[WWW - 2023.07.31]
Identifying and Definitional Attributes
QH 040000 v6
Data Element
Data Element
Current
17-May-2022
Standard
Information Management Strategic Governance Committee (IMSGC), Queensland Health
17-May-2022
Sex refers to a person's genetic, hormonal and physical characteristics (sex characteristics). A person's sex is usually described as being either male or female. A person may have both male and female characteristics, or neither male nor female characteristics.
Clinical and administrative purposes
Sex (code)
Health care client-sex
Representational Attributes
Numeric
Code
N
1
1
Permissible Values

Permissible_values

CodeDescription
1Male
2Female
3X
Supplementary Values

Supplemenary_values

CodeDescription
9Not stated/inadequately described
Collection and Usage Attributes
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The value meaning of 'X' has been assigned to Code 3 for this value domain, which replaces 'Other' for the superseded value domain Sex code N. Terms such as 'indeterminate', 'intersex', 'non-binary', and 'unspecified' are variously used to describe the 'X' category of sex.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.
Shall not be null
The Australian Bureau of Statistics (ABS) Standard for Sex and Gender Variables includes the following Alternate Code system:

M Male
F Female
X Other

Standard Question Module
For the collection of sex, the following standard tick box question module could be used:
What is your sex? Please [tick/mark/select] one box.
• Male
• Female
• X, please specify _______________

Mandatory elements
The following elements should be included:
• the word 'sex' in the question to clearly articulate the concept being collected;
• label the response options 'Male', 'Female' and 'X'; and
• a note that only one response is permitted.

Optional elements
The following elements may be included:
• the response option for X’ is labelled `X, please specify’; and
• a write-in facility is available when the ' X' response option is selected.

The inclusion of the write-in facility for ‘X' allows respondents the opportunity to describe their sex using a term they are comfortable with, whilst also maximising the potential for analysis of the responses provided. Where the 'X' code has been selected for sex, the data element Person-sex, text may be used to capture any further (optional) specification of sex descriptors.

Allowable variations
Minor variations to the question wording are allowed. For example:
Which of the following describes your sex? Please [tick/mark/select] one box
or
Sex, please [tick/mark/select] one box.

Optional inclusions
Organisations should refrain from making assumptions about a person's sex based on indicators such as their name, voice or appearance. Respondents should be presented with all response options for sex. The Australian Bureau of Statistics (ABS) Standard for Sex and Gender Variables recommends a standard script explaining the importance of the question. Refer to the ABS standard for explanatory information that can be included in self-completed questionnaires (e.g., web forms and paper forms), or read in face-to-face and telephone interviews. The inclusion of explanatory material is optional and at the discretion of those undertaking the collection.

Supplementary values
Code 9 Not stated/inadequately described
This supplementary value is used to code inadequately described responses and non-responses for sex. It is not to be used on primary collection forms. It is primarily for use in administrative collections when transferring data from data sets where the item has not been collected.

For national reporting of Person-sex (NHDD) data element, the following mapping occurs:
Code 1 Male maps to Code 1 Male
Code 2 Female maps to Code 2 Female
Code 3 X maps to Code 3 Another term
Code 9 Not stated/inadequately described maps to Code 9 Not stated/inadequately described

For Australian Trauma Registry (ATR) reporting, Code 3 – x will map to Code 3 – Intersex or indeterminate.

From 01 July 2023 the mapping from the Hospital Based Corporate Information System (HBCIS) is as follows:
For HBCIS hospitals,
Code M Male is mapped to code 1 Male
Code F Female is mapped to code 2 Female
Code I Indeterminate/Intersex is mapped to code 3 X.

Queensland Hospital Admitted Patient Data Collection (QHAPDC):
QHAPDC will use the permissible values in this data element from 01 July 2023.
This data element must not be null.
Code 4 cannot be used as a permissible value in future versions of the Person-Sex (code) data element as code 4 is used within Queensland Health information systems and data collections for the existing value 'Not stated/inadequately described'.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 6
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementPerson-sex (QHAPDC)QH 042431 Version 2Current
SupersedesData ElementData ElementPerson-sex (code)QH 040000 Version 5Superseded
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-diagnosis related group (AR-DRG v10.0)QH 041587 Version 11Current
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-diagnosis related group (AR-DRG v11.0)QH 041587 Version 12Draft
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-major diagnostic category (AR-DRG v10.0)QH 041588 Version 11Current
Is used in the derivation ofData ElementDerived Data ElementEpisode of admitted patient care-major diagnostic category (AR-DRG v11.0)QH 041588 Version 12Draft
Implementation in Metadata Sets

Implemented

  • 1 - 11
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionElective Surgery Data Collection (ESDC)QH 020110 Version 3MandatoryDraft17-May-2022
Information AssetData CollectionEmergency Data Collection (EDC)QH 020159 Version 3MandatoryDraft17-May-2022
Information AssetData CollectionGastrointestinal Endoscopy Data Collection (GIEDC)-RemovalsQH 020277 Version 3MandatoryDraft17-May-2022
Information AssetData CollectionGastrointestinal Endoscopy Data Collection (GIEDC)-WaitingQH 020276 Version 3MandatoryDraft17-May-2022
Information AssetData CollectionQueensland Cancer Register (QCR) Data CollectionQH 020002 Version 3Draft17-May-2022
Information AssetData CollectionQueensland Health Non-Admitted Patient Data Collection (QHNAPDC)QH 020262 Version 3MandatoryDraft01-Feb-2023
Information AssetData CollectionQueensland Health Non-Admitted Patient Data Collection (QHNAPDC)QH 020262 Version 2MandatoryCurrent17-May-202231-Jan-2023
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 2MandatoryCurrent01-Jul-2023
Information AssetData CollectionQueensland Perinatal Data Collection (QPDC)QH 020003 Version 2MandatoryCurrent17-May-2022
Information AssetData CollectionRadiation Therapy Data Collection (RTDC)QH 020274 Version 3MandatoryDraft17-May-2022
Information AssetData CollectionSpecialist Outpatient Data Collection (SODC)QH 020606 Version 3MandatoryDraft17-May-2022
Source and Reference Attributes
Australian Institute of Health and Welfare
Person-sex METeOR Identifier: 635126 https://meteor.aihw.gov.au/content/635126
Australian Bureau of Statistics 2016. Standard for Sex and Gender Variables (Cat. no. 1200.0.55.012).
Attorney-General's Department 2015. Australian Government Guidelines on the Recognition of Sex and Gender.