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Hi Karen,
Thanks for the question. I think this question is referring to the Health Services Sex or Gender Marker in the BC Standard. This data element is intended to accommodate legacy systems with only one data field. Here is what the standard says: "Health Services Sex or Gender Marker (HSSGM) refers to the documented gender or sex of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation. This data element may also be called “Administrative Gender or Sex,” “Legal Gender or Sex,” “Recorded Gender or Sex,” “Documented Gender or Sex.”"
The following guidance, which emphasizes the importance of provenance, is provided: "For incoming data, provenance of the data including source jurisdiction or organization, purpose (e.g., birth certificate, passport, BC services card), and validity period is extremely important for interpreting the content of the data. The local system is just one source of potentially many, each of which represents the actual value found official or legal documents. The codes for HSSGM should be restricted to the markers presented in Table 7.2.2.1 (M, F, X and U). The X marker can be used by people who do not identify as solely male or female. The U marker can be used by people who do not want a specific gender marker to be visible on their identification. If HSSGM is not required in the local system, default to collecting Gender Identity."
Many jurisdictions will have systems like this that will need to be reimagined to be inclusive - something that we are actively working on in BC. The HSSGM is an interim measure to accommodate current systems on their way to necessary transformations in their architecture for a standards based approach.