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Nonbinary Gender and Unknown Sex

California State Legislation SB-179 formally recognizes the nonbinary gender. Certain laboratory tests have reference ranges established by biological male and female sex (sex-specific reference ranges). For these tests, reference ranges for nonbinary individuals are not yet established.

For patients with nonbinary gender or unknown sex, and have a laboratory test with sex-specific reference ranges within the UCI laboratory system, the male and female reference ranges will be provided with the test result in Epic reports. Flagging for tests with sex-specific ranges will occur outside of the overlap between male and female ranges.

Comments regarding reference ranges and abnormal flagging for patients with nonbinary gender or unknown sex will be provided at the bottom of Epic reports:

Comments for Nonbinary Gender or Unknown Sex
Both male and female reference ranges are provided above because a reference range for nonbinary individuals is not yet established. For nonbinary gender or patients with unknown sex, recommend correlation with the most appropriate range.

Results that fall outside the overlap of male and female reference ranges are flagged for patients with nonbinary gender or unknown sex. Correlation with the most appropriate range is recommended to determine if the flagged result is clinically significant.


Critical values within the UCI laboratory system will be flagged as critical for all patients. All other laboratory tests in the UCI laboratory system will be reported as usual for all patients.

Reference ranges for tests with sex-specific reference ranges are provided in the table below:

Test Name Age Female Reference Range Male Reference Range
Albumin >1 year 3.7—5.3 g/dL 4.2—5.5 g/dL
Apoprotein A1 All ages 101—199 mg/dL 94—178 mg/dL
Apoprotein B All ages 49—103 mg/dL 52—109 mg/dL
Copper >11 years 85—155 mcg/dL 70—140 mcg/dL
Creatinine All ages 0.6—1.2 mg/dL 0.7—1.3 mg/dL
Dehydroepiandrosterone sulfate >13 years 80—560 ug/dL 35—430 ug/dL
Erythrocyte Sedimentation Rate (ESR) >14 years 0—20 mm/hr 0—15 mm/hr
Estradiol

Post-Menopausal: 0—40 pg/mL

Non-Pregnant
Mid-Luteal Phase: 49—291 pg/mL
Peri-Ovulatory Phase: 95—433 pg/mL

0—47 pg/mL
Ferritin All ages 10—107 ng/mL 23—233 ng/mL
Free Protein S Antigen >19 years 50—134% 70—148%
Follicle Stimulating Hormone (FSH) Mid-Follicular Phase: 3.8—8.8 mlU/mL
Mid-Cycle Peak: 4.5—22.5 mlU/mL
Mid-Luteal Phase: 1.8—5.1 mlU/mL
Post-Menopausal: 16.5—113.6 mlU/mL
1.3—19.3 mlU/mL
Glucose Tolerance 1 Hour Post-Prandial >15 years 57—145 mg/dL 63—157 mg/dL
Growth Hormone >18 years 0—10 ng/mL 0—1 ng/mL
Hematocrit 1—17 years 34—44% 37—49%
Hematocrit >18 years 34—44% 39.5—50%
Hematocrit (Blood Gas) All ages 38—46% 43—51%
Hemoglobin 12—17 years 11.5—15.0 g/dL 13.0—16.0 g/dL
Hemoglobin >18 years 11.5—15.0 g/dL 13.0—16.9 g/dL
Insulin (random level) 3—9 years 4.0—40.7 mlU/mL

2.9—30.9 mlU/mL

Insulin (random level) 10—12 years 7.9—56.2 mlU/mL

6.3—50.1 mlU/mL

Insulin (random level) 13—14 years 7.9—56.2 mlU/mL

7.9—50.1 mlU/mL

Insulin (random level) 15—17 years 7.4—51.3 mlU/mL

7.1—66.1 mlU/mL

Iron 0—15 years 30—127 mcg/dL

30—110 mcg/dL

Iron >16 years 37—170 mcg/dL

49—181 mdg/dL

Luteinizing Hormone (LH) Mid-Follicular Phase: 2.1—10.9 mlU/mL
Mid-Cycle Peak: 19.2—103.0 mlU/mL
Mid-Luteal Phase: 1.2—12.9 mlU/mL
Post-Menopausal: 10.9—58.6 mlU/mL

1.2—8.6 mlU/mL

Myoglobin All ages 0—50 ng/mL

0—65 ng/mL

O2 Content All ages 16.0—21.5 mL/dL

17.5—23.0 mL/dL

Progesterone

Mid-Follicular Phase: 0.3—1.5 ng/mL
Mid-Luteal Phase: 5.2—18.6 ng/mL
Post-Menopausal: 0.0—0.8 ng/mL

Pregnancy
First Trimester: 4.7—50.7 ng/mL
Second Trimester: 19.4—45.3 ng/mL

0.1—2.1 ng/mL

Prolactin

Pre-Menopausal: 3.3—26.7 ng/mL
Post-Menopausal: 2.7—19.6 ng/mL

2.6—13.1 ng/mL

RBC >13 years

3.70—5.00 mill/mcL

4.38—5.62 mill/mcL

Sex Hormone Binding Globulin 20—49 years

17—136 nmol/L

13—90 nmol/L

ST2 >18 years

0.0—38.7 ng/mL

0.0—52.0 ng/mL

Testosterone (% free testosterone) >20 years

0.2—0.4%

0.3—0.4%

Uric Acid All ages

2.3—6.6 mg/dL

4.4—7.6 mg/dL

Uric Acid, Urine All ages

250—750 mg/total volume

250—800 mg/total volume

Urinalysis (epithelial cells and squamous cells) All ages

0—10/HPF

0—5/HPF

 

Estimated Glomerular Filteration Rate (GFR): For non-binary individuals or unknown sex, the MDRD equation for female sex is used to calculate the estimated glomerular filtration rate (GFR). To estimate the GFR for male sex, multiply the estimated GFR result by 1.348.

Cystatin C with eGFR: For non-binary individuals or unknown sex, cystatin C-based eGFR is calculated for female sex. To estimate the eGFR for male sex, multiply the cystatin C-based eGFR result by 1.07.

 

Updated 4/19/2019