Created by Brett Esler, last modified by Reuben Daniels on 02 Aug, 2022

Develop a suitable representation for gender identity for individuals.

Context of concept:

  1. Patient
  2. RelatedPerson
  3. Person
  4. Practitioner

Background

Extension - consider R5 individual gender identity:

Gender Harmony Project

Recently updated national standards / specifications

Required values based on ABS / AIHW

  • Sex
    • Coded sex values
      • Male
      • Female
      • X (a different term)
      • Not stated or inadequately described
    • String sex value (optional when the X coded value is used)
      • Free text

  • Gender Identity
    • Coded gender identity values
      • Man, boy or male
      • Woman, girl or female
      • Non-binary
      • X (a different term)
      • Not stated or inadequately described
    • String sex value (optional when the X coded value is used)
      • Free text
    • Alternative value
      • Prefer not to answer

Options

Option 1

  • Sex
    • Define an AUSex extension as follows
      • Context may be Patient, RelatedPerson, Person, Practitioner
      • code (code, 1..1) with a required binding to the AUSex value set
      • value (String, 0..1) to capture a free text sex value

    • Notes:
      • The AUSex value set will be defined as all the codes from the AUSex code system
      • The AUSex code system defines concepts for Male, Female, X, Not stated or inadequately described
      • The value data element may only be present if the code value is X
  • Gender Identity
    • Define an AUGenderIdentity extension as follows
      • Context may be Patient, RelatedPerson, Person, Practitioner
      • code (code, 0..1) with a required binding to the AUGenderIdentity value set
      • value (String, 0..1) to capture a free text gender identity value
      • preferNotToAnswer (Boolean, 0..1)
    • Notes:
      • The AUGenderIdentity value set will be defined as all the codes from the AUGenderIdentity code system
      • The AUGenderIdentity code system defines concepts for Man, boy or male, Woman, girl or female, Non-binary, X and Not stated or inadequately described
      • The value data element may only be present if the code value is X
      • At least one of code or preferNotToAnswer must be present but not both.
      • The preferNotToAnswer may only be present as follows:
        • code is not present
        • value is not present
        • preferNoteToAnswer has a fixed value of true.
  • For discussion
    • Should SNOMED CT-AU values be used if available?

Comments:

Here is the list of child concepts under 429019009 | Finding related to biological sex | in SNOMED CT which is pretty for descripting sex:

  • 248153007 | Male |
  • 248152002 | Female |
  • 32570681000036106 | Indeterminate sex |
  • 32570691000036108 | Intersex |
  • 407374003 | Transsexual |
    • 407377005 | Female-to-male transsexual |
    • 407376001 | Male-to-Female transsexual |
    • 472945003 | Previously asexual transsexual |
    • 472977000 | Previously bisexual transsexual |
    • 472946002 | Previously heterosexual transsexual |
    • 472947006 | Previously homosexual transsexual |


For gender, the current administrative gender table should still be ok which contains:

  • Male
  • Female
  • Other
  • Unknown
Posted by jeffrey.chen at 04 Aug, 2022 13:38

Agency Terminology Analyst has provided the following analysis of coverage of ABS concepts for recording gender identity

ABS preferred code

Definition

SNOMED concept ID

SNOMED concept

Status of the concept

1

Persons who described their gender as man or male.

446151000124109

Identifies as male gender (finding)

Current SNINT concept; released in their May release. These concepts will be updated in our database when SNOMED international update is run, likely in few months. The concepts can still be presented for consideration by the ballot.

2

Persons who described their gender as woman or female.

446141000124107

Identifies as female gender (finding)|

Current SNINT concept; released in their May release. These concepts will be updated in our database when SNOMED international update is run, likely in few months. The concepts can still be presented for consideration by the ballot.

3

Persons who described their gender as non-binary.

33791000087105

Identifies as nonbinary gender (finding)

Current SNINT concept; released in their May release. These concepts will be updated in our database when SNOMED international update is run, likely in few months. The concepts can still be presented for consideration by the ballot.

4

Persons who described their gender as a term other than man/male, woman/female or non-binary.*

TBC

Identifies as gender other than male, female or nonbinary (finding)

Could create a local term for this concept in SNOMED-AU. Final term can be shared at the time of meeting as still working towards finalising it. We aim to add it in SNOMED CT-AU August release.
Posted by danielletavaresrixon at 11 Aug, 2022 08:38