AU Base Implementation Guide
6.0.0-ci-build - CI Build
AU Base Implementation Guide
6.0.0-ci-build - CI Build
AU Base Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 6.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/steveswinsburg/au-fhir-base/ and changes regularly. See the Directory of published versions
| Page standards status: Informative |
This page addresses how sex and gender related concepts can be structured in FHIR and conformant to AU Base. Where possible, AU Base has considered the logical data element models provided by HL7 International’s Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1 specification.
The table below provides an overview of the sex and gender related concepts in AU Base.
Legend:
Supported1: The sex or gender related concept is marked as Must Support.
Localised: The sex or gender related concept is localised for use in an Australian context but is not marked as Must Support.
Not Localised: The sex or gender related concept is relevant and not yet localised for use in an Australian context.
Not Applicable: This sex or gender related concept is not applicable for use with this resource type.
Notes:
AU Base supports representation and exchange of Administrative Gender, i.e. the basic Patient.gender property, in:
In AU Base, the Patient.gender value is regarded as a Recorded Sex or Gender. If assertions regarding the nature of the Patient.gender value are required, a single instance of the Person Recorded Sex or Gender extension can be included with these assertions and its genderElementQualifier subelement set to a value of "true".
Example: Patient resource with Patient.gender qualified with Person Recorded Sex or Gender extension
{
"resourceType" : "Patient",
...
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "248153007",
"display" : "Male"
}
]
}
},
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1515311000168102",
"display" : "Biological sex at birth"
}
]
}
},
{
"url" : "genderElementQualifier",
"valueBoolean" : true
}
]
}
],
...
"gender" : "male"
}
AU Base supports representation and exchange of the Name to Use data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) in:
Name to Use is represented using "usual" in name.use.
Example: RelatedPerson resource with name to use
{
"resourceType" : "RelatedPerson",
...
"name" : [
{
"use" : "usual",
"family" : "Franklin",
"given" : [
"Stella"
]
}
],
...
}
AU Base supports representation and exchange of the Pronouns data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) in:
Pronouns is represented with the Individual Pronouns extension. In AU Base the value element of the Individual Pronouns extension is constrained to be Australian Pronouns (extensible).
When populating the value element of the Individual Pronouns extension:
Example: Practitioner resource with pronouns
{
"resourceType" : "Practitioner",
...
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-pronouns",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA29519-8",
"display" : "she/her/her/hers/herself"
}
]
}
},
{
"url" : "period",
"valuePeriod" : {
"start" : "2001-05-06"
}
}
]
},
...
}
Example: Patient resource with prefer not to answer for pronouns
{
"resourceType" : "Patient",
...
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-pronouns",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/data-absent-reason",
"code" : "asked-declined",
}
]
}
}
]
},
...
}
AU Base supports representation and exchange of the Gender Identity data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) and aligned to Australian Bureau of Statics Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 in:
Gender Identity is represented with the Individual Gender Identity extension. In AU Base the value element of the Individual Gender Identity extension is constrained to be Gender Identity Response value set (extensible).
When populating the value element of the Individual Gender Identity extension:
text and no codingExample: Patient resource with gender identity
{
"resourceType" : "Patient",
...
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "446141000124107",
"display" : "Identifies as female gender (finding)"
}
]
}
}
]
},
...
}
AU Base supports representation and exchange of the Recorded Sex or Gender (RSG) data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) in:
RSG is represented with the Person Recorded Sex or Gender extension. In AU Base:
RSG information includes the various sex and gender concepts that are often used in existing systems but are known to not reliably represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. When populating recorded sex or gender it is important to select a meaningful terminology for the value element of the Person Recorded Sex or Gender extension. For example, when representing a biological sex value it is recommended to use a biological sex value set. See Sex Assigned at Birth for specific guidance on the representation of Sex Assigned at Birth.
Example: Patient resource with recorded gender from a passport
{
"resourceType" : "Patient",
...
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "female"
}
]
}
},
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "46098-0"
}
]
}
},
{
"url" : "effectivePeriod",
"valuePeriod" : {
"start" : "2024-12-25"
}
},
{
"url" : "sourceDocument",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org.au/CodeSystem/rsg-source-document-type",
"code" : "passport"
}
]
}
},
{
"url" : "sourceField",
"valueString" : "Sex"
},
{
"url" : "jurisdiction",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "AU",
"display" : "Australia"
}
]
}
}
]
}
],
...
}
AU Base supports representation and exchange of the Sex Assigned at Birth data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) in:
Sex Assigned at Birth is represented with the Person Recorded Sex or Gender extension:
The FHIR Work Group is interested in views on whether Biological Sex value set should be a required binding in future releases of AU Base. Please join a meeting or contact the FHIR Work Group if you have any views or perspectives on this.
When populating the value element of the Person Recorded Sex or Gender extension for Sex Assigned at Birth:
Example: Patient resource with Sex Assigned at Birth from birth certificate
{
"resourceType" : "Patient",
...
{
"url" : "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
"extension" : [
{
"url" : "value",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "248153007",
"display" : "Male"
}
]
}
},
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1515311000168102",
"display" : "Biological sex at birth"
}
]
}
},
{
"url" : "effectivePeriod",
"valuePeriod" : {
"start" : "1974-12-25"
}
},
{
"url" : "acquisitionDate",
"valueDateTime" : "2005-12-06"
},
{
"url" : "sourceDocument",
"valueCodeableConcept" :
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "71230-7",
"display" : "Birth certificate"
},
{
"system" : "http://snomed.info/sct",
"code" : "444561001",
"display" : "Birth certificate"
}
],
"text" : "Scan of birth certificate"
}
},
{
"url" : "sourceField",
"valueString" : "Sex"
},
{
"url" : "jurisdiction",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1",
"code" : "QLD"
}
]
}
},
{
"url" : "comment",
"valueString" : "Patient transitioned from male to female in 2001, but their birth certificate still indicates male."
}
]
},
...
}
AU Base supports representation and exchange of Sex Parameter for Clinical Use (SPCU) information (as defined by the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1) in:
SPCU is represented with the Patient Sex Parameter For Clinical Use extension. When using the Patient Sex Parameter For Clinical Use extension:
The guidance on this page is dependent on the availability of the intendedClinicalUse element, added to the SPCU extension in the September 2025 Ballot of the HL7 International FHIR Extensions Pack.
comment or intendedClinicalUse element.MedicationRequest can hold an SPCU element value "female-typical" while referencing a Patient resource (in MedicationRequest.subject) that holds an SPCU value of "male-typical" and a comment or intendedClinicalUse indicating that SPCU value applies to all prescribed medications.Patient resource. For example, instead of including an SPCU value directly in a MedicationRequest, the MedicationRequest.subject element could reference a contained Patient resource that includes the SPCU value.Resource specific SPCU usage includes:
comment or intendedClinicalUse elements are included to provide the clinical context and/or appropriate clinical uses for an SPCU value.Example: Patient resource with Sex Parameter for Clinical Use
{
"resourceType":"Patient",
...
"extension":[
{
"url":"http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse",
"extension":[
{
"url":"value",
"valueCodeableConcept":{
"coding":[
{
"system":"http://terminology.hl7.org/CodeSystem/sex-parameter-for-clinical-use",
"code":"female-typical",
"display":"Apply female-typical setting or reference range"
}
]
}
},
{
"url":"period",
"valuePeriod":{
"start":"2025-07-01"
}
},
{
"url":"comment",
"valueString":"Apply female-type setting for all radiology tests"
}
]
}
]
...
}
Example: ServiceRequest resource with Sex Parameter for Clinical Use
{
"resourceType":"ServiceRequest",
...
"extension":[
{
"url":"http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse",
"extension":[
{
"url":"value",
"valueCodeableConcept":{
"coding":[
{
"system":"http://terminology.hl7.org/CodeSystem/sex-parameter-for-clinical-use",
"code":"male-typical",
"display":"Apply male-typical setting or reference range"
}
]
}
},
{
"url":"comment",
"valueString":"Apply male-type setting for all pathology tests"
}
]
}
]
...
}
IG © 2017+ HL7 Australia. Package hl7.fhir.au.base#6.0.0-ci-build based on FHIR 4.0.1. Generated 2025-08-12
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