Increasingly, organisations are improving how they handle Gender (Identity/Diversity) and Sex (Biological) within the processes and practices.
As this is an area where the medical and social terminology intersects, often a number of standards and systems present different views on this.
Patients, Contacts, & People
At the core of the Careright System is a Person, who is often a Patient, Contact or even Staff Member.
Database Table | Field | UI Label | Definition | Values |
people | gender_code | Sex | This is strongly influenced by: https://meteor.aihw.gov.au/content/635994 It includes possible options for use in admissions. | sex: - { code: '4', default: true, description: 'Other / Not stated' } - { code: '1', description: 'Male' } - { code: '2', description: 'Female' } - { code: '3', description: 'Indeterminate' } - { code: '5', description: 'Intersex' } |
people | gender_diversity | Gender Diversity | A free text description by the individual as to how they self-describe their gender identity. On 1st July 2024; many jurisdictions changed to https://meteor.aihw.gov.au/content/741842 - this is supported by CareRight; though our user interface labeling contains legacy values
Currently in HMDS statutory reporting we are mapping using the following:
using the following definition https://meteor.aihw.gov.au/content/741842 We anticipate any future statutory reporting body requirements will use the same logic. | Definable via a Generic Code table. |
Specifying entries when the options provided are insufficient:
Example suggestions:
Admissions
Admissions are typically structured with a view towards biological sex.
For example; an extract from VAED 2021-2022:
A person’s sex is usually described as either being male or female. Some people may have both male and female characteristics. Sex is assigned at birth and is relatively fixed.
A person’s sex may change during their lifetime as a result of procedures known alternatively as Sex change, Gender reassignment, Transsexual surgery, Transgender reassignment or Sexual reassignment. Throughout this process, which may be over a considerable period of time, sex could be recorded as either Male or Female.
In data collections that use the ICD-10-AM classification, where sex change is the reason for admission, diagnoses should include the appropriate ICD 10 AM code(s) that clearly identify that the person is undergoing such a process. This code(s) would also be applicable after the person has completed such a process, if they have a procedure involving an organ(s) specific to their previous sex (for example, where the patient has prostate or ovarian cancer).
In some cases, an individual may choose to report their gender when sex is being requested.
3 Indeterminate
Code 3 Indeterminate should be used for infants with ambiguous genitalia, where the biological sex, even following genetic testing, cannot be determined. This code should not generally be used on data collection forms completed by the respondent.
Code 3 can only be assigned for infants aged less than 90 days.
4 Other
Includes:
• An intersex person, who because of a genetic condition was born with reproductive organs or sex chromosomes that are not exclusively male or female and who identifies as being neither male nor female
• A non-intersex person who identifies as neither male nor female
Excludes: Transgender, transsexual and chromosomally indeterminate individuals who identify with a particular sex (male or female).
How should I model things in CareRight?
In general; for those that wish to be addressed by their gender identity, we recommend selecting a Sex of Other / Not Stated and completing the relevant information.
Where this conflicts with Admission guidelines, we recommend adding a Patient Notice with a category of Preferred pronouns and gender information.
