<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="us-core-birthsex" />
  <text>
    <status value="extensions" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top">
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a>
          </th>
          <th style="width: 100px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a>
            <span style="float: right">
              <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
                <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" />
              </a>
            </span>
          </th>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-us-core-birthsex-definitions.html#Extension" title="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).">Extension</a>
            <a name="Extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Extension</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-us-core-birthsex-definitions.html#Extension.url">url</a>
            <a name="Extension.url"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">1</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">1</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="color: darkgreen">"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy" />
            <a href="StructureDefinition-us-core-birthsex-definitions.html#Extension.valueCode">valueCode</a>
            <a name="Extension.valueCode"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Value of extension</span>
            <br />
            <span style="font-weight:bold">Binding: </span>
            <a href="ValueSet-birthsex.html">Birth Sex</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">required</a>): Code for sex assigned at birth<br /><br /></td>
        </tr>
        <tr>
          <td colspan="5" class="hierarchy">
            <br />
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
              <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" /> Documentation for this format</a>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <url value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex" />
  <version value="4.0.0" />
  <name value="USCoreBirthSexExtension" />
  <title value="US Core Birth Sex Extension" />
  <status value="active" />
  <date value="2019-05-21" />
  <publisher value="HL7 International - US Realm Steering Committee" />
  <contact>
    <name value="HL7 International - US Realm Steering Committee" />
    <telecom>
      <system value="url" />
      <value value="http://www.hl7.org/Special/committees/usrealm/index.cfm" />
    </telecom>
  </contact>
  <description value="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)." />
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166" />
      <code value="US" />
    </coding>
  </jurisdiction>
  <copyright value="Used by permission of HL7 International, all rights reserved Creative Commons License" />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="complex-type" />
  <abstract value="false" />
  <context>
    <type value="element" />
    <expression value="Patient" />
  </context>
  <type value="Extension" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Extension">
      <path value="Extension" />
      <short value="Optional Extensions Element" />
      <definition value="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc)." />
      <comment value="The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
      </mapping>
      <mapping>
        <identity value="iso11179" />
        <map value=".patient.administrativeGenderCode" />
      </mapping>
    </element>
    <element id="Extension.id">
      <path value="Extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="canonical" />
      </type>
      <type>
        <code value="code" />
      </type>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="id" />
      </type>
      <type>
        <code value="instant" />
      </type>
      <type>
        <code value="integer" />
      </type>
      <type>
        <code value="markdown" />
      </type>
      <type>
        <code value="oid" />
      </type>
      <type>
        <code value="positiveInt" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="unsignedInt" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="url" />
      </type>
      <type>
        <code value="uuid" />
      </type>
      <type>
        <code value="Address" />
      </type>
      <type>
        <code value="Age" />
      </type>
      <type>
        <code value="Annotation" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="ContactPoint" />
      </type>
      <type>
        <code value="Count" />
      </type>
      <type>
        <code value="Distance" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="HumanName" />
      </type>
      <type>
        <code value="Identifier" />
      </type>
      <type>
        <code value="Money" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Reference" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Signature" />
      </type>
      <type>
        <code value="Timing" />
      </type>
      <type>
        <code value="ContactDetail" />
      </type>
      <type>
        <code value="Contributor" />
      </type>
      <type>
        <code value="DataRequirement" />
      </type>
      <type>
        <code value="Expression" />
      </type>
      <type>
        <code value="ParameterDefinition" />
      </type>
      <type>
        <code value="RelatedArtifact" />
      </type>
      <type>
        <code value="TriggerDefinition" />
      </type>
      <type>
        <code value="UsageContext" />
      </type>
      <type>
        <code value="Dosage" />
      </type>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.value[x]:valueCode">
      <path value="Extension.value[x]" />
      <sliceName value="valueCode" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <strength value="required" />
        <description value="Code for sex assigned at birth" />
        <valueSet value="http://hl7.org/fhir/us/core/ValueSet/birthsex" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Extension">
      <path value="Extension" />
      <definition value="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc)." />
      <comment value="The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex." />
      <min value="0" />
      <max value="1" />
      <isModifier value="false" />
      <mapping>
        <identity value="rim" />
        <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
      </mapping>
      <mapping>
        <identity value="iso11179" />
        <map value=".patient.administrativeGenderCode" />
      </mapping>
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <fixedUri value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex" />
    </element>
    <element id="Extension.valueCode">
      <path value="Extension.valueCode" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <binding>
        <strength value="required" />
        <description value="Code for sex assigned at birth" />
        <valueSet value="http://hl7.org/fhir/us/core/ValueSet/birthsex" />
      </binding>
    </element>
  </differential>
</StructureDefinition>