Sex/Gender Subtypes

After discussing with two international law colleagues, I think it is best to avoid the phrasing "Administrative gender" and to use "Recorded gender" instead. This is more in line with language in various domains, as "administrative" doesn't always translate well and may be misunderstood as implying the involvement of an executive-style branch of government. I brought this up with colleagues in surgery, pharmacy, law, and bench biology, and I am recommending "Recorded gender", as it is more easily understood in an international, multi-disciplinary context.

The other issue is that there exists no standard definition of the sex/gender distinction and it is likely to be susceptible to a number of changes in the future. Therefore, I suggest (and this will be forthcoming in the document I have) that we define "Gender finding" as describing any gender datum, with a gender datum being any socio-culturally specific identifier without strictly reproducible criteria. (Gender findings would include "Recorded gender finding", "Gender identity finding", and "Gender modality finding").

A "Sex finding" would then describe a sex datum, which is (at least in the theoretical sense), culturally independent; i.e. if there was a standard set by one jurisdiction as to what "intersex" means, it could be reproduced in another jurisdiction using the same criteria. (Sex findings would include "Sex assignment finding" and "Sex for clinical use finding" [SFCU]; personally, I don't like SFCU, as it is liable to become a dumping ground for everything that was previously under "biological sex", but I think its necessary to make sure that current rule-based structures don't all break overnight).

This separation is also useful because there is no international standing definition of "legal gender" or "legal sex". Therefore they are folded into "Recorded gender" as they both represent culturally-specific records (and are therefore a gender datum under this split).

(I can also post an early draft of what I have thus far if it's easier for people to see how it fits together graphically; it's about 50 pages thus far; also, if anyone has data representing the identities of gender-marginalized persons who are from the Indian subcontinent [other than the censuses performed in India/Nepal] or who are First Nations/Native American, it would be very helpful-- so far I've been essentially reconducting a literature review of identities and it's the slowest part right now. Thank you!).

I am not sure we would need a "Sex for clinical use" subtype if we approached this the way you describe for "Sex finding" as I think there would be an overlap that would not provide much additional benefit.  Sex for clinical use is an information model construct that I don't think we want to instantiate in the terminology.  This might extend to Sex assignment as well since it is also an information model construct and the values would be very similar if not identical to sex for clinical use.

Jim Case I'm attaching a document which summarizes a bit of the hierarchy as I've modeled it thus far, which might help clarify why I did it this way. Obviously a work in progress, but this might align better with the current HL7 proposal.

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