Sex

Field Length:  1

For cases diagnosed Jan 1, 2026 and forward:

Record the sex designated to a patient at birth, most often based on visual anatomy.

Coding Instructions

1. Assign the sex of the patient assigned at birth

2. Assign code 1 or 2 when the patient’s sex is documented as male or female, respectively, and there is no other information to indicate the patient was assigned a different sex at birth

3. When sex is not known
   a. Assign code 1 when the primary site is C600-C639
   b. Assign code 2 when the primary site is C510-C589
   c. Assign code 9 for primary sites not included above

4. Assign code 9
   a. When sex is unknown (excluding Coding Instructions 3.a and 3.b) or sex is not yet determined
   i. Do not assign code 9 when sex is documented as male or female and there is no other information about sex assigned at birth
   b. If patient is born with Disorders of Sexual Development (DSD) and sex is not clearly defined
   c. When patient’s sex is documented as other than male or female (e.g., non-binary, transsexual), and there is no additional information about sex assigned at birth

For cases prior to Jan 1, 2026:

Enter the one character code which describes the patient's sex:

 If the patient is transsexual, code to the gender at birth, if known.

Definitions

Intersex: A person born with ambiguous reproductive or sexual anatomy; chromosomal genotype and sexual phenotype other than XY-male and XX-female. An example is 45,X/46,XY mosaicism, also known as X0/XY mosaicism.

Transsexual: A person who was assigned one gender at birth based on physical characteristics but who self-identifies psychologically and emotionally as the other gender.

Coding Instructions

1. Assign code 3 for

   1. Intersexed (persons with sex chromosome abnormalities)

   2. Hermaphrodite - Hermaphrodite is an outdated term.

2. Codes 5 and 6 may be used for cases diagnosed prior to 2015

3. Codes 5 and 6 have priority over codes 1 and 2

4. Assign code 5 for transsexuals who are natally male or transsexuals with primary site of C600-C639

5. Assign code 6 for transsexuals who are natally female or transsexuals with primary site of C510-C589

6. Assign code 4 for transsexuals with unknown natal sex and primary site is not C510-C589 or C600-C639

7. When gender is not known

   1. Assign code 1 when the primary site is C600-C639

   2. Assign code 2 when the primary site is C510-C589

   3. Assign code 9 for primary sites not included above