Representing Patient Sex (At Birth)

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard for observations
Final
Production
Rating 5
No
Free
N/A
Standard for observation values
Final
Production
Rating 5
Yes
Free
N/A
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • HL7 Version 2 and 3 need to be harmonized.

  • See LOINC projects in the Interoperability Proving Ground.

  • For more information about observations and observation values, see Appendix II for an informational resource developed by the Health IT Standards Committee. 

Comment

Administrative sex is not…

Administrative sex is not perfectly aligned with "Sex at birth" because at birth an infant can be undifferentiated. In addition, if we want sex recorded on the birth certificate, then many sates allow this to be changed: https://www.lambdalegal.org/know-your-rights/article/trans-changing-birth-certificate-sex-designations And as of January 2017, NY has allowed a person to have "Non-binary" as her birth certificate gender identity, see http://www.pbs.org/newshour/rundown/new-york-city-issues-nations-first-birth-certificate-marked-intersex/

Is "Sex at birth" different…

Is "Sex at birth" different from Administrative Gender collected during registration?  This needs clarification in the industry, as different approaches have been used in multiple places.  It appears that "Sex at birth" has a) been considered a clarification of the meaning of "Administrative Gender", and b) been considered to be a separate demographic.

Need Sex Assigned at Birth

Administrative sex is used to indicate the sex a person has listed with their insurance company. Administrative sex and sex assigned at birth are not always the same. If someone legally changes their sex or the sex listed with their insurance company is different, then their administrative sex and sex assigned at birth no longer align. Therefore, it is necessary to ask both administrative sex and sex assigned at birth to accurately identify all transgender/GenderQueer patients. When insurance companies accept both sex assigned at birth and gender identity, then administrative sex will no longer be necessary.

 

Chris Grasso, MPH

Associate Vice President for Informatics and Data Services

Fenway Health

Best Practice Recommendation from American Clinical Lab Assoc.

The American Clinical Laboratory Association (ACLA) has developed a Best Practice Recommendation for administrative sex and clinical patient gender used for laboratory testing and reporting. Please add the hyperlink below to the "Limitations, Dependencies, and Preconditions for Consideration" section, referencing ACLA's guidance document.

http://www.acla.com/acla-best-practice-recommendation-for-administrative-and-clinical-patient-gender-used-for-laboratory-testing-and-reporting/