FFFFF Sex and Gender Examples (Informative)

The Gender Identity Sequence (0010,0041), which contains the patient’s chosen gender identity. This Sequence may record multiple identities. This may capture a history of past identities, or it may reflect social choices. During transition a patient might choose to publicly use one identity but privately use another.

The Sex Parameters for Clinical Use Category Sequence (0010,0043), which contains codes to describe sex-related parameter choices. Most often patients will have the “Female-typical” or “Male-typical” characteristic. This means that the typical normal reference ranges, alert limits, drug and hormone reactions, body fat characteristics, lean body mass algorithms, etc. apply. But there may be comments or references to indicate that specific typical parameters should not be used. For example, a cardiology exam might be ordered with a Sex Parameters for Clinical Use Category Code Sequence (0010,0046) of "Male-typical" and the Sex Parameters for Clinical Use Comment (0010,0042) "Hormonal treatment, use gender identity Creatinine reference ranges". This could also reflect tumors affecting hormone levels that will change appropriate normal ranges or algorithm selection.

The Person Names to Use Sequence (0010,0011) holds the names that the patient wants to use during conversation or in instructions. These names may reflect social status, rank, name changes, formal vs informal names, personal identity, etc. It is present so that staff can begin a conversation without unnecessarily disturbing the patient. "Herr Doktor Professor Schmidt" may be very sensitive about getting the full list of titles right, or "Captain Smith" may become angry if addressed as “Joan”. Recent name changes might not yet be legally complete, but using the old name can cause serious distress.

The Third Person Pronouns Code Sequence (0010,0014) lists the pronouns wanted to be used in instructions given in writing or to care givers. In direct conversation the third person is rarely used.