Transgender Person Example

{
  "resourceType" : "Patient",
  "id" : "patient-example-sex-and-gender",
  "text" : {
    "status" : "generated",
    "div" : "<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\u00a0(use:\u00a0USUAL))</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. \n 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/gender-harmony/).\">Individual Gender Identity:</td><td colspan=\"3\"><ul><li>value: <span title=\"Codes: {http://snomed.info/sct 446141000124107}\">Identifies as female gender (finding)</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>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/individual-genderIdentity",
    "extension" : [{
      "url" : "value",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "446141000124107",
          "display" : "Identifies as female gender (finding)"
        }]
      }
    },
    {
      "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",
      "valueCodeableReference" : {
        "reference" : {
          "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",
      "valueCodeableReference" : {
        "reference" : {
          "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 their 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's License"
        }]
      }
    },
    {
      "url" : "effectivePeriod",
      "valuePeriod" : {
        "start" : "1974-12-25"
      }
    },
    {
      "url" : "acquisitionDate",
      "valueDateTime" : "2005-12-06"
    },
    {
      "url" : "sourceDocument",
      "valueCodeableReference" : {
        "reference" : {
          "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's 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",
      "valueCodeableReference" : {
        "reference" : {
          "reference" : "Observation/1"
        }
      }
    },
    {
      "url" : "supportingInfo",
      "valueCodeableReference" : {
        "reference" : {
          "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"
  }
}