# SDOHCC Observation Sexual Orientation - SDOH Clinical Care v3.0.0-ballot

## Resource Profile: SDOHCC Observation Sexual Orientation 

 
Profile for observations about the sexual orientation of an individual. For further details on this profile see[Specifications for Personal Characteristics](specifications_for_personal_characteristics.md). 

**Usages:**

* Examples for this Profile: [Observation/SDOHCC-ObservationSexualOrientationExample](Observation-SDOHCC-ObservationSexualOrientationExample.md)
* CapabilityStatements using this Profile: [SDOHCC Coordination Platform](CapabilityStatement-SDOHCC-CoordinationPlatform.md), [SDOHCC Referral Recipient](CapabilityStatement-SDOHCC-ReferralRecipient.md), [SDOHCC Referral Recipient - Light](CapabilityStatement-SDOHCC-ReferralRecipientLight.md) and [SDOHCC Referral Source](CapabilityStatement-SDOHCC-ReferralSource.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.sdoh-clinicalcare|current/StructureDefinition/SDOHCC-ObservationSexualOrientation)

### Formal Views of Profile Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-SDOHCC-ObservationSexualOrientation.csv), [Excel](../StructureDefinition-SDOHCC-ObservationSexualOrientation.xlsx), [Schematron](../StructureDefinition-SDOHCC-ObservationSexualOrientation.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "SDOHCC-ObservationSexualOrientation",
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 1
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "pc"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/sdoh-clinicalcare/ImplementationGuide/hl7.fhir.us.sdoh-clinicalcare"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation",
  "version" : "3.0.0-ballot",
  "name" : "SDOHCCObservationSexualOrientation",
  "title" : "SDOHCC Observation Sexual Orientation",
  "status" : "active",
  "date" : "2025-12-13T17:11:59+00:00",
  "publisher" : "HL7 International / Patient Care",
  "contact" : [
    {
      "name" : "HL7 International / Patient Care",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/patientcare"
        },
        {
          "system" : "email",
          "value" : "patientcare@lists.hl7.org"
        }
      ]
    }
  ],
  "description" : "Profile for observations about the sexual orientation of an individual. For further details on this profile see [Specifications for Personal Characteristics](specifications_for_personal_characteristics.html).",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "workflow",
      "uri" : "http://hl7.org/fhir/workflow",
      "name" : "Workflow Pattern"
    },
    {
      "identity" : "sct-concept",
      "uri" : "http://snomed.info/conceptdomain",
      "name" : "SNOMED CT Concept Domain Binding"
    },
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/fivews",
      "name" : "FiveWs Pattern Mapping"
    },
    {
      "identity" : "sct-attr",
      "uri" : "http://snomed.org/attributebinding",
      "name" : "SNOMED CT Attribute Binding"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Observation",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sexual-orientation|7.0.0",
  "derivation" : "constraint",
  "differential" : {
    "element" : [
      {
        "id" : "Observation",
        "path" : "Observation",
        "short" : "Observation about an individual's sexual orientation",
        "definition" : "Defines constraints that  represent the minimum requirement for personal characteristic observations which are observations that are usually self-attested but may be attested to on behalf of the subject (e.g., for a minor or incapable subject) and are generally only verifiable by the source of attestation (e.g., race, ethnicity, sexual orientation, gender identity and personal pronouns), but may sometimes be verifiable by someone other than the source of attestation (e.g., recorded sex).",
        "comment" : "For observations about the sexual orientation of an individual.",
        "constraint" : [
          {
            "key" : "SDOH-Obs-1",
            "severity" : "error",
            "human" : "Either subject or extension-Observation.subject must exist but not both",
            "expression" : "subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()",
            "xpath" : "true()",
            "source" : "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation"
          },
          {
            "key" : "SDOH-Obs-2",
            "severity" : "error",
            "human" : "Focus is only allowed if subject is present",
            "expression" : "focus.exists() implies subject.exists()",
            "xpath" : "true()",
            "source" : "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation"
          },
          {
            "key" : "SDOH-Obs-3",
            "severity" : "error",
            "human" : "Must have either performer or derivedFrom",
            "expression" : "performer.exists() or derivedFrom.exists()",
            "xpath" : "true()",
            "source" : "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation"
          }
        ]
      },
      {
        "id" : "Observation.extension",
        "path" : "Observation.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "rules" : "open"
        }
      },
      {
        "id" : "Observation.extension:OtherSubject",
        "path" : "Observation.extension",
        "sliceName" : "OtherSubject",
        "requirements" : "This extension is adding only US Core Practitioner as an option for Observation.subject. When the subject is Practitioner, personal characteristics should be based on the attestation and consent of the practitioner.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
            ]
          }
        ],
        "condition" : ["SDOH-Obs-1"],
        "mustSupport" : true
      },
      {
        "id" : "Observation.extension:OtherSubject.value[x]",
        "path" : "Observation.extension.value[x]",
        "min" : 1,
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0"
            ]
          }
        ]
      },
      {
        "id" : "Observation.status",
        "path" : "Observation.status",
        "short" : "final | corrected | entered-in-error | unknown",
        "definition" : "The status of the observation value.",
        "requirements" : "Further constrained to values that are relevant for personal characteristic observations.",
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus"
        }
      },
      {
        "id" : "Observation.category",
        "path" : "Observation.category",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "pattern",
              "path" : "$this"
            }
          ],
          "rules" : "open"
        },
        "min" : 1
      },
      {
        "id" : "Observation.category:PersonalCharacteristic",
        "path" : "Observation.category",
        "sliceName" : "PersonalCharacteristic",
        "requirements" : "Used for filtering personal characteristic observations.",
        "min" : 1,
        "max" : "1",
        "patternCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
              "code" : "personal-characteristic"
            }
          ]
        },
        "mustSupport" : true
      },
      {
        "id" : "Observation.code",
        "path" : "Observation.code",
        "comment" : "*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. NOTE: In LOINC, System Patient is used in the modeling of codes referenced by the Personal Characteristics profiles (e.g., 72826-1 Race OMB.1997, 69490-1 Ethnicity OMB.1997, 76691-5 Gender identity, 76690-7 Sexual orientation, 90778-2 Personal pronouns – Reported, and 99502-7 Recorded sex or gender). If the draft profiles are adopted, new LOINC codes without System Patient would be needed since these profiles can also be used to capture characteristics of a provider (using an extension) or a related person (using focus).",
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ObservationCode"
            }
          ],
          "strength" : "preferred",
          "description" : "Codes identifying names of simple observations.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/observation-codes"
        }
      },
      {
        "id" : "Observation.subject",
        "path" : "Observation.subject",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0"
            ]
          }
        ],
        "condition" : ["SDOH-Obs-1", "SDOH-Obs-2"]
      },
      {
        "id" : "Observation.focus",
        "path" : "Observation.focus",
        "max" : "1",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
          }
        ],
        "condition" : ["SDOH-Obs-2"]
      },
      {
        "id" : "Observation.effective[x]",
        "path" : "Observation.effective[x]",
        "comment" : "At least a date should be present unless this observation is a historical report.  For recording imprecise or \"fuzzy\" times (For example, a blood glucose measurement taken \"after breakfast\") use the [Timing](datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.\r\nNOTE: dateTime is Must Support, but currently tooling does not support this.",
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
                "valueBoolean" : true
              }
            ],
            "code" : "dateTime"
          },
          {
            "code" : "Period"
          }
        ]
      },
      {
        "id" : "Observation.performer",
        "path" : "Observation.performer",
        "condition" : ["SDOH-Obs-3"],
        "mustSupport" : true
      },
      {
        "id" : "Observation.value[x]",
        "path" : "Observation.value[x]",
        "requirements" : "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations. NOTE: This is a value set is for testing purposes only and will ultimately need to be aligned with vetted value sets where terms like “asexual” and “pansexual” may be included.",
        "min" : 1,
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "binding" : {
          "strength" : "extensible",
          "description" : "Codes for sexual orientation",
          "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11"
        }
      },
      {
        "id" : "Observation.value[x].extension:DataAbsentReasonMasked",
        "path" : "Observation.value[x].extension",
        "sliceName" : "DataAbsentReasonMasked",
        "requirements" : "“Masked” is never used for data capture, but \"masked\" is used to suppress information when data is exchanged. For this reason, other flavors of null are included in the value set for Observation.value, but “masked” can be captured here.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1"
            ]
          }
        ]
      },
      {
        "id" : "Observation.value[x].extension:DataAbsentReasonMasked.value[x]",
        "path" : "Observation.value[x].extension.value[x]",
        "definition" : "The information is not available due to security, privacy or related reasons.",
        "fixedCode" : "masked",
        "mustSupport" : true
      },
      {
        "id" : "Observation.value[x].coding",
        "path" : "Observation.value[x].coding",
        "mustSupport" : true
      },
      {
        "id" : "Observation.value[x]:valueCodeableConcept",
        "path" : "Observation.value[x]",
        "sliceName" : "valueCodeableConcept",
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "strength" : "extensible",
          "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11"
        }
      },
      {
        "id" : "Observation.dataAbsentReason",
        "path" : "Observation.dataAbsentReason",
        "max" : "0"
      },
      {
        "id" : "Observation.interpretation",
        "path" : "Observation.interpretation",
        "max" : "0"
      },
      {
        "id" : "Observation.bodySite",
        "path" : "Observation.bodySite",
        "max" : "0"
      },
      {
        "id" : "Observation.method",
        "path" : "Observation.method",
        "min" : 1,
        "mustSupport" : true,
        "binding" : {
          "strength" : "extensible",
          "description" : "Methods for personal characteristic observations.",
          "valueSet" : "http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationMethod"
        }
      },
      {
        "id" : "Observation.specimen",
        "path" : "Observation.specimen",
        "max" : "0"
      },
      {
        "id" : "Observation.referenceRange",
        "path" : "Observation.referenceRange",
        "max" : "0"
      },
      {
        "id" : "Observation.derivedFrom",
        "path" : "Observation.derivedFrom",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0",
              "http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|7.0.0",
              "http://hl7.org/fhir/StructureDefinition/Observation"
            ]
          }
        ],
        "condition" : ["SDOH-Obs-3"],
        "mustSupport" : true
      }
    ]
  }
}

```
