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> <b> Patricia Roth </b>  male, DoB: 1974-12-25 ( Medical record number: 12345 (USUAL))</p> </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="Identifies as female gender (finding)"/> 
        </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="internationalEquivalent">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/icaosex"/> 
        <code value="M"/> 
        <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    -->
      <valueCodeableReference> 
        <reference> 
          <reference value="DocumentReference/1"/> 
        </reference> 
      </valueCodeableReference> 
    </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="internationalEquivalent">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/icaosex"/> 
        <code value="M"/> 
        <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   -->
      <valueCodeableReference> 
        <reference> 
          <reference value="DocumentReference/2"/> 
        </reference> 
      </valueCodeableReference> 
    </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="internationalEquivalent">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/icaosex"/> 
        <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    -->
      <valueCodeableReference> 
        <reference> 
          <reference value="DocumentReference/1"/> 
        </reference> 
      </valueCodeableReference> 
    </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-sexForClinicalUse">
    <extension url="value">
      <valueCodeableConcept> 
        <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/sex-for-clinical-use"/> 
        <code value="specified"/> 
        <display value="Specified sex for clinical use"/> 
        </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">
      <!--    MedicationUsage indicating patient underwent hormone therapy    -->
      <valueCodeableReference> 
        <reference> 
          <reference value="MedicationUsage/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>