Talk:Irreversible Damage/Archive 3

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The Mexican standoff

@Bravetheif, Crossroads, and IHateAccounts: That's basically where we are at. Okay, so let's break up the disagreements into a few distinct parts... –MJL ‐Talk‐^☖ 03:22, 24 December 2020 (UTC)

Jack Turban in the lead

• Special:Diff/996023481

Now, I am for calling the claims of the book, in the lead, fringe because Rapid onset gender dysphoria is easily considered fringe. If attributing Turban is what gets us there, then that is fine with me. –MJL ‐Talk‐^☖ 03:22, 24 December 2020 (UTC)

• Include, Repeating from above: Jack Turban is, in fact, a well respected expert in these topics [1]. Acceptable use of self-published works "2. The author is an established expert on the topic of the article whose work in the relevant field has previously been published by reliable third-party publications..." The Psychology Today publication, while it is listed as a "blog" under the PT website, should be valid with attribution under WP:USESPS.— Preceding unsigned comment added by IHateAccounts (talk • contribs) 03:28, 24 December 2020 (UTC) - strike through because sockpuppet account
• Include; I agree Bravetheif (talk) 03:37, 24 December 2020 (UTC)
• Exclude. Emphasizing what Turban said is cherry-picking and hence WP:UNDUE. Other experts on gender dysphoria, such as Ken Zucker and Ray Blanchard, commended the book. [2] The expert body WPATH described ROGD as unproven and said it may or may not warrant further investigation. [3] It is against the NPOV policy for editors to emphasize Turban's view over that of all these other experts. Crossroads ^-talk- 03:40, 24 December 2020 (UTC)

"Blanchard's findings and research have been rejected by the World Professional Association for Transgender Health (WPATH), the largest association of medical professionals who provide care for transgender people, as lacking empirical evidence.[15][16]" I submit that it's you who's cherry picking. IHateAccounts (talk) 03:45, 24 December 2020 (UTC)

@IHateAccounts: Let's not get into who is cherry picking here. We're here to come to a WP:Consensus. (edit conflict) –MJL ‐Talk‐^☖ 03:54, 24 December 2020 (UTC)

It isn't clear what you're quoting, but if it is what I think it is, that has nothing to do with the ROGD hypothesis. Blanchard has published many papers on the topic of gender dysphoria in peer-reviewed journals over decades. Some of his findings became more widely accepted than others. He still counts as an expert in the topic, and on this matter neither him nor WPATH agree that it can be called "fringe". Crossroads ^-talk- 04:04, 24 December 2020 (UTC)

They appear to be quoting Ray Blanchard. I believe the point they are making is that Blanchard is not considered a credible researcher in the field. Bravetheif (talk) 07:34, 24 December 2020 (UTC)

You can bring in as many experts as you like, that doesn't change the fact that there is only a single study supporting ROGD, and that that study has been widely criticised. Until more studies conclusive studies have supported it, ROGD remains a fringe theory. Bravetheif (talk) 03:54, 24 December 2020 (UTC)

Not just one study. For example, this paper says, authors of case histories and a parent-report study warrant that gender identity development is diverse, and a new developmental pathway is proposed involving youth with postpuberty adolescent-onset transgender histories.6–8, citing 3 papers. Your conclusion that it is a "fringe theory" is your own original research. We go by the WP:Due weight of reliable sources and WP:Scholarship. None of the relevant experts are calling it a fringe theory except for Turban. That is why labeling it as fringe is undue. Crossroads ^-talk- 04:04, 24 December 2020 (UTC)

Of those sources, only one is a study of ROGD! Ref 6 makes no mention of ROGD, and Ref 8 is a commentary on multiple studies including the Littman one. The book is not generally supporting alternate theories of gender identity, it specifically supports ROGD. Bravetheif (talk) 04:14, 24 December 2020 (UTC)

It shows that ROGD is "unproven", not "fringe", according to the scholarly literature. It is under investigation. Nobody calls it fringe except for Turban, and that in a low-quality outlet. Crossroads ^-talk- 05:53, 24 December 2020 (UTC)

@Crossroads: "The term "fringe science" covers everything from novel hypotheses which can be tested by means of the scientific method to wild ad hoc hypotheses and mumbo jumbo". It is fringe science, and it has been refuted by more people than Turban. Bravetheif (talk) 06:13, 24 December 2020 (UTC)

So you say we should edit the String Theory wiki page as well as "fringe science", because it fits your definition perfectly... — Preceding unsigned comment added by 155.69.173.63 (talk) 05:38, 28 January 2021 (UTC)

That quote about fringe science is out of context; there is more to the definition than that. Only two of those sources are published scholarship, and one is from sociology, which is the wrong academic field (it should be psychology or psychiatry when it comes to medical matters like this). And I don't see where they call it "fringe". That label needs to be both sourced and due. Crossroads ^-talk- 06:48, 24 December 2020 (UTC)

The claim that the book is based on "fringe" research has been sourced: the Turban article. No original research or synthesis is required to make that claim in the main article. This discussion is entirely to determine if the label is due, and in doing so it is permissible to make original logical inferences; WP:NOR does not apply to discussions. While the sources I cited do not explicitly call ROGD "fringe", they clearly do not consider it reputable or mainstream, making it fringe. As for the sources themselves, ROGD is also a sociological theory, so the Florence source is perfectly fine. Julia Serano is a respected authority on the topic and her article has been cited by multiple reliable scientific and non-scientific sources (including the Buzzfeed News article). Buzzfeed News, while not a scientific source, is considered generally reliable according to WP:RSP and provides a decent summary of scientific thought on the matter. Furthermore, as MJL has already pointed out, there are more than enough independent scientific sources to substantiate that withholding gender affirming care from trans teenagers is fringe. Bravetheif (talk) 07:29, 24 December 2020 (UTC)

Even disregarding the ROGD debate, the book makes claims against gender affirming care for trans individuals goes against a pretty strong scientific consensus.^{[4][5][6][7][8]} Turban's highlights this in his article, and this criticism should not be ignored. –MJL ‐Talk‐^☖ 04:26, 24 December 2020 (UTC)

What Turban says on that matter can be in the body so long as it specifically described and attributed to him, but the fact remains that Zucker and Blanchard did commend the book, so it's still cherry picking to put Turban's view in the lead. On top of that, some editors have expressed doubts about the reliability of Psychology Today and thus what it says about the book. [9][10] Whatever the book says about transition seems to follow directly on its views on ROGD. And there is debate among clinicians about the implications of that sort of presentation of gender dysphoria. [11] However, authors of case histories and a parent-report study warrant that gender identity development is diverse, and a new developmental pathway is proposed involving youth with postpuberty adolescent-onset transgender histories.6–8 These youth did not yet participate in the early evaluation studies.5,9 This raises the question whether the positive outcomes of early medical interventions also apply to adolescents who more recently present in overwhelming large numbers for transgender care, including those that come at an older age, possibly without a childhood history of GI. It also asks for caution because some case histories illustrate the complexities that may be associated with later-presenting transgender adolescents and describe that some eventually detransition....Prospective longer-term follow-up studies of clinical samples like the study of Sorbara et al1 are needed to inform clinicians so that an individualized approach can be offered that differentiates who will benefit from medical gender affirmation and for whom (additional) mental health support might be more appropriate. This paper is only 2 months old. Crossroads ^-talk- 05:53, 24 December 2020 (UTC)

@Crossroads: Where did Blanchard and Zucker commend the book? Did they do so in a published opinion piece, via Twitter, or somewhere else?
I feel like we can disregard the 2010 discussion of Psychology Today, but I understand the 2018 conversation still has some weight. However, we do have to keep in mind that many editors were narrowly focussing on its reliability in regards to Religiosity and intelligence and not this field.
My point is with this book is that is completely against any form of gender-affirming care (which is something that even your cited author has shown support for [12]). Compare with: [13][14]. –MJL ‐Talk‐^☖ 20:00, 26 December 2020 (UTC)

@MJL: There's some more background on the people Crossroads is digging up to label as "expert" supporters in an opinion column by Heidi Beedle [15]:

"Reviewers also include Kenneth Zucker, fired by Toronto’s Centre for Addiction and Mental Health for espousing conversion therapy; Ray Blanchard, who developed the debunked theory of autogynephilia, which essentially suggests that trans women are sexual deviants; and Michael Bailey, author of The Man Who Would Be Queen, the 2003 version of Shrier’s book."

A further look at both Zucker's and Blanchard's bios seems to confirm that their positions today on gender issues are WP:FRINGE level. IHateAccounts (talk) 21:59, 26 December 2020 (UTC)

Opinion pieces are not reliable sources. See WP:RSOPINION. Neither Shrier's opinion columns nor this one can be taken as an accurate picture of scientific understanding in this area. MJL, my source for what those researchers said is here. Are we really sure it's against gender-affirming care generally? We would need a definitely reliable source in that regard. It seems to be focused on "ROGD". Crossroads ^-talk- 23:15, 26 December 2020 (UTC)

@Crossroads: I mean, I don't know what the book says exactly since I haven't read it, but Shrier has critised it here, and Zucker (who was interviewed for the book) said he was not a fan if it according to the National Review. –MJL ‐Talk‐^☖ 23:58, 26 December 2020 (UTC)

Also, as Srey Sros noted below, the Blanchard and Zucker endorsements are a part of the promotional material for the book. That's significantly different than writing an article-length review of the book's contentions. Can we even be sure they read the final published product? Not really.. –MJL ‐Talk‐^☖ 00:06, 27 December 2020 (UTC)

• Include. I'm not involved in this standoff, as it were, but I thought I'd offer my thoughts. There are two main components to this dispute as far as I can tell.

1. The first is fairly simple: Turban is clearly an established expert on the topic, and the source meets criteria for inclusion.

2. The second is about whether or not the views and practices advocated by the book are considered fringe. There's been a bit of confusion as to what we are determining: whether the book's content is fringe versus whether Littman's "ROGD" theory is fringe. I'm confident that both very solidly qualify as fringe, but Turban's criticism, at least in this article, is aimed not at Littman's theory but at Shrier's book. This is an important distinction to make. Fringe theories are not necessarily wrong. Fringe theories are those that significantly deviate from mainstream views or scientific consensus. If Irreversible Damage doesn't fit that definition, I don't know what does. As I imagine we're all aware, and as MJL (and Turban himself) pointed out above, there is a very strong medical consensus in favor of gender-affirming care, from which Shrier's book departs very significantly.

But really, only the first discussion is relevant. It is not our place as editors to decide which views are fringe and which are not, or to sort through scientific papers and synthesize their content. Wikipedia should not be an uncritical mouthpiece for fringe theories, nor should it be a RationalWiki-style WP:SYNTH debunking article. Our job, and our only job, is to report concisely what the reliable sources say about a topic, proportionally to the notability of given aspects and viewpoints. It doesn't matter which scientists support Littman's "ROGD" and which reject it. Turban's article is one of the top Google results for Irreversible Damage. His article seems to be one of the most notable things that happened to the book, aside from Target pulling it from stores. As for whether Zucker's and Blanchard's support of the book is equally notable, unless there's some source I'm missing, that seems pretty clear. The only evidence of support I can find of support from either of them is on the jacket of the book, which is promotional material and not even close to be RS. Srey Sros^talk 07:21, 24 December 2020 (UTC)

• Exclude as currently proposed in the diff. Of course the controversy should be noted and Turban is referenced in the article which seems fine, but unclear why this opinion should be given so much prominence in the lead.-Pengortm (talk) 17:33, 25 December 2020 (UTC)

AFAICT Turban's article is by far the most notable and perhaps the only RS commentary on the book from an expert in the relevant field. Especially given that the book makes medical arguments and recommendations, to me it seems necessary to feature his remarks in the lead. Srey Sros^talk 19:03, 26 December 2020 (UTC)

Does it? Do any reliable sources say it makes treatment recommendations? Crossroads ^-talk- 23:15, 26 December 2020 (UTC)

Literally above you linked to an editorial review page containing dehumanizing, horrific language towards trans individuals, language like "a terrible new plague that endangers our children—‘rapid-onset gender dysphoria.’ This book explains what it is, how it has spread, and what we can do about it", "a monstrous ideological fad that has already ruined countless children’s lives", " how transgender extremists have brainwashed not just these young women, but large portions of the country", and "the ‘transgender craze,’... This book deftly arms the reader with tools for both recognizing and resisting, and will prove important for parents, health care professionals, and policy makers alike." How you are arguing the content of the book afterwards is beyond me. IHateAccounts (talk) 00:52, 27 December 2020 (UTC)

I'm assuming you haven't read the book, because it is blindingly clear from the text that she is making claims (and yes, recommendations), related to trangender medicine and treatment for GD. Aside from the quotes provided by IHateAccounts above, here are a few particularly clear excerpts. All emphasis is mine.

• From the book's blurb, describing the book practically as a how-to to "untrans" your kid: Abigail Shrier’s essential book will help you understand what the trans craze is and how you can inoculate your child against it—or how to retrieve her from this dangerous path.
• From Chapter 2 of the book, a sentence both making claims (incorrect ones, but that's beside the point) about what doctors are doing and opining on what they should do: Instead of immediately accommodating every adolescent’s demands for hormones and surgeries, doctors ought to be working to understand what else might be wrong. At best, doctors’ treatments are ineffective; at worst, doctors are administering needless hormonal treatments and irreversible surgeries on patients likely to regret them.
• From Chapter 9 of the book, an excerpt where Shrier is providing her own lurid assessment of the risks related to treatment for trans youth (an assessment that significantly deviates from current standards of care, at that): The dangers are legion. The safeguards absent. Perhaps the greatest risk of all for the adolescent girl who grasps at this identity out of the blue, like it is the inflatable ring she hopes will save her, is also in some ways the most devastating: that she’ll wake up one morning with no breasts and no uterus and think, I was only sixteen at the time. A kid. Why didn’t anyone stop me?

I'd like to note that WP:OR does not apply to our own editorial discretion. We do not need an RS to make the judgement that this book deals with medical matters. If we did we couldn't apply WP:MEDRS to anything without an independent source saying that it provides biomedical information. Hopefully these examples illustrate my point. Srey Sros^talk 01:13, 27 December 2020 (UTC)

Bravetheif pointed Chapter 6 as an example of this. They're right, that is probably the best example. I don't know how I missed that when paging through for quotes. I would think it difficult to read through that chapter and come away with the conclusion that Shrier is not making any claims about medicine, but if anyone does I'd be interested to hear why they think so. Srey Sros^talk 02:20, 27 December 2020 (UTC)

@Crossroads: Chapter 6 "The Shrinks" is dedicated to making the case against providing gender affirming care to transgender youths. That is a treatment recommendation. From your other comments, you appear to have not only have read this book but personally own a copy, so I would appreciate it if you would stop being so obtuse about its contents. Bravetheif (talk) 01:23, 27 December 2020 (UTC)

@Bravetheif: we could do better than to call another editor's behavior obtuse on an article talk page, please. –MJL ‐Talk‐^☖ 01:58, 27 December 2020 (UTC)

@MJL: I apologise, you're right Bravetheif (talk) 02:04, 27 December 2020 (UTC)

I have not bought or read this book. I know how heated these topics can be and I am trying to make sure it stays fair (rather than coming off as one-sided and turning away people who should hear the other side because it looks to them like a hatchet job). Crossroads ^-talk- 04:28, 27 December 2020 (UTC)

Trying to include known WP:FRINGE individuals or viewpoints (such as Blanchard and Zucker's theories that try to paint LGBT individuals as sexual deviants), and denying that the book crosses the line into treatment recommendations, seems more like bothsidesism, "a media bias in which journalists present an issue as being more balanced between opposing viewpoints than the evidence supports", which is definitely something that violates WP:NPOV. IHateAccounts (talk) 18:30, 27 December 2020 (UTC)

• Include From other comments in this thread it seems the the book is based on fringe science - FrogInACar — Preceding undated comment added 03:06, 27 December 2020‎ (UTC)
• Exclude The lead should be a summary of the body text. It's inappropriate to shoehorn POV labels into the lead that aren't found in the body. Turban's viewpoint doesn't represent the academic consensus; some of his claims (for instance, about desistance statistics) are contested or poorly supported. gnu57 16:30, 29 December 2020 (UTC)
• Include I think SreySros' summary pretty much captures the situation, and I concur with the conclusion. XOR'easter (talk) 16:30, 30 December 2020 (UTC)

Citing PragerU

• Special:Diff/995995538

PragerU is not really a publisher, in my view. We already have a cite to Newsweek, so why retain the weaker cite to a glorified YouTube video? –MJL ‐Talk‐^☖ 03:22, 24 December 2020 (UTC)

The PragerU video also lists Shrier as a "presenter" but does not give her authorship credit for the script so it's not WP:ABOUTSELF even before we get to the fact that most of what she's talking about, isn't about herself but is rather her making claims about others. IHateAccounts (talk) 03:29, 24 December 2020 (UTC) - strike through because sockpuppet account

• Exclude; So I have already had a discussion with @IHateAccounts: (as to not repeatedly revert edits) on their talk page. Although I don't think the source is WP:MANDY, you both bring up good points and I agree with your assessment. Bravetheif (talk) 03:37, 24 December 2020 (UTC)
• Exclude; there is never a reason to cite "PragerU" for anything, they are unreliable and undue. Really, all coverage of Shrier's opinions needs to be from WP:Secondary sources, not from whatever tidbits editors try to hunt down. Crossroads ^-talk- 03:40, 24 December 2020 (UTC)
• Exclude: this YouTube video is not a good WP:SPS—I can't think of a single fact we can draw from it that couldn't be sourced better or wouldn't be undue. — Bilorv (talk) 19:46, 29 December 2020 (UTC)
• Exclude per Bilorv. With enough work, one could perhaps imagine a circumstance where citing PragerU would be acceptable, but that's getting into the "well, technically, that happening wouldn't violate the laws of physics" level of possibility. Shrier's opinions should be cited to secondary sources, so that we have some indication that the opinion is worth reporting on. XOR'easter (talk) 16:34, 30 December 2020 (UTC)

Ty Turner response

• Special:Diff/996024407

Now, this is really two questions: should we include Ty Turner's response to the book in the article or no? If so, how should we include it (via prose or external link template)? I honestly don't have an opinion on this one and was only trying to establish a compromise with my recent edit. –MJL ‐Talk‐^☖ 03:22, 24 December 2020 (UTC)

• Exclude; YouTubers are unreliable and undue. Inclusion of his opinion requires a reliable secondary source. Crossroads ^-talk- 03:40, 24 December 2020 (UTC)
• Include; I think including the Ty Turner response, providing it is attributed, is warranted. He was directly discussed in the book and is a public figure. Although I think the Leelah Alcorn line should be kept (Special:Diff/996017447), if a consensus is reached that that statement is too contentious I suggest it be dropped but the first sentence kept. Bravetheif (talk) 03:45, 24 December 2020 (UTC)

• @Bravetheif: We already discussed the Leelah Alcorn line, and we seemed to have been in agreement then about removing it. –MJL ‐Talk‐^☖ 03:52, 24 December 2020 (UTC)

  @MJL: In this case the statement is directly attributed to Ty Turner, rather than presented as a statement of fact. He dedicates a reasonable portion of the video to the book's treatment and misgendering of Leelah Alcorn. If that still crosses a line for you than I will relent Bravetheif (talk) 04:05, 24 December 2020 (UTC)

  @Bravetheif: Crossroads is right, YouTube is not a reliable source. I would be extremely uncomfortable making this highly contentious claim, even if attributed, when all we have is a user generated source to back it up. Having Turner's response be mentioned is one thing, but mentioning details like that are another. –MJL ‐Talk‐^☖ 04:18, 24 December 2020 (UTC)

  Ty Turner is only mentioned on two neighboring pages of the book. [16] What about other YouTubers and researchers mentioned in the book, some at greater length? Will they get their self-published sources inserted into the article too? The best thing is to exclude all sources below a reasonable cutoff of reliability. Crossroads ^-talk- 04:50, 24 December 2020 (UTC)

  Most other people discussed as "influencers" in the book made a conscious decision not to read or comment on the book. If they had commented I don't see why they should be excluded either. If there are a bunch of reactions from people discussed in the book, then the section should be restructured to summarise their sentiments. Like IHateAccounts said, it is WP:ABOUTSELF and WP:DUE Bravetheif (talk) 06:32, 24 December 2020 (UTC)

  Merely asserting DUE does not make it so. WP:DUE is explicitly about viewpoints that have been published by reliable sources; a YouTube upload is neither published nor reliable. ABOUTSELF is about such sources being permissible in certain cases; it is not an argument for using such sources. And it states that such uses would be usually in articles about themselves or their activities; this article is not about Turner and the book that it is about barely mentions him. Crossroads ^-talk- 06:39, 24 December 2020 (UTC)

  I was trying to reference IHateAccount's argument that it's DUE, not just assert it. Bravetheif (talk) 06:46, 24 December 2020 (UTC)

• Include: Turner, as a public figure deliberately targeted in the book, made a video in response and the video is WP:ABOUTSELF and WP:DUE. IHateAccounts (talk) 03:46, 24 December 2020 (UTC) - strike through because sockpuppet account
• Comment: How is Turner a public figure? Is he WP:Notable? Not that I can see. YouTubers aren't inherently public figures. "He was mentioned in the book" is not an argument for inclusion per our policies and guidelines. YouTube is not an RS and he was not covered on any secondary source, so is undue. Crossroads ^-talk- 04:07, 24 December 2020 (UTC)

  This secondary source considers him not just a public figure, but an influencer. Bravetheif (talk) 06:39, 24 December 2020 (UTC)

  Yes, that's the book he was mentioned in. I'm talking about his reaction to that very book not having gotten secondary coverage. He's not WP:Notable. Crossroads ^-talk- 06:42, 24 December 2020 (UTC)

  You asked how he was a public figure. The book clearly considers him one. We're also not writing a Wikipedia article about him, so WP:Notable isn't really relevant here. Bravetheif (talk) 06:46, 24 December 2020 (UTC)

• ExcludeInclude: Not seeing evidence of Turner being a prominent enough public figure or having particular expertise that they should be cited.-Pengortm (talk) 17:40, 25 December 2020 (UTC) Update: seeing the below, I changed my mind (thanks) although continue to think that this should be given limited prominence and as the article grows potentially should be excluded in favor of more substantial reviews.-Pengortm (talk) 22:09, 27 December 2020 (UTC)

@Pengortm: and @Crossroads: Ty Turner was a finalist in the 2020 12th Shorty Awards [17], and has also been covered by Men's Health [18]. Definitely notable and a public figure, even if - at only 20 years old - he has not built up a "someone has written a wikipedia article" resume yet. IHateAccounts (talk) 19:42, 26 December 2020 (UTC)

• Question. I understand the arguement quite well for why Ty Turner should not be included in prose, but why should we not link to his video response as an external link? The link would probably fall within WP:ELMAYBE. –MJL ‐Talk‐^☖ 19:36, 26 December 2020 (UTC)

  Per WP:ELNO point 11. Crossroads ^-talk- 23:16, 26 December 2020 (UTC)

• Include Book obviously considers him a notable figure, its reasonable to include his response - FrogInACar — Preceding undated comment added 03:06, 27 December 2020‎ (UTC)
• Very weak and qualified include I weakly support mentioning the fact that Turner was bothered by the coverage of him in the book. However, the book's coverage of him is actually quite minor and insubstantial. The book mentions lots of other people as well, and it would be impractical to track down and include all of their responses. I do see the point that Turner is a relatively prominent commentator, even if not yet Wikipedia-notable. But I don't think that we should include general book review-type content sourced to a youtube video. Cheers, gnu57 16:30, 29 December 2020 (UTC)
• Exclude: Wikipedia has no "right of response". This is a YouTube WP:SPS by a non-professional and so is no more due than any YouTube book review. Whether the figure is notable or not does not change things. This would be an inappropriate external link to include anywhere in the article. — Bilorv (talk) 19:46, 29 December 2020 (UTC)

References

"withholding gender-affirming medical care from transgender youth" or questioning the diagnosis of transgender youth

Based on some reviewing of the Shrier book, reviews, and medical association statements, it is not clear to me that Shrier is advocating for "withholding gender-affirming medical care from transgender youth". It appears that the primary controversial thing she is doing is questioning the diagnosis of being transgender as being as accurate as often assumed. This appears also to be a minority opinion and out of step with major medical association statements and the informed opinion of Turban. It seems that Shrier is advocating for a narrower/more stringent definition of being transgender. This may well result in "withholding gender-affirming care", but is not the same thing. If I say high cholesterol (which triggers treatments like statins) only starts at 300, and all the experts say it starts at 200, I am making a dubious claim of the wrong cut-off (with potentially dangerous results), but not saying that people should not be treated for high cholesterol. So, where does Shrier advocate for "withholding gender-affirming medical care from transgender youth" or what source claims this. The Toobin article has strong critiques which deserve to be integrated into the article, but I am not seeing it clearly say this. -Pengortm (talk) 04:28, 17 January 2021 (UTC)

Well that's 6 lines of WP:OR that doesn't match the sources in any way... IHateAccounts (talk) 05:47, 17 January 2021 (UTC) - strike through because sockpuppet account

The book attempts to undermine the "Affirmative care" model of (talk) therapy for young people experiencing gender dysphoria, and discourages these young people from having access to it, so that is pretty much the same as "withholding". We should follow the sources as to the language used. Newimpartial (talk) 16:12, 17 January 2021 (UTC)

I think the terms "withholding" and "undermining" appear to be the syntheses of editors. The first few sentences of my comment above were indeed my interpretation of trying to explain the issue. Nonetheless, the crux of the issue is, again, "So, where does Shrier advocate for "withholding gender-affirming medical care from transgender youth" or what source claims this."? I have not seen this answered.-Pengortm (talk) 16:25, 17 January 2021 (UTC)

The review in Psychology today seems quite clear on this point. As far as Shrier's own views are concerned, this column rather succinctly makes the points that she opposes the medical consensus that supports "affirmative therapy" and denies the diagnoses of most transgender youth. Newimpartial (talk) 16:46, 17 January 2021 (UTC)

Again, I have read the review Psychology today you reference does not seem clear on this point to me. If I have missed or misread, I apologize, but please point me to where in this review this point is stated? Based on the Shrier piece you reference, the main issue seems to be with the idea that, "doctors must accept patients’ self-diagnosis when it comes to gender dysphoria." Especially for a general audience, just saying "withholding gender-affirming medical care from transgender youth" seems a tendentious summary of her position and the critiques of her position.-Pengortm (talk) 19:11, 17 January 2021 (UTC)

The key passage in Shrier's piece is The current medical protocol, which jumps straight to affirmation and medication, never makes any real attempt to sort out the majority who might be likely to outgrow it from the small number who never will. Before any medical determination can be made, it wraps them all in the now popular social identity—“transgender.” That seems to me to be quite explicitly questioning the diagnosis of transgender youth, and she is also clearly opposing the availability of gender-affirming care, by supporting e.g. legislative interventions to deny these patients access to hormone blockers - and, by the logic of the piece, gender-affirming care in general. Newimpartial (talk) 19:19, 17 January 2021 (UTC)

I read the passage in question. I agree with you that this Shrier is quite explicitly questinong diagnostic criteria for youth. However, it still seems to take a leap that we editors should not be making to say that she is against care for transyouth. It would seem more clear to readers and to be a more honest portrayal of the sources to simply say that she is questioning the diagnostic criteria.-Pengortm (talk) 04:00, 18 January 2021 (UTC)

But her positions such as support for state legislation to deny blockers to trans youth go quite a bit beyond "questioning diagnostic criteria". That looks like whitewashing, to me. Newimpartial (talk) 04:40, 18 January 2021 (UTC)

Can you please elaborate on the sourcing and details of this point so I can better understand the case you are making? I don't see mention of this point in the article. In any case, to make connections like this I think we will need other reliable sources making the point and need to be careful to avoid original research and be particularly sensitive to the fact that Shrier is a living person so BLP issues apply here. Thanks -Pengortm (talk) 19:29, 18 January 2021 (UTC)

Shrier's piece in City Journal, which I linked above, opens with her support for the proposed resrrictions. Newimpartial (talk) 19:45, 18 January 2021 (UTC)

You seem to be putting words in Shrier's mouth which she has not said. She does not open with saying whether or not she supports these bills. At the end she does say near the end, "Perhaps a medical establishment that refuses to submit the risks and benefits of these protocols to rigorous inquiry deserves to have its hands tied by new laws". Read in the context of this article it is clear that she is questioning the diagnostic criteria and treatments which she believes may be applied inappropriately in some cases. I continue to think that we need to change the wording of this unless more clear justification can be provided without requiring extensive interpretation of meanings by wiki editors.-Pengortm (talk) 04:44, 22 January 2021 (UTC)

The publisher's information about the book is also remarkably lucid about the POV it presents: Abigail Shrier, a writer for the Wall Street Journal, has dug deep into the trans epidemic, talking to the girls, their agonized parents, and the counselors and doctors who enable gender transitions, as well as to “detransitioners”—young women who bitterly regret what they have done to themselves. Key words like "trans epidemic", "enable" and the emphasis on "detransitioners" make the book's intentions clear (as well as transparently misgendering many of the book's subjects). Newimpartial (talk) 20:42, 17 January 2021 (UTC)

Again, this seems to be editor interpretation rather than a clear conclusion supported by the reliable sources that Shrier favors "withholding gender-affirming medical care from transgender youth". I am not seeing anything but flimsy wikipedia editor original research to get to this conclusion. -Pengortm (talk) 04:47, 22 January 2021 (UTC)

On pages 97-99 of the book she offers a (slanted) explanation of what "gender-affirming care" is, and eventually asserts We would expect any half-decent therapist to challenge these ideas she has, to push back on their substance, to expose their source. She is very clearly opposed to "gender-affirming care" and not just to "surgical interventions". Newimpartial (talk) 02:25, 25 January 2021 (UTC)

I echo the concerns of Pengortm - the article currently contains at least some synthesis of sources that is not satisfactory. PaleCloudedWhite (talk) 10:25, 25 January 2021 (UTC)

@Pengortm: I'm very confused by this edit. You tagged She has been accused by Jack Turban of promoting the denial of gender-affirming medical care from transgender youth, saying in your edit summary that Turban's article does not directly state this. Turban's article reads (emphasis mine): Shrier claims that “in most cases—nearly 70 percent—gender dysphoria resolves," and thus youth should not be provided gender-affirming medical care. That statistic is false. That quote was copied into the citation that you cut in half with your tag. Srey Sros^talk 00:01, 31 January 2021 (UTC)

Additionally, Turban's article is the most notable and most reliable source we have from an expert in the field. I don't see why his description of what the book supports is not eligible to be repeated in wikivoice. Srey Sros^talk 00:05, 31 January 2021 (UTC)

Considering the court ruling in Bell v Tavistock, that children under the age of 16 in England and Wales are unlikely to be competent to consent to puberty blocking treatment - one aspect of "gender affirming care" - it doesn't seem credible that the article should state, in Wikipedia's voice, that 'promoting the denial of gender-affirming medical care from transgender youth' is "a fringe position". PaleCloudedWhite (talk) 00:40, 31 January 2021 (UTC)

This is a slippery-slope argument and, more importantly, WP:OR. The article should follow the sources, which state that the mainstream medical position is to support gender-affirming care as a basic standard, regardless of the rules surrounding age of access to medication. Newimpartial (talk) 01:06, 31 January 2021 (UTC)

Slippery slope to what? Medical practitioners - mainstream or not - are bound by law, not the other way round. Although there is likely to be an appeal against the Bell v Tavistock ruling, the current situation in England and Wales is that prescribing puberty-blocking drugs to under-16s without parental consent is against the law, so how is "fringe" being defined here? Being mindful of the Bell v Tavistock ruling is no more WP:OR than the current situation in the article, where one individual is used as the source for stating that the book occupies a "fringe position", and then several citations from various profesional medical bodies have been hung on that one assertion, yet none of those citations refer specifically to Shrier's book. PaleCloudedWhite (talk) 17:52, 31 January 2021 (UTC)

PaleCloudedWhite, per the policy WP:PSCI, "An explanation of how scientists have reacted to pseudoscientific theories should be prominently included. This helps us to describe differing views fairly." Further, per the content guideline WP:NFRINGE, "The notability of a fringe theory must be judged by statements from verifiable and reliable sources, not the proclamations of its adherents." My understanding is that court decisions are primary sources, and I don't think that one primary source from a court of law has anything close to equal weight with publications from several professional scientific/medical bodies, some of which appear to have been published in peer-reviewed journals.

The core of my point here is that, despite your correct assertion that medical practitioners are bound by the law, the law does not determine (or at least has not determined in this case) the medical or scientific mainstream. Since the view described as fringe is framed by its proponents including Shrier as a medical/scientific one rather than a legal one, medical and scientific sources - and medical and scientific consensus - are what determine whether it is fringe or not. warmly, ezlev. talk 19:02, 31 January 2021 (UTC)

Clearly I have not made myself understood. "Gender-affirming care" is not synonymous with the distribution of puberty-blocking drugs to minors. Rather, it is the name for an approach to care that can involve many modalities, of which gender-affirming talk therapy is probably the most important but which can also involve medicinal, surgical or other interventions. Shrier objects to all of these modalities in principle, when it comes to minors, and instead supports an approach to talk therapy that would confront the young person's gender identity with their sex assignment and try to convince them to form a more positive emotional connection to their assigned sex. In any case, Shrier's attempts to deny young people access to medicinal or surgical interventions is only part of her objection to gender-affirming care, and probably not the most important IMO.

Meanwhile, AFAIK the Bell v Tavistock ruling only concerned one aspect of gender-affirming care, namely access to puberty-blocking drugs for people under 16 in the UK. Therefore, to argue that because this case has placed restrictions on one modality of treatment in one jurisdiction therefore the medical consensus in favour of gender-affirming care somehow no longer applies is what I am calling a "slippery slope argument", though perhaps the more appropriate metaphor would be hypothetical dominoes. In any case, until the reliable sources start saying something different about the medical consensus - and Shrier's own work is far from being MEDRS in itself - then opposition to gender-affirming care remains a FRINGE position, no matter what ages of consent are set for medicinal or surgical interventions in whichever jurisdictions. The latter legal question just isn't germane to the consensus of health practitioners. Newimpartial (talk) 19:05, 31 January 2021 (UTC)

While I agree that the Turban source is a valuable one which should be cited in this article, one blog post is not sufficient to put something in wikipedia voice. Describing its positions needs to attribute this to the voice of the author. Re-reading the Turban source and the new text I think I think I was wrong to put in the failed verification tag. Still, I think Turban's views should be first established in the body of the article and then we should summarize the body of the article in the lead. As well, I think the current summary of the Turban article is a bit misleading--that we need to make clear that the main point of contention is that Shrier believes that many putative cases of gender dysphoria are not that or will resolve--while Turban argues that she is incorrect in this. Summarizing this as Shrier just being against gender-affirming care is misleading and not a good summary of the source and debate. We also need to be careful about this being about a living person--even though this is not a biography page, it falls under the WP:BLP restrictions. -Pengortm (talk) 20:24, 31 January 2021 (UTC)

I think there are two very different matters at issue here. The fundamental one is whether Shrier's book was written in opposition to gender-affirming care for minors. From reading the book, and its reception, it seems obvious to me that it was written in such opposition. Her argument is that many AFAB people come to question their gender identity in their youth (mostly preteen to early 20s) as a result of social pressures including influencers and societal sexism, and that this phenomenon is so widespread that the preferred treatment modality should be for therapists and other practitioners to question the client's declared gender identity rather than affirming it. This is opposition to gender-affirming care in the most direct and obvious sense, and I haven't seen any of the reception of the book - whether positive or critical, and including the author's own interviews - offering any alternative interpretation of the book's argument. Therefore it is my belief that this objectively true statement should be in Wikivoice.

That said, I replaced the previous statement, which had been contested, with an attributed statement that I don't think can be contested at all. I preferred the version without specific attribution, because the line of argument is fundamental to Shrier's book and is confirmed by primary and secondary sources, but I did take it out of wikivoice pending consensus here. I do not think there is a policy-compliant reason to remove this obviously true and clearly-sourced observation from the lede; however, I do agree that the discussion of Turban's column in the body should be expanded beyond "he gave the book a negative review", to encompass an actual account of the critique made (which happens to represent the mainstream medical consensus on the topic, as Shrier herself is most willing to recognize). 20:55, 31 January 2021 (UTC)

To be clear, I think you make a reasonable argument for interpreting Shrier this way--hower, I think this requires too much synthesis for an editor to make. I think I can make a reasonable argument to the contrary (see above). The issue is we need to be sticking as close to the sources as possible and not synthesizing the literature together based on our opinions--and to be clear your opinion may be very well educated and well reasoned--but that is still synthesis.-Pengortm (talk) 22:28, 31 January 2021 (UTC)

I don't think what I stated above is SYNTH, it seems to me to be the only reading of the book that is supported either internally or by secondary RS. What is your reasonable argument to the contrary? I must have missed it. Newimpartial (talk) 23:33, 31 January 2021 (UTC)

What is the book about?

Since the IP is edit warring, let's get a consensus. In the book, does Shrier express support for:

A. "the unproven[1] and contentious[2][3] hypothesis of rapid onset gender dysphoria" [19]

-or-

B. "the controversial neologism [1][2] hypothesis of rapid onset gender dysphoria" [20]

I venture that A is preferable. B is ungrammatical and also incorrect - Shrier supports a hypothesis, not a mere neologism as though it's just a terminology dispute. A also contains a citation to WPATH, which is what we should be going by per WP:MEDRS. Crossroads ^-talk- 03:32, 18 January 2021 (UTC)

I agree with your assessment of the book's claims and of the wording for the article. There's no such thing as a neologism hypothesis (well, other than something like this). The ROGD article is describing the term ROGD as a neologism for the hypothesis. It's not undue, as the IP argues, to refer to it as unproven and contentious. "Controversial" and "contentious" are basically synonyms, and no reliable sources (no sources at all, to my knowledge) argue that the hypothesis is proven. Citing the original paper to justify this doesn't make sense to me. Srey Sros^talk 03:56, 18 January 2021 (UTC)

Yes, neologism hypothesis just plain sounds weird. And if one tries to make it make sense, then it puts the emphasis in the wrong place; the coining of a term is not what's contentious, but rather the idea to which that term refers. Citing the original paper is at best redundant when the link to ROGD is right there, and it also runs up against WP:PRIMARY. XOR'easter (talk) 08:24, 18 January 2021 (UTC)

Yep, A is better. — Bilorv (talk) 11:12, 18 January 2021 (UTC)

Turns out the IP is a block-evader and one I had even dealt with in the past. [21] They were just blocked again for 6 months. Crossroads ^-talk- 05:34, 19 January 2021 (UTC)

The phrase "the unproven[1] and contentious[2][3] hypothesis" is a bad-faith argument. Studies that challenge transgender identity are labeled as bigoted or hateful. Like other Wikipedia articles, there's too much political bias. 2601:681:4503:C440:A049:8719:3B3:B5EA (talk) 05:29, 5 February 2021 (UTC)

The phenomenon isn't being labeled as bigoted or hateful in this article, it's being described as unproven and contentious, which is in line with core Wikipedia policies like WP:NPOV and WP:WEIGHT as well as content guidelines like WP:FRINGE. The bottom line is that Wikipedia articles are intended to fairly represent all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources. Describing a view which reliable sources say is both unproven and contentious as "unproven and contentious" isn't bad-faith, nor is it a sign of political bias. It's Wikipedia doing exactly what Wikipedia is supposed to do. warmly, ezlev. talk 05:44, 5 February 2021 (UTC)

"expresses support for the unrecognized and contentious medical phenomenon of rapid onset gender dysphoria"

"Expresses support for the ... medical phenomenon of rapid onset gender dysphoria" is misleadingly worded; it makes it sound as though Shrier thinks dysphoria itself is a good thing. Instead the lead should say that Shrier is supporting a particular idea about dysphoria; I think "phenomenon" should be replaced with some other word. Cheers, gnu57 05:07, 2 February 2021 (UTC)

Genericusername57, I think that's a good point. How about "proposed clinical phenomenon," or "medical entity," or something that closely paraphrases the sources like "medical concept"? Or changing "support for" to something else? I think you're right about the problem, but I'm not sure of the solution. warmly, ezlev. talk 05:38, 2 February 2021 (UTC)

Genericusername: as far as I can tell, Shrier is expressing support for the existence if a condition of which most medical authorities deny the existence. To say that Shrier supports "a particular idea" about it would not be NPOV, and would in fact be endorsing a FRINGE medical view on the word of a NON-MEDRS source. Newimpartial (talk) 11:51, 2 February 2021 (UTC)

I am not sure that most medical authorities deny the existence of this. Yes, this seems not to be acknowledged in medical protocols--but this is a different thing than denying the existence of. In any case, I think the ROGD stuff should not be so prominent in the lead and a more NPOV summary in the lead which is more understandable to a general audience is necessary.-Pengortm (talk) 16:54, 2 February 2021 (UTC)

No medical authorities whatsoever support ROGD as a diagnosis, so yes, I think that counts as the medical community denying its existence. And what exactly do you feel not to be NPOV about the current "unrecognized and contentious" phrasing, both terms of which are uncontestibly true and documented by multiple RS? Newimpartial (talk) 17:07, 2 February 2021 (UTC)

@Newimpartial: I have no idea what you're trying to say here. Do you think "expresses support for the ... medical phenomenon" is appropriately NPOV? Would you oppose replacing "medical phenomenon" with a word like "theory", "hypothesis", "concept", etc? gnu57 17:29, 2 February 2021 (UTC)

No, I do not support the current wording in detail, nor do I oppose replacing "medical phenomenon" with "hypothesis", "supposition", "concept" or "theory" in roughly that order. Perhaps "supports the interpretation of youth gender dysphoria according to the unrecognized and contentious concept of" would be the most clear statement for readers.

What I object to is any version based on your initial idea that would read something like "supports a specific interpretation of ROGD", which would assume the thing to be proven. Perhaps this wasn't what you intended, but in the current editing environment it seemed the most likely outcome of your proposed direction. Newimpartial (talk) 17:40, 2 February 2021 (UTC)

Oh, sorry, I didn't intend anything like that. I just think "phenomenon" is both non-neutral and on the wrong side of the map-territory distinction. We'd never say "Person A supports the phenomenon of general relativity" or "Person B supports the phenomenon of astral projection". (In both cases the person's support for the concept/theory/model has no bearing on the existence (or not) of the thing itself.) gnu57 18:14, 2 February 2021 (UTC)

I agree with both of you, I think. Shrier claims that a phenomenon exists, and medical organizations agree that the phenomenon does not exist. Additionally, I feel like grammatically and conceptually "Suppports a phenomenon" and "Supports a concept" don't really make sense, unless the person in question wants more of the phenomenon/concept. Another issue here, as noted by Crossroads in an edit summary, is that unrecognized is a bit unclear. It's recognized in that some organizations issued statements indicating they are aware that Littman and the paper exist, but it's unrecognized in that the reputable organizations agree that the phenomenon doesn't exist. The problem I have with Crossroads' wording is that Shrier expresses support for the unrecognized and contentious medical condition of rapid onset gender dysphoria presupposes the existence of the medical condition (we wouldn't call being psychic an unrecognized medical condition, for instance). I would propose adding a sentence to the lede to create something like this:

In the book Shrier expresses support for the interpretation of youth gender dysphoria according to the unrecognized and contentious concept of rapid onset gender dysphoria, and criticizes gender-affirming care as an approach to treatment for gender dysphoria in young people. Rapid onset gender dysphoria is not recognized as a medical entity by any major medical organization, and gender-affirming care has been endorsed as a treatment method for transgender youth by the American Psychiatric Association, the American Academy of Pediatrics, the Endocrine Society, the American Academy of Child and Adolescent Psychiatry, and the World Professional Association for Transgender Health.

Sources

What do you all think of something like that? Srey Sros^talk 19:18, 2 February 2021 (UTC)

Upon reflection, I think the key thing the article needs at this time is a sourced explanation of this kind in the body of the article. The lede content should then follow from the description in the body. One thing editors (including the IP) have recently been drawing attention to on the article page is the overweighting of the lede. This has been partially addressed already, but adding this proposed explanation to the body - not the lede - would go the rest of the way IMO. Newimpartial (talk) 14:37, 3 February 2021 (UTC)

I still feel like the lead's current wording unrecognized... medical phenomenon of rapid onset gender dysphoria presupposes the existence of such a phenomenon. I don't mean to beat a dead horse here, but I feel like we haven't really discussed this aspect of it. Perhaps that's because I'm so completely wrong in my reading of this that nobody has cared to correct me, but if not maybe we ought to find a more neutral wording here. I like Newimpartial's proposal above, perhaps something like expresses support for the interpretation of youth gender dysphoria according to the unrecognized and contentious concept of ROGD? Srey Sros^talk 01:09, 10 February 2021 (UTC)