{
  "resourceType": "Patient",
  "id": "patient-example-sex-and-gender",
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "446141000124107",
                "display": "Female gender identity"
              }
            ]
          }
        },
        {
          "url": "period",
          "valuePeriod": {
            "start": "2001-05-06"
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001."
        }
      ]
    },
    {
      "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"
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001."
        }
      ]
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "male",
                "display": "Male"
              }
            ]
          }
        },
        {
          "url": "type",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://loinc.org",
                "code": "76689-9",
                "display": "Sex Assigned At Birth"
              }
            ]
          }
        },
        {
          "url": "effectivePeriod",
          "valuePeriod": {
            "start": "1974-12-25"
          }
        },
        {
          "url": "acquisitionDate",
          "valueDateTime": "2005-12-06"
        },
        {
          "url": "sourceDocument",
          "valueReference": {
            "reference": "DocumentReference/1"
          }
        },
        {
          "url": "sourceField",
          "valueString": "SEX"
        },
        {
          "url": "jurisdiction",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://www.usps.com/",
                "code": "OH",
                "display": "Ohio"
              }
            ]
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001, but their birth certificate still indicates male."
        }
      ]
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "male",
                "display": "Male"
              }
            ]
          }
        },
        {
          "url": "type",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://local-code-system.org/recorded-sex-or-gender-type",
                "code": "insurance-card",
                "display": "Insurance Card"
              }
            ]
          }
        },
        {
          "url": "effectivePeriod",
          "valuePeriod": {
            "start": "2021-05-25"
          }
        },
        {
          "url": "acquisitionDate",
          "valueDateTime": "2021-06-06"
        },
        {
          "url": "sourceDocument",
          "valueReference": {
            "reference": "DocumentReference/2"
          }
        },
        {
          "url": "sourceField",
          "valueString": "SEX"
        },
        {
          "url": "jurisdiction",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://local-code-system.org/recorded-sex-or-gender-jurisdiction",
                "code": "ICCA-P",
                "display": "Indigo Crucifix Cobalt Aegis Payer"
              }
            ]
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001, but her insurance card still indicates male."
        }
      ]
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender",
      "extension": [
        {
          "url": "value",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://ohio.example.gov/drivers-license-sex",
                "code": "M",
                "display": "Male"
              }
            ]
          }
        },
        {
          "url": "type",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://jurisdiction-specific.example.com/document-type-code-system",
                "code": "drivers-license",
                "display": "Driver\u0027s License"
              }
            ]
          }
        },
        {
          "url": "effectivePeriod",
          "valuePeriod": {
            "start": "1974-12-25"
          }
        },
        {
          "url": "acquisitionDate",
          "valueDateTime": "2005-12-06"
        },
        {
          "url": "sourceDocument",
          "valueReference": {
            "reference": "DocumentReference/1"
          }
        },
        {
          "url": "jurisdiction",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://www.usps.com/",
                "code": "OH",
                "display": "Ohio"
              }
            ]
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001, but their driver\u0027s license still indicates male."
        }
      ]
    },
    {
      "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": "specified",
                "display": "Apply specified setting or reference range"
              }
            ]
          }
        },
        {
          "url": "period",
          "valuePeriod": {
            "start": "2002-07-13"
          }
        },
        {
          "url": "comment",
          "valueString": "Patient transitioned from male to female in 2001."
        },
        {
          "url": "supportingInfo",
          "valueReference": {
            "reference": "Observation/1"
          }
        },
        {
          "url": "supportingInfo",
          "valueReference": {
            "reference": "MedicationStatement/2"
          }
        }
      ]
    }
  ],
  "identifier": [
    {
      "use": "usual",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MR"
          }
        ]
      },
      "system": "urn:oid:1.2.36.146.595.217.0.1",
      "value": "12345"
    }
  ],
  "active": true,
  "name": [
    {
      "use": "official",
      "family": "Roth",
      "given": [
        "Patrick"
      ]
    },
    {
      "use": "usual",
      "family": "Roth",
      "given": [
        "Patricia"
      ]
    },
    {
      "use": "nickname",
      "given": [
        "Pat"
      ]
    }
  ],
  "gender": "male",
  "birthDate": "1974-12-25",
  "deceasedBoolean": false,
  "managingOrganization": {
    "reference": "Organization/1"
  },
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}