Gender Harmony call: August 12th meeting notes (HL7 International)

Hello,

I am not sure if we are late responding to this work. Alberta is using following values as part of Clinical Information System at Alberta Health Services.

Category Lists - Administrative (captured at Registration)

1. Legal Sex (aka Administrative Gender) - value shown on government issued ID, example healthcare card or Drivers license. captured on all patients.

-Female
-Male
-Unknown
-X

2. Gender Identity - If indicated by patient that they identify differently than what is on ID

-Female
-Male
-Transgender Female / Male-to-Female
-Transgender Male / Female-to-Male
-Other
-Choose not to disclose
-Undetermined
-A-Gender
-Not Listed
-Two-Spirit
-Intersex

Category Lists - Clinical (captured by Clinicians if clinically relevant)

1. Sex Assigned at Birth

-Female
-Male
-Unknown
-Not recorded on Birth Certificate
-Choose not to disclose
-Uncertain

2. Sexual Orientation

-Lesbian
-Gay
-Straight (not lesbian or gay)
-Bisexual
-Something Else
-Don't know
-Choose not to disclose.

Note: These values are subject to adjustment in future as part of CIS work.


Thanks
Harsh

Reply from Zander Keig:

Hello All,

In response to 2a "legal gender"

It sounds like people are using "sex" and "gender" interchangeably, which is confusing, because unless it has changed very recently, no US State or US FED GOV ID uses "gender"

I know it gets confusing for people, because some States have "legal gender change" court process (ex. California and Kansas) in order to correct sex marker on a birth certificate and/or drivers license. The US Passport says sex, not gender.

Zander

Hello All,

Below are the minutes of meeting from the August 12th ,HL7 International Gender Harmony call (Thanks to Marcy Antonio):


1. ONC (Office of the National Coordinator for Health Information) interoperability forum
a. Happening next week and have been invited to present at the USCDI (US Core Data for Interoperability) session. Will be using this time to talk about how the data element gets promoted in the USCDI.

2. Discussion around three options
a. 'Legal gender'
i. Passport or driver licence gender, birth certificate sex; Identify the code that goes along with it; then would have a type - this legal gender is my passport, so that gender identity is independent to this.

b. 'Gender identity'
i. Displayable, disclosed, and independent to legal gender; all the non-physical, cultural and social characteristics

c. 'Sex phenotype' or 'sex for clinical use' or 'sex identity’:
i. How to define ‘phenotype’ - is physical attributes; but it isn't necessarily things only that can be observed with the naked eye but can include things that are measurable.
ii. 'Other' is undisclosed as a proxy value and allows a way for separating public and private information. The 'other' would come up as a flag to look deeper, and would also address the privacy considerations in providing a way to mask independently.
iii. Possible way forward: male pattern, female pattern, other (does not fit male or female), unknown (typically a trauma case), undisclosed
iv. What is relevant to the clinicians? May make more sense to focus on the clinical aspect.
v. Is pattern the right word?

3. Further considerations
a. Need to have flexibility for jurisdictions.
b. ‘M’, ‘F’ or 'Other' (where different considerations will get mapped to other). Backwards compatibility- can't assume that an F in the new world is the same as the F in the old world.
c. If using 'other' need to consider all the descriptions that would fall within this.

4. Discussion for next call
a. How to address 'sex phenotype' is 'sex for clinical use' a better match? Male pattern and female pattern - is this too simplified; is pattern the correct word?

Regards,
Smita