Submitted by NCQA on 2023-09-20 NCQA Comment on Sex Parameter for Clinical Use: for USCDI v5 Context-Specified Sex Parameter for Clinical Use Elements: NCQA encourages ONC to expand sex-related data elements to include the Gender Harmony Project data elements Sex Parameter for Clinical Use. Specifically, we recommend: Updating the submitted data element name to align with the updated Gender Harmony project data element: Sex Parameter for Clinical Use (previously Sex for Clinical Use). Adding the context-specific Sex Parameter for Clinical Use elements to the appropriate Data Classes in USCDI (including clinical tests, laboratory, diagnostic imaging, procedures), as recommended by the Gender Harmony Project team. Including these context-specified elements will begin to enable documentation and exchange of structured data based on clinical observation and reflects a step toward anatomy-based identification of clinical need. This remains a high priority area for NCQA, and we have begun incorporating Sex Parameter for Clinical Use into measure specifications to expand patient population definitions previously specified using only administrative gender. Data standards that enable collection of disaggregated sex- and gender-related data promotes broad health equity and supports health equity in performance measurement as well. We are supportive of Gender Harmony’s work and driving industry adoption.