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We have decided to model documented instances of sex and gender identity in OMRSE rather than sex and gender themselves. The reason for this because it is usually discrepancies in documentation that cause problems when delivering health care to transgendered and inter-sexed individuals. For example, ordering a pap smear for a patient whose documented sex/gender in an EHR is male and billing that service with an insurance company who also has been identified as male with their insurance company is often problematic.
2010 - the Institute of Medicine (IOM) report on the health lesbian, gay, bisexual and transgender (LGBT) persons recommends that data on gender identity be collected in electronic health records (EHRs) and that this goal be incorporated into meaningful-use objectives.