Existing Wording: Tracking a patient's gender presents a number of challenges due to biological variations, differing cultural expectations and legal restrictions, and the availability of various kinds of gender re-assignment. The basic gender included in Patient.gender has a limited use, that of the administrative gender: the gender that the patient is considered to have for administration and record keeping purposes. In addition, to this gender, other kinds of gender may be represented:

•Birth Sex - the sex assigned at birth / on the birth registration. Some countries allow variations such as not yet determined, unknown, or undifferentiated, while others do not. The US realm defines a US Specific extension for this for Meaningful Use

•Clinical Gender - an observation about the patient, typically using the LOINC code 76691-5 ). LOINC also provides a set of possible codes , or SNOMED CT has the descendents of 285116001 : Gender identity finding

Comment:

Since you provide a LOINC code for Clinical Gender in the 2nd bulleted section, suggest also providing the LOINC code for "Sex assigned at birth" (76689-9) in the 1st bulleted section text description.

Summary:

Provide LOINC code for sex assigned at birth