Code 1 - Male
Persons who have male or predominantly masculine sex characteristics or male sex assigned at birth
Code 2 - Female
Persons who have female or predominantly feminine sex characteristics or female sex assigned at birth.
Code 3 - X
Persons who have mixed or non-binary sex characteristics (if known), or a non-binary sex assigned at birth or reported their sex as another term.
The value meaning of 'X' has been assigned to Code 3 for this value domain, which replaces 'Other' for the superseded value domain Sex code N. Terms such as 'indeterminate', 'intersex', 'non-binary', and 'unspecified' are variously used to describe the 'X' category of sex. The label 'Other' was previously used but has been changed to recognise the problem of othering and the offence it causes.
Sex characteristics are chromosomal, gonadal and anatomical. Where there is an inconsistency between anatomical and chromosomal characteristics, sex is based on anatomical characteristics.
The term 'sex' refers to a person's physical characteristics. A person's sex is usually described as being either male or female; some people may have both male and female characteristics, or neither male nor female characteristics.
Sex is assigned at birth and is relatively fixed. However, a person's sex may change during their lifetime as a result of procedures commonly referred to as sex change, gender reassignment, gender affirmation, transsexual surgery, transgender reassignment or sexual reassignment. Throughout this process, which may be over a considerable period of time, sex may be recorded as either male, female or X.
Collection of sex excludes gender information, which is interrelated but conceptually distinct. The concept of sex is based on the physical aspects of a person's body while the concept of gender relates to the way a person feels, presents and is recognised within the general community and may refer to outward social markers such as their name, outward appearance, mannerisms and dress. Sexual orientation is a separate concept to sex and gender, involving a person's emotional or sexual attraction to another person, and is not covered in the collection of sex information.
In general, both sex and gender should not be collected in a single collection instrument. The Australian Government Guidelines on the Recognition of Sex and Gender recommends the preferred Australian Government approach of collecting and using gender information, with sex only being collected where there is a legitimate need to know the sex characteristics of the target population. It should be recognised that in some cases an individual may choose to report their gender when sex is being requested.
Organisations should ensure when they collect sex and/or gender information they use the correct terminology for the information they are seeking. Male and female are predominantly associated with the set of physical attributes that define the different types of sexes, while masculine and feminine characteristics are predominantly associated with the set of factors that make up gender. However, it should be recognised that male/female and masculine/feminine are sometimes used interchangeably to refer to sex and/or gender.
In a large healthcare organisation where patient information is shared across multiple clinical settings, there is a legitimate need to know both the Sex and Gender of a healthcare consumer, to deliver equitable quality of care. The Sex and Gender fields should not be used interchangeably, and care should be taken when seeking the information for data capture to be sure responses are recorded in the correct field.