Talk:World Professional Association for Transgender Health

Regarding Standards of Care

It would be nice if the article stayed that way with regard to SOCs, and not get changed back again to a US-centric view. In many European Countries, the HBIGDA-SOC are not the SOCs usually used, but local SOCs exist. The HBIGDA-SOC would be a real improvement there, believe me!
And I am thinking that maybe it would be a good idea to put SOCs into a seperate article altogether. It is not directly related to surgery, and a seperate article would also provide the opportunity to cover the different standards better.
AlexR 23:56 4 Jun 2003 (UTC)

Good idea. The part about who Harry Benjamin was and what the HBIGDA does doesn't really fit in this article. It would also be interesting to discuss the trends seen in recent revisions of the SOC. And as you say, in many European countries at least the official care providers have their own protocols that are way behind the HBIGDA SOCs. -- Kimiko 07:22 5 Jun 2003 (UTC)

Thanks, Alex and Kimiko. My only problem with that is that the Standards of Care is the proper name of a specific document, so changing that is kind of like saying "Other countries use their own version of the Magna Carta," or "Other religions have their own Ten Commandments," you know? A Google search returns only one other document using the term Standards of Care that deals with GID, and that it also from the US, by a group called the Health Law Project and was written for the express purpose of rebutting the HBIGDA document. Can you cite an example of another set of guidlines that uses this title? Also, it should be noted that standards of care (common noun) is a term used throughout the medical industry for all types of topics, with a special focus on Psychiatry. So perhaps this could be said in a different way, as the current edit offers readers no additional info, but simply removes clarity from the factual points. What do you think? (Also, I'm going to do an HBIGDA page, hopefully today, and I'll move most of it, but this still needs to be worked out first) Thanks, Paige 12:20 5 Jun 2003 (UTC)

You could use protocol (as I did above) to describe other standards than the HBIGDA SOCs. At least, that's what it is called in the Netherlands. Protocol can also refer to anything, just like standards of care (no caps). -- Kimiko 13:54 5 Jun 2003 (UTC)

Alex, would you agree with this solution? It sure seems like a good one to me. Please let us know what you think so I can set up the HBIGDA article and move some of this there, okay? Thanks, Paige 14:30 5 Jun 2003 (UTC)

The German Standards of Care are explicitly called "Standards of Care", and as far as I know, other some other European SOCs are also called SOCs. So I'd stick to SOC and call the HBIGDA-SOCs explicitly so. Also, I have encountered the term "Standards of Care" many times when other illnesses were the subject, hearth attacks, for example, or diabetes.
Do you want to set up an article specifically about the HBIGDA-SOCs? I'd call it "SOCs for transgender/transsexuals", leaving room for both SOCs about other illnesses in other articles and other SOCs than the HBIGDA for transgender/transsexuals in the same article. Since the Wikipedia is an international project, I think those other Standards would be best put together with the most influential ones.
AlexR 15:58 5 Jun 2003 (UTC)

Alex and Kimiko, if you have a chance, please check out the changes I made and the new Harry Benjamin International Gender Dysphoria Association article. Thanks, Paige 14:37 6 Jun 2003 (UTC)

Hm, I would have put the standards in a seperate article, not under the heading of the HBIGDA. The HBIGDA should explain only the HBIGDA; after all, the standards are not the only thing they do. And, on the other hand, an article about SOCs under that heading would have provided the opportunity saying something about other SOCs. Plus, the information that SOCs for other illnesses exist have nothing whatever to do with the HBIGDA.
Also, I am getting fairly annoyed that the paragraph about transgender people who opt for SRS is constantly edited out. Not only transsexuals have surgery, and not all those who have surgery are transsexuals. Editing this information out invaldidates other people's life -- mine, for example -- and is definitely a violation of the NPOV! -- AlexR 17:12 6 Jun 2003 (UTC)

No harm was meant. That line simply makes the article confusing. If on Wikipedia, "A transsexual is a person who establishes a permanent identity with the opposite gender to his or her birth sex," and SRS is "the surgical procedure by which a person's physical appearance and function is changed to that of the opposite sex," then how are non-TG readers supposed to understand a person seeking SRS who isn't a transsexual? It's confusing. Either one of those definitions needs to be changed or some explanation should be given. Your life and your TG-identification is a very specific circumstance which places you as a minority (post-op TG) within a minority (TG), which probably warrants an in-depth discussion, right? Personally, I would find it much more apealing if you wrote a full paragraph explaining that under whichever article you choose, SRS, TG or TS. Readers will probably be interested in hearing WHY some choose the indentifiers they choose, don't you think? However, as it stands now, it only reduces the clarity of the definitions. My revision wasn't intended to be POV, it was purely 100% editorial.

Can you please expound upon that line so it becomes clear to non-TG readers at least? (Please double check the grammar as well. Themself needs to be plural to match the number of persons and it would be preferable if the independent clause did not begin with also.)

As for the HBIGDA-SOC being placed under the HBIGDA article, it was simply for organization. The two terms a very much linked, and since no one has actually provided any facts on the other SOCs, there isn't enough detail for two separate articles yet. If you could please flesh out your criticism of my "US-centric" focus on the HBIGDA-SOC with some details about other guidlines, protocols or SOC's, instead of just knocking what I wrote, it would solve the problem.

I think the line about SRS patients calling themselves TG instead of TS as well as the edits you want about other SOC's are only modifiers of the existing information. Isn't it kind of counterproductive to add modifiers without explaining them or adding any new facts. We should be expanding these articles, not just watering them down. By adding the info you keep referring to, you'd be increasing the level of detail, which is the exact opposite of what's happening right now, I think. Either way, I'm done editing this one because I don't want to make people mad. Sorry. Paige 20:04 6 Jun 2003 (UTC)

Hi Paige! I don't think the line is confusing, and the difference between transsexuals and transgenders can easily be examined from the corrospondung articles. (Although the TS article could, IMO, use a bit of clean-up; maybe I'll do that sometime.) Anyway, my life and being post-op transgender is by no means a special case. Transmen who do not identify as transsexual and who had upper surgery are quite common, not only in Germany (and being a founder of the only German association of transmen, I know many), but also, from what I hear, in other countries, including the US. It is therefore extremely annoying if one keeps reading that surgery=transsexual equation, which simply isn't one. I also know it's more common among transwomen to make that equation, although, from what I can observe, it is by no means as widespread as it used to be. This is not just a modifier, either, but an essential information. And it needs not much further explanation, because, as I said, if people want to know the difference, the articles about TS and TG are only one click away.
As for the HBIGDA article, I think it was quite clear from the information already present in the debate that other SOCs exist. Therefore to write an article that makes it impossible to add this information where it belongs looks quite US-centric to me. And no other information about other SOCs were provided yet because it makes sense to write about the HBIGDA-SOCs first, since they are the most widespread ones, and they can very well be used as reference. And I have to admitt that I did not see the need to hurry with information about the German SOCs (which are the ones I know best) because the information is probably not all that relevant to English speaking users, mur merely interesting. The other reason why I only wanted to point out the differences, and for that the HBIGDA-SOCs needed to be written about first. Also, other standards are not only used in Germany, not even predominantly. In fact, the only country I know where the pure and plain HBIGDA-SOCs are used regulary are the USA, in all other countries I know the guidelines or local SOCs differ.
As for any grammar or spelling mistakes, I apologise. Not only is English not my first language, for some reason I usually write in the middle of the night.
-- AlexR 20:31 6 Jun 2003 (UTC)

I forgot to add: It was not my intention to keep you or anybody from working at this articles. It is just that I have had the transsexual vs. transgender debate far, far too many times - without ever having seen the point in it in the first place. By now, that may make my reactions more brusque that necessary in that particular stuation. No offense was indented. AlexR 07:42 7 Jun 2003 (UTC)

I agree with Alex that it would be better to put the SOCs (HBIGDA or other) on their own page. Also, SOCs not only specify standards for SRS as stated at the beginning of the article, but also for HRT, RLT and psychotherapy, as explained further down. -- Kimiko 20:38 7 Jun 2003 (UTC)

The distinction between TS and TG does not need to be discussed here as it is already covered in the Transgender article (linked also from Transsexual). Links to (one of) those articles would be enough. However, discussion of whether the SOCs should provide rules for those who don't want to go all the way (only hormones, or only one type of surgery) is appropriate here (or better yet, the SOCs article once that material is moved). -- Kimiko 20:48 7 Jun 2003 (UTC)

WPATH leaked emails

Michael Shellenberger's think tank published a report detailing pretty extensive criticism of the organisation, as well as releasing over 100 pages of WPATH members' communications in screenshots. The publication has dedicated articles in The Economist, [1], The Irish Independent [2], The National Post, [3], KABB (a San Antonio radio station) [4], and op-eds in The Guardian, [5] and The Washington Post, [6]. There are countless questionable right-wing outlets as well, but I omitted them for obvious reasons. This should be enough to include a sentence or two about the report, but I am not familiar enough with the topic to do it myself, other than know this needs a mention. Szmenderowiecki (talk) 08:11, 10 March 2024 (UTC)

Agree this significant story should be in the article. Use the WaPo and Guardian articles as reference, I suggest. You should be aware though that the history of this page shows a record of deletions of anything that isn't sympathetic to WPATH, so any change will likely need to be defended. Fig (talk) 09:41, 10 March 2024 (UTC)

I would recommend being very careful. Bare in mind Wikipedia:RSOPINION for the 2 op:ed sources. I would also mention that it might be worth waiting for some more high quality Sources to discuss on this topic first as they would if this was notable. LunaHasArrived (talk) 16:02, 10 March 2024 (UTC)

I don't think this is DUE at this time, and a healthy pinch of WP:NOTNEWS applies. I've read the report, and it is full of misinformation, misleading presentation, and outright falsehoods. I think this is reflected in the fact that the only publications making any significant noise about this are all highly partisan in this topic and are considered either questionable or outright unreliable via discussions at RSN.

Of the four sources presented here (I'm excluding the two op-eds because of WP:RSOPINION): The Economist appears to be sceptical of the claims of Shellenberger's report. The non-profit group that published the files...claims that the documents reveal “widespread medical malpractice on children and vulnerable adults”. That claim is questionable. The Irish Independent is more to be about the situation of trans health care in Ireland, than any sort of substantial commentary on the report, and doesn't seem to be an substantial departure from what RTÉ said about the plans in January. KABB appears to be sceptical of the content of the report. Their article opens with A report released Monday alleges. Only the National Post seems to offer substantial content on it while taking it at face value.

I agree with LunaHasArrived, we should wait to see how high quality, non-partisan sources cover this, if they do at all. Sideswipe9th (talk) 17:13, 10 March 2024 (UTC)

I agree with most of the points here, the notability seems debatable at best and most sources just talk about it in the context of, “this is what an activist group is saying”. If we included this, by this logic we’d have to include everything that groups like Genspect and SEGM say. Snokalok (talk) 18:53, 10 March 2024 (UTC)

I just read through the report and listed sources here and agree this is undue; I want to note that Shellenberger is famous for his climate change denialism and that this report misgenders every trans person it discusses (A Florida non-binary counselor with they/them pronouns replied, offering her services. She told... she added. (p30) was impressively egregious), it goes in for ridiculous fearmongering and misinformation (autogynophilia, the false claim "most trans people grow out of it", saying that transition is unethical since people won't be attracted to you anymore (repeatedly...) and plenty of citations to the Society for "it's not conversion therapy if we do it to trans people"-Based Gender Medicine & co), and it was in fact made in collaboration with Genspect, who *checks notes* run a forum to help parents put their kids through conversion therapy and think there's a connection between anime and transition ...[7]

WP:FRINGE/WP:ONEWAY: Fringe views, products, or those who promote them, may be mentioned in the text of other articles only if independent reliable sources connect the topics in a serious and prominent way. However, meeting this standard indicates only that the idea may be discussed in other articles, not that it must be discussed in a specific article. If mentioning a fringe theory in another article gives undue weight to the fringe theory, discussion of the fringe theory may be limited, or even omitted altogether. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:36, 18 March 2024 (UTC)

Sideswipe9th, this immediately follows your excerpt from the Economist article:

But wpath’s standards of care have been cited by other medical organisations, particularly in America. wpath’s president, Marci Bowers, said in response that “wpath is and has always been a science- and evidence-based organisation.” Yet the discussions show that the provision of so-called gender-affirming care is riddled with far more doubt than wpath’s message that such treatments are “not considered experimental”.

Though skeptical of the explicit claims made in the report, they clearly think its revelations notable and aspects of them to be troubling.

They later state

The conversation ventures into the absurd—and sounds more ideological than clinical—when talking about unusual requests for body modifications.

and

But a doctor in Canada says that after joining the forum her “expectations of scientific discourse were soon dashed”. Her posts were met with “emotional, political or social reactions rather than clinical ones”.

The article has a strictly informative tone throughout, and does not pronounce any final judgement on the matter. But that such statements from a reputable, nonbiased source concerning a medical association that offers professional guidance concerning irreversible, profoundly life-altering surgeries on psychologically vulnerable adults and children alike should arouse concern and suspicion about said organization, is obvious. DestroyerOfSense (talk) 12:35, 17 March 2024 (UTC)

I was not the one making the quote from the economist. Also given another week has passed I think unless there's more high quality non partisan sources that have been published it might be fair to say this shouldn't be included. LunaHasArrived (talk) 14:48, 18 March 2024 (UTC)

You're right. My apologies. I've edited my comment accordingly. DestroyerOfSense (talk) 01:28, 19 March 2024 (UTC)

From the preface to the report: The WPATH Files are semi-private conversations inside WPATH's internal online forum for discussing specific medical cases. In other words, they dumped some stuff from an online forum in which clinicians were discussing topics about treating patients. Not sure why that would merit inclusion in an encyclopedia article. Hist9600 (talk) 22:11, 18 March 2024 (UTC)

Whether something merits inclusion is determined by coverage in reliable sources. Here, it seems that several reliable sources find it to have at least some notability, although I can see a case being made to reduce coverage on WP:RECENTISM grounds. Zylostr (talk) 21:13, 1 April 2024 (UTC)

Proposed paragraph

I recently added this paragraph to the page; it was reverted and I was directed to this talk page for discussion.

Proposed coverage of WPATH Files

In March 2024, leaked internal messages and video footage from WPATH were published by Environmental Progress, an advocacy group founded by Michael Shellenberger. In the leaked exhanges, some medical professionals expressed concerns about the ability of minors and patients with mental health conditions to consent to hormone replacement and puberty blocker treatments recommended by WPATH guidelines. They also discussed complications produced by gender-affirming care and requests from some patients for "non-standard" body modification surgeries. Shellenberger contends that the documents show that gender-affirming care is "neither science nor medicine". Several experts indicated that the link between hormone therapy and cancer presented in Environmental Progress's report on the leaks is oversimplified and misleading, and transgender journalist Erin Reed indicated that she identified 216 instances of errors and misrepresentations in the report.

One reason provided for rejecting this change was that the paragraph primarily relies on the National Post, which is not a reliable source. I disagree with this rationale for several reasons:

• The paragraph does not rely on the National Post. Every sentence except the first that is sourced to the National Post is also sourced to a source recognized as reliable on WP:RSP. The first sentence deals with basic factual claims, and its attribution could easily be switched to the Economist source.
• Although the National Post is not in WP:RSP, I believe it should be considered a reliable source per WP:NEWSORG, as it is a major Canadian newspaper.

I believe there may be a case to reduce or omit coverage of this incident on WP:RECENTISM grounds. However, the presence of in-depth coverage in multiple RS sources indicates to me that some coverage is called for. Zylostr (talk) 21:35, 1 April 2024 (UTC)

No, there are plenty of newspapers that are not considered reliable sources as they often produce biased content. That is the whole reason why we have Wikipedia:Reliable sources/Perennial sources which lists which newspaper and media has consensus on being reliable or not. The National Post appears to be categorized and discussed as biased even in their main page article, so they is unlikely to qualify as a reliable source - if you think it was, you could raise it at the WP:RS notice board first.

As was discussed further up already, the Economist article is skeptical on the claims, so that leads credence to non inclusion.

And so all we are left with is skepticism and no sources that discussed the original revelation after March 5th. Per above already cited, Wikipedia is wP:NOTNEWS, so this leak seem to not have had lasting notable effects as we are now a month past with no further coverage on it (other than from fringe or unreliable sources). Raladic (talk) 22:10, 1 April 2024 (UTC)

I have to question why this would be considered news, or even especially attributable to WPATH as an organization. This just looks like some forum members were discussing some cases, and then someone dumped some of that data. What does it tell us about WPATH as an organization? Basically nothing, because it's just some forum members having a few discussions. The report itself is also not a reliable source (fringe), and the author of the report is amateur, not a credible expert in the field. Hist9600 (talk) 00:06, 2 April 2024 (UTC)

While the Economist article appears to cast doubts on some of the claims made by Environmental Progress, it also implies that the leaks may point to legitimate concerns. For instance, it states that the discussions show that the provision of so-called gender-affirming care is riddled with far more doubt than wpath’s message that such treatments are “not considered experimental”. The due weight for this content comes not from the seemingly WP:FRINGE group Environmental Progress itself, but rather the credence lent to it by the Economist and the Telegraph. Zylostr (talk) 16:36, 6 April 2024 (UTC)

I have to say by this point if there isn't any more recent articles on the leaks that Wikipedia:NOTNEWS. Would be a very good reason to not include it. These "leaks" seem to have had no mainstay presence and based on current sources I don't think in 2 years time someone would be shocked to see the "leaks" missing on this page. LunaHasArrived (talk) 16:49, 6 April 2024 (UTC)

@Zylostr Wholeheartedly agreed. As a long-time reader of The Economist, its weight and quality as a source is about as close to unimpeachable as it gets. DestroyerOfSense (talk) 14:26, 9 April 2024 (UTC)

In the telegraph again today. This won’t go away and not putting it in the article simply makes us look ridiculous. Springnuts (talk) 20:35, 12 April 2024 (UTC)

Do you mind listing the telegraph article here. And honestly most of the stuff I've seen on WPATH recently has been to do with their condemning of the Cass report. LunaHasArrived (talk) 20:43, 12 April 2024 (UTC)

[[8]]. An opinion piece about a massive elephant in the room. We lose all credibility if we close our eyes to it. Springnuts (talk) 07:16, 13 April 2024 (UTC)

Ah, unfortunately an opinion piece doesn't do much on Wikipedia, see Wikipedia:RSOPINION LunaHasArrived (talk) 08:09, 13 April 2024 (UTC)

Opinion pieces cannot be used to establish facts about a subject on Wikipedia. Hist9600 (talk) 03:03, 20 April 2024 (UTC)

The Telegraph is not a reliable source on trans issues. Like The Times, it has been printing scaremongering culture-war vitriol pretty much every day for years. — OwenBlacker (he/him; Talk) 22:34, 12 April 2024 (UTC)

OK, no elephants here. Springnuts (talk) 09:06, 13 April 2024 (UTC)

You seem to be insistent on PUSHing this perspective, claiming that not including it damages our credibility. Even without considering that including it might be what damages Wikipedia's credibility, we should remember, there is no deadline here. — OwenBlacker (he/him; Talk) 08:41, 15 April 2024 (UTC)

I agree with Springnuts and others that these developments merit inclusion in Wikipedia. Al83tito (talk) 20:59, 19 April 2024 (UTC)

User:OwenBlacker: You said that both The Telegraph and The Times are not reliable sources when it comes specifically to trans issues. What would be a few sources that are questioning or even critical of transgender issues, that you would deem to be reliable sources and non-vitriolic?

We should be open to articles that are critical or make public new knowledge that is contrary to any views, established orthodoxies, or understandings of fact. If any articles that are questioning or critical on transgender issues are by default non-reliable and vitriolic, that means that we are doing the work in reverse: first deciding what the conclusions should be in Wikipedia, and then only accepting as reliable sources those confirm that conclusion. This approach entrenches one view, insulating it from any critiques and from new knowledge as it comes to light that could update our understanding of any given topic. And that is not the way Wikipedia is meant to work.Al83tito (talk) 22:00, 19 April 2024 (UTC)

I made some review of the press up to today, and here's what I got:

• There's a much-belated article on Rzeczpospolita about the files, by Tomasz Witkowski. In Polish, but basically he's shocked and calling WPATH assholes for entertaining such discussionswithout using the word. (paywalled and in Polish, but will send raw text by wikimail on demand)
• The North State Journal, based in North Carolina, says that the disclosures may impact litigation over state minor transitioning ban that is pending in federal court.
• Media Matters had this article published early this month saying that some mainstream media "took the bait".

Other than these articles, there is basically no new coverage of the files. Szmenderowiecki (talk) 02:14, 20 April 2024 (UTC)