This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Extension: sexForClinicalUse

Patient Administration Work Group

Maturity Level: 1

Informative

Use Context: Any

Summary

Defining URL: http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse

Version: 5.0.0-ballot

Name: sexForClinicalUse

Title: sexForClinicalUse

Modifier: This extension is not a modifier extension

Status: draft

Definition: **Sex for Clinical Use (SFCU) Overview** Sex for Clinical Use is a categorization of sex 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. While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems. **Sex for Clinical Use (SFCU) Contexts** Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context [sexForClinicalUse](extension-patient-sexforclinicaluse.html) that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply. The [sexForClinicalUse](extension-patient-sexforclinicaluse.html) extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare). **Sex for Clinical Use (SFCU) Categorization** For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems. **Female** - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations. **Male** - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations. **Specified** - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment. **Unknown** - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. **Sex for Clinical Use (SFCU) History and Practices** Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender. In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use.

Committee: Patient Administration Work Group

Status: draft. Extension maintained by: HL7

Sex for Clinical Use (SFCU) Overview

Sex for Clinical Use is a categorization of sex 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.

While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems.

Sex for Clinical Use (SFCU) Contexts

Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply.

The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare).

Sex for Clinical Use (SFCU) Categorization

For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems.

Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations.

Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations.

Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment.

Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices

Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender.

In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use.

Context of Use: Use on Element ID Resource

Summary

Name	Card.	Type	Description & Constraints
sexForClinicalUse	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse sexForClinicalUse: Sex for Clinical Use (SFCU) Overview Sex for Clinical Use is a categorization of sex 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. While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems. Sex for Clinical Use (SFCU) Contexts Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply. The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare). Sex for Clinical Use (SFCU) Categorization For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems. Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations. Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations. Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment. Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender. In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use. Use on Element ID Resource
value	1..1	CodeableConcept	A context-specific sex for clinical use Binding: Sex for Clincal Use (required)
period	0..1	Period	When the sex for clinical use applies
comment	0..1	string	Context about the sex for clinical use
supportingInfo	0..*	CodeableReference(Resource)	Source of the sex for clincal use
Documentation for this format

Full Structure

Name	Card.	Type	Description & Constraints
extension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse sexForClinicalUse: Sex for Clinical Use (SFCU) Overview Sex for Clinical Use is a categorization of sex 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. While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems. Sex for Clinical Use (SFCU) Contexts Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply. The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare). Sex for Clinical Use (SFCU) Categorization For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems. Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations. Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations. Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment. Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender. In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use. Use on Element ID Resource
Slices for extension	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:value	1..1	Extension	A context-specific sex for clinical use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"value"
value[x]	1..1	CodeableConcept	Value of extension Binding: Sex for Clincal Use (required)
extension:period	0..1	Extension	When the sex for clinical use applies
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"period"
value[x]	1..1	Period	Value of extension
extension:comment	0..1	Extension	Context about the sex for clinical use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"comment"
value[x]	1..1	string	Value of extension
extension:supportingInfo	0..*	Extension	Source of the sex for clincal use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"supportingInfo"
value[x]	1..1	CodeableReference(Resource)	Value of extension
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse"
value[x]	0..0
Documentation for this format

XML Template

<!-- sexForClinicalUse -->

<extension xmlns="http://hl7.org/fhir"
     url="http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse" >
 <-- extension sliced by value:url  in the specified orderOpen-->
 <extension url="value"> I 1..1 Extension  <!-- I 1..1 A context-specific sex for clinical use -->
  <valueCodeableConcept><!-- I 1..1 CodeableConcept Value of extension --></valueCodeableConcept>
 </extension>
 <extension url="period"> I 0..1 Extension  <!-- I 0..1 When the sex for clinical use applies -->
  <valuePeriod><!-- I 1..1 Period Value of extension --></valuePeriod>
 </extension>
 <extension url="comment"> I 0..1 Extension  <!-- I 0..1 Context about the sex for clinical use -->
  <valueString value="[string]"/><!-- I 1..1 Value of extension -->
 </extension>
 <extension url="supportingInfo"> I 0..* Extension  <!-- I 0..* Source of the sex for clincal use -->
  <valueCodeableReference><!-- I 1..1 CodeableReference 
      Value of extension --></valueCodeableReference>
 </extension>
</extension>

JSON Template

{ // sexForClinicalUse
    "extension" : [ //  sliced by value:url  in the specified order, Open 
      { // A context-specific sex for clinical use // I R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "value", // R! 
        "valueCodeableConcept" : { CodeableConcept } // I R! Value of extension
      },
      { // When the sex for clinical use applies // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "period", // R! 
        "valuePeriod" : { Period } // I R! Value of extension
      },
      { // Context about the sex for clinical use // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "comment", // R! 
        "valueString" : "<string>" // I R! Value of extension
      },
      { // Source of the sex for clincal use // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "supportingInfo", // R! 
        "valueCodeableReference" : { CodeableReference(Resource) } // I R! Value of extension
      }
    ],
    "extension" : [{ Extension }], // IAdditional content defined by implementations
    "extension" : { Extension }, // I R! A context-specific sex for clinical use
    "extension" : { Extension }, // IWhen the sex for clinical use applies
    "extension" : { Extension }, // IContext about the sex for clinical use
    "extension" : [{ Extension }], // ISource of the sex for clincal use
    "url" : "http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse" // R! 
  // value[x]: Value of extension: Prohibited
  }

Summary

Name	Card.	Type	Description & Constraints
sexForClinicalUse	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse sexForClinicalUse: Sex for Clinical Use (SFCU) Overview Sex for Clinical Use is a categorization of sex 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. While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems. Sex for Clinical Use (SFCU) Contexts Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply. The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare). Sex for Clinical Use (SFCU) Categorization For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems. Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations. Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations. Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment. Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender. In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use. Use on Element ID Resource
value	1..1	CodeableConcept	A context-specific sex for clinical use Binding: Sex for Clincal Use (required)
period	0..1	Period	When the sex for clinical use applies
comment	0..1	string	Context about the sex for clinical use
supportingInfo	0..*	CodeableReference(Resource)	Source of the sex for clincal use
Documentation for this format

Full Structure

Name	Card.	Type	Description & Constraints
extension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse sexForClinicalUse: Sex for Clinical Use (SFCU) Overview Sex for Clinical Use is a categorization of sex 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. While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems. Sex for Clinical Use (SFCU) Contexts Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a 'default' for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply. The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare). Sex for Clinical Use (SFCU) Categorization For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as 'Specified'. The 'Specified' category is often represented as 'Other' in existing systems. Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations. Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations. Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment. Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient's clinical sex from administrative gender. In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use. Use on Element ID Resource
Slices for extension	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:value	1..1	Extension	A context-specific sex for clinical use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"value"
value[x]	1..1	CodeableConcept	Value of extension Binding: Sex for Clincal Use (required)
extension:period	0..1	Extension	When the sex for clinical use applies
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"period"
value[x]	1..1	Period	Value of extension
extension:comment	0..1	Extension	Context about the sex for clinical use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"comment"
value[x]	1..1	string	Value of extension
extension:supportingInfo	0..*	Extension	Source of the sex for clincal use
id	0..1	id	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"supportingInfo"
value[x]	1..1	CodeableReference(Resource)	Value of extension
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse"
value[x]	0..0
Documentation for this format

XML Template

<!-- sexForClinicalUse -->

<extension xmlns="http://hl7.org/fhir"
     url="http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse" >
 <-- extension sliced by value:url  in the specified orderOpen-->
 <extension url="value"> I 1..1 Extension  <!-- I 1..1 A context-specific sex for clinical use -->
  <valueCodeableConcept><!-- I 1..1 CodeableConcept Value of extension --></valueCodeableConcept>
 </extension>
 <extension url="period"> I 0..1 Extension  <!-- I 0..1 When the sex for clinical use applies -->
  <valuePeriod><!-- I 1..1 Period Value of extension --></valuePeriod>
 </extension>
 <extension url="comment"> I 0..1 Extension  <!-- I 0..1 Context about the sex for clinical use -->
  <valueString value="[string]"/><!-- I 1..1 Value of extension -->
 </extension>
 <extension url="supportingInfo"> I 0..* Extension  <!-- I 0..* Source of the sex for clincal use -->
  <valueCodeableReference><!-- I 1..1 CodeableReference 
      Value of extension --></valueCodeableReference>
 </extension>
</extension>

JSON Template

{ // sexForClinicalUse
    "extension" : [ //  sliced by value:url  in the specified order, Open 
      { // A context-specific sex for clinical use // I R! 
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "value", // R! 
        "valueCodeableConcept" : { CodeableConcept } // I R! Value of extension
      },
      { // When the sex for clinical use applies // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "period", // R! 
        "valuePeriod" : { Period } // I R! Value of extension
      },
      { // Context about the sex for clinical use // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "comment", // R! 
        "valueString" : "<string>" // I R! Value of extension
      },
      { // Source of the sex for clincal use // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "supportingInfo", // R! 
        "valueCodeableReference" : { CodeableReference(Resource) } // I R! Value of extension
      }
    ],
    "extension" : [{ Extension }], // IAdditional content defined by implementations
    "extension" : { Extension }, // I R! A context-specific sex for clinical use
    "extension" : { Extension }, // IWhen the sex for clinical use applies
    "extension" : { Extension }, // IContext about the sex for clinical use
    "extension" : [{ Extension }], // ISource of the sex for clincal use
    "url" : "http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse" // R! 
  // value[x]: Value of extension: Prohibited
  }

Constraints

ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div)
ext-1: Must have either extensions or value[x], not both (xpath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')]))
ele-1: On Extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.value[x]: All FHIR elements must have a @value or children (xpath on Extension.extension.value[x]: @value|f:*|h:div)
ele-1: On Extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.value[x]: All FHIR elements must have a @value or children (xpath on Extension.extension.value[x]: @value|f:*|h:div)
ele-1: On Extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.value[x]: All FHIR elements must have a @value or children (xpath on Extension.extension.value[x]: @value|f:*|h:div)
ele-1: On Extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.extension: All FHIR elements must have a @value or children (xpath on Extension.extension.extension: @value|f:*|h:div)
ext-1: On Extension.extension.extension: Must have either extensions or value[x], not both (xpath on Extension.extension.extension: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")]))
ele-1: On Extension.extension.value[x]: All FHIR elements must have a @value or children (xpath on Extension.extension.value[x]: @value|f:*|h:div)
ele-1: On Extension.value[x]: All FHIR elements must have a @value or children (xpath on Extension.value[x]: @value|f:*|h:div)

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Examples of this extension

Transgender: Patient/patient-example-sex-and-gender