"^^xsd:date ]       ]     ] [
    fhir:url [ fhir:v "comment"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:string ;
    fhir:v "Patient transitioned from male to female in 2001."       ]     ] )
      ] [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"^^xsd:anyURI ] ;
        ( fhir:extension [
    fhir:url [ fhir:v "value"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a sct:248153007 ;
    fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "248153007" ] ;
    fhir:display [ fhir:v "Male" ]         ] )       ]     ] [
    fhir:url [ fhir:v "type"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a sct:1515311000168102 ;
    fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "1515311000168102" ] ;
    fhir:display [ fhir:v "Biological sex at birth" ]         ] )       ]     ] [
    fhir:url [ fhir:v "effectivePeriod"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:Period ;
    fhir:start [ fhir:v "1974-12-25"^^xsd:date ]       ]     ] [
    fhir:url [ fhir:v "acquisitionDate"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:dateTime ;
    fhir:v "2005-12-06"^^xsd:date       ]     ] [
    fhir:url [ fhir:v "sourceDocument"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a loinc:71230-7 ;
    fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "71230-7" ] ;
    fhir:display [ fhir:v "Birth certificate" ]         ] [
    a sct:444561001 ;
    fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "444561001" ] ;
    fhir:display [ fhir:v "Birth certificate" ]         ] ) ;
    fhir:text [ fhir:v "Scan of birth certificate" ]       ]     ] [
    fhir:url [ fhir:v "sourceField"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:string ;
    fhir:v "Sex"       ]     ] [
    fhir:url [ fhir:v "jurisdiction"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    fhir:system [ fhir:v "https://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "QLD" ]         ] )       ]     ] [
    fhir:url [ fhir:v "comment"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:string ;
    fhir:v "Patient transitioned from male to female in 2001, but their birth certificate still        indicates male."       ]     ] )
      ] [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"^^xsd:anyURI ] ;
        ( fhir:extension [
    fhir:url [ fhir:v "value"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    fhir:system [ fhir:v "http://hl7.org/fhir/administrative-gender"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "female" ]         ] )       ]     ] [
    fhir:url [ fhir:v "type"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    a loinc:46098-0 ;
    fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "46098-0" ]         ] )       ]     ] [
    fhir:url [ fhir:v "effectivePeriod"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:Period ;
    fhir:start [ fhir:v "2024-12-25"^^xsd:date ]       ]     ] [
    fhir:url [ fhir:v "sourceDocument"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    fhir:system [ fhir:v "http://terminology.hl7.org.au/CodeSystem/rsg-source-document-type"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "passport" ]         ] )       ]     ] [
    fhir:url [ fhir:v "sourceField"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:string ;
    fhir:v "Sex"       ]     ] [
    fhir:url [ fhir:v "jurisdiction"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:CodeableConcept ;
            ( fhir:coding [
    fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "AU" ] ;
    fhir:display [ fhir:v "Australia" ]         ] )       ]     ] )
      ] ) ; #
      fhir:identifier ( [
    fhir:use [ fhir:v "usual" ] ;
    fhir:type [
          ( fhir:coding [
    fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "MR" ]       ] )     ] ;
    fhir:system [ fhir:v "urn:oid:1.2.36.146.595.217.0.1"^^xsd:anyURI ] ;
    fhir:value [ fhir:v "12345" ]
      ] ) ; #
      fhir:active [ fhir:v true] ; #
      fhir:name ( [
    fhir:use [ fhir:v "official" ] ;
    fhir:family [ fhir:v "Roth" ] ;
        ( fhir:given [ fhir:v "Patrick" ] )
      ] [
    fhir:use [ fhir:v "usual" ] ;
    fhir:family [ fhir:v "Roth" ] ;
        ( fhir:given [ fhir:v "Patricia" ] )
      ] [
    fhir:use [ fhir:v "nickname" ] ;
        ( fhir:given [ fhir:v "Pat" ] )
      ] ) ; #     Legal Name: Patrick Roth, goes by Patricia (formally), but also Pat (informally)
      fhir:gender [ fhir:v "male"] ; #
      fhir:birthDate [ fhir:v "1974-12-25"^^xsd:date] ; #
      fhir:deceased [
    a fhir:boolean ;
    fhir:v false
      ] ; #
      fhir:managingOrganization [
    fhir:reference [ fhir:v "Organization/example1" ]
      ] . #