Talk:World Professional Association for Transgender Health

Reversion of objective edit

Raladic, you reverted my addition of important criticism of this organization from 2 very reliable sources, The Economist and The New York Times. In particular, The Economist describes how WPATH leaders interfered with the production of systematic reviews that they had commissioned from Johns Hopkins University. Also, both The Economist and NYT report that WPATH removed minimum ages for the treatment of children under the pressure from Dr. Rachel Levine. [1] [2] [3] These are not some fringe sources, but well respected publications. You wrote that there is a consensus not to include this information. Could you please explain where the consensus was reached not to include into this particular article the information about the John Hopkins story and WPATH being criticized for developing recommendations under pressure from an official? Regarding WP:CRITS essay, which is not a rule, we can incorporate the above information under a different title or make it part of another section of the article. It does not mean that notable criticism should not be mentioned in the article. Sean Waltz O'Connell (talk) 06:53, 13 August 2024 (UTC)

You may read previous discussions in the archives. Keep in mind one of Wikipedia's core policies of WP:NOTNEWS and as it appears, the Economist piece was not picked up by any other reliable source, so it doesn't appear to have had enduring notability and thus is undue for inclusion.

Further, as I already stated in the reversion as well, some of this criticism on age centers on the Standards of Care, which is a publication from WPATH, and so the content (if due) belongs there. And you will find the discussion around age is already included in the article there in the SOC8 section. Raladic (talk) 15:25, 13 August 2024 (UTC)

Thank you for your response.

I reviewed the discussions in the archives but couldn’t find any previous mention of the Johns Hopkins story. It’s also worth noting that The Economist article has been referenced and discussed by several other mainstream media outlets, indicating its notability.

For example, an op-ed in The Washington Post directly cites the Economist article:

"Last week, The Economist reported that other documents unsealed in the Alabama case suggest something has gone wrong at WPATH itself, which reportedly commissioned evidence reviews from Johns Hopkins University, then tried to meddle with the result. Internal communications suggest that research should be 'thoroughly scrutinized to ensure that publication does not negatively affect the provision of transgender health care in the broadest sense.' Now, assuming this is true, I’m sure WPATH sincerely believed it was doing its best for gender-dysphoric kids. But such meddling makes it harder to find out whether the group is right about that."

[4]

Similarly, an op-ed from The New York Times notes:

"The World Professional Association for Transgender Health... blocked publication of a Johns Hopkins systematic review it had commissioned that also found scant evidence in favor of the gender-affirming approach. Recently released emails show that WPATH leaders told researchers that their work should 'not negatively affect the provision of transgender health care in the broadest sense.'"

[5]

While op-eds aren’t used as primary sources in Wikipedia articles, the fact that this story has garnered attention from The Washington Post, The New York Times, and The Guardian highlights its significance:

"Evidence has since emerged suggesting that WPATH actually tried to suppress the systematic reviews that it commissioned from Johns Hopkins University because the results undermined its preferred approach... WPATH was pressured by the Biden administration to remove minimum ages for treatment from its 2022 standards of care."

[The Guardian, August 2024 - https://www.theguardian.com/commentisfree/article/2024/aug/04/bma-stance-on-puberty-blockers-defies-first-principle-of-medicine-first-do-no-harm-cass-review]

Furthermore, The New York Sun also covered the story:

"Wpath wielded a heavy hand after it in 2018 commissioned from evidence-based medicine experts at Johns Hopkins University a series of systematic literature reviews... After some of the Hopkins teams’ findings raised concerns among Wpath leadership that they might 'negatively affect the provision of transgender health care,' Wpath compromised the independence of the Hopkins researchers."

[6]

Given this widespread coverage, it seems inaccurate to claim that The Economist article lacks enduring notability, as the information provided by the Economist article has been referenced or discussed by several other mainstream media outlets, indicating its notability.

Regarding the age limits, the information that WPATH removed these under political pressure was not available during the discussions on this page in early June 2024. Therefore, there couldn’t have been a consensus against including information that wasn’t known at the time. The key issue here is not the appropriateness of the age limits but rather that WPATH’s decisions may have been influenced by political pressure, a concern reported by both The Economist and The New York Times. Sean Waltz O'Connell (talk) 06:14, 16 August 2024 (UTC)

As you said yourself and are aware, we generally discount opinion pieces, especially when it appears that the authors may have an agenda that has been called out before, as for the Guardian article (who itself has a strong anti-trans bias, there has been discussions of starting a RSN for its reliability on the topic), it cites SEGM on this, a known anti-trans hate group as tracked by the Southern Poverty Law Center, so we take that reporting with a large grain of salt as those motivations are very questionable.

So, it looks like it may be a concerted smear campaign effort by transphobic groups, which is why it appears not have been picked up by more neutral news organizations and thus is WP:UNDUE at this point in time as enduring notability of it is questionable and Wikipedia is WP:NOTNEWS. Raladic (talk) 16:25, 16 August 2024 (UTC)

Opinion pieces were cited not in order to be used in the article, but to show that the information provided by the Economist was picked up by other mainstream media, who dedicated space to its discussion. "Smear campaign" is your personal, subjective opinion. So far no serious source accused the Economist and NYT of engaging in a smear campaign on this topic. It is highly unlikely that liberal news outlets such as WP, NYT or the Guardian could be accused of anti-trans bias. Especially since there is little to no ideological incentive for such a news outlet to do so. Objective criticism can only be considered biased, if the one making the presumption is doing so through a subjective lens. And neutral reporting requires presentation of all points of view, that is what a professional reporter would do. However I do not see that the Guardian cited SEGM, it only linked to a repost of the Economist article at the SEGM website, maybe because the original Economist article is paywalled. The Economist and NYT are highly respected news outlets, known for fact checking and accuracy, and are listed as generally reliable at WP:RSP. If the information got so much attention in the mainstream media, it shows the enduring notability, and it seems clear that WP:UNDUE doesn't apply here. Sean Waltz O'Connell (talk) 09:12, 17 August 2024 (UTC)

If there are no further objections or valid concerns to address, I will proceed with reinstating the deleted information to the article. Sean Waltz O'Connell (talk) 08:05, 20 August 2024 (UTC)

I have objected, with our policy-based reasoning for why it is undue. Opinion pieces are not "picked up by other mainstream media", especially not when the authors have questionable motives as I explained. Also yes, the Guardian did cite SEGM as that is what they linked to for the part you're trying to add, and SEGM is not RS. You questioning above that "maybe because its paywalled" is WP:OR and irrelevant, they cited it to SEGM.

And per WP:RSOPINION, opinion pieces are not generally reliable because they usually do not get fact checked by the newspaper, they just get published, so they can not be used for statements of facts.

It appears this is your first time editing a WP:Contentious topic, I have just placed an introduction of what that mean on your talk page. Note that on contentious topics, special extra care has to be taken, with strict adherence to our policies, which again, as I explained means that this piece is WP:UNDUE due to the policies already cited as wikipedia is WP:NOTNEWS. Raladic (talk) 15:19, 20 August 2024 (UTC)

Note to other editors, this was taken by the other user to Wikipedia:Neutral point of view/Noticeboard#World Professional Association for Transgender Health where it was found similarly undue by several editors for a variety of policy-based reasons. Raladic (talk) 18:08, 26 August 2024 (UTC)

The truth is it was dismissed by several editors that argue that anything that doesn’t agree with their preconceived notions as opinion and undue. The articles were not opinions. The editors are biased. I can’t recall a single time they’ve allowed anything that doesn’t align with what they think transgender medicine should be. If you look at their bios, they have personal reasons for squelching any conversation. It doesn’t do Wikipedia any good to have such blatant bias. PerseusMeredith (talk) 23:55, 26 August 2024 (UTC)

If you want to argue, bring it up on WP:NPOVN and answer the specific points. Until then, Raladic probably has their way. Bluethricecreamman (talk) 23:58, 26 August 2024 (UTC)

Friendly reminder not to attack other editors by casting aspersions.

If you have policy based arguments on the specific article, you may bring them at the notice board that I linked, but otherwise please refrain from accusing editors of bias. Raladic (talk) 00:28, 27 August 2024 (UTC)

I think this clearly should be included. Any other page, the NY Times and Economist articles would be enough to include a reference. This is whitewashing. PerseusMeredith (talk) 17:41, 26 August 2024 (UTC)

If I'm not mistaken, sources like The Economist and The New York Times are listed as credible by Wikipedia, why cant information from said sources be used in this article?--JonJ937 (talk) 13:00, 4 September 2024 (UTC)

you really don't understand why? wikipedia organzational capture. People with a bias label everything else a bias. 24.63.3.107 (talk) 15:42, 1 November 2024 (UTC)

The Economist has a long history of false reporting on trans issues. I don't think its appropriate to cite them as a source. HenrikHolen (talk) 15:21, 7 November 2024 (UTC)

This presumption is unfounded on this platform. The reliability of The Economist is well-established, since it was confirmed at WP:RSPSS, where it’s listed as a reliable source, including on trans-related topics, following broad community consensus in an RFC: [7] This designation affirms that the source meets Wikipedia's standards (as a reputable source). Sean Waltz O'Connell (talk) 10:47, 8 November 2024 (UTC)

In light of this ongoing topic of conversation, kindly, draw attention to the subject of recent controversies involving the organization referenced, which has been highlighted in the British medical Journal (BMJ), a well-regarded, peer-reviewed publication in the medical field... The British Medical Journal, has brought attention to recent dissension involving WPATH (refer to source):[8]. According to the BMJ report, there are significant concerns about WPATH's involvement with research findings from Johns Hopkins University, suggesting attempts to influence the direction or content of these reports. Given this high-profile coverage, alongside the previous sources mentioned addressing similar issues above; it seems essential to include this information to present a nuanced view of the organization's activities and create a balanced article review Parker.Josh (talk) 12:33, 2 November 2024 (UTC)

Just a note about the BMJ article, it was commissioned by the journal but it was externally peer reviewed before publication. Only mentioning it since it was kind of hard to find on the website. Dr vulpes (Talk) 23:57, 2 November 2024 (UTC)

Thanks for the information. BMJ is certainly another well-respected source, besides the Economist, that covers the John Hopkins reviews related controversy. I believe there can be no policy based objections to inclusion of this information. Sean Waltz O'Connell (talk) 12:06, 5 November 2024 (UTC)

We don't just looks at where something is published, but also the who. The fact that the author of that article is an activist with a COI and thus failing WP:INDEPENDENT clause of WP:RS. Refer to the discussion at Talk:Cass_Review#BMJ_Investigations_article for another recent article by the same author.

The article you referenced cites SEGM, a group known for pushing WP:FRINGE theories, so the credibility of this article is questionable. Raladic (talk) 15:32, 5 November 2024 (UTC)

These are not valid objections. I don't see any reliable independent source calling the author an activist. You need very good sources for such strong claims, not personal websites of some activists. If you can refute that, please provide a reputable citation in lieu of conjecture.

BMJ is a well-respected scholarly source, and the article in question is peer-reviewed. There is no rule that would invalidate a respected source for interviewing members of a certain organization. Objective journalism requires the presentation of all existing opinions, and SEGM is an important organization whose opinion is quoted pretty much by every source covering the subject. For example, NYT and Associated Press also quote SEGM, that does not mean that those sources are not reliable. In addition to the Economist and BMJ, highly reliable sources, there is another scholarly source that covers this issue. I provide below the relevant quote:

Article 36 (children should be protected from any activities that could harm their development) raises the same concerns as Article 33. All these considerations have become even more relevant after information, made public through a current U.S. court case, has shown that WPATH, in following its rights-based approach, actively suppressed the publication of evidence-based information pertaining to medical interventions for gender dysphoria (Exhibit 167) (Boe v. Marshall, 2024; Economist, 2024). After receiving the results of the systematic reviews that WPATH commissioned Johns Hopkins University researchers to conduct, WPATH leadership became “painfully aware that there are many gaps in research to back up our recommendations” (Exhibit 190, page 9) (Boe v. Marshall, 2024) for children and adolescents in WPATH 8 guidelines (Coleman et al., 2022). The Johns Hopkins researchers reached out to U.S. federal authorities, noting that “we have been having issues with the sponsor (WPATH) trying to restrict our ability to publish” and that “we found little to no evidence about children and adolescents” (Exhibit 173, page 23).

Kozlowska, K., Ambler, G. R., Dechêne, S., Almaraz Almaraz, M. C., Eliacheff, C., Entwistle, K., Esteva de Antonio, I., Gómez Gil, E., Hofman, P., Hunter, P., Kaltiala, R., Koener, B., Landén, M., Ledrait, A., Maguire, A. M., Masson, C., O’Malley, S., Raven, M., Ryan, H., … Scher, S. (2024). Evolving national guidelines for the treatment of children and adolescents with gender dysphoria: International perspectives. Human Systems, 0(0). [9] Sean Waltz O'Connell (talk) 14:33, 6 November 2024 (UTC)

According to GLADD, the UKS LGBT doctor's union, the author's previously published work presents "one-sided and harmful narratives about trans people in the UK", engages in "selective citing of aspects of the review", compares "gender-affirming care to gay conversion therapy in the 1950s" which "is incorrect and deeply offensive to the LGBTQ+ community" (not supported by any major medical organization in the world), "wrongfully pathologised trans identities as an illness or undesirable, a disappointing misrepresentation of who people are."[10]

The BMA's deputy council chair stated "We have recently written to the BMJ, which is editorially independent, to challenge its article “Gender dysphoria in young people is rising—and so is professional disagreement” and express our concern, that alongside criticisms made by LGTBQ+ organisations such as GLADD and neurodivergent doctors, in our view, it lacks equality, diversity and inclusion awareness and patient voice. That the article has been used by transphobic lobby groups around the world is of particular concern to us."[11]

The RCS England Pride in Surgery Forum, a group of LGBTQ+ individuals in the field, wrote "The article on gender dysphoria in young people by Jennifer Block (1) would appear at first inspection to offer an evidence-based review. However, the assertions made are in some cases unsupported by reference, and in others are based on only some of the available evidence. ... Suffice it to say that this ‘investigation’ does not report evenly on the available evidence."[12]

This is concerning and does not point towards the reliability of the source. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:34, 6 November 2024 (UTC)

Given that the article can't give a consistent number of systematic reviews that John Hopkins published (stating 1 and 2 at different parts of the article) and that previous articles have gotten basic facts wrong (like the age of institutions). Given that the author also fails to disclose that Gordon Guyatt has been paid by SEGM to complete systematic reviews (highly relevant to the article given that it mentions SEGM and their systematic reviews and uses lots from SEGM) I really struggle to see why we should treat this particular peice as a rs despite where it comes from. LunaHasArrived (talk) 18:49, 6 November 2024 (UTC)

It says that there was one paper published after 2020, the 2021 meta data analysis. What is the other one? The articles are based on court documents from John Hopkins itself. PerseusMeredith (talk) 21:31, 6 November 2024 (UTC)

The article says nothing about "after 2020". There was another one [13] published in September 2020 (after the dispute that was complained about in August 2020). The article also describes the SEGM systematic reviews as forthcoming when one [14] was published on the 10 of September (over a month before the bmj article). Either way the biggest problem is failing to note Gordon Guyatt's obvious connection to SEGM. These problems mean I can't trust this article to provide accurate or relevant information. LunaHasArrived (talk) 10:33, 7 November 2024 (UTC)

Advocacy groups do not qualify as reliable sources and cannot be used to challenge the reliability of genuinely credible sources, especially peer-reviewed scholarly publications. It’s also worth noting that the BMA itself is under significant criticism regarding its position on this issue, including from some of its own members: [15] [16].

The BMJ report states that two Johns Hopkins reviews were published, with only one published following the dispute with WPATH, who reportedly attempted to prevent its release. The Economist corroborates this: 'The Hopkins team published only one paper after WPATH implemented its new policy: a 2021 meta-analysis on the effects of hormone therapy on transgender people.' Thus, there is no contradiction.

We now have three reliable sources referencing the Johns Hopkins reviews: BMJ, The Economist, and a group of international scholars noted above. This story has received wide coverage in mainstream media, with numerous op-eds examining the implications. The evidence presented is based on publicly available court documents—primary sources that we cannot interpret directly, but which have been analyzed by three secondary sources, including two peer-reviewed scholarly ones. Our role here is not to perform original analysis but to accurately reflect what reliable sources state, and we now have ample, reputable sources to support this information for inclusion per Wikipedia rules. Sean Waltz O'Connell (talk) 11:14, 7 November 2024 (UTC)

It's notable that the economist definitely is misreporting here, it states the policy was implemented in august 2020 and this other review was published in September 2020 that 2 sources get this wrong and state this contradiction does not strengthen their position. As well as this the economist definitely is wrong when they state "more than six years after signing the agreement, the EPC team does not appear to have published anything else" with the Economist having only referred to one Published document in the article. Our role as editors does definitely include OR on talk pages to see whether Sources have made mistakes. LunaHasArrived (talk) 12:59, 7 November 2024 (UTC)

No, you're reading far too much into this, and this level of "fact-checking" is way beyond.

What the BMJ piece says:

The SOC8 update began in 2018, when WPATH commissioned systematic reviews from a team at Johns Hopkins University, Baltimore. Over the next few years that team “completed and submitted a number of reviews to the WPATH SOC8 Chairs and Chapters,” said a March 2023 email exclusively obtained by The BMJ through a public records request. But the process didn’t go smoothly, and just two manuscripts were published: one on the impact of hormones on mental health and another on prolactin levels in trans women taking oestrogen

No date limits here, just talking about the process as a whole. The "prolactin" paper was published in September 2020.

Now what the Economist says:

After wpath leaders saw two manuscripts submitted for review in July 2020, however, the parties’ disagreements flared up again. In August the WPATH executive committee wrote to Ms Robinson that WPATH had “many concerns” about these papers, and that it was implementing a new policy in which WPATH would have authority to influence the EPC team’s output—including the power to nip papers in the bud on the basis of their conclusions. Ms Robinson protested that the new policy did not reflect the contract she had signed and violated basic principles of unfettered scientific inquiry she had emphasised repeatedly in her dealings with WPATH. The Hopkins team published only one paper after WPATH implemented its new policy: a 2021 meta-analysis on the effects of hormone therapy on transgender people.

This timeline and number of papers is not in any sort of factual disagreement. So, JH submitted 2 manuscripts for review in July (we don't know which ones), this triggered a disagreement, they wrote in August to indicate that they were implementing a new policy, but we don't know when that took effect because sending an email saying you're going to do something isn't the same as doing it. Especially as the BMJ says:

WPATH sent an update to Robinson and all SOC8 coauthors in October 2020 stating, “It is paramount that any publication based on the WPATH SOC8 data is thoroughly scrutinized and reviewed to ensure that publication does not negatively affect the provision of transgender healthcare in the broadest sense.”

So it is clear this is ongoing wrangling that kicked off in July, and was not settled for months. It is totally sensible to read this that the prolactin paper was already reviewed (possibly one of the two July manuscripts submitted) and went out in September while WPATH and JH were still wrangling over the sign-off policy, and then JH only published one more review after the new policy came into effect.

You're quibbling over alleged inconsistencies in a timeline where no such inconsistencies necessarily exist, and this is in absolutely no way enough of a basis to exclude a source. Void if removed (talk) 13:54, 7 November 2024 (UTC)

Since noone pointed it out yet, this BMJ piece is investigative journalism from the BMJ investigations unit and thus WP:PRIMARY. Flounder fillet (talk) 20:44, 8 November 2024 (UTC)

No it isn't, it is secondary. It's giving information about the primary sources, which is the emails etc uncovered in discovery. Void if removed (talk) 00:02, 9 November 2024 (UTC)

Investigative journalism is defined as primary by policy according to WP:PRIMARYNEWS. Flounder fillet (talk) 05:01, 9 November 2024 (UTC)

Where the journalist is reporting on their own experiences. Void if removed (talk) 08:19, 9 November 2024 (UTC)

The location WP:PRIMARYNEWS links to simply mentions "investigative reports". Flounder fillet (talk) 20:42, 9 November 2024 (UTC)

The rule does not say that every investigative report is a primary source. It cites as an example "The journalist goes undercover and reports their experiences." That clearly is not the situation with BMJ. Also, BMJ is not a newspaper, it is a peer reviewed scholarly journal. JonJ937 (talk) 13:12, 11 November 2024 (UTC)

The essay at WP:PRIMARYNEWS does in fact state the following:

Investigative reports [end of header] The journalist goes undercover and reports their experiences. The journalist meets with people and reads documents to uncover corruption. (Defined as a primary source by policy.)

Where "by policy" links to WP:NOR#defs, which states:

Further examples of primary sources include: archeological artifacts; census results; video or transcripts of surveillance, public hearings, etc.; investigative reports; trial/litigation in any country (including material – which relates to either the trial or to any of the parties involved in the trial – published/authored by any involved party, before, during or after the trial); editorials, op-eds, columns, blogs, and other opinion pieces, including (depending on context) reviews and interviews (see Wikipedia:Reliable sources § News organizations); tabulated results of surveys or questionnaires; original philosophical works; religious scripture; medieval and ancient works, even if they cite earlier known or lost writings; tomb plaques and gravestones; and artistic and fictional works such as poems, scripts, screenplays, novels, motion pictures, videos, and television programs. For definitions of primary sources:[...]

Flounder fillet (talk) 21:55, 11 November 2024 (UTC)

Again, this rule does not say that every investigative report is a primary source. It is about situations where a journalist reports their personal experiences, like going undercover, etc. In that case their account would be a primary source. That is the exact situation cited as an example. It is not the same with peer reviewed scholarly journals that share their own analysis, which clearly qualify as secondary sources. JonJ937 (talk) 10:36, 12 November 2024 (UTC)

The example is a part of an explanatory essay(WP:USEPRIMARY) about the WP:NOR policy. The "rule" here is the second thing I quoted, and it simply states "investigative reports", presumably for some good reason. Flounder fillet (talk) 16:55, 12 November 2024 (UTC)

From my point of view, there is no valid reason to dismiss this incident or the reliable sources reporting on it.

When you consider respected publications like The Economist, BMJ, and the scholarly journal articles cited, it’s hard to argue that these sources are anything but credible. The incident in question has been verified by a sufficient number of independent outlets, solidifying its authenticity.

Given this strong corroboration, there is no doubt about the event’s occurrence, particularly since this information was not challenged by any other credible sources.

As noted previously by users, our role here is not to offer personal interpretations but to relay the facts as presented by the reliable sources available. Parker.Josh (talk)

The continued coverage of this, including now in a peer-reviewed journal, makes it untenable not to include any mention at all. However, I think the thing worth mentioning is the organisation trying to restrict publication of the systematic reviews, not the bit about changing the age limit. I also don't think a standalone Criticism section is best practice; rather, we should amend the Standards of Care section first paragraph to something like this (new part in bold):

WPATH released Version 8, the latest edition, in 2022; it is ,which it described as being based upon a “more rigorous and methodological evidence-based approach than previous versions.” Critics have questioned the evidential integrity of the standards, suggesting that WPATH attempted to prevent the publication of systematic reviews that may "negatively affect the provision of transgender healthcare in the broadest sense".

Barnards.tar.gz (talk) 12:07, 9 November 2024 (UTC)

I agree that given the coverage in reliable sources, it’s important to include information about the Johns Hopkins reviews, and your suggestion to incorporate it within the SOC8 discussion rather than as a standalone section seems sound. For full context, though, adding more specific details about these reviews could enhance clarity. Reliable sources indicate that WPATH commissioned systematic reviews from Johns Hopkins University, but when the findings diverged from WPATH’s expectations, they attempted to influence the content and ultimately blocked publication.

For instance, BMJ’s investigation highlights specific concerns among WPATH authors regarding the potential legal implications of endorsing interventions for minors without proven health benefits. According to BMJ:

The hesitation among some WPATH SOC8 authors was that independent appraisals of the evidence would undermine legal efforts to protect affirming interventions from legislative restriction in minors. In a form that appears to have been part of WPATH’s SOC8 publication process and is now legal evidence, a chapter author wrote, “Our concerns, echoed by the social justice lawyers we spoke with, is that evidence based review reveals little or no evidence and puts us in an untenable position in terms of affecting policy or winning lawsuits.” Several WPATH SOC8 authors were serving as expert witnesses in lawsuits brought by the American Civil Liberties Union and other plaintiffs. Another commented that any language in the guidelines undermining medical necessity—such as “insufficient evidence” or “limited data”—would empower the people calling treatments experimental and arguing for limiting them to clinical trials.

Presenting it this way may address WPATH’s actions while focusing on the essential context. Perhaps a wording like the following would convey the necessary information effectively:

WPATH released Version 8, the latest edition, in 2022; it is , which it described as being based upon a “more rigorous and methodological evidence-based approach than previous versions.” However, WPATH faced criticism for attempting to influence and block the publication of systematic reviews it had commissioned from Johns Hopkins University, which raised concerns about the evidential integrity of the standards themselves

Additionally, given the significant coverage of the Rachel Levine controversy in major outlets like the New York Times, The Economist, The Hill, and now BMJ, it seems that this aspect also warrants inclusion in some form to provide a complete picture of current discussions around WPATH. Sean Waltz O'Connell (talk) 14:57, 11 November 2024 (UTC)

IMHO, the "however" is editorialising, and "for attempting to influence" is a wikivoice claim of a disputed action. I'd go with Barnards' wording, personally, I think its neutral and obviously DUE by this point, and I'd start there and see if it needs expanding or rephrasing later. Void if removed (talk) 15:09, 11 November 2024 (UTC)

I think both Hopkins reviews and Rachel Levine incidents need to be covered in this article, as both were reported by multiple reliable sources. Barnards' wording is good, but we need to mention which reviews in particular WPATH tried to suppress. I.e, reviews commissioned from John Hopkins University. JonJ937 (talk) 10:49, 12 November 2024 (UTC)

If my wording looks like editorializing as is interpreted, then in view of the above comments - I believe Barnard's wording would be appropriate, with the inclusion of who produced the review, being John Hopkins University. Sean Waltz O'Connell (talk) 11:33, 12 November 2024 (UTC)

Actually, another issue is that, as worded, the quote can be read as being from the critics, when actually it is from WPATH.

How about:

Critics have questioned the evidential integrity of the standards, after emails emerged suggesting that WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure publication did not "negatively affect the provision of transgender healthcare in the broadest sense".

Makes it clearer where the criticism it is coming from, and why, what triggered it, and who the quote is from, but also doesn't make the strong claim that they definitely did suppress anything, merely that they attempted to impose final approval before greenlighting any publication.

Possible alternatives to "emails emerged suggesting": "legal filings suggested", "unsealed court documents suggested". Void if removed (talk) 12:39, 12 November 2024 (UTC)

Looks good to me. Flounder fillet (talk) 17:20, 12 November 2024 (UTC)

I'm generally fine with your version, and agree that 'unsealed court documents suggested' is a better phrasing. But we might consider adding:

"This led to the Johns Hopkins team publishing only one review, despite John Hopkins team providing WPATH with material for multiple."

Accordingly, as reported, WPATH apparently withheld approval for the unspecified number of additional reviews, which prevented their publication. Although specific details from those deliberations remain unclear, both The Economist and BMJ reported on the outcome. Sean Waltz O'Connell (talk) 16:25, 14 November 2024 (UTC)

I agree with void if removed's proposed wording, but I think Sean's addition also makes sense JonJ937 (talk) 12:25, 17 November 2024 (UTC)

Because there is still an element of unclarity, I would prefer to leave that extra sentence out for now, because the only thing we know with certainty is that WPATH sought to gatekeep, not the extent of how successful that gatekeeping was (and thus we cannot state for sure that this gatekeeping was definitely what "led" to the other reviews not being published. There could have been other reasons too. But otherwise I think Void's iteration is good, plus "unsealed court documents suggested", leading to the following version:

Critics have questioned the evidential integrity of the standards, after unsealed court documents suggested that WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure publication did not "negatively affect the provision of transgender healthcare in the broadest sense".

Barnards.tar.gz (talk) 19:50, 17 November 2024 (UTC)

Fails use of loaded terms per MOS:CLAIM. Also MOS:WEASEL - who are those "Critics" and why is their questioning here relevant, are they independent and qualified? Per further above, it still looks like we only have primary news on this. Raladic (talk) 20:04, 17 November 2024 (UTC)

The Economist and BMJ, along with the scholarly research referenced earlier, are not primary, sources. If additional attribution is deemed necessary, we could revise the text to read:

'Reports in The Economist and the BMJ have questioned the evidential integrity of the standards after unsealed court documents suggested that WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure their publication would not "negatively affect the provision of transgender healthcare in the broadest sense."'

I support the latest version proposed by Barnards. Sean Waltz O'Connell (talk) 11:12, 19 November 2024 (UTC)

The BMJ investigative journalism report is primary, see further up, by a person who has a vested interest in this, thus also failing WP:INDEPENDENT as was discussed at length here and Talk:Cass_Review#BMJ_Investigations_article already, and the economist source was already discussed at length, so let's not rehash this again.

It's not unusual for an organization to have final approval rights for publication of something it commissioned, so what is the purpose of the sentence you're proposing, other than to cast allegations of doubt into the room that no other actual secondary independent source has reported on, presumably because they are simply not noteworthy.

And again, the MOS:CLAIM and MOS:WEASEL - still stands - who are the people that have "questioned the evidential integrity", what is their qualifications as to why their commentary here is relevant?

If you remove this weasel wording and claims, then all you're left with is - "WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University." - which is not unusual in the world of research and basically becomes non-news, just as we don't usually report on the fact that the sky is blue. Raladic (talk) 16:26, 19 November 2024 (UTC)

I believe we’ve already discussed at length that both The BMJ and The Economist are reliable secondary sources, not primary ones. Additionally, a third peer-reviewed scholarly source corroborates the findings reported by these two outlets. With three reliable sources, there is ample basis for including the information, meeting Wikipedia's standards for verifiability and weight.

The Economist and BMJ, as well as the group of international scholars I quoted above, are qualified to analyze the evidence, and I proposed direct attribution of the information in my post above, if you are not happy with just "critics".

At this point, continuing this discussion without new arguments, risks becoming circular. There appears to be a rough consensus in favor of Barnards' version, and we should move forward with its implementation. Alternatively, if there are lingering objections, we can initiate an RFC to seek broader community input and settle the matter conclusively.

I also took note of your earlier objections to addition a few months prior, regarding suitable coverage & corroboration, which I believe have now been addressed by these recent developments in coverage. Sean Waltz O'Connell (talk) 09:15, 20 November 2024 (UTC)

The person for the article in the BMJ is Jennifer Block, an investigative journalist and activist, that is primary as @Flounder fillet has shown above. The BMJ is just a place to publish, it's not an organization that puts their name behind a paper or piece, unless they author it AS the BMJ.

So if you want to attribute it, it would be "The activist Jennifer Block criticized it" - who else is there? The Economist article doesn't have a named author and was investigative in nature as well, so also primary. In there Ms Robinson is quoted as having protested that the organization that commissioned the reviews, as is their purview, has rights over publishing.

So at best you'd have Ms. Robinson criticized WPATH in unsealed court documents that gave WPATH final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure publication did not "negatively affect the provision of transgender healthcare in the broadest sense". - which is a "so what" WP:DUE question. Papers get commissioned and then sometimes not published all the time, it's non-news and Wikipedia is WP:NOTNEWS.

So this part "Critics have questioned the evidential integrity of the standards" is a failed WP:WEASEL sentence for lack of these "Critics", even failing WP:SYNTH since the "evidential integrity" part does not appear in either, and the BMJ investigative article also just references Robinson. Raladic (talk) 18:44, 20 November 2024 (UTC)

As demonstrated, this is not primary, and there's no sensible reason not to include it. Void if removed (talk) 15:06, 21 November 2024 (UTC)

In my opinion the latest phrasing suggested by @Barnards.tar.gz seems appropriate. It effectively reflects the information provided by reliable sources. Parker.Josh (talk) 22:25, 19 November 2024 (UTC)

The BMJ article is not a primary source, as has been explained above by other users. It was commissioned by BMJ, explicitly titled as a BMJ Investigation, and underwent peer review. This demonstrates that BMJ fully endorses the article and its findings, making it as reliable as any source can be within its scope.

Furthermore, no independent, reliable source has characterized the author of the BMJ article as an activist. Wikipedia policy requires such claims to be supported by verifiable, reliable sources, and in the absence of such evidence, we cannot make or entertain such labels.

As for The Economist, it is listed as a reliable source at WP:RSPSS, including on trans-related topics, further reinforcing its credibility.

Given that most users commenting here have supported the compromise wording, we should respect WP:CONSENSUS and proceed with its implementation. Prolonging this discussion without new arguments risks unnecessary circularity. Sean Waltz O'Connell (talk) 13:27, 21 November 2024 (UTC)

After three months of this its clearly due for inclusion. Void if removed (talk) 15:06, 21 November 2024 (UTC)

In line with the prevailing consensus reached above, I have incorporated the agreed-upon compromise wording regarding the aforementioned developments Sean Waltz O'Connell (talk) 17:16, 22 November 2024 (UTC)

Raladic, you cannot make edits such as this that go against the consensus. Your proposed wording had no support from other users. As a seasoned user you know this violates Wikipedia guidelines. Please revert your edit, to abide by the consensus worked out by the majority on this page. Sean Waltz O'Connell (talk) 17:39, 22 November 2024 (UTC)

No, you should know, that WP:NPOV policy violations are prime and "This policy is non-negotiable, and the principles upon which it is based cannot be superseded by other policies or guidelines, nor by editor consensus." - the text you inserted violated them (as I also mentioned two days ago), blatantly, so I have reworded it to state the facts, neutrally, as extracted from the sources, and attributed the person that raised criticism per WP:INTEXT (we attribute to the person, not to a place where something was published in) without the undue POV violations in it. So the point that the SOC was based on research from multiple contracted organizations, as extracted from the sources you linked is that, as is the fact that one researcher out of many of them has criticized it, neutrally, fact based. Raladic (talk) 18:30, 22 November 2024 (UTC)

You should strike that accusation of "blatant" NPOV violation, for what was a pretty accurate and neutral rendition of the sources. What you've come up with bears little relation to the information in either of them as presented by the sources and does not inform the reader of the salient points. And you're wrong to call Robinson a "critic". Void if removed (talk) 23:51, 22 November 2024 (UTC)

Refining a controverted addition is fairly standard practice. Having one consensus does not preclude new bold edits to be made. But if there is the assertion here that the consensus at this section specifies the form of attribution that was inserted and nothing else, I would have to NACK the addition as a whole, since investigative reports are PRIMARY as a matter of policy, which cannot be overridden by the local consensus here (thus making the local consensus erroneous) and there has been no substantive reason given why the vague attribution to critics is appropriate, again contrary to countervailing guidelines. Thus, I do not believe that the burden for inclusion has been met. Alpha3031 (t • c) 21:39, 22 November 2024 (UTC)

investigative reports are PRIMARY

This is the third time this false claim has come up in relation to this source. An investigative report is primary for the material that the investigative reporter produces themselves, from their first-hand experience.

In this instance, the primary source is substantially the material disclosed in discovery that has been reported on elsewhere, which this source is then secondary for, providing analysis and synthesis and commentary etc.

The material being added is not primary.

The text before was:

Reports in The Economist and The BMJ have questioned the evidential integrity of the standards, after unsealed court documents suggested that WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure publication did not "negatively affect the provision of transgender healthcare in the broadest sense".

Lets look at what it has been "refined" to.

WPATH commissioned a series of reviews to support the development of the latest version of the Standards of Care 8 from various research organizations, but retained the publishing rights to the contracted research.

This is editorialising to the point of WP:SYNTH and should be self-reverted. No mention of the questioning of the integrity of the standards, no mention that this emerged in discovery.

WPATH sent an update to all SOC 8 coauthors in October 2020 stating, "It is paramount that any publication based on the WPATH SOC8 data is thoroughly scrutinized and reviewed to ensure that publication does not negatively affect the provision of transgender healthcare in the broadest sense."

No mention this came after they attempted to seek final approval of the Johns Hopkins systematic reviews. This sentence doesn't explain anything.

Karen Robinson, one of the researchers at Johns Hopkins University one of the contracted research organizations said that "We had hoped to publish more of those reviews but for a few reasons have not done so"

What is the point of this? The edit comment refers to them as "the actual critic" which is false, they are not a "critic". It puts an entirely positive/banal spin on things.

referring to WPATHs retained rights to limit independent publishing that was contracted to support the development of the SOC 8

This is editorialising, again hammering home the POV about "retained rightS".

I struggle to see you can consider these changes "refining". It isn't an improvement to what was already reflective of the sources.

This isn't even close to NPOV, and "refining" does not mean "obfuscate what the sources actually said and how they presented the information".

The story is: after 2 systematic reviews by Johns Hopkins were published, WPATH tried to enforce a new protocol whereby they would have final say over publication, which met with initial resistance from Johns Hopkins. After that, no further reviews were published. This was not publicly known until it emerged in discovery. This has called into question the integrity and independence of the SOC8 evidence review process.

Please tell me how a disinterested reader is informed of this by this "refinement" you're defending. Void if removed (talk) 23:39, 22 November 2024 (UTC)

Quite frankly, I don't care for any specific refinement, I am just pointing out that a vague Critics have questioned is entirely unacceptable to me without strong justification for that specific wording, and that I would otherwise NACK the proposal for inclusion, with reference to the aforementioned guidelines.

I don't think the PRIMARY issue particularly significant in this case (since PRIMARY would not preclude inclusion) but investigative reports are defined without qualification as a primary source as a matter of policy, it does not matter whether it is factually a primary source outside of Wikipedia's use of the term, because when things are specifically defined it is no longer a question of fact. Contrast for example, opinion pieces, including [...] reviews and interviews [...] which are considered PRIMARY depending on context. Alpha3031 (t • c) 02:28, 23 November 2024 (UTC)

Critics have questioned

The actual wording removed wasn't even that, but the more speciefic/non-WP:WEASEL improvement Reports in The Economist and The BMJ have questioned, so this is a non-objection.

I don't think the PRIMARY issue particularly significant in this case I agree, because it isn't primary.

What the definition says is:

The journalist goes undercover and reports their experiences. The journalist meets with people and reads documents to uncover corruption. (Defined as a primary source by policy.)

These aspects of a report would be WP:PRIMARY. None of that is relevant here, where what is discussed for inclusion is secondary coverage of an existing story with additional analysis and 3rd party commentary. Just because it is part of a BMJ "investigations" series by the "investigations" unit doesn't make the entirety of the piece primary. An investigation that is primary is one where the journalist themselves uncovers the story through their own actions, where they are reporting their first-hand experience of events, and where they are then the primary source for the information. That is not the case here, since what is being raised for inclusion from the BMJ is an expansion of a story that has already been covered in other sources, with additional reactions. A source can be both primary for some information and secondary for others. In this case, what's been proposed for inclusion is the BMJ's secondary coverage and analysis of an existing story.

To illustrate: the primary source of the quote "negatively affect the provision of transgender healthcare in the broadest sense" is a legal filing that is in the public domain, which was first covered by the Economist in June, which has now been further covered and analysed by the BMJ in a peer-reviewed article in October. There are no grounds for calling that primary. Void if removed (talk) 09:45, 23 November 2024 (UTC)

Investigative reports are primary in the same way that breaking news stories are primary, and the same way that opinion pieces are primary, because the policy that defines what the word primary means on Wikipedia explicitly defines them as primary, even though they can in some situations be used as secondary sources. Now, I'll need reread the BMJ since the last time I read it was over a week ago, so I'll respond to the rest later. Alpha3031 (t • c) 10:30, 23 November 2024 (UTC)

I don't think expert opinion is necessarily primary when not part of an investigative report (i.e., the quotes are not covered under WP:RSOPINION), but they also don't represent analysis, synthesis or commentary on the part of the journalistic source. Whichever attribution we choose should reflect that. Alpha3031 (t • c) 10:48, 23 November 2024 (UTC)

I'm going to decline to comment on the Economist article for now other than to say attributing to The Economist statements made in its editorial voice are appropriate should we find inclusion in general appropriate. I don't think attribution to Block or BMJ would be appropriate, except for statements made in the publication's own voice, which would make specific attribution unfortunately more difficult if we do end up using BMJ. I believe would be substantively accurate to attribute to Robinson the bulk of the usable criticism, though I do not necessarily agree that that would be the most appropriate attribution — I would be less inclined to support attributions that do not mention that Robinson is being quoted in the Economist and BMJ articles if Robinson is attributed. I also do not see any reason why we should consider the BMJ article anything other than a standard investigative report, and with that, I think I've spent enough time on this, and will be signing off for now. Alpha3031 (t • c) 11:33, 23 November 2024 (UTC)

The source itself is not neutral as it is an investigative report by an involved party and primary, so any of the investigative commentary is not due for inclusion, so what we are left with is what is extractable neutrally as facts.

Which is that a) WPATH retained publishing rights and clarified so to ALL SOC 8 contributing researching organizations as quoted, Johns Hopkins being among them, b) Ms. Robinson was unhappy about this and commented the quoted sentence in her personal capacity (presumably as more would violate the contracts) c) no one officially at neither Johns Hopkins, nor WPATH commented further on it as mentioned in the refs. d) no actual secondary sources have picked up on this "story", presumably because there isn't one, other than normal course of research business. So the rest of the investigative commentary of the sources that are trying to portray a drama around evidence (the original wording itself was WP:EDITORIALIZEd WP:SYNTH as "questioned the evidential integrity of the standards" does not appear in either of the two sources) are investigative by the authors of the refs and are primary, thus not includable, as was already pointed out by multiple editors now, no matter how many more times you claim it isn't so. Same for the WP:SYNTH violation that was the combining of part of the quote that WPATH issued guidance to ALL organizations/authors and instead this construct "...suggested that WPATH sought final approval of systematic reviews it had commissioned from Johns Hopkins University to ensure publication did not "negatively affect the provision of transgender healthcare in the broadest sense". which synthesized using a WP:CLAIM violation to spin on things (hence the WP:NPOV problem) and combining it with a separate quote to try to present some kind of conclusion, which was corrected by presenting that quote in its entirety as "WPATH sent an update to all SOC 8 coauthors in October 2020 stating, "It is paramount that any publication based on the WPATH SOC8 data is thoroughly scrutinized and reviewed to ensure that publication does not negatively affect the provision of transgender healthcare in the broadest sense.". And yes, once we've extracted the actual facts of the story, turns out, there's not much there, which is exactly what I already pointed out above.Raladic (talk) 02:31, 23 November 2024 (UTC)

the original wording itself was WP:EDITORIALIZEd WP:SYNTH as "questioned the evidential integrity of the standards"

I thought this was a fair summary, but I've changed it to "evidence base" which does appear in the sources.

the combining of part of the quote that WPATH issued guidance to ALL organizations/authors

I've split that now.

involved party

Explain this please. Void if removed (talk) 09:46, 23 November 2024 (UTC)

The argument that every investigative report constitutes a primary source cannot be sustained and should cease. This repetitive and unfounded claim undermines the discussion. I recall that the same user previously argued that every report by The Economist was merely an opinion piece, a position that similarly lacked merit. That matter had to be escalated to WP:RSN, where the community affirmed The Economist's reliability as a source. Continuing to waste the community's time with such baseless arguments is counterproductive & unfounded.

Moreover, the character assassination attempts directed at the BMJ author must also stop, as there is a complete absence of any reliable sources supporting such allegations. We now have three reliable sources addressing this incident. Notably, no one has mentioned this peer-reviewed scholarly journal, which also analyzed court documents and states:

After receiving the results of the systematic reviews that WPATH commissioned Johns Hopkins University researchers to conduct, WPATH leadership became “painfully aware that there are many gaps in research to back up our recommendations” (Exhibit 190, page 9) (Boe v. Marshall, 2024) for children and adolescents in WPATH 8 guidelines (Coleman et al., 2022). The Johns Hopkins researchers reached out to U.S. federal authorities, noting that “we have been having issues with the sponsor (WPATH) trying to restrict our ability to publish” and that “we found little to no evidence about children and adolescents” (Exhibit 173, page 23).

This confirms that the research did not support WPATH's recommendations and that the Johns Hopkins researchers explicitly raised concerns about WPATH attempting to restrict their ability to publish.

Additionally, whether WPATH attempted to restrict all commissioned researchers is irrelevant here. The Johns Hopkins team appears to have been the most prominent group involved, as the sources specifically discuss their case rather than any others. Sean Waltz O'Connell (talk) 14:25, 23 November 2024 (UTC)

Depathologization in the lead

@Dr vulpes why did you remove the depathologization shift from the lead? The shift from a pathologizing approach to a more human rights based one is well covered in the body, and many high quality RS discuss it in depth. I believe the lead can't adequately summarize the body without it. Best, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 01:38, 26 August 2024 (UTC)

Hey @Your Friendly Neighborhood Sociologist, it's mostly just a style move if you feel like it's better in the start then go ahead and just pop it back in. I tend to keep the introduction section as short as possible and then expand with citations and sources in the main text. The only style guide rule at play is not putting citations in the lead and when I read something that is important I really want to give it a source. I was planning on coming back after dinner to try and build it out some more but if you would like me to step back for a bit while you make some changes that's totally fine by me. Also if you see any parts of the article that you think I might be able to expand or find sources for just ping me and I'll take my best shot with it. Dr vulpes (Talk) 01:53, 26 August 2024 (UTC)

@Dr vulpes That makes sense, thanks! I'll try and move it back in tomorrow but trim it and add a source since it's a somewhat contentious statement. No need to step back, I've been trying to rewrite the article for a while but it's been piecemeal, I think it took me 3 months to remember to make the 2001 - present section after making the 79-2000 one lol. There are a few things I've been wanting to add more details on and would appreciate your help with:

• How WPATH has evolved to pay more attention to trans men (the early versions focused more on trans women), and the role of Lou Sullivan in that (slightly covered by Bevan and the SAGE encylopedia of trans studies)
• A better summary of the transfeminist critique of WPATH ~1990s (and afterwards but that seemed to be the height) and their general interactions with trans orgs - Dallas Denny was a name that popped up a few times as she critiqued WPATH and later became involved in the 5th SOC IIRC
• Their impact on the DSM (particularly the DSM-IV and V, and the inclusion of autogynephilia in them) and the ICD
• How they've lobbied/effected public policy over the years and which medical orgs they've collaborated with
• A description of "triadic therapy", I think the sources exist in the article for that I just keep forgetting to add the specific name lol
• More info on the EEF/Janus Informational Facility and how HBIGDA took over from them, some source allude to it, few make the connection as explicitly as they could considering how explicit the first call to members was about it.[17]

Best, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 03:21, 26 August 2024 (UTC)

Got it, I'll do some digging and expand what I can. When I'm at a good-ish place or if I get stuck I'll just ping you again here. Thanks for being cool about the edits I made, I understand that some topics that are important to people can be a bit sensitive and your professionalism has not gone unnoticed. Looking forward to working together! Dr vulpes (Talk) 04:38, 26 August 2024 (UTC)

Y WPATH and Transmen: Added sources about this shift in the 7th edition. Still can add more in depth but at least there's something there now. 02:03, 27 August 2024 (UTC)

? Summary of transfeminist critique of WPATH: I don't know if I have the best background for this one but I can give it my best effort.

Yg Impact on the DSM

Yg Public Policy

Yg Triadic Therapy

clock EEF/Janus Informational Facility I'll start working on this

Hey @Your Friendly Neighborhood Sociologist, just wanted to give you a quick update on my progress. Feel free to update if you tackle any of these!

Dr vulpes (Talk) 02:03, 27 August 2024 (UTC)