Transgender Person Example (id = "patient-example-sex-and-gender")

<?xml version="1.0" encoding="UTF-8"?>

<Patient xmlns="http://hl7.org/fhir">
  <id value="patient-example-sex-and-gender"/> 
    
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b> Patricia Roth </b>  male, DoB: 1974-12-25 ( Medical record number/12345 (use: USUAL))</p> <hr/>  <table class="grid"><tr> <td style="background-color: #f3f5da" title="Record is active">Active:</td> <td> true</td> <td style="background-color: #f3f5da" title="Known status of Patient">Deceased:</td> <td colspan="3">false</td> </tr> <tr> <td style="background-color: #f3f5da" title="Alternate names (see the one above)">Alt Names:</td> <td colspan="3"><ul> <li> Patrick Roth (OFFICIAL)</li> <li> Pat (NICKNAME)</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Patient Links">Links:</td> <td colspan="3"><ul> <li> Managing Organization: <a href="organization-example-gastro.html">Organization/1</a>  &quot;Gastroenterology&quot;</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="The pronouns to use when referring to an individual in verbal or written communication.">Individual Pronouns:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://loinc.org LA29519-8}">she/her/her/hers/herself</span> </li> <li> period: 2001-05-06 --&gt; (ongoing)</li> <li> comment: Patient transitioned from male to female in 2001.</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Recorded sex or gender (RSG) information includes the various sex and gender concepts
           that are often used in existing systems but are known NOT to represent a gender
           identity, sex parameter for clinical use, or attributes related to sexuality, such
           as sexual orientation, sexual activity, or sexual attraction. Examples of recorded
           sex or gender concepts include administrative gender, administrative sex, and sex
           assigned at birth.  When exchanging this concept, refer to the guidance in the
           [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).">Person Recorded Sex Or Gender:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://hl7.org/fhir/administrative-gender male}">Male</span> </li> <li> type: <span title="Codes: {http://loinc.org 76689-9}">Sex Assigned At Birth</span> </li> <li> effectivePeriod: 1974-12-25 --&gt; (ongoing)</li> <li> acquisitionDate: 2005-12-06</li> <li> sourceDocument: <a href="broken-link.html">DocumentReference/1</a> </li> <li> sourceField: SEX</li> <li> jurisdiction: <span title="Codes: {https://www.usps.com/ OH}">Ohio</span> </li> <li> comment: Patient transitioned from male to female in 2001, but their birth certificate
                 still indicates male.</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Recorded sex or gender (RSG) information includes the various sex and gender concepts
           that are often used in existing systems but are known NOT to represent a gender
           identity, sex parameter for clinical use, or attributes related to sexuality, such
           as sexual orientation, sexual activity, or sexual attraction. Examples of recorded
           sex or gender concepts include administrative gender, administrative sex, and sex
           assigned at birth.  When exchanging this concept, refer to the guidance in the
           [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).">Person Recorded Sex Or Gender:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://hl7.org/fhir/administrative-gender male}">Male</span> </li> <li> type: <span title="Codes: {http://local-code-system.org/recorded-sex-or-gender-type insurance-card}">Insurance Card</span> </li> <li> effectivePeriod: 2021-05-25 --&gt; (ongoing)</li> <li> acquisitionDate: 2021-06-06</li> <li> sourceDocument: <a href="broken-link.html">DocumentReference/2</a> </li> <li> sourceField: SEX</li> <li> jurisdiction: <span title="Codes: {http://local-code-system.org/recorded-sex-or-gender-jurisdiction ICCA-P}">Indigo Crucifix Cobalt Aegis Payer</span> </li> <li> comment: Patient transitioned from male to female in 2001, but their insurance
                 card still indicates male.</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Recorded sex or gender (RSG) information includes the various sex and gender concepts
           that are often used in existing systems but are known NOT to represent a gender
           identity, sex parameter for clinical use, or attributes related to sexuality, such
           as sexual orientation, sexual activity, or sexual attraction. Examples of recorded
           sex or gender concepts include administrative gender, administrative sex, and sex
           assigned at birth.  When exchanging this concept, refer to the guidance in the
           [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).">Person Recorded Sex Or Gender:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://ohio.example.gov/drivers-license-sex M}">Male</span> </li> <li> type: <span title="Codes: {http://jurisdiction-specific.example.com/document-type-code-system drivers-license}">Driver's License</span> </li> <li> effectivePeriod: 1974-12-25 --&gt; (ongoing)</li> <li> acquisitionDate: 2005-12-06</li> <li> sourceDocument: <a href="broken-link.html">DocumentReference/1</a> </li> <li> jurisdiction: <span title="Codes: {https://www.usps.com/ OH}">Ohio</span> </li> <li> comment: Patient transitioned from male to female in 2001, but their driver's license
                 still indicates male.</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="A Sex Parameter for Clinical Use is a parameter that provides guidance on how a
           recipient should apply settings or reference ranges that are derived from observable
           information such as an organ inventory, recent hormone lab tests, genetic testing,
           menstrual status, obstetric history, etc..  This property is intended for use in
           clinical decision making, and indicates that treatment or diagnostic tests should
           consider best practices associated with the relevant reference population.  When
           exchanging these concepts, refer to the guidance in the [Gender Harmony Implementation
           Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).">Patient Sex Parameter For Clinical Use:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://terminology.hl7.org/CodeSystem/sex-parameter-for-clinical-use specified}">Apply specified setting or reference range</span> </li> <li> period: 2002-07-13 --&gt; (ongoing)</li> <li> comment: Patient transitioned from male to female in 2001.</li> <li> supportingInfo: <a href="broken-link.html">Observation/1</a> </li> <li> supportingInfo: <a href="broken-link.html">MedicationStatement/2</a> </li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="An individual's personal sense of being a man, woman, boy, girl, nonbinary, or
           something else. This represents an individual’s identity, ascertained by asking
           them what that identity is. 
 In the case where the gender identity is communicated by a third party, for example,
           if a spouse indicates the gender identity of their partner on an intake form, a
           Provenance resource can be used with a Provenance.target referring to the Patient,
           with a targetElement extension identifying the gender identity extension as the
           target element within the Patient resource.  When exchanging this concept, refer
           to the guidance in the [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gende
          r-harmony/).">Individual Gender Identity:</td> <td colspan="3"><ul> <li> value: <span title="Codes: {http://snomed.info/sct 446141000124107}">Female gender identity</span> </li> <li> period: 2001-05-06 --&gt; (ongoing)</li> <li> comment: Patient transitioned from male to female in 2001.</li> </ul> </td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/individual-genderIdentity">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="446141000124107"/> 
          <display value="Female gender identity"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="period">
      <valuePeriod> 
        <start value="2001-05-06"/> 
      </valuePeriod> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001."/>         
    </extension> 
  </extension> 
    
  <extension url="http://hl7.org/fhir/StructureDefinition/individual-pronouns">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://loinc.org"/> 
        <code value="LA29519-8"/> 
        <display value="she/her/her/hers/herself"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="period">
      <valuePeriod> 
        <start value="2001-05-06"/> 
      </valuePeriod> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001."/>         
    </extension> 
  </extension> 
    
  <extension url="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://hl7.org/fhir/administrative-gender"/> 
        <code value="male"/> 
        <display value="Male"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="type">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://loinc.org"/> 
        <code value="76689-9"/> 
        <display value="Sex Assigned At Birth"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="effectivePeriod">
      <valuePeriod> 
        <start value="1974-12-25"/> 
      </valuePeriod> 
    </extension> 
    <extension url="acquisitionDate">
      <valueDateTime value="2005-12-06"/> 
    </extension> 
    <extension url="sourceDocument">
          <!--    Reference to a scan of the birth certificate    -->
      <valueReference> 
          <reference value="DocumentReference/1"/> 
      </valueReference> 
    </extension> 
    <extension url="sourceField">
      <valueString value="SEX"/> 
    </extension> 
    <extension url="jurisdiction">
      <valueCodeableConcept> 
        <coding> 
        <system value="https://www.usps.com/"/> 
        <code value="OH"/> 
        <display value="Ohio"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001, but their birth certificate still
       indicates male."/>         
    </extension> 
  </extension> 
    
  <extension url="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://hl7.org/fhir/administrative-gender"/> 
        <code value="male"/> 
        <display value="Male"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="type">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://local-code-system.org/recorded-sex-or-gender-type"/> 
        <code value="insurance-card"/> 
        <display value="Insurance Card"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="effectivePeriod">
      <valuePeriod> 
        <start value="2021-05-25"/> 
      </valuePeriod> 
    </extension> 
    <extension url="acquisitionDate">
      <valueDateTime value="2021-06-06"/> 
    </extension> 
    <extension url="sourceDocument">
          <!--    Reference to a scan of the insurance card   -->
      <valueReference> 
          <reference value="DocumentReference/2"/> 
      </valueReference> 
    </extension> 
    <extension url="sourceField">
      <valueString value="SEX"/> 
    </extension> 
    <extension url="jurisdiction">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://local-code-system.org/recorded-sex-or-gender-jurisdiction"/> 
        <code value="ICCA-P"/> 
        <display value="Indigo Crucifix Cobalt Aegis Payer"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001, but their insurance card still
       indicates male."/>         
    </extension> 
  </extension> 
  
  <extension url="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://ohio.example.gov/drivers-license-sex"/> 
        <code value="M"/> 
        <display value="Male"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="type">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://jurisdiction-specific.example.com/document-type-code-system"/> 
        <code value="drivers-license"/> 
        <display value="Driver's License"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="effectivePeriod">
      <valuePeriod> 
        <start value="1974-12-25"/> 
      </valuePeriod> 
    </extension> 
    <extension url="acquisitionDate">
      <valueDateTime value="2005-12-06"/> 
    </extension> 
    <extension url="sourceDocument">
          <!--    Reference to a scan of the driver's license    -->
      <valueReference> 
          <reference value="DocumentReference/1"/> 
      </valueReference> 
    </extension> 
    <extension url="jurisdiction">
      <valueCodeableConcept> 
        <coding> 
        <system value="https://www.usps.com/"/> 
        <code value="OH"/> 
        <display value="Ohio"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001, but their driver's license still
       indicates male."/>         
    </extension> 
  </extension> 
    
  <extension url="http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/sex-parameter-for-clinical-use"/> 
        <code value="specified"/> 
        <display value="Apply specified setting or reference range"/> 
        </coding> 
      </valueCodeableConcept> 
    </extension> 
    <extension url="period">
      <valuePeriod> 
        <start value="2002-07-13"/> 
      </valuePeriod> 
    </extension> 
    <extension url="comment">
      <valueString value="Patient transitioned from male to female in 2001."/>         
    </extension> 
    <extension url="supportingInfo">
          <!--    Observation about an organ inventory (prostate)    -->
      <valueCodeableReference> 
        <reference> 
          <reference value="Observation/1"/> 
        </reference> 
      </valueCodeableReference> 
    </extension> 
    <extension url="supportingInfo">
          <!--    MedicationStatement indicating patient underwent hormone therapy    -->
      <valueCodeableReference> 
        <reference> 
          <reference value="MedicationStatement/2"/> 
        </reference> 
      </valueCodeableReference> 
    </extension> 
  </extension> 
    
  <identifier> 
    <use value="usual"/> 
    <type> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> 
        <code value="MR"/> 
      </coding> 
    </type> 
    <system value="urn:oid:1.2.36.146.595.217.0.1"/> 
    <value value="12345"/> 
  </identifier> 
  <active value="true"/> 
      <!--    Legal Name: Patrick Roth, goes by Patricia (formally), but also Pat (informally)
      -->
  <name> 
    <use value="official"/> 
    <family value="Roth"/> 
    <given value="Patrick"/> 
  </name> 
  <name> 
    <use value="usual"/> 
    <family value="Roth"/> 
    <given value="Patricia"/> 
  </name> 
  <name> 
    <use value="nickname"/> 
    <given value="Pat"/> 
  </name> 
  <gender value="male"/> 
  <birthDate value="1974-12-25">
  </birthDate> 
  <deceasedBoolean value="false"/> 
  <managingOrganization> 
    <reference value="Organization/1"/> 
  </managingOrganization> 
</Patient>