diff --git a/input/fsh/au-erequesting-diagnosticrequest.fsh b/input/fsh/au-erequesting-diagnosticrequest.fsh
index ab529a8..96303f3 100644
--- a/input/fsh/au-erequesting-diagnosticrequest.fsh
+++ b/input/fsh/au-erequesting-diagnosticrequest.fsh
@@ -10,6 +10,20 @@ Description: "This profile sets minimum expectations for a ServiceRequest resour
 
 * ^extension[http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm].valueInteger = 0
 
+* extension contains http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse named sexParameterForClinicalUse 0..1 MS
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][0].extension[code].valueCode = #SHALL:populate-if-known
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][0].extension[actor][0].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-placer"
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][1].extension[code].valueCode = #SHALL:handle
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][1].extension[actor].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-filler"
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][2].extension[code].valueCode = #SHALL:handle
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][2].extension[actor].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-server"
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][3].extension[code].valueCode = #SHALL:able-to-populate
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][3].extension[actor].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-server"
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][4].extension[code].valueCode = #SHALL:no-error
+* extension[sexParameterForClinicalUse] ^extension[http://hl7.org/fhir/StructureDefinition/obligation][4].extension[actor][0].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-patient"
+* extension[sexParameterForClinicalUse] ^comment = "Requesters can reliably provide this as the sex parameter to be used for the requested service and, when present, as the Placer's requested patient sex parameter for clinical use in the diagnostic request."
+
+
 * identifier MS 
 * identifier ^extension[http://hl7.org/fhir/StructureDefinition/obligation][0].extension[code].valueCode = #SHALL:populate-if-known
 * identifier ^extension[http://hl7.org/fhir/StructureDefinition/obligation][0].extension[actor][0].valueCanonical = "http://hl7.org.au/fhir/ereq/ActorDefinition/au-erequesting-actor-placer"
diff --git a/input/pagecontent/changes.md b/input/pagecontent/changes.md
index ba5907c..1dfcb12 100644
--- a/input/pagecontent/changes.md
+++ b/input/pagecontent/changes.md
@@ -17,6 +17,7 @@ This change log documents the significant updates and resolutions implemented fr
   - AU eRequesting ServiceRequest profile renamed to be AU eRequesting Diagnostic Request [FHIR-46842](https://jira.hl7.org/browse/FHIR-46842)
   - Removed draft and unknown from ServiceRequest.status [FHIR-47097](https://jira.hl7.org/browse/FHIR-47097)
   - added Request status reason extension as a Must Support element with cardinality 0..1 [FHIR-47098](https://jira.hl7.org/browse/FHIR-47098)
+  - added Patient Sex Parameter for Clinical Use extension to AU eRequesting Diagnostic Request [FHIR-46997](https://jira.hl7.org/browse/FHIR-46997)
 - Added _include search parameters ServiceRequest:patient, ServiceRequest:requester and ServiceRequest:encounter to AU eRequesting Placer, Filler, Patient and Server CapabilityStatements [FHIR-46942](https://jira.hl7.org/browse/FHIR-46942)
 - Renamed AU eRequesting Patient Access actor and CapabilityStatement to be AU eRequesting Patient [FHIR-46802](https://jira.hl7.org/browse/FHIR-46802)
 - Clarified profile-specific implementation guidance on populating ServiceRequest.code and removed additional binding in AU eRequesting Pathology Request and AU eRequesting Imaging Request [FHIR-46847](https://jira.hl7.org/browse/FHIR-46847)