AU eRequesting Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-erequesting/ and changes regularly. See the Directory of published versions

Sex and Gender

Page standards status: Informative

This page addresses how sex and gender related concepts can be structured in FHIR and conformant to AU eRequesting.

AU eRequesting places Must Support on some concepts and inherits sex and gender related elements localised in AU Base, which 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 (Gender Harmony IG). AU Core profiles referenced in AU eRequesting place Must Support on some concepts and inherit sex and gender elements localised in AU Base.

The table below provides an overview of the sex and gender concepts that are included in AU eRequesting by definition, or by reference to AU Core or AU Base.

Legend:

Supported: 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.

Sex and Gender Concept	Administrative Gender	Name to Use	Pronouns	Gender Identity	Recorded Sex or Gender	Sex Assigned at Birth	Sex Parameter for Clinical Use (SPCU)
AU eRequesting Diagnostic Request
AU eRequesting Imaging Request
AU eRequesting Pathology Request
AU Core Patient
AU Core Practitioner
AU Core RelatedPerson

Administrative Gender (Patient.gender)

By reference to AU Core Patient, AU eRequesting supports the exchange of Administrative Gender, i.e. the basic Patient.gender property, as a Must Support element in AU Core Patient. As per AU Base, the Patient.gender value SHALL be regarded as a Recorded Sex or Gender. AU Core adopts without change, the implementation guidance defined in the Administrative Gender (Patient.gender) section of the AU Base Sex and Gender page.

Name to Use (NtU)

By reference to AU Core Patient, AU eRequesting supports the exchange of the Name to Use data element (as defined in the HL7 Gender Harmony IG), and name.use is a Must Support element in AU Core Patient and AU Core RelatedPerson. It is important to note that, name.period is not a Must Support element. AU Core adopts without change, the implementation guidance defined in the Name to Use (NtU) section of the AU Base Sex and Gender page.

Pronouns​

By reference to AU Core Patient, AU eRequesting supports the exchange of the Pronouns data element (as defined in the HL7 Gender Harmony IG). The Individual Pronouns extension is a Must Support element in AU Core Patient, with the value element of the extension constrained to be Australian Pronouns (extensible). AU Core adopts without change, the implementation guidance defined in the Pronouns section of the AU Base Sex and Gender page.

Gender Identity (GI)

By reference to AU Core Patient, AU eRequesting supports the exchange of the Gender Identity data element (as defined in the HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation, Edition 1). The Individual Gender Identity extension is a Must Support element in AU Core Patient, with the value element of the extension constrained to be Gender Identity Response (extensible). AU Core adopts without change, the implementation guidance defined in the Gender Identity section of the AU Base Sex and Gender page.

Recorded Sex or Gender

In AU Core profiles referenced by AU eRequesting, Recorded Sex or Gender is not Must Support. See the implementation guidance defined in the Recorded Sex or Gender section of the AU Base Sex and Gender page for more information.

Sex Assigned at Birth

In AU Core, Sex Assigned at Birth is profiled as AU Core Sex Assigned At Birth. While elements within AU Core Sex Assigned at Birth are Must Support, usage of the profile is not Must Support in AU Core Patient which is referenced by AU eRequesting. That profile provides an implementation of the guidance in the Sex Assigned at Birth section of the AU Base Sex and Gender page.

Sex Parameter for Clinical Use (SPCU)

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.

AU eRequesting supports the exchange of the Sex Parameter for Clinical Use (SPCU) data element (as defined by the HL7 Gender Harmony IG). The Patient Sex Parameter for Clinical Use extension is a Must Support element in AU eRequesting Diagnostic Request, AU eRequesting Imaging Request and AU eRequesting Pathology Request and a maximum of one SPCU value is allowed.

The inclusion of an SPCU value indicates that the requester is explicitly providing a sex parameter intended for use in fulfilment of the requested diagnostic service. When it is present in an AU eRequesting Imaging Request or AU eRequesting Pathology Request, it conveys the AU eRequesting Placer’s intended SPCU for the diagnostic request and can be relied upon by AU eRequesting Filler to support the requested service.

It is recommended that the clinical context for the SPCU value is also provided (e.g. Use female reference intervals when interpreting results). Clinical context clarifies the intended use of the SPCU, supports accurate interpretation by AU eRequesting Fillers, and reduces ambiguity where the patient’s other sex and gender attributes may differ. Clinical context can be included in either the comment or intendedClinicalUse element.

See the implementation guidance defined in the Sex Parameter for Clinical Use (SPCU) section of the AU Base Sex and Gender page.