Talk:Cass Review/Archive 10

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New Source in the BMJ addresses Yale white paper and BMA

Recently published in the BMJ, is quite scathing about the Yale report. One to discuss.

https://adc.bmj.com/content/early/2024/10/13/archdischild-2024-327994

This sort of thing is why I wanted to move away from the current bloated "response" structure. It's getting complicated and the responses are evolving and generating their own responses. Void if removed (talk) 21:17, 14 October 2024 (UTC)

Void if removed how would you prefer to restructure it? FirstPrimeOfApophis (talk) 21:27, 14 October 2024 (UTC)

See here Void if removed (talk) 21:30, 14 October 2024 (UTC)

OK, I support it. FirstPrimeOfApophis (talk) 21:49, 14 October 2024 (UTC)

I think adding responses to the Cass Review is obviously necessary, but adding all these different responses to other responses to it like that article may be overdoing it. I think that everything that's currently in the article is fine, but do we really need to add every new article that is released criticizing or giving an opinion on another organization's response? Some may be an exception, but for the most part, I think we should just stick with organizations responding to the Cass Review instead of organizations responding to other organizations on it. That would help prevent the response section from becoming more "bloated" in the future. Usr Trj (talk) 03:54, 15 October 2024 (UTC)

This adds significant new perspective on some existing content (especially the Yale white paper). It is a high quality, peer-reviewed source, far better than some recent additions, and clearly WP:DUE. Aside from direct responses and additional context applicable to claims currently in this page, the paper also has lots of information that can be used as a high quality source to expand the background, implementation and general reception. For example:

The purpose of the Cass Review was to make recommendations to the National Health Service (NHS) in England (NHSE) on how to improve services for people under 18 experiencing issues with gender identity. It was underpinned by a robust research programme, engaged over 1000 stakeholders and took 4 years to complete. The results of the Review were embraced by the UK clinical community, as well as a number of other professional and third sector organisations and both main political parties. The editor-in-chief of the BMJ aptly observed, ‘The Cass Review is an opportunity to pause, recalibrate, and place evidence informed care at the heart of gender medicine. It is an opportunity not to be missed for the sake of the health of children and young people.’ NHSE accepted the Review’s recommendations in full and has initiated a 3-year implementation plan.

Void if removed (talk) 08:44, 15 October 2024 (UTC)

I am not in favor of responses to responses either Snokalok (talk) 12:02, 15 October 2024 (UTC)

If we have a low-quality initial response that is debunked by a high-quality further response (like here), it isn't acceptable for us to present only the initial source. This will lead to WP:FALSEBALANCE between responses and mislead readers. FirstPrimeOfApophis (talk) 16:34, 15 October 2024 (UTC)

Void if removed on second thoughts, separating immediate and further responses seems risky. For example, a reader will read our lengthy and uncritical presentation of the Integrity Project paper in "Initial Responses" and not be informed of its flaws unless they read the "Further Responses" section as well, where we present a summary of this peer-reviewed journal article. This risks amplifying misinformation.

As a compromise, I suggest where further responses address a specific initial response, the initial response and further response should be presented in the same place. Where further responses address a range of initial responses (e.g. this: https://www.bmj.com/content/385/bmj.q1141) they should go in a "Further Responses" section. FirstPrimeOfApophis (talk) 16:34, 15 October 2024 (UTC)

In an ideal world, what I would like to see is:

• Background
• Methodology
• Interim Review
• Final Review
  • Findings
  • Recommendations
  • Implementation
• Reception
  • UK Political (Labour, Conservative, SNP)
  • UK Medical (NHSE, RCPCH, RCGP, BPS, RCP, AoMRC, BMA)
  • International Medical (AAP, Endocrine Society, CPS, AUMC, WPATH, PATHA)
• Subsequent Events
  • Ban on private puberty blockers
  • Adult clinic review
  • Scottish gender clinics
• Wider Response
  • Cass Reflections on review
  • Yale team criticism (inc. response)
  • Scholarly reactions
  • Others etc...
  • Popular media

Keep reception to the best, most relevant, highest quality and immediate responses. Cull or rehome everything else in "Wider Response". Void if removed (talk) 17:00, 15 October 2024 (UTC)

Interesting. So Final Review > Implementation would only be what is currently in the NHS England section? FirstPrimeOfApophis (talk) 17:43, 15 October 2024 (UTC)

Yes - I think the other points are notable fallout of the Cass Review, but not actually to do with its implementation. Void if removed (talk) 19:07, 15 October 2024 (UTC)

I don't like the idea of separating reception and responses since many people see those things as one and the same. But IF that happens, the RANZCP and JSPN should be kept with the others in the "International Medical" section. What would "Scholarly reactions" be? I don't know what "Popular media" would entail. Usr Trj (talk) 12:11, 16 October 2024 (UTC)

There are quite a few red flags with this paper:

• 1) probably shocking almost nobody, one of the authors is the founder of SEGM (hardly independent from the Yale group)
• 2) The section "Medicine, law and The Integrity Project" paints a ridiculously incomplete picture of trans healthcare in the US
  • 1) It says WPATH, the endocrine society, and trans advocacy groups oppose such bans - ignoring that every major medical org in the US opposes those bans including places like the AAP and APA
  • 2) It neglects to note the states banning trans healthcare do so entirely due to conservative and anti-LGBT advocacy groups
• 3) "Criticism of the Cass Review process" is fairly weak
  • 1) Yale, and many others, have questioned putting somebody with no experience with trans kids in charge of their future across a country. The paper's response to that seems to be "nuh uh, we wanted somebody like that". That's a difference in values, not an error. Besides, they note that applied to the named systematic reviewers too, not just Cass.
  • 2) The statement this is critiquing, "many of the Review's author's identities are unknown", cites Following the completion of the "research programme" by the University of York, "A Clinical Expert Group (CEG) was established by the Review to help interpret the findings" (p 26), defined as "clinical experts on children and adolescents in relation to gender, development, physical and mental health, safeguarding and endocrinology" (p 62). There is no further information about the qualifications of the members of the CEG, nor how they were selected. This paper says Cass was the sole author and mixes up the Review's CEG with it's CPG, ignoring the critique that Cass had an anonymous group discuss how to transform reviews into policy recommendations, and then guffs about "polarization" justifying a secret panel helping develop the recommendations.
  • 3) Their critique of Yale is that "McNamara et al assert that the Review contravenes standard practice in scientific evaluations by not using GRADE in its recommendations" but they don't, they point out that CPGs are subject to greater scrutiny and scientific rigour than the Review was
• 4) It completes skips over the reports criticisms of Cass misrepresenting data and repeating false claims (ie, most kids desist)

There were many more issues in this paper, but I wanted to flag some obvious ones. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 19:44, 15 October 2024 (UTC)

Thank you for doing the work to actually interrogate this source. Snokalok (talk) 20:57, 15 October 2024 (UTC)

This looks like a peer-reviewed paper (I assume? I don't know) in a respectable journal, about the subject of the article, and hence quite reasonably eligible to be used as a source, unless there is some overriding reason that it should not be considered reliable. Disagreeing with the conclusions of the paper are not a reason for it not to be considered a reliable source. In short, I don't think your red flags are very red. In long:

1) Guilt by association fallacy based on one of the five authors (not the lead author).

2) It's not the job of this paper to present a complete account of trans healthcare in the US.

3.1) The Integrity Project paper says they would have preferred a review led by someone with industry experience. This paper says they think that would have compromised independence. On this matter, the two papers disagree. So yes, that's not an error.

3.2) What do you mean by "it's CPG"? The paper states that there were over 1000 individual contributors and that it wouldn't have been appropriate to name them. Maybe you would have preferred Cass name them. That's an opinion, not a red flag.

3.3) McNamara et al does make that assertion, on page 9: The Review introduces GRADE (p 55) but never evaluates the evidence using the GRADE framework.. This paper explains that (a) the NICE systematic reviews did use GRADE, and (b) GRADE is indeed (appropriately) absent from the Cass Review recommendations: but this is because GRADE is a tool for CPGs and not designed for Reviews

4) Maybe you think the paper should have covered more ground, but that's not a red flag.

Ultimately this paper is part of the ongoing back-and-forth conversation between increasingly disconnected groups of researchers, and our job here is to summarise that conversation with due weight, not to submit our own entries in the debate.

Barnards.tar.gz (talk) 23:12, 15 October 2024 (UTC)

1) SEGM's affiliation does raise issues of WP:DUE, WP:FRINGE, and WP:INDEPENDENT

2) It said it's job was to situate the Yale report in it. It failed and presented a both-sides-ism between anti-LGBT lobbying groups and every major medical org.

3.2) The Cass Review says The research programme, led by the University of York, comprised appraisal of the published evidence and guidelines, an international survey and quantitative and qualitative research. A Clinical Expert Group (CEG) was established by the Review to help interpret the findings. The cass review repeatedly mentions this group, separately from the workshops and broader polls (see page 62-63). The red flag here is the BMJ's strawman, Yale never called for all those contributors, just the CEG, and the paper is misrepresenting who Yale is talking about. If BMJ said "how dare you ask for the CEG", that'd be a difference of opinion, them saying "you're asking for thousands of names" is nonsense.

3.3) Here, we compare the Review’s approach with one of the most widely accepted frameworks for determining evidence quality: Grading of Recommendations Assessment, Development and Evaluation (GRADE).1 and Clinical practice guidelines throughout medicine consider all relevant factors, but the Review takes the unusual step of elevating its own assessment of evidence quality above the considerations that guideline developers value. and The Review fixates on evidence quality to the exclusion of many other factors that are rigorously considered by the developers of clinical practice guidelines - Simply put, the Cass Review made recommendations for how trans kids should be treated clinically. They did the work of a CPG without the rigor is Yale's critique, and the papers defense is "it isn't officially a CPG so the unrigorous recommendations are fine".

4) Yale noted multiple false statements in the Cass Review. A paper supposedly dissecting it and defending the Cass review ignoring those is noteworthy. At a minimum, it means any attempts to downplay the false statements noted by Yale can't be done using this as some gotcha.

our job here is to summarise that conversation with due weight - a flawed paper co-authored by the head of a pro conversion therapy group attacking strawmen hardly seems due to me. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:56, 15 October 2024 (UTC)

@Barnards.tar.gz, the metadata for the BMJ article gives the date of acceptance, which is usually a good indicator that it's peer reviewed.

This source ticks all the boxes for the WP:MEDRS ideal. BTW, it looks like this would be a good moment to mention WP:MEDASSESS:

Here, "assess evidence quality" essentially means editors should determine the appropriate type of source and quality of publication. Respect the levels of evidence: Do not reject a higher-level source (e.g., a meta-analysis) in favor of a lower one (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source. Editors should not perform detailed academic peer review.

Things like whether one of the authors has been cancelled for holding a reprehensible POV, or that we think they ought to have mentioned a longer list of organizations, are not actually valid criteria according to MEDRS.

@Void if removed, have you considered a structure that is more topical? Like:

• Multiple centers: Cass recommends, and nobody cared (except maybe some non-London-based parents who will spend less time schlepping their kids halfway across the country to these appointments).
• Future research: Cass recommends, but This Group has some concerns about privacy.
• Puberty blockers: Cass discourages, and was roundly condemned by a long list, who in turn were criticized by That Group.

In other words, instead of having separate ==Findings== and ==Responses== sections, let's have multiple ==Content with responses== (sub)sections. WhatamIdoing (talk) 01:28, 16 October 2024 (UTC)

I just want to make clear that the alleged reprehensible POV is being part of an organisation that maintains the importance of exploratory psychotherapy, which the Cass Review makes explicitly clear is not conversion therapy, stating that it is harmful to conflate the two - indeed, one of the systemic failings identified was that clinicians were fearful of being accused of "conversion therapy" if they engaged in bog-standard exploratory psychotherapy, and so dumped their patients straight onto GIDS, further overloading the service. That this (IMO highly pertinent) perspective is not mentioned in the article on the subject is of course a subject of much discussion over many months. IMO, Wikipedia is not a reliable source, and the BMJ is.

As for restructuring - I think it is important to have the findings together, as they are all of a whole, and that lets the reader understand the scope and intent of the review. I think interspersing that with criticism is going to make it exceptionally hard to read what the report actually covered, especially given the interdependence of some findings and the criticism thereof. Inevitably, anything on blockers would balloon, but it overlaps with findings on desistence, mental health, social transition, reliability of international standards etc etc.

Perhaps another approach would be to keep findings as-is, have the immediate reception from the major bodies, then move implementation after reception, and have coarser implementation measures (blockers etc), along with criticism of those measures? Void if removed (talk) 08:33, 16 October 2024 (UTC)

I just want to make clear that the alleged "reprehensible POV" is the plain facts SEGM opposed bans on conversion, is known for spreading pseudoscience, has attempted to ban public healthcare for trans healthcare for all ages, and works with the conversion therapy groups like the American College of Pediatricians. RS point out SEGM is inseperable from Genspect, which has done all the same, but also operates a discord for how to put kids through conversion therapy. These are ridiculously FRINGE and trying to paint that as "they just support psychotherapy" is nonsense.

Your Sandbox link misrepresents sources and puts actual peer reviewed work next to opinion pieces from SEGM leaders and their primary sources. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:11, 16 October 2024 (UTC)

This is completely irrelevant to discussion of how to incorporate the response in the BMJ into the article on the Cass review; further attempts to argue about SEGM should be removed per WP:NOTFORUM. 212.36.63.7 (talk) 18:24, 16 October 2024 (UTC)

It’s not irrelevant, it’s interrogating a source. Being from an RS doesn’t make a source necessary reliable, and vetting sources is a fully reasonable thing for an editor to do. Snokalok (talk) 22:57, 16 October 2024 (UTC)

Interrogating a source is reasonable. Dismissing a peer-reviewed source in a top-tier medical journal by claiming it is WP:FRINGE is not though. Do you have a reason not to cite this? It seems to me to be significant and relevant, and higher quality than several other sources used on this page. Void if removed (talk) 09:42, 17 October 2024 (UTC)

Yes, all the reasons YFNS said and also the fact that responses to responses is something that I and several other editors don’t agree with for this article. The Wakefield study was peer reviewed and published in a top tier journal too, by the logic you’ve presented here that should be sufficient for inclusion. Snokalok (talk) 10:42, 17 October 2024 (UTC)

I knew someone would try the 'but Wakefield' line. I have no idea why it doesn't apply to sources like the Integrity Project or Horton which have even less standing, but which support the POV you want to push. If the BMJ has fucked up to that extent then there'll be plenty of RS coverage and an eventual retraction which we can definitely put in this page; until then, let's stick with established MEDRS rules. None of the reasons YFNS gave are remotely relevant to whether the source is reliable and due: point 1 is just irrelevant guilt-by-association; and 2-4 are an attempted debunking of the contents of the article, of no bearing here because YFNS' arguments on this talk page are not a WP:MEDRS. 212.36.63.7 (talk) 12:02, 17 October 2024 (UTC)

Horton is a poor example: A peer reviewed study published in the leading journal of trans healthcare that isn't mentioned anywhere in the article despite being cited by nearly every source criticizing the Cass Review. It is 4 times as due as the BMJ piece, and the only apparent reason for not including it is it doesn't support the POV some editors want to push :) Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 15:16, 17 October 2024 (UTC)

This isn’t even a research paper though, it’s an opinion piece by a freelance journalist Snokalok (talk) 11:33, 16 October 2024 (UTC)

You might be thinking of earlier investigation by Jennifer Block, the source currently under discussion is a peer-reviewed paper with five co-authors. Void if removed (talk) 12:01, 16 October 2024 (UTC)

Oh I see, my mistake Snokalok (talk) 22:54, 16 October 2024 (UTC)

I like your idea on the structure. I think that is also somewhat in line with the spirit of WP:CRITS, providing balanced treatment of each topic, rather than repeating the Cass POV in one section and all the criticism (and the criticism of that criticism etc.) in another section. -- Maddy from Celeste (WAVEDASH) 15:43, 16 October 2024 (UTC)

I also think this structure is better. Loki (talk) 15:57, 16 October 2024 (UTC)

I can't see that being a terribly useful article to the reader.

• The Cass review found x relating to puberty blockers
  • WPATH condemned this and said it was bad
  • Yale published a white paper saying it was bad
  • Someone got a letter to the editor published saying they read how the Yale paper said it was bad
  • Japanese guidelines referred to the Cass review and carried on prescribing blockers
• The Cass review found x relating to social transition
  • WPATH condemned this and said it was bad too
  • Yale published a white paper saying it was bad too
  • Someone got a letter to the editor published saying they read how the Yale paper said it was bad as well

And so on...

You can't separate these things out like that when they are all interrelated.

This is a recipe for an unreadable mess. Void if removed (talk) 16:02, 16 October 2024 (UTC)

Agree with @Void if removed. That will make it impossible to follow the Cass Review or what any of the others are saying about it. Zeno27 (talk) 17:54, 16 October 2024 (UTC)

@Zeno27, I'd like you to imagine a paragraph that says something like this (I'm making this up):

The Cass Review found that social transition should be approached cautiously, as if it were a behavioral intervention with potentially lasting effects. The Twitterverse ridiculed it for saying that haircuts were medical treatments that needed approval from a doctor. WPATH and Yale said it was bad and there's no evidence behind it.

Can you tell me how this make it difficult to figure out what the critics are saying about this part of the Cass Review? Do you really think that it's harder to find out what Cass said and what critics said when they're all in the same paragraph, instead of having one paragraph towards the top of the article that has the first sentence, and all the critics responses several screens lower in the article? WhatamIdoing (talk) 23:23, 19 October 2024 (UTC)

I will say that the way you've phrased that paragraph is maybe not the best example because it's currently unclear whether WPATH is criticizing Cass or the Twitterverse. Loki (talk) 23:29, 19 October 2024 (UTC)

My issue with presentation like that is the possibility of false balance, that is when (as in your example) what Cass is summarising is the findings of a systematic review. We wouldn't ordinarily present a MEDRS like that with people griping about hyperbolic misrepresentations of it on social media.

My other issue is the degree to which criticisms of the Cass Review are holistic: that is allegations of excluding evidence, cisnormative bias, involvement of allegedly FRINGE groups etc. These are criticisms that aren't simply point by point, they are levelled at the report as a whole and underpin all criticisms.

I think we're much better explaining what the report as a whole was about and give coverage to why people objected to it as a whole, because I think that really gets to the heart of a significant difference of opinion, which is (broadly):

• Cass approached this as children and young people experiencing gender-related distress, and how to alleviate that with a minimal harm approach
• Critics believe these are transgender children and young people, and that affirmation of that identity alleviates distress

Everything spins out of this difference of perspective, and I don't think reiterating it piecemeal throughout the review's findings capture quite how fundamental it is. When people object to Cass' findings and recommendations on social transition, or puberty blockers, or diagnostic overshadowing, or desistence, or exploratory therapy, that all stems from this different perspective. It is also exceptionally hard to talk about because of the strong social stigma associated with anything that even remotely looks like denying someone's identity - but from the critical perspective that's essentially the starting point of the Cass Review.

To navigate this requires looking at the same patient group from two entirely different and fundamentally incompatible perspectives and fairly rendering both positions neutrally. Void if removed (talk) 09:06, 20 October 2024 (UTC)

Also agree with @Void if removed. The actual findings and recommendations of the Review should be as clear as possible to the reader, and the best way to do that is keep them separate from other content. The ongoing political and scientific discussion of those findings and recommendations should be introduced separately, where all DUE and RS sources can be included. FirstPrimeOfApophis (talk) 19:28, 16 October 2024 (UTC)

I'm cautiously optimistic towards restructuring the article. Is there a ballpark estimate for the number of subsections required if we go with the content with responses-standard? Draken Bowser (talk) 18:14, 16 October 2024 (UTC)

SEGM's affiliation does raise issues of WP:DUE, WP:FRINGE, and WP:INDEPENDENT — Yes, it raises issues of how WP:FRINGE can possibly be applied to a peer-reviewed article in the BMJ because of affiliations of one of its authors. The policy simply cannot be applied here: peer-reviewed BMJ articles on gender medicine are part of mainstream gender medicine. If anything, SEGM's founder being published in this context is evidence against the organisation more broadly being treated as FRINGE. 212.36.63.7 (talk) 15:30, 16 October 2024 (UTC)

Lengthy analysis of the Cass Review in The Times, with coverage of this paper: https://www.thetimes.com/uk/healthcare/article/six-months-on-how-has-the-cass-review-reshaped-gender-medicine-cj33lsgnm

In an article published this week in the Archives of Disease in Childhood, a peer-reviewed British medical journal, a group of leading paediatricians identified a series of unfounded claims, misrepresentations and factual errors in the US paper that underpins the BMA’s stance. They found the McNamara paper was “tailored for the courtroom” and written with the “primary purpose” of supporting lawsuits in the US, where the issue of gender medicine remains bitterly divided along party political lines and is settled through legal action. It warned that doctors should not use the flawed paper to “jeopardise the implementation of crucial reforms” in the NHS. The lead author Dr Ronny Cheung, a paediatrician based in London, said the US report had been “very influential in swaying online discourse” and he was “very surprised” it was cited by the BMA, whose stance is at odds with the rest of the medical profession. “The overwhelming response from medical royal colleges, and politicians on both sides of the debate, has been to recognise the potential for the Cass Review to help us move things forward,” Cheung said. Cass welcomed moves to debunk the critiques of her report. She said it had been “frustrating” to see her report misrepresented, but that “it is heartening to see respected clinicians and academics now feel able to challenge the misinformation”.

Void if removed (talk) 08:58, 19 October 2024 (UTC)

Snokalok can you clarify why you have reverted this change https://en.wiki.x.io/w/index.php?title=Cass_Review&diff=1251696753&oldid=1251695385? "strong dispute" needs to be based on actual WP policies to be relevant, otherwise it is just WP:STONEWALLING. Please see Barnards.tar.gz and WhatamIdoing's detailed policy-based response to the supposed "red flags" above. FirstPrimeOfApophis (talk) 17:58, 17 October 2024 (UTC)

Omg my notifs are working again!

Anyway, the complaints are numerous and reasonable.

1. responses to responses are unnecessary and UNDUE (not capitalizing this to yell, just to highlight the policy) for the article.

2. The source is not INDEPENDENT and has affiliation with a FRINGE organization that pushes conversion therapy.

3. DUE weight is also called into question by the fact that we’ve already agreed to cut much more consequential papers on the Cass Review, such as Cal Horton, for reasonable reasons.

4. Whether MEDRS even applies to criticism here is tenuous, since this isn’t an article on puberty blockers, GAC, or anything else, it’s an article on a published document - and while the material of that document is biomedically-related, ultimately the subject of the article is the document itself. The Cass Review here is not being cited as a source on puberty blockers, it’s being cited as a source on the Cass Review. This is as much of a history article as it is anything else.

There is not a consensus that these issues are sufficiently mitigated, irrelevant, or overcome. I don’t even know if there’s a majority opinion, though that is certainly still a lower bar than a consensus. Thus, we shouldn’t be including it. We wouldn’t include the Wakefield study on a relevant article without consensus either. Snokalok (talk) 18:38, 17 October 2024 (UTC)

To clarify, what I meant by strong disputing is that like half the editors on this page are against its inclusion on valid grounds. Snokalok (talk) 18:41, 17 October 2024 (UTC)

A reminder that we're talking about a living person, that WP:BLP applies to talk pages, and that "pushes conversion therapy" is a strong claim.

Do you have a source for "pushes conversion therapy" that isn't self-published and doesn't boil down to claiming "exploratory therapy is conversion therapy"? Because - I repeat - the Cass Review says it isn't. Void if removed (talk) 21:51, 17 October 2024 (UTC)

The Cass Review is only one study, and the vast majority of sources say that SEGM pushes conversion therapy. Also, SEGM is an organization, not a person, living or otherwise. Loki (talk) 23:57, 17 October 2024 (UTC)

The Cass Review is only one study

The Cass Review is not a study, it is an independent review.

SEGM is an organization, not a person, living or otherwise

We are talking about the 5 co-authors of this paper, one of whom founded SEGM. I think we're in BLP territory if you want to exclude a MEDRS on the basis that one of the authors founded, in your words, an organisation that "pushes conversion therapy" Void if removed (talk) 07:53, 18 October 2024 (UTC)

I’m going to go through this point by point because there’s so much to unpack here.

1. BLP doesn’t apply to organizations, and the individual’s connection itself to SEGM (which is the only thing BLP would apply to here) is yet undisputed.

2. Since the point you’re disputing is whether SEGM as an organization pushes conversion therapy, let’s look at SEGM.

Copy pasted from the SEGM page

“In May, 2021, SEGM called for an amendment to the Canadian criminal code C-6, which outlawed conversion therapy, falsely claiming that conversion therapy can only be applied to lesbian, gay, and bisexual people as opposed to transgender people as well. This position is not supported by any major medical organization, which define conversion therapy as including efforts to change sexual orientation or gender identity.” Cited to Science-Based Medicine[1]

So already, we have a clear example of them pushing for anti-trans conversion therapy, regardless of specific techniques employed, to remain legal.

3. I’m also glad you agree already that SEGM pushes the specific technique of gender exploratory therapy, good, because GET is widely considered conversion therapy. Here’s a collective statement I pulled from the GET section of the conversion therapy page, by six major MEDORGS all specializing in trans care saying that GET is conversion therapy (see section 9)[2]

4. I don’t recall the Cass Report, which as I recall is not peer reviewed, ever saying such a thing. The most it said about gender exploratory therapy was that there was an unhelpful lack of clear definition for the terms “affirmative” and “exploratory” in a treatment context. But please, if I’m wrong, show me. Snokalok (talk) 07:29, 18 October 2024 (UTC)

six major MEDORGS all specializing in trans care saying that GET is conversion therapy

I'm glad you cited this, because that is WPATH's response to the Interim Cass review, calling the "psychotherapeutic" approach and "exploratory therapy" "tantamount to 'conversion'".

These were defined in both the Interim and final review as:

Therapeutic approaches that acknowledge the young person’s subjective gender experience, whilst also engaging in an open, curious, non-directive exploration of the meaning of a range of experiences that may connect to gender and broader self-identity (Bonfatto & Crasnow, 2018; Churcher Clarke & Spiliadis, 2019; Di Ceglie, 2009; Spiliadis, 2019)

I made this point to you back in June. So now we're all clear that the exploratory approach described in the Cass Review is the same thing as the what SEGM advance, and that Cass says is not conversion, and that it is harmful to compare the two. Void if removed (talk) 08:18, 18 October 2024 (UTC)

Alright, then we get a new problem - the fact that the Cass Review, while it does rely on systematic reviews, is not a systematic review itself, merely the opinion of an unknown list of individuals led by Hillary Cass without, to my knowledge, peer review. That does not make it particularly definitive; and it is not for the British government to unilaterally dictate what is and isn’t conversion therapy in contravention to the global field of trans health, as represented by the assortment of medorgs I cited above. The wider consensus of the global medical field remains that GET is conversion therapy, and may I repeat: SEGM has advocated for trans conversion therapy to remain legal regardless of whether it takes the form of GET or not. Snokalok (talk) 08:40, 18 October 2024 (UTC)

it is not for the British government

As I'm very tired of repeating, an independent review commissioned by NHSE is not the British government.

SEGM has advocated for trans conversion therapy to remain legal

That isn't what the sources say.

What they actually said in 2021 was:

In young people, gender dysphoria arises from a wide range of causes, often in complex developmental and family contexts (Churcher Clarke & Spiliadis, 2019; D’Angelo, 2020). Should Bill C-6 pass as written, it will effectively make it illegal to consider the role of developmental, family, and mental health issues in generating or contributing to a young person’s gender dysphoria. There is a very real risk that all forms of supportive and explorative psychotherapies for young patients who present with gender dysphoria will be classified as “conversion”.

And what the Cass Review said in 2024 was:

concerns were expressed about potential accusations of conversion practice when following an approach that would be considered normal clinical practice when working with other groups of children and young people. Throughout the Review, clinicians working with this population have expressed concerns about the interpretation of potential legislation on conversion practices and its impact on the practical challenges in providing professional support to gender-questioning young people. This has left some clinical staff fearful of accepting referrals of these children and young people. Clinical staff must not feel that discharging their clinical and professional responsibility may expose them to the risk of legal challenge, and strong safeguards must be built into any potential legislation on conversion practices to guard against this eventuality. This will be of paramount importance in building (as opposed to diminishing) the confidence of clinicians working in this area. Any ambiguity could serve to further disadvantage these children and young people rather than support them.

These are the exact same thing. Expressing concerns about the potential criminalisation of exploratory psychotherapy is not "pushing conversion therapy". Bearing in mind that what you're arguing is that a peer-reviewed source published in a well-respected medical journal should not be cited because you're claiming one of the five authors founded an organisation which pushes "conversion therapy", do you actually have a source for that which isn't based on the claim psychotherapy is conversion and isn't also blatantly applicable to the Cass Review itself? Void if removed (talk) 09:51, 18 October 2024 (UTC)

This discussion is irrelevant and distracting. You can't decide in a Talk page whether or not exploratory therapy is the same as conversion therapy, and it has no bearing on whether or not this source should be included. Please try to stay on topic and avoid WP:FORUM. 62.172.33.18 (talk) 13:28, 18 October 2024 (UTC)

Snokalok thanks for this.

1. responses to responses are unnecessary and UNDUE for the article.

From WP:DUE "Neutrality requires that mainspace articles and pages fairly represent all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in those sources. (The relative prominence of each viewpoint among Wikipedia editors or the general public is irrelevant and should not be considered.)" (my emphasis)

Neutrality is not negotiable; it is not for editors to make arbitrary decisions like "we'll include early responses but not later responses which respond to those early responses".

2. The source is not INDEPENDENT and has affiliation with a FRINGE organization that pushes conversion therapy.

One of the five authors is co-founder and senior adviser to SEGM. Is this what you are referring to? She is not the lead author or the peer reviewer. One of the authors being involved in advocacy is not sufficient conflict of interest to discard a reputable source, otherwise we would have to discard the Integrity Report white paper.

Also see WP:ALLOWEDBIAS "A neutral point of view should be achieved by balancing the bias in sources based on the weight of the opinion in reliable sources and not by excluding sources that do not conform to the editor's point of view."

Considering how badly the white paper fails WP:INDEPENDENT adding this countervailing and more reliable source is the best way to achieve NPOV.

WP:FRINGE refers to theories, not people or organisations. There are no fringe theories articulated in this source. Whatever the authors believe (or not) outside this source is not relevant to determining the validity of this source.

3. DUE weight is also called into question by the fact that we’ve already agreed to cut much more consequential papers on the Cass Review, such as Cal Horton, for reasonable reasons.

This is an argument about other sources, not this one.

4. Whether MEDRS even applies to criticism here is tenuous, since this isn’t an article on puberty blockers, GAC, or anything else, it’s an article on a published document - and while the material of that document is biomedically-related, ultimately the subject of the article is the document itself. The Cass Review here is not being cited as a source on puberty blockers, it’s being cited as a source on the Cass Review. This is as much of a history article as it is anything else.

I don't really understand this. Are you saying it should be excluded because it meets MEDRS?

There is not a consensus that these issues are sufficiently mitigated, irrelevant, or overcome. I don’t even know if there’s a majority opinion, though that is certainly still a lower bar than a consensus. Thus, we shouldn’t be including it.

Opposition to changes is only valid if it is based on genuine Wikipedia policies. See WP:JUSTDONTLIKEIT.

FirstPrimeOfApophis (talk) 07:27, 18 October 2024 (UTC)

1. Yes, all significant viewpoints in proportion to their prominence. What is the prominence in the field of these criticisms of criticisms of criticisms? Has their been some manor surge in citations that would make this paper stand out in the field? What is paper’s significance, even, as a criticism of a criticism of a criticism? If Yale University and this group of researchers go back and forth in a locked room for centuries on end, shall we meticulously record every blow exchanged? Responses to responses are due I’d argue when they’re the Cass Review team or Cass herself responding to criticisms of their work, they are not due when it’s random people chiming in because then where does it end?

2. If an organization’s entire purpose is advocating for fringe theories, then it’s reasonable to say that the organization itself falls under fringe. Likewise, I notice you consider Yale biased for, reasons that aren’t clear. Certainly SEGM has a compelling interest in the furtherance of a biased goal, but what biased goal - what lack of independence - does the Yale group have that needs to be balanced? A look at their website says their only concern is scientific rigor as it applies to pieces of research which may affect policy. I see no bias in this org that needs to be balanced.

3. And? We’re applying our policies evenly, are we not?

4. No, I’m saying that whether or not the hierarchy of MEDRS is an applicable argument to begin with here is debatable.

5. You have your policy based arguments, other editors on this page have theirs which they’ve already stated, but at the end of the day, no matter how invalid you think other editors’ arguments are or how answered by your points they are, you don’t have consensus, and per WP:SATISFY, no one is obligated to satisfy you. Snokalok (talk) 07:48, 18 October 2024 (UTC)

You seem to think 'consensus' means that you get to veto the inclusion of this source no matter the majority opposing you. I'm afraid that's not how it works, and I would really appreciate it if you'd read the writing on the wall before I have to waste hours of my life writing up a complaint to the administrators about your extremely blatant POV pushing. 212.36.63.7 (talk) 13:12, 18 October 2024 (UTC)

No, consensus means not having half the thread against inclusion. But please, if you find that problematic, ask ANI, and you can explain how it’s not just me that’s challenging the inclusion of this source, it’s @LokiTheLiar, @Your Friendly Neighborhood Sociologist, @Usr Trj, @LunaHasArrived and I *think* @Maddy from Celeste(?) - none of whom are obligated to satisfy you simply because you don’t find their reasons for opposing inclusion to be good enough.

I’m not the only one vetoing inclusion. I’m just the one you’re arguing with right now. If it was just me, you’d have consensus since consensus doesn’t mean unanimous, but it isn’t. By my measure it’s about half the editors in this thread. But please, if you believe that to still be an issue, I invite you to ask ANI. Snokalok (talk) 13:47, 18 October 2024 (UTC)

I'll say I echo snokalok here and am especially concerned about including criticisms of criticisms. I would also say the Void should probably stop pushing for this article being included as it cites his substack (which strikes me as a minor COI and he should have mentioned). LunaHasArrived (talk) 13:58, 18 October 2024 (UTC)

Wait were you in this thread already or am I misremembering? Either way, I didn’t know about the COI but that feels really significant Snokalok (talk) 14:18, 18 October 2024 (UTC)

I've not been in this thread before (been in others surrounding). The Coi should probably have been disclosed (perhaps void should edit the first comment in this topic and insert it) and as I said, Void should probably stop pushing for inclusion. LunaHasArrived (talk) 14:32, 18 October 2024 (UTC)

Yes, you are 'misremembering'. Of the five people you mentioned only one, YFNS, expressed any opposition to the inclusion of the source in the thread or in the page edit history. 212.36.63.7 (talk) 14:33, 18 October 2024 (UTC)

I don't really have an opinion on the inclusion of the source, as I haven't looked into this besides just skimming this thread. I would, however, caution about using words like found here as it may imply accuracy and thus skew the POV. -- Maddy from Celeste (WAVEDASH) 14:02, 18 October 2024 (UTC)

Snokalok it looks like we will be moving to other forms of dispute resolution, but since you took the time to respond I ought to reply.

1. Yes, all significant viewpoints in proportion to their prominence. What is the prominence in the field of these criticisms of criticisms of criticisms? Has their been some manor surge in citations that would make this paper stand out in the field?

Where does "prominence in the field" come from? It is "...published by reliable sources, in proportion to the prominence of each viewpoint in those sources." The reliable source here is Cheung et al, an article published in a peer-reviewed medical journal, basically the highest level of RS on Wikipedia. The viewpoint is "the Integrity Project white paper misrepresented the role and process of the Cass Review, and its methodological criticism of Cass and the Yorkshire systematic reviews were unfounded." Whether or not you agree with that viewpoint, do you accept that that wording is proportionate to its prominence in the source in question?

What is paper’s significance, even, as a criticism of a criticism of a criticism?

It is significant because it was published in a peer-reviewed scientific journal. It is also significant as a response to Cass in its own right, because it examines the background, methodology, recommendations and implementation of the Review. Also AFAIK it is the only peer-reviewed published response to the Cass Review Final Report (maybe another editor can correct me on that?) so the views expressed therein are significant by default.

If Yale University and this group of researchers go back and forth in a locked room for centuries on end, shall we meticulously record every blow exchanged? Responses to responses are due I’d argue when they’re the Cass Review team or Cass herself responding to criticisms of their work, they are not due when it’s random people chiming in because then where does it end?

It ends when new significant viewpoints stop being published in reliable sources. Your comparison with a history article in point 4 above is apt. There are new significant viewpoints on historical events published in RS millennia after they took place. There is no arbitrary time-limit on a DUE source and editors cannot impose one of their own. Obviously, later sources will often be phrased as responses to earlier ones, that's normal scholarship.

2. If an organization’s entire purpose is advocating for fringe theories, then it’s reasonable to say that the organization itself falls under fringe.

It may be reasonable if you are using the word "fringe" in another context. WP:FRINGE refers to theories, not people or organisations. Anyway, it's a moot point, because SEGM hasn't published this article or contributed significantly to its preparation.

Likewise, I notice you consider Yale biased for, reasons that aren’t clear. Certainly SEGM has a compelling interest in the furtherance of a biased goal, but what biased goal - what lack of independence - does the Yale group have that needs to be balanced?

I am surprised you ask, because it is addressed prominently in Cheung et al:

"On the same day the paper was published on The Integrity Project website which is hosted by Yale Law School, a version of it was introduced into evidence in a landmark US legal case in which the lead author served as an expert witness. Another iteration has been submitted by the same author group to a Supreme Court case in the USA...Several of the McNamara et al coauthors have served and continue to serve as paid expert witnesses, so far in more than a dozen ongoing court cases over the practice of regulation of youth gender medicine, where they oppose the state bans on medical and surgical gender transition treatments. Various versions of McNamara et al have already been introduced into evidence in at least two high-profile court cases." (my emphasis)

From WP:IIS "An independent source is a source that has no vested interest in a given Wikipedia topic and therefore is commonly expected to cover the topic from a disinterested perspective. Independent sources have editorial independence (advertisers do not dictate content) and no conflicts of interest (there is no potential for personal, financial, or political gain to be made from the existence of the publication). Interest in a topic becomes vested when the source (the author, the publisher, etc.) develops any financial or legal relationship to the topic. "

A look at their website says their only concern is scientific rigor as it applies to pieces of research which may affect policy. I see no bias in this org that needs to be balanced.

Hopefully you can see why this is not a good way to gauge an organisation's bias.

3. And? We’re applying our policies evenly, are we not?

My point is, the Horton article was excluded for different reasons to the ones you are giving for excluding Cheung et al. They are unrelated.

4. No, I’m saying that whether or not the hierarchy of MEDRS is an applicable argument to begin with here is debatable.

I am not trying to be obtuse, but I still don't understand how this supports excluding Cheung et al.

FirstPrimeOfApophis (talk) 17:55, 18 October 2024 (UTC)

2.1) The founder of SEGM was one of the authors so I'm not sure how you got SEGM hasn't "contributed significantly to its preparation."

2.2) This circles back to my original red flag #2: Those bans are opposed by every major medical organization in the United States, and are only supported by anti-LGBT lobbying groups. For example, here's the APA[3], and here's the Endocrine Society, American Medical Association, American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American Society for Reproductive Medicine, the American College of Physicians, and the American Association of Clinical Endocrinology[4], opposing these bans and saying As political attacks on gender-affirming care escalate, it is the responsibility of the medical community to speak out in support of evidence-based care.

- The BMJ piece takes issue with an organization following the advice of every major medical organization in the U.S., and tries to paint it as "transgender advocacy groups" vs states. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:45, 18 October 2024 (UTC)

SEGM's involvement is not relevant. You keep bringing them up so you can allege this makes the BMJ source WP:FRINGE, even though as a published peer-reviewed review article in a top medical journal it is part of the academic consensus used to determine which views are mainstream and which are fringe. Frank Forfolk (talk) 13:19, 19 October 2024 (UTC)

It certainly is relevant, or at least it can be relevant. If we were talking about a study over at race and intelligence, and it came out that one of the authors was a founder of the Pioneer Fund, that would be extremely relevant even if the study was peer reviewed and published in a mainstream journal.

Does it overwhelm everything else? No, and I'll admit that being peer reviewed in a mainstream journal certainly does count for something, but the dodgy authorship combined with the fact that it goes against the recommendation of most WP:MEDORGs suggests that we're at least in WP:FRINGE/ALT territory. Loki (talk) 20:21, 19 October 2024 (UTC)

That is an outrageous comparison. You're comparing literal Nazi eugenicists to one named co-author of a paper in a top medical journal. Void if removed (talk) 20:38, 19 October 2024 (UTC)

We quite simply are not. This is a matter of legitimate controversy among reliable sources, with a range of credible positions in WP:MEDRS, none of which can be called ‘fringe’ for disagreeing with a strong consensus that does not exist. WP:FRINGE is there to keep homeopaths and climate deniers from trying to sneak false balance into articles; it is not there for editors to dismiss high-tier MEDRS, concurring with top-tier MEDRS, that they don’t like, and simply reading the actual guidelines makes it obvious why they don’t apply here. Scholarly opinion is generally the most authoritative source to identify the mainstream view, and this is a weighty scholarly opinion. Frank Forfolk (talk) 21:08, 19 October 2024 (UTC)

I tend to agree with Loki here. The comparison with the Pioneer Fund hypothetical might not be exact, but it's a reasonable analogy. XOR'easter (talk) 00:41, 20 October 2024 (UTC)

I really don’t think it is. Can you point to any policy or guideline that would support treating this as anything other than a high quality WP:MEDRS because one secondary author out of five is affiliated with an alleged (with vigorous disagreement, going by the SEGM talkpage) fringe group? Frank Forfolk (talk) 03:49, 20 October 2024 (UTC)

WP:FRINGE/WP:PROFRINGE. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 04:22, 20 October 2024 (UTC)

Yes, that is also why literally just yesterday/today, a discussion at the Village pump (Wikipedia:Village_pump_(policy)#RfC_on_reform_of_WP:FTN,_WP:FRINGE) re-affirmed why we have strong anti-fringe policy on Wikipedia.

The WP:GENSEX CTOP area sees its fair share of fringe theories, this is not just for homeopaths or climate deniers.

Fringe people, such as authors involved in this paper, do publish papers to try to make their position appear less fringe, but that's where strong eyes are needed to discern things such as this. Raladic (talk) 05:46, 20 October 2024 (UTC)

So you can tell this has fringe authors (plural) because you have "strong eyes"? Do those who disagree have weak eyes? Void if removed (talk) 07:09, 20 October 2024 (UTC)

Do you have a source for that? Void if removed (talk) 07:02, 20 October 2024 (UTC)

In this discussion I see hyper-fixation on one co-author's affiliation, and near-zero consideration of the other 80% of co-authors. The lead author, Dr. (C.) Ronny Cheung, is/was an National Institute for Health and Care Excellence advisor, and was appointed Officer of Health Services at the Royal College of Paediatrics and Child Health[5]. Elaine Lockhardt is Chair of the Royal College of Psychiatrists' Child and Adolescent Faculty.[6]. Ian K. Maconochie, among other qualfications, is a Fellow of the Royal College of Paediatrics and Child Health, Fellow of the American College of Emergency Physicians. Camilla C. Kingdon is a former president of the Royal College of Paediatrics and Child Health. These are qualified pediatric researchers, not minor players or grad students authoring a white paper. Dismissing all of these authors, published in a well regarded peer-reviewed journal, based on guilt-by-association or dislike of their view (even if it's a minority view in some circles), is nothing more than ideological gate-keeping. I do share the wariness of tedious "response to response to response" play-by-play, that are more likely to confuse than educate readers (remember, we should be writing for a global general audience, not merely to amuse ourselves or show a teacher how good we are at finding sources), and there is discussion to be had about how much weight this and other papers should receive, but if nothing else, this paper can be used to assess due weight to give to other views. And, bad-faith Wakefield comparisons aside, I will place editorial decisions of Archives of Disease in Childhood high above the opinions of any Wikipedian (even those who might agree with me). Ours is not to do the jobs of journal editors or even journalists, ours is to summarize significant views in reliable sources in proportion to the prominence of those views, even opinionated, biased, or disagreeable views. --Animalparty! (talk) 01:40, 27 October 2024 (UTC)

Straw poll on inclusion

Since the actual numbers here have become a matter of some dispute, can we actually separate the issues of how to include the source (i.e. how to structure the page to minimise recursive response bloat) with whether the source is reliable and due, in principle. To my mind, productive discussion on the former broke down in the face of highly contentious discussion about the latter. Frank Forfolk (talk) 15:17, 18 October 2024 (UTC)

"The source" is:

• Cheung, C. Ronny; Abbruzzese, Evgenia; Lockhart, Elaine; Maconochie, Ian K.; Kingdon, Camilla C. (2024-10-14). "Gender medicine and the Cass Review: why medicine and the law make poor bedfellows". Archives of Disease in Childhood (Review). doi:10.1136/archdischild-2024-327994. ISSN 0003-9888. PMID 39401844.

WhatamIdoing (talk) 23:49, 19 October 2024 (UTC)

Include

1. If we're going to have a paragraph describing the claims made by the Integrity Project white paper then I think it would be negligent not to provide readers with a sentence's worth of context letting them know that a WP:MEDRS strongly criticised those claims. Nobody in this thread has given credible arguments against the review being a MEDRS. Frank Forfolk (talk) 15:17, 18 October 2024 (UTC)
2. It's obviously eligible in the sense that it is a MEDRS. The more interesting question is what is the proposed text that uses it as a source. Barnards.tar.gz (talk) 11:58, 19 October 2024 (UTC)
3. Yes, of course. It's a review article in a major medical journal, thus a top-shelf WP:MEDRS. And it is specifically relevant to the topic of this article. Arguments to exclude don't appear to be based on Wikipedia policy, which does not have provisions for personal "peer-review" and negation of sources, or say anything about responses-to-responses. I suggest turning this into a proper WP:RFC and notifying WP:MED; I think further arguing amongst the existing participants will be a waste of time. Crossroads ^-talk- 22:08, 19 October 2024 (UTC)

   I definitely think getting outside eyes on this is the right approach. Frank Forfolk (talk) 11:45, 20 October 2024 (UTC)

4. I support Flounder fillet's revised text, for reasons given here and here. I also agree with Crossroads wrt opening an RFC. FirstPrimeOfApophis (talk) 06:34, 20 October 2024 (UTC)
5. Inlcude, with care. As I've stated above, 4 out of 5 co-authors are well-regarded pediatricians & psychiatrists. And even if all 5 were card-carrying members of SEGM, it wouldn't make a lick of difference, as all are independent of the CASS review, and being "non-neutral" is a red-herring anyway: per WP:BIASEDSOURCES, reliable sources are allowed to be biased and/or non-neutral. Per WP:SCHOLARSHIP, WP:BESTSOURCES, and WP:MEDRS, a peer-reviewed science article in a reputable journal beats the pants off a non-peer-reviewed white paper, and so should help determine WP:DUEWEIGHT to devote to various opinions. --Animalparty! (talk) 20:36, 27 October 2024 (UTC)

Exclude

1. The connection to SEGM is suspicious enough for me to not support inclusion yet, at a minimum. Loki (talk) 20:50, 18 October 2024 (UTC)
2. I second this. Usr Trj (talk) 07:40, 19 October 2024 (UTC)
3. Exclude both for SEGM reasons and because responses to responses. Snokalok (talk) 14:00, 19 October 2024 (UTC)
4. ++, we're scraping the bottom of the barrel if we're turning to SEGM for defenses of the review, and we don't need endless responses. Moreover, I find it interesting that multiple include voters oppose comparable sources critical of the review. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 03:45, 20 October 2024 (UTC)
5. I read the discussions above and feel that given the source interrogation presented by YFNS (here) leaves a lot to doubt about the source's quality. That said, much of the discussion concerned WP:MEDRS and WP:MEDASSESS in relation to WP:FRINGE and WP:DUE. I think the participants at WP:MED would be the natural next step for seeking input. I also did not see a detailed proposal as to the content for it were included, but I saw several proposals for how it could be weaved together onto what is currently on the page, which seems like putting the cart before the horse. Relm (talk) 10:08, 21 October 2024 (UTC)
6. Per the very in-depth analysis of the source by @Your Friendly Neighborhood Sociologist and it's lack of WP:INDEPENDENCE at the related thread at Wikipedia:Reliable_sources/Noticeboard#c-Your_Friendly_Neighborhood_Sociologist-20241027153200-FirstPrimeOfApophis-20241026093400. Raladic (talk) 20:44, 27 October 2024 (UTC)

Discussion

So an entirely new account made this straw poll as their first edit? Huh, interesting, that. Silverseren^C 15:22, 18 October 2024 (UTC)

I'm Special:Contributions/212.36.63.7, apologies for not making that obvious. I have a lot on my plate right now. Frank Forfolk (talk) 15:33, 18 October 2024 (UTC)

• @Relm: We are here to discuss the source’s reliability, not whether we personally think it is correct. This should be done by applying WP:MEDRS guidelines. YFNS’ disputations of the claims made in the source are WP:OR and have no bearing on its reliability. Frank Forfolk (talk) 12:18, 21 October 2024 (UTC)

  Per WP:OR

  This policy does not apply to talk pages and other pages which evaluate article content and sources, such as deletion discussions or policy noticeboards. Snokalok (talk) 12:25, 21 October 2024 (UTC)

  Right, but that just says it’s okay to post it. Excluding an RS from article space based on OR is still using OR to determine the content of article space. Frank Forfolk (talk) 12:31, 21 October 2024 (UTC)

  That's not really how it works, because most of how we even make a determination of whether a source is RS is based on OR. Alpha3031 (t • c) 12:42, 21 October 2024 (UTC)

  Surely that applies to determining the reliability of the source — who published it, where, the reputation of that source for accuracy — not its factual accuracy. The only challenge to the former is the SEGM stuff which has its own problems, the rest of YFNS’ ‘interrogation’ is just quoting bits from the source and saying ‘no, wrong’. But YFNS posting on a talkpage is not an RS, and while I admit I’m using common sense reasoning here, the principle behind sourcing and verifiability is that we leave it for RSes to determine what’s true, on Wikipedia we just summarise it (and if RSes vigorously disagree, as in this case, we describe that without taking sides). It seems obvious that OR applies in principle to negative claims (‘an RS says this, but here’s why it’s wrong, so we exclude it’) as to positive claims (‘no RS says this, but here’s why it’s right, let me put it in the article’). I hope I’m making sense here. Frank Forfolk (talk) 13:09, 21 October 2024 (UTC)

  If you open the edit dialog on WP:RSN, you should see an editnotice that says "The reliability of a source depends on its context. Please supply the source, the article it is used in, and the claim it supports." That is because whether a source is considered reliable for a claim depends on the claim being made. Alpha3031 (t • c) 13:37, 21 October 2024 (UTC)

  Okay but the context here is a top-shelf MEDRS directly addressing criticisms of the professional methodology of a major independent medical review and series of studies. It’s one of the best sources you could possibly have in this context. Frank Forfolk (talk) 13:46, 21 October 2024 (UTC)

  That's the source. We also need the statement being made. Alpha3031 (t • c) 14:08, 21 October 2024 (UTC)

  Well what about literally just ‘this review in the BMJ said that the Cass review and York studies were methodologically sound, disputing other sources saying otherwise’. We can’t even get something like that into the article at the moment. Frank Forfolk (talk) 14:47, 21 October 2024 (UTC)

  Sure, that's a proposed wording. Now, if someone inserted that into an article I was watching, I'd probably ask "which other sources". Alpha3031 (t • c) 15:00, 21 October 2024 (UTC)

  I mean this is the actual wording that got reverted. Frank Forfolk (talk) 16:49, 21 October 2024 (UTC)

  And do you not see the problem with this wording? It presents a paper with serious neutrality and independence concerns and which objectively mischaracterizes both the Cass Review and the criticism of such, as being a definitive shut down of any and all criticism broadly construed. This is exactly why we evaluate our sources on an individual basis. Snokalok (talk) 18:45, 21 October 2024 (UTC)

  And I would argue that everything you just said applies to the Yale white paper far more than the BMJ review, which is why when two RS disagree we should summarise what each says rather than trying to decide on the talk page which one is correct. Frank Forfolk (talk) 21:50, 21 October 2024 (UTC)

  And as said previously, what issues of independence and neutrality does Yale University have? Snokalok (talk) 03:34, 22 October 2024 (UTC)

  You’re right, the non-peer-reviewed source where several authors are acting as paid witnesses in court cases the paper was written to support has no independence concerns whatsoever. Frank Forfolk (talk) 04:23, 22 October 2024 (UTC)

  Frank, I'm inclined to agree with Snokalok for this specific wording. See MOS:SAID, for reference, but the degree of certainty expressed would not be appropriate with a single source, even if accepted for the sake of argument that source was much higher quality. Alpha3031 (t • c) 00:49, 22 October 2024 (UTC)

  One thing that needs to be noted is that reliability depends on the context it is used for (see WP:RSCONTEXT, WP:SOURCE). I have not read the earlier discussion fully, and am not sure I will, but there are certainly cases where normally sufficient sources should not be used. It is thus difficult to divorce the appropriateness of using a source from how that source is used. Alpha3031 (t • c) 12:28, 21 October 2024 (UTC)

• @Raladic: Just to be clear, you're placing the opinion of one Wikipedian over the peer-reviewed editorial judgment of a reliable scholarly journal. Like amateur Wikipedans know science better than the science journals themselves? --Animalparty! (talk) 21:42, 27 October 2024 (UTC)

  There is no need to rehash things in multiple places. I stand by the comment that I trust YFNS's assessment of the article.

  Peer-review looks at whether a paper is suitable for publication. It doesn't make them unimpeachable, nor necessarily right.

  This content space has seen a lot of misinformation, much of it pushed by fringe groups including by publishing bad papers. So just blindly ignoring the partial authorship involvement of a group designated as an anti-trans hate group is not going to serve our purpose of maintaining a NPOV and thus, contextual analysis as done by YFNS can help us get better pictures of a particular source. Raladic (talk) 22:12, 27 October 2024 (UTC)

  (EC) We routinely judge and discard poor studies, peer-reviewed or not. That is the basis of WP:FRINGE and our determination of the strength of a study, its contributors, and its overall merits. That is just common practice on science-related topics and has been for years, if not decades, on Wikipedia. Silverseren^C 22:14, 27 October 2024 (UTC)

Response bloat

As time has moved on, what were "responses" to the Cass Review upon its publication are increasingly more broad effects and impacts. Citations to it in guidelines. Commentary in opinion pieces. This is getting unwieldy.

I think we need to start restructuring into immediate, direct responses, and subsequent impact (domestically and internationally) on guidelines like the Japanese ones which are more "contextual", and the Australian review of services.

I suggest citing this BMJ investigation from May (which for some reason we aren't) which very explicitly notes the difference in reception between the UK and the US, and this places into context the polarised responses.

So something like:

• Reception (containing some of what's there already, but only the actual immediate direct reception
• Subsequent impact (for eg. the creation of a review into adult services, the impact on services in Scotland etc) with an international section, which can contain the Japanese and Australian content, which aren't really "responses" but "things that happened after, in the context of the cass review's findings"
• Further commentary (noting the divisions between the US/UK per the BMJ piece, notable opinion pieces etc)

I think there's space for some of the more subjective commentary, but cramming it all into "responses" is not aiding the reader, or balancing it well. Void if removed (talk) 09:29, 8 October 2024 (UTC)

I didn't think it was that bloated or hard to read. However, it seems misleading to say the Cass Review had an impact on the Japanese guidelines and the Australian review of services. The Japanese guidelines continued to recommend puberty suppression and seemingly dismissed it's relevance to Japan by calling it "specific to the unique situation in the UK" and the review of Australian services was rejected and so nothing really changed. I think both of these fit better in the response section. Usr Trj (talk) 10:24, 8 October 2024 (UTC)

They aren't a "response to cass" is my point. They are things that happened after, taking cass into consideration. The more time passes and the more we try and cram into "responses" the worse it is going to get.

Many things in "responses" are very clear statements in response.

Others aren't, but could go in a different section just fine. Void if removed (talk) 10:33, 8 October 2024 (UTC)

Then maybe you should've called the section "Aftermath" or something else instead. Using the word "Impact" implies that the Cass Review had a notable influence on Australia and Japan and led to notable changes in those countries, which it hasn't. Usr Trj (talk) 10:54, 8 October 2024 (UTC)

I'm not sure I agree, the section being "impact" can also be used to highlight notable points of lack of impact IMO. Aftermath sounds a bit dramatic to me, what about just "influence"? Or "Subsequent events"? Void if removed (talk) 11:26, 8 October 2024 (UTC)

"Subsequent events" will probably be confusing. People might expect to find (e.g.,) information about when new programs were opened, or if there was a follow-up report. WhatamIdoing (talk) 04:21, 9 October 2024 (UTC)

Sure - that was where I was originally hoping to put the material about adult services review etc. These aren't directly about the cass review, but are things that happened as a result. I'm trying to draw a line under the most significant direct responses and create somewhere else in this article that can be expanded with relevant but less directly responsive material. I'm out of synonyms though. "Later developments"? "Outcomes"? Void if removed (talk) 08:27, 9 October 2024 (UTC)

Also, I think the interviews with Cass that you moved to "Further Commentary" fit much better under the "Hilary Cass's response" section as they were previously, since Cass was directly responding to criticism in them. Usr Trj (talk) 10:29, 8 October 2024 (UTC)

Hilary Cass published extensive reflections on the review a month ago. Right now, there is nowhere for these to go, but they are certainly due. I hope that by starting this section with some of her comments it can be expanded with this. Void if removed (talk) 10:35, 8 October 2024 (UTC)

I don’t think it’s helpful to the reader to separate the responses like this, it makes them read the reception section and think those are the only responses. Snokalok (talk) 12:24, 8 October 2024 (UTC)

The point is to separate immediate, direct, PR type reactions like RCGPs and WPATH's from longer term, more contextual outcomes and influences like the adult services review. How about "initial reception" instead of "reception"? Void if removed (talk) 12:45, 8 October 2024 (UTC)

I’m not opposed to considering the idea but where do you draw the line? Snokalok (talk) 12:48, 8 October 2024 (UTC)

I draw the line at, basically, the direct responses we currently have from major orgs (or anything simliar to that which happens to come along, though it seems unlikely at this late stage).

I think the Japanese guidelines are too vaguely connected - nothing says they are a "response" to Cass (which is why I object to their inclusion at all in that current section). They don't describe it as such themselves, and it doesn't even really contain a response to Cass, merely describing it. However, it is clear they are a "response" to a changing context, with The Cass Review and WPATH butting heads making it reasonable to reissue service guidelines that make it clear what it all means for clinicians there. I think that is a sort of "second wave" wider impact sort of thing (as is the review of adult services, NHS Scotland etc).

IMO, if it is a press release explicitly stating "here's what we think of the Cass Review" its a response. Anything vaguer than that (rejected calls for a similar review in Australia) to me feel like a second order effect - and the advantage is that something structured like that can grow without cluttering up the more immediate responses. The more that gets added there, the harder it is a for a reader to grok the timeline, frankly. Every future international guideline that cites the Cass Review (whether endorsing or rejecting it) could be relevant in that sort of section. Void if removed (talk) 13:36, 8 October 2024 (UTC)

I’d be okay with sections labeled “Early reception” and “Later reception” Snokalok (talk) 14:21, 8 October 2024 (UTC)

Yes I think that's preferred rather than this completely separate section that's now below.

Also regarding the line @Void if removed is trying to draw - that's not how the medical community works - reception in medical papers is done through discussion and citing of them within a new separate paper - it is still inherently reception.

So I think with that, @Snokalok's suggestion to split it into early and later works better if you're concerned about timeline. Raladic (talk) 14:55, 8 October 2024 (UTC)

I think you'll want to reconsider your claim. If it's true that "reception in medical papers is done through discussion and citing of them within a new separate paper", then none of the self-published press releases we're citing should be considered True™ Responses, and perhaps they should all be removed.

(Sure, it's an Argument from consequences, but I suspect you won't like the consequences of your claim.) WhatamIdoing (talk) 04:24, 9 October 2024 (UTC)

Add the word "often" to the sentence ..reception in medical papers is often done through discussion and citing.. if we must quibble about words.

I think it was clear what I meant to say, which was only in response to VIR's point that if something doesn't explicitly says "here's what we think of the Cass Review" then it's not a response, which isn't how stuff is commonly addressed in published papers and I didn't say that only peer-reviewed responses are responses, just that a common way of mentioning something in citation and discussing it in papers and that such a mention still constitutes a response. Basically, the inverse of what you are implying, VIR was saying that papers that are not explicitly titled "response to Cass" are not a response, which is what I tried to refute. Raladic (talk) 04:47, 9 October 2024 (UTC)

@Raladic, I'm not sure exactly what kind of source you're talking about. Which of these two categories sounds closest to the mistake that we need to avoid?

• Cass Review gets published, and ____ puts out a press release to say that Cass got some facts wrong: Science by press release.
• Cass Review gets published, and ____ publishes a paper about trans teens that never mentions the Cass Review by name, but Wikipedia editors decide that this paper is a response to the Cass Review (because the subject matter overlaps, and the entire trans-healthcare profession, at least insofar as this can be determined from social media, is thinking of nothing else, so obviously any publication post hoc is indisputably ergo propter hoc): Wikipedia:No original research violation.

WhatamIdoing (talk) 18:34, 9 October 2024 (UTC)

So what counts as "early"? What counts as "later"?

The line I'm trying to draw is the difference between essentially breaking, reactive responses, and considered, down the line impacts/incorporation/rejection of actual findings.

That's more of a qualitative split, though it becomes somewhat temporal by necessity.

For example, the BMA's response is, IMO, is a "response" - but it isn't an early one because it took them months to actually state it. Void if removed (talk) 15:10, 8 October 2024 (UTC)

Actually I just took a look at what the responses are, and what we have is scientific responses, published by the scientific community, and we have some advocacy organization responses.

So I just took another stab to separate it like that, as well as to address the timeline issue, I actually found after reading the paragraphs that all that was needed was adding dates to some of the early in April one to make it clear those were immediately following the release and the new later responses already mostly had the dates and I added a few where I felt it was useful to readers without having to open the ref.

I also kept Cass's individul personal responses in her section, rather than having them split up across different sections, to make it clear that those are her individual personal opinions as a person, rather than in an official capacity of the review itself. Raladic (talk) 15:14, 8 October 2024 (UTC)

We went over that before - they aren't "scientific responses". Most of them are comments in popular journalistic sources, and the Yale white paper is not a scientific publication. Old section title was least bad consensus. Void if removed (talk) 15:21, 8 October 2024 (UTC)

They are scientific responses by medical and legal scholars, many of them published in peer reviewed journals, which is how the scientific community operates.

In any case, I renamed it into academic, which is irrefutably accurate. Raladic (talk) 15:26, 8 October 2024 (UTC)

I mean, you say "many of them published in peer reviewed journals", but only two in this section are published in journals, and at least one of those citations isn't peer-reviewed, and probably neither. So, in the first sentence:

The report was praised by some academics in the UK, who agreed with its findings stating a lack of evidence; while others both in the UK and internationally disagreed with the report's methodology and findings.

None of the citations here are peer-reviewed, even Abbasi's editorial in the BMJ, and aside from that one these are just comments in popular press so it doesn't justify this title. The Yale white paper isn't peer-reviewed either. This latest commentary probably isn't, it is hard to say for sure, I think it is at the editor's discretion at JAH?

(I really think that this latest commentary would be better under a "further commentary" section - it is commentary on the commentary as much as anything, noting the other responses. And that is the sort of section that can be expanded with other perspectives, illustrating the different points of view. There will be other academic works providing commentary and perspectives beyond simply a straightforward "response")

And the "advocacy organizations" title doesn't fit with the EHRC (who are not an advocacy org, but a regulator). Also, minor, but "organisations" please. TBH I would happily lose that entire section at this point, there's plenty of better material now, surely WP:NOTEVERYTHING... Void if removed (talk) 16:09, 8 October 2024 (UTC)

They are still academic responses. As I said, some are peer reviewed, but nonetheless, even others such as the Yale white paper were still drafted by academics with academic citing and all.

The same for the latest, which was published in a journal and it didn’t just reference the other responses, it also specifically cited the existing evidence that does exist and is the basis why gender affirming puberty blockers for transgender youth is still used in most of the world outside the U.K.

As for advocacy organizations as a title, I carefully considered it and actually checked the charter of the EHRc before I made that title and they are also that The Commission has responsibility for the promotion and enforcement of equality and non-discrimination laws in England, Scotland and Wales… Promotion is advocacy, so aside from also being tasked with enforcement, they are also tasked with promotion, which is advocacy, so as a banner it is appropriate. Raladic (talk) 16:24, 8 October 2024 (UTC)

No, this is wrong - advocacy groups seek to influence and bring about political change. The EHRC is an independent body set up by the UK government to reflect and enforce existing law and policy. There are quite significant differences between lobbying and pressure groups and a regulator like the EHRC, and this title misrepresents that. I disagree with your interpretation of "promotion" as making them the same thing, when they are not.

some are peer reviewed

I think by "some" it is "at most one, and possibly none". This sort of thing is why it was compromised to "assorted", so as not to mislead the reader into thinking these opinions had a more academic stamp than they actually do. Void if removed (talk) 17:00, 8 October 2024 (UTC)

I didn’t call the section advocacy groups, it was titled organization.

In any case, this easy to solve since we already had other UK government bodies further up from the NHS response, so I moved it up there and renamed it into UK government bodies to accurately group it. Raladic (talk) 19:24, 8 October 2024 (UTC)

It's not a government agency. It is an independent regulator.

Again, all these details are why we had "assorted", which was fine. Void if removed (talk) 19:29, 8 October 2024 (UTC)

It’s a Non-departmental public body, which is a very U.K. specific thing.

You have to remember that we write Wikipedia for a global audience, so I renamed the section to include the word public bodies now and specifically linked to the Non-departmental public body for the EHRC, which is helpful for readers who want to understand that they are a public body that is still accountable to parliament, but not directly part of the government as you pointed out. But they are still vested with their power through the county’s respective legal framework, just as most other National human rights institutions are to be able to actually enforce the charter they are tasked with. Raladic (talk) 19:45, 8 October 2024 (UTC)

Aside from the retitling - which is inaccurate and confusing still - there was a logic to the organisation of responses which this now breaks.

Previously, the responses flowed in decreasing order of importance.

1. Political responses. The immediate acceptance of the Cass Review across the political spectrum was hugely significant for an issue that is still deeply politically polarised in the US for example, and sits above the national health service, which the gov ultimately controls.

2. Health services. As the implementers of the review's recommendations, these responses were paramount.

3. UK medical bodies. As the bodies responsible for training and accrediting doctors, these responses again would affect how well-accepted the review was within the UK medical community.

4. International medical orgs. No direct influence on implementation, but a huge impact on how this was received by the broader medical community (will other countries follow suit, or will the UK be isolated?), and may have an impact over the long term

5. Others. Basically notable interesting but not directly impactful responses.

The EHRC fits into this latter category. Its opinion is interesting but utterly unimportant to the actual implementation of the review.

The way you've restructured it doesn't follow this flow, and also misrepresents the response of health services as government responses.

The previous title and order was absolutely fine, and EHRC being dumped under "assorted" was not a problem, so I don't know why you're insisting on retitling this section confusingly and cumbersomely in order to justify it. Void if removed (talk) 08:22, 9 October 2024 (UTC)

The addition of the recent Mermaids charity commission result to the UK political responses section makes absolutely clear this bloated Response section needs trimming down.

I've moved it to a "Further developments" section and retitled "Reception" to "Initial reception".

I propose also moving to this section everything that is not a timely (say, 3-4 months) and direct actual response to the Cass Review (of the form eg. we welcome/we reject the Cass Review). I suggest relocating:

• The updated Japanese guidelines (not a direct response, later)
• The commentary in JAH (later)
• The NIE extension to the ban on blockers (not a direct response, later)
• The RANZCP rejection of an enquiry (not a direct response)

It can be liberally expanded this way for ongoing commentary and continuing political fallout, but it is overstuffed and unmanagable right now and we can devote more space for these things without disrupting the description of the initial reception. Some of these elements could be used to start their own subsection on eg. Academic commentary etc. Void if removed (talk) 08:55, 25 October 2024 (UTC)

I strongly oppose relocating the Japanese guidelines and the RANZCP rejection of an enquiry. People who want this information are going to go to the "Response from other health bodies globally" section and if there are responses from other global health bodies in other sections, the "Response from other health bodies globally" section becomes pointless and could mislead readers who read only one section into thinking that's all there is. It would also be confusing as it would make readers go all over different sections of the article just to read responses from other global health bodies. For the convenience of the reader, all of these responses from global health bodies should be kept together regardless of whether it's a direct response or not. 2601:483:802:7420:E173:D4CA:97B1:E9B9 (talk) 10:52, 25 October 2024 (UTC)

I second everything said here. Snokalok (talk) 15:16, 26 October 2024 (UTC)

Receptions in the medical world often take time, particularly when they are in the form of published papers or policy changes so I don't think that timeline thing serves anybody as the IP editor above pointed out.

If the response is a reception of the Cass Review, no matter the time since the review, it belongs in the appropriate section of those that we have, which are grouped by their type of reception.

Else likely we'd just have each of those sub-sections twice over time, which doesn't serve encyclopedic value other than being an arbitrary time break.

Also, we already have the Cass_Review#Subsequent_events so the new "Further developments" section you just created makes no sense as Further developments can be seen as synonymous with Subsequent events, so if anything, the charity commission note should be moved there, but the Reception section and all the other receptions that address the Cass Review should stay in it, without renaming of the section. Raladic (talk) 14:34, 25 October 2024 (UTC)

I've renamed it to "wider clinical impact" as it (right now) covers NHSS, blockers and the adult services review. Also moved those after the initial reception.

Seriously don't see why we can't use a "further developments" section as a starting point to grow beyond simply "responses". There is plenty that can be added here. Void if removed (talk) 16:08, 25 October 2024 (UTC)

A "wider clinical impact" would be if the scope of it expands broadly worldwide outside of what the original scope was, which was a review to inform the local UK government policies on transgender youth healthcare, but right now, it appears that the review is widely criticized worldwide, so we have a "narrow clinical impact" by the UK government departments that ordered the review, namely the UK NHS and other UK government bodies.

We don't use WP:CRYSTALBALL's for titling sections, so right now we have receptions, some from the UK, many worldwide which are that.

And separately, we have action by various UK government departments and bodies as a result of the Cass Review, as would be expected if a government orders a document to inform its local government policies. Raladic (talk) 17:12, 25 October 2024 (UTC)

As well as being clumsily-worded, Raladic's section title "Subsequent government actions in the UK" is inaccurate. The UK Government does not set clinical policy for NHS England or NHS Scotland or direct the findings of Charity Commission inquiries.

A "wider clinical impact" would be if the scope of it expands broadly worldwide outside of what the original scope was No, "wider clinical impact" is any impact on clinical practice outside of youth gender services in NHS England, which was the scope of the Review. So adult gender services, NHS Scotland are "wider clinical impact". There is no reasonable interpretation of "wider" that means only "worldwide".

The problem with "wider clinical impact" as a section title is that it includes the ban on puberty blockers, which was a change in regulation rather than clinical practice.

I will change the section title to "Wider impact". FirstPrimeOfApophis (talk) 08:29, 26 October 2024 (UTC)

I mean, the NHS is an arm of the government though. Like objectively speaking, they are an arm of the British government. That’s the entire point of being a public sector entity.

You can certainly debate the level of influence other sections of the British government can and might exert regarding politically contentious healthcare topics, but the fact is, the NHS is objectively a government entity. Snokalok (talk) 15:30, 26 October 2024 (UTC)

Like objectively speaking, "arm of the British government" is a meaningless phrase, and the independence of NHS England, NHS Scotland and the Charities Commission from government interference is a matter of UK law, not "debate". FirstPrimeOfApophis (talk) 16:33, 26 October 2024 (UTC)

First line of Charity Commission for England and Wales: The Charity Commission for England and Wales is a non-ministerial department of His Majesty's Government.

First line of NHS England: NHS England, formerly the NHS Commissioning Board for England, is an executive non-departmental public body of the Department of Health and Social Care. which itself: The Department of Health and Social Care (DHSC) is a ministerial department of the Government of the United Kingdom. - further The Secretary of State publishes annually a document known as the NHS mandate which specifies the objectives which the Board should seek to achieve - so yes, the UK government does set the NHS mandate.

I don't know how you are seriously arguing that they are not part of the wider UK Government.

So now that we have cleared that up, please self-revert the section title since that section summarizes the actions of the various arms of the UK's government, be they "public bodies" or other sub-sidiaries of the ministries. Raladic (talk) 17:10, 26 October 2024 (UTC)

This is just confusing language. Actions taken by bodies like the Charity Commission, the NHS, and the EHRC are not actions by the UK Government. Void if removed (talk) 19:12, 26 October 2024 (UTC)

Again, as we've now proven above, they are.

If you need a convenient list of the Departments of the Government of the United Kingdom, here you go.

Government, or more specifically, the Government of the United Kingdom isn't just the prime minister, it's the governing of the country and is often done so with some separation of power, but it is nonetheless the government of the country. Raladic (talk) 19:23, 26 October 2024 (UTC)

If by proven you mean repeat then sure. Attributing the actions of the Charity Commission to the government of the day is incredibly confusing to anyone in the UK. The CC is an independent body accountable to government and government interference in it's decision making would be seen as highly improper.

https://www.gov.uk/government/publications/charity-commission-governance-framework/governance-framework

The Commission is, by law, independent from ministerial influence or control over its day-to-day operations and decision-making. The Charities Act 2011 (‘the Act’) section 13 (4), states that: ‘In the exercise of its functions, the Commission shall not be subject to the direction or control of any Minister of the Crown or other government department.’

You're just wrong about this. Please revert this incorrect info and DROPTHESTICK. Void if removed (talk) 09:36, 27 October 2024 (UTC)

The NHS is inarguably part of the UK government. I wonder if this is a difference between American and UK English here, where you're using government to mean the party in power, because this seems quite inarguable to me.

The Federal Reserve is part of the US government even though it's very insulated from the President. Similarly no matter how independent the NHS is, it's very clearly part of the UK government. Parliament approves its budget and its expenses are paid by UK taxes. Loki (talk) 16:50, 27 October 2024 (UTC)

You're right that it is a difference between American and British/Commonwealth use of "government", although I'm less sure how you have decided the American use is "inarguably" right for an article on a UK topic describing the UK government? We use "government" to essentially mean the members of the Cabinet, whose powers over other public bodies can be quite limited. According to this article, a comparable term in US English might be the (presidential) "administration". Just as it would not be accurate to describe a decision made by the Federal Reserve tomorrow as an "action" of the Biden Administration, so it is not right to describe the clinical decisions of NHS England as actions of the UK Government. FirstPrimeOfApophis (talk) 20:40, 28 October 2024 (UTC)

In that case: I agree that the NHS is not part of the Starmer administration (or for that matter, part of the Johnson, May, or Sunak administrations), but that's not what anyone here was saying when they said the NHS was part of the government.

The issue here is that there isn't really a better word in UK English for what we're talking about. Loki (talk) 20:00, 31 October 2024 (UTC)