The purpose of this page is to discuss decisions related to how to model documented sex and gender identity in OMRSE.
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.
In 2010 the Institute of Medicine (IOM) issued a report recommending that data on gender identity and sexual orientation be collected EHRs and that this goal be incorporated into meaningful-use objectives. As a result several LGBT health organizations such as the Fenway Institute and The Center for Excellence for Transgender Health have conducted research and issued recommendations regarding the best way to gather information about gender identity. They recommend a two-part question.
- What is your current gender identity?
- What was your sex assigned at birth?
Typical recommended options for the first question include
- Male
- Female
- Transmale/transman/FTM Other
- Transfemale/transwoman/MTF
And May include options such as:
5. Genderqueer/gender-non-conforming
6. Different identity: please state________________
Because the two-question format is likely to be widely adopted, I think it is best if the ontology, at a minimum accomodates the data gathered by these questions. The answer to the first question is a document act and results in a documented gender identity, so we will need something like self-identified gender identity in the ontology.
Likewise, the second question asks about sex assigned at birth.