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)

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)

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)