Talk:Sex differences in medicine

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Yes, Sexism

It comes as no surprise to me that this article is deeply flawed, due to the boring yet irritatingly predictable sexism against men in western society. "Histrionic personality disorder" is noted as due to sexist "attitudes", "anti-social behavior" as given no such appendage. Considering that the lists sole purpose is to list the differences, it manages to miss out that, if you go by the WHO, cancer affects more men than women. It also fails to mention cardiovascular disease. Or tuberculosis, both of which affect men more than women. Females are generally less vulnerable than males to chronic illnesses. Thats quoting Wikipedia. "Overall, men are more likely to suffer from cancer, with much of this driven by lung cancer." But, subject as one author here might say, to "deeply ingrained social attitudes".....

Mensrights 24/1/2011 86.42.240.56 (talk) 12:59, 24 January 2011 (UTC)

added that respiratory infections and tuberculosis are more common in men. Cancer was already on the list. Hope I've helped even out some of the bias Feralcateater000 (talk) 22:27, 21 February 2021 (UTC)

it

it is a rather well known fact - the reference:

http://www2.health-center.com/mentalhealth/personality/borderline.htm

It is a disputed fact. Read the text of Histrionic personality disorder (from the US National Library of Medicine), or do a little research on the social causes of medical diagnosis. Wikipedia does not exist in order to provide free web hosting for weirdo distortions of reality. Tannin

I looked at the linked source and didn't se any statistics at all on sex-specificity. I also agree with Tannin that a web-page is not an authoritative "reference." But I want to add another observation: the article mixes up two different kinds of so-called sex-specific illnesses. It seems pretty obvious that only males will get testicular cancer, and only females will get cervical cancer. This is VERY different from illnesses like heart attacks, suicide, or BPD. In these cases, epidemiologists at best provide probabilities and tendencies. But even if 90% of all BPD patients were female and 10% were male (and we are assuming too that males and females seek treatment and are diagnosed equally, which is far from certain), one can hardly call BPD a "sex-specific illness." Slrubenstein

the bpd is qoted as 3 times more frequent - there is paragraph in the middle. frequency of histrionics is disputed by some, but there are more diagnosed females. the frequencies for eating disorder are also supported on that web page.

Sorry I missed that. In any event, it is still by no means "sex-specific." To list it as such in this article, especially without going into the methodological issues, would be misleading. If you are especially interested in (and knowledgeable about) the issues concerning sex and the prevelance of various disorders (BPD, Bulemia) I wouldn't want to discourage you from contributing to an article. BUT it should not be called "sex-specific illnesses," it should be something like The relationship between one's sex and illness -- and it really would have to go into greater detail about likely sociological/cultural causes, as well as methodological issue like bias in reporting and diagnosis. Slrubenstein

i agree article could have a better title. it discusses illnesses which are not exclusively specific to a sex, but which occur with different frequencies -abcdef

this is link to gender specific medicine. the term seems not to be exclusive.

http://cpmcnet.columbia.edu/dept/partnership/publications.html

abcdef - I fixed the title. I created the link carelessly - not properly considering the exact meaning of the phrase. Martin

Article title

Surely it would be clearer if this page were called "Gender and illness", since it's nothing to do with sex? ··gracefool |☺ 04:53, 18 Aug 2004 (UTC)

That would be exactly backwards! "Sex" is biological, "Gender" is sociological. Medical statistics are compiled with regard to sex, not gender. "Sex" is a euphemism for "sexual intercourse", not a synonym. Which is not to say the article couldn't be better titled or better written... - Nunh-huh 05:00, 18 Aug 2004 (UTC)

I agree, the current Title is terrible. It is implying illness caused by sex. Since we have Gender-biased diagnosing, would Gender-biased Illnesses be any better? Exit2DOS ^{• Ctrl • Alt • Del} 23:38, 16 November 2011 (UTC)

The thing is, like Nunh-huh said, Wikipedia currently defines Sex as a biological/anatomical classification, and Gender as a sociological/psychological classification. It is because of these definitions that Gender does not have direct biological impacts on illness. Thus, to use the word "Gender" instead of "Sex" would go against the biological aim of the article and the category it's in. Changing the title would also most likely be either inconsistent with the category its in, inaccurate, or in-concise. DialecticArguments (talk) 23:35, 12 March 2016 (UTC)

Endometriosis

Endometriosis has, very rarely, been found in men undergoing estrogen treatment for prostate cancer. Although this is rare, it is significant for understanding endometriosis as a disease. It casts severe doubt on the main suggested cause of endometriosis, retrograde menstruation. I will amend the page (which currently says it only occurs in women) to this effect. — Preceding unsigned comment added by Louisecooke (talk • contribs) 21:43, 17 April 2006 (UTC). Signature added by SUM1 (talk) 24 December 2019

Inconsistency

I've noticed an inconsistency within the article. The article states that "Sex differences in medicine should not be confused with gender differences. The Institute of Medicine recognizes sex differences as biological at the chromosomal level, whereas gender differences are based on self-representation and other factors including biology, environment and experience." However, it goes on to say that Sex-related illnesses have "social causes that relate to the gender role expected of that sex in a particular society" and "different levels of prevention, reporting, diagnosis or treatment in each gender." These two parts of the article directly contradict each other. My only question is, what should be the intent of this article? To note illnesses that are more common in one sex than the other with a physiological explanation, or to also list diseases with behavioral, societal, and psychological causes that are preventable in a gender neutral society? DialecticArguments (talk) 00:03, 13 March 2016 (UTC)

Unsupported, Over-generalized "Scientific" Claims

Making claims such as "occurs exclusively in men" or "occur only in women" is not ethical and completely incorrect when reporting or reiterating research results. To claim that men or women cannot develop a specific disease ignores the other genders and sexes who most definitely can even though legally they are classified as the sex male or female or socially identify as a man or woman. For example: in the wiki article of Klinefelter syndrome these people (whether one would like to classify them as males/men or females/women or other), it states that those with Klinefelter syndrome can develop "certain health problems that typically affect females." The percentage about women verses men who are diagnosed with breast cancer can be somewhat misleading because males can still die from breast cancer, due to the fact that it is so rare that it takes a long period of time to convince doctors to attempt to diagnose until much later stages. — Preceding unsigned comment added by SWillow (talk • contribs) 02:00, 24 March 2017 (UTC)

In response to a lot of the above topics

I attempted to help remove the confusion regarding gender in the article by mentioning that disease does not care about gender (I added that trans men can also develop endometriosis or ovarian cancer). I didn't do this the other way around because a lot of the research on prostate cancer does seem to indicate trans women are less susceptible, and given that intersex people in general are rare I was worried mentioning them would be WP:UNDUE Feralcateater000 (talk) 22:36, 21 February 2021 (UTC)

Change of Wikilink to men and women

@Maneesh: I've just reverted your two edits to the Wikilinks for men and women [1], [2]. Not all men are male humans, and not all women are female humans. Trans and non-binary people exist, and still have the same rate for some illnesses and disorders as a cisgender. For example a trans woman can still get prostate cancer, and a trans man can still get cervical cancer. Sideswipe9th (talk) 21:04, 13 December 2021 (UTC)

Transwomen are obviously also men, adult males. The edit summary was crystal clear: almost each and every line (and each and every RS that supports each line) uses man/men and woman/women. The fact that some males identify as trans (or "non-binary") has no relevance here. Maneesh (talk) 22:48, 13 December 2021 (UTC)

No, trans women are not men. Trans women are women. Likewise trans men are not women. Trans men are men. Trans is an adjective applied to man/woman. Sideswipe9th (talk) 22:52, 13 December 2021 (UTC)

This is religious thinking, you are entitled to it, but you can't use a title in section here the way you have. Look at all the points, the section titles reflect those points accurately and must use man/woman. Maneesh (talk) 22:54, 13 December 2021 (UTC)

No. It is not religious thinking, and I am going to ask you to self-revert per WP:BRD, as there is not a consensus for this change from the previously stable version. Sideswipe9th (talk) 22:56, 13 December 2021 (UTC)

Please count the number of occurrences of "men" and "women" below each respective title out of the total number of points. Maneesh (talk) 22:57, 13 December 2021 (UTC)

Also please note, the article is titled Sex differences in medicine. Using male/female would be more appropriate here than man/woman. Sideswipe9th (talk) 22:58, 13 December 2021 (UTC)

Men are adult human males, women are adult human females - is it surprising to you that the underlying RS generally use those words that way?Maneesh (talk)

I will not be baited into an edit war with you. I will ask one last time, please self-revert per WP:BRD as there is not a consensus for this change you have made. Sideswipe9th (talk) 23:08, 13 December 2021 (UTC)

I see nothing in BRD that compels me to revert my own (not bold at all) edit. "Men" and "women" is what is being used on almost each and every line in the sections you are trying to revert . Please do put up an RfC if you need to. Maneesh (talk) 23:12, 13 December 2021 (UTC)

Bold, Revert, Discuss. You Boldly made two edits 1, 2. They were reverted 3. Now it is time to Discuss why those changes are WP:DUE and to establish a consensus for them. Right now, there is no consensus for this edit. Sideswipe9th (talk) 23:16, 13 December 2021 (UTC)

Ain't a bold edit, you don't acknowledge that the title is merely reflecting the the content below it. Looking at BRD, all of these seem to apply:

BRD is not a justification for imposing one's own view or for tendentious editing.

BRD is not a valid excuse for reverting good-faith efforts to improve a page simply because you don't like the changes.

Maneesh (talk) 23:19, 13 December 2021 (UTC)

Maneesh, if you insist in your editing that transwomen are ... men and trans men are women you will be blocked from editing: I have never seen any other result come from that POV impulse, when an editor insists on following it to its logical conclusion. This will happen even faster if you remove sources to do so, as you have today. So you will have to decide which is more important to: your POV or continuing to edit Wikipedia. You can't have both, as your recent edit history makes clear. Newimpartial (talk) 23:34, 13 December 2021 (UTC)

I have no problem saying "transwomen are male", particularly in the talk section of an article on sex differences in medicine. Not POV, just a simple facts. I'm terribly uninterested in a wikpedia that censors such simple truths. Please do go out there and do your best to ban me if you think your efforts will be successful. Maneesh (talk) 23:38, 13 December 2021 (UTC)

You best route, is to open an RFC on the matter-in-question. GoodDay (talk) 19:19, 15 December 2021 (UTC)

Wouldn’t including transgender people in this article mostly be wp:UNDUE? Also trans women are less likely than cisgender men to develop prostate cancer, according to this source: https://academic.oup.com/jcem/article/105/9/e3293/5864158 So treating them as though they are cisgender men is wrong. Their bodies do not behave the same way. Feralcateater000 (talk)

More strange reverts

Most of the illnesses in the lists are not "sex-related". Almost each and every line uses "men" and "women", associated changes to reflect that simple fact have been reverted. Trans identification has nothing to do with sex-related differences, vague ideas around gender have no place in this article. Maneesh (talk) 23:30, 13 December 2021 (UTC)

Perhaps in your mind "men" means AMAB people and "women" means AFAB people, but that isn't what the recent, reliable sources say, which is what matters on Wikipedia. Also, stop edit-warring and please obtain consensus for your edits before reinstating them. Newimpartial (talk) 23:36, 13 December 2021 (UTC)

What is in my mind doesn't really matter. What matters is that this article uses "men" and "women", so do the underlying MEDRS, and the titles that summarize that information need to as well. Maneesh (talk) 23:40, 13 December 2021 (UTC)

Actually as I said above, the underlying MEDRS use male/female. Sideswipe9th (talk) 23:41, 13 December 2021 (UTC)

Each one I've spot checked uses man/men/male(s) and woman/women/female(s) synonymously. Which ones did you find that only used "male" and "female"? Maneesh (talk) 23:43, 13 December 2021 (UTC)

In the current "Women" section, the following sources use male/female 10, 28-31, 35, 42, 43, 45. In the current "Men" section, the following sources use male/female 25, 26, 30, 35, 47, 48, 49, 50, 52, 54, 58, 59, 60, 61. I was unable to access the texts to sources 33, 34, 38, 40, 55, 56, 57 due to a mixture of dead URLs, or being unable to quickly find a copy of the relevant paper/chapter. Sideswipe9th (talk) 00:01, 14 December 2021 (UTC)

Spot checking it seems that, as I've already said, at least some (I suspect most) of those RS use "men" synonymously with "male" and "woman" synonymously with "female". E.g.: 28: "Estimated new cases and deaths from breast cancer (men only) in the United States in 2021:[1] New cases: 2,650. Deaths: 530. Male breast cancer is rare.[2] Fewer than 1% of all breast carcinomas occur in men.[3,4]". This current WP article uses "men" and "women" overwhelmingly. Maneesh (talk) 00:08, 14 December 2021 (UTC)

Just to be clear, as silly as I feel doing this, this is a standard usage of those terms in English.Maneesh (talk) 00:10, 14 December 2021 (UTC)

It is not standard usage of those terms in English. At least not for about the last decade. Also you've cherry picked a single example. Sideswipe9th (talk) 00:11, 14 December 2021 (UTC)

I don't know if English is your first language? Go out and throw a rock and read the news, google news query for woman AND female. Denying that "woman" and "female" are used synonymously every day is absurd. I read a lot of research, I know these words are used synonymously all the time the way they are outside of research. Why you are trying to suggest that isn't true is more than a little puzzling. Maneesh (talk) 00:16, 14 December 2021 (UTC)

Yes, English is my first language. And like any living language, it evolves over time. Woman or man has not be synonymous with female or male for the better part of the last decade. Woman and man are gender related terms. Male and female are sex related terms. On an article titled "Sex differences in medicine" it is more accurate to use sex related terms than gender related terms. Sideswipe9th (talk) 00:23, 14 December 2021 (UTC)

I would say that while I agree with you that quibbling over using Male vs Men or Female vs Women in this article is dumb, and we should use the most inclusive language which makes clear these studies were almost exclusively conducted on AMAB/AFAB cis individuals. But also that your statement here "like any living language, it evolves over time: perhaps glosses over the fact that science (and especially scientific language) is slow to change. It lags behind the rest of society, for the sake of precision and convention. We should do our best in this article to portray the most modern language which does not remove that precision. — Shibbolethink ^{(♔ ♕)} 00:50, 21 December 2021 (UTC)

I'm just throwing rocks 45: "POTS is more frequent in women (female:male ratio, 4.5:1), and most cases occur between the ages...". You do realize it's an easy bet that almost all the cites you make use of the synonymous terms. How long do you think you can call this "cherry picking"?Maneesh (talk) 00:43, 14 December 2021 (UTC)

I don't even need to bother opening the articles, 21 "Sex differences in pharmacokinetics predict adverse drug reactions in women", perhaps we should notify Biology of Sex Differences, since they are using decade old language in the titles of their 2020 articles. Maneesh (talk) 03:42, 14 December 2021 (UTC)

Woman or man has not be synonymous with female or male for the better part of the last decade....you do realize that the google query is live and returns mainstream stories that are mere hours old, don't you? Maneesh (talk) 01:01, 14 December 2021 (UTC)

I am very unimpressed with the constant goal post shifting. It makes it very hard to assume good faith. The discussion is on language MEDRS use, not what NEWSORG use. Likewise this shift from Please count the number of occurrences of "men" and "women" below each respective title out of the total number of points to Each one I've spot checked uses man/men/male(s) and woman/women/female(s) synonymously. is dishonest. Sideswipe9th (talk) 01:32, 14 December 2021 (UTC)

Ah so now that you can see that I'm not cherry picking and have falsified your claim about English you claim goalpost shifting and dishonesty. You really need to take a hard look at the RS in this article and read virtually any mainstream writing today to know that your original claim,Woman or man has not be synonymous with female or male for the better part of the last decade., is not just false but ridiculous. Likewise, your reverts don't make much sense. Maneesh (talk) 02:18, 14 December 2021 (UTC)

What exactly is being argued here? GoodDay (talk) 01:36, 14 December 2021 (UTC)

Maneesh is playing a fairly elaborate shell game, as far as I can tell. Sideswipe9th is the gull, in this scenario. Newimpartial (talk) 01:43, 14 December 2021 (UTC)

You believe it is a shell game to show the plainly visible examples of man/male and woman/female being used synonymously? In line with the strange claims I've sen you make in these related discussions. Maneesh (talk) 01:47, 14 December 2021 (UTC)

Please see my more elaborate explanation below. Newimpartial (talk) 02:35, 14 December 2021 (UTC)

This article (virtually each and every line), the underlying MEDRS and everyday English use man/male, woman/female synonymously. Newimpartial is in denial of these facts and has prevented the section titles (EDIT: I should say introductory sentences...as the titles already say "Man" and "Woman" before my edits) from reflecting the content of the article. Maneesh (talk) 01:46, 14 December 2021 (UTC)

I've been on this planet for quite a few decades. An adult human male, is called a man & an adult human female, is called a woman. So, what's the dispute? GoodDay (talk) 01:51, 14 December 2021 (UTC)

And these terms have contextually-specific meanings. Anyone who thinks any of these terms always means the same thing has not made very good use of their time on the planet, IMO. As far as my reverts, I am not preventing anything except POV editing without Talk page consensus. ONUS and BRD both back my reverts. Newimpartial (talk) 01:55, 14 December 2021 (UTC)

GoodDay yep, you can see the denial of that plain language and obvious truth here. The article uses "Man" and "Woman" everywhere, the revert is happening on sentences in the intros and being justified by claims that deny the plain knowledge you've just recited. Maneesh (talk) 02:11, 14 December 2021 (UTC)

Ya'll can figure it out for yourselves. This already has become (looking at the edit-spats) one of the lamest disputes, in this projects 20+ year history. GoodDay (talk) 01:59, 14 December 2021 (UTC)

Thank you for that provocative insight GoodDay... Sideswipe9th (talk) 02:00, 14 December 2021 (UTC)

Whatever. GoodDay (talk) 02:01, 14 December 2021 (UTC)

FWIW: the articles Man & Woman open with "adult male human" & "adult female human". Hope that helps. GoodDay (talk) 02:20, 14 December 2021 (UTC)

The thing is, GoodDay: recent, reliable sources use "man" and "male human" in the sense of sex assignment, or gender identity, or without specifying (or even distinguishing) which one is meant. Context is key (and the same is true of "woman" and "female human"). Maneesh's POV approach, to shoehorn in edits as though "man" always meant "assigned male at birth" (and in turn, in his unsubstantiated opinion, meaning in all instances XY or YY chromosomes as well) is, as I stated earlier essentially a shell game. Don't be a mug. Newimpartial (talk) 02:35, 14 December 2021 (UTC)

I'm not a cup full of beer. GoodDay (talk) 12:59, 14 December 2021 (UTC)

I saw this comment at WP:AE first, and responded (somewhat mirthlessly) here. AE does not bring out my gaiest humour. Newimpartial (talk) 13:47, 14 December 2021 (UTC)

Contrary to some claims above, it is still the norm in WP:MEDRS to simply use "women" to refer to adult humans of the female sex. Anyone is free to confirm this by opening Google Scholar, searching for "only in women" or "pregnant women", in quotes, and selecting "since 2021". We do not and should not engage in alienesque writing and random shout-outs to gender identity, as the medical sources themselves do not do this. Crossroads ^-talk- 07:48, 14 December 2021 (UTC)

Crossroads, what you are doing here (not entirely well, but with seemingly good intentions) is appealing to context to decide the usage of "men" and "women", etc. This is the correct procedure, although the way you are doing it leaves out important nuances in "women's health" communication over the last few years.

However, my point is that your approach here is the diametrical opposite to the rationale behind Maneesh's edits as expressed in this discussion: he is denying the relevance of context and playing a shell game with denotation, as I noted above. Newimpartial (talk) 10:15, 14 December 2021 (UTC)

Your best route is to open up an RFC on the matter-in-question. GoodDay (talk) 19:20, 15 December 2021 (UTC)

That would be a waste of time because there is already an explicit community-wide consensus on that from the WP:Village Pump: "the terminology in articles, especially medical articles, is dependent upon the support of reliable sources and it is expected that editors would use the same terminology presented in said sources." And even if there wasn't, WP:STICKTOSOURCE and WP:NOR are clear. We simply use the terminology that the experts writing the MEDRS do. Plus, Wikipedia is not for advocacy about how sex-differences writing is done. Crossroads ^-talk- 19:40, 15 December 2021 (UTC)

And that means that the question needs to be decided based on actual sources. Where sources support, for example, specific language related to transgender hetb, then that would be the relevant STICKTOSOURCE, NOR language in those cases. Newimpartial (talk) 19:46, 15 December 2021 (UTC)

Sure, but that is not nearly as common as you seem to think. Crossroads ^-talk- 19:54, 15 December 2021 (UTC)

I don't think you know what I'm thinking - after all, I'm wearing my chic tinfoil beret. Newimpartial (talk) 20:16, 15 December 2021 (UTC)

You might have a point on MEDRS using "man" or "woman" except for the fact that those words do depend on context, and sources generally dont say in which way they are using it. Pretending that "man" or "woman" can only mean genetic sex is silly, they very obviously can refer to gender identities. If you are saying that the terms "man" and "woman" on this page refer to genetic sex and include any "assigned male at birth" or "assigned female at birth" respectively then that needs to be clear. I dont have an opinion on which way to do this is best, but I think it silly to pretend that the phrasing in men or in women is not ambiguous as to who exactly is covered. nableezy - 17:08, 20 December 2021 (UTC)

Consider familiarizing yourself with this important research area. How do you think articles in the "Journal of Sex Differences" are using the terms men and women? I happened to read this highly cited (2k+) review, Sex differences in immune responses recently where "men" and "women" are used throughout (along with "male" and "female"). Look at the NIH. Contrived phrases like AMAB would not make sense here, virilized 46,XX CAH can be "assigned male at birth" (though consensus is that they should not be). Would all the sex differences in, say, that review I just showed you make sense if you WP:SYNTH replaced the use of "man"/"male" with "assigned male at birth"? This here is a very highly cited review on the critically important topic of sex differences COVID-19 disease outcomes. Do you see the synonymous use man/male woman/female throughout? Do you see any uses of "AFAB" or "AMAB"? Do you see any sort of suggestion that "man" and "women" are ambiguous in these sources? Do you see any use of the refined term "genetic sex" in these sources? Do you think that all these examples might just be representative of all of MEDRS? Maneesh (talk) 18:14, 20 December 2021 (UTC)

Re Do you think that all these examples might just be representative of all of MEDRS? Why on earth would someone look at your hand-picked examples and reach that conclusion? On the face of it, that seems wildly improbable. Newimpartial (talk) 18:25, 20 December 2021 (UTC)

If anyone is so unfamiliar with MEDRS that they might think that the above observations are a result of sampling: pick your favorite disease and look for highly cited reviews on sex differences: cancer, Alzheimer’s, heart disease. Check all the same things I asked to be check above, I didn't in picking these reviews but I am read enough to know that I don't need to. Go ahead and pick some yourself. Maneesh (talk) 18:37, 20 December 2021 (UTC)

The idea that you think AFAB or AMAB are contrived terms indicates you are not familiar with transgender medical literature. The reason men and women are unambiguous in your sources is (e.g. second nature article) that some of them exclude intersex and transgender individuals from the study, others (first nature article) explicitly disclose they are not studying gender and only sex, making the terms less ambiguous. Santacruz ⁂ Please ping me! 18:59, 20 December 2021 (UTC)

they are not studying gender and only sex, making the terms less ambiguous What is the title of the article this talk page is associated with? Maneesh (talk) 19:07, 20 December 2021 (UTC)

Why exactly are you opposed to clarifying the usage here is specific to sex? nableezy - 22:34, 20 December 2021 (UTC)

There is no problem in clarifying in his article that there are two sex categories (male/female) and that (man/woman) is generally used by MEDRS synonymously throughout. Why are you trying to misrepresent what the studies say and alter the clearly consensus conventions they write in? Most sex difference studies in humans talk about men and women, that's just the way it is. I've already shown you the problem with contrived AMAB style language above, it shouldn't be a surprise to you that serious studies avoid this language. Why do you think you know better than the obvious conventions of MEDRS? Maneesh (talk) 23:05, 20 December 2021 (UTC)

What is wrong with MEDRS sources like this methodological paper, this pharmacology review article or this 2016 piece? Colour me confused. Newimpartial (talk) 00:34, 21 December 2021 (UTC)

Look at your Nature article. Look where it says Intersex and transgender individuals were not represented in this study. See how that clarifies what it is including in "men" and "women". We need to have that type of clarity. And not ignore the fairly obvious fact that it is indeed ambiguous to say "men" or "women". nableezy - 18:58, 20 December 2021 (UTC)

What proportion of RS do you believe provide this disclaimer? What impact does that have on the conclusions on sex differences? EDIT: Also "not represented" does not imply "not included" (they've used that phrase carefully here, and understandably so). Maneesh (talk) 19:10, 20 December 2021 (UTC)

For context, here's the sentence and the one prior to it. This patient group, cohort A, consisted of 39 patients (17 male and 22 female). Intersex and transgender individuals were not represented in this study. In this context, it is absolutely clear that "not represented" is synonymous with "not included". In a study titled "Sex differences in immune responses that underlie COVID-19 disease outcomes" not including trans and intersex individuals makes sense, as it could potentially skew the results. Why? Some intersex conditions, like Klinefelter and Turner syndromes have a increased rates of autoimmune conditions and immunodeficiencies. Sideswipe9th (talk) 19:49, 20 December 2021 (UTC)

I dont think it really matters the proportion, I dont think this is a due weight issue. This is a clarity issue. Do you actually believe that man and woman cannot refer to genders and not strictly sex? If you do not think that, why oppose clarifying what the usage refers to here? nableezy - 19:51, 20 December 2021 (UTC)

It is a due weight issue; why would it make sense to write in the convention of a small area when all of sex differences (and beyond) in MEDRS writes differently? If anyone believes that "not represented" == "not included", You should have no trouble quoting exclusion procedure/criteria in the study. The claims about Klinefelter are embarrassingly uninformed, many subsets of men and women have heightened rates of autoimmunity. Klinefelter *males* are *males*. Many words have contextually different meanings that doesn't mean that they aren't used in specific meanings. It's quite clear that male/men/man and female/women/woman are used synonymously (not a surprise if you look at man and woman). I can link to highly cited studies across any disease area all day that all do the same thing because that is how essentially all of MEDRS is written; you don't seem to be familiar with this fact. Maneesh (talk) 22:50, 20 December 2021 (UTC)

Aside from your misreading of Man and Woman as if they use the terms "male" and "female" always in the sense you attribute to the MEDRS (they clearly don't): Maneesh, do you actually believe that all of sex differences (and beyond) in MEDRS writes differently? If so, what is the evidence for your belief? Are you under the misapprehension, for example, that studies across any disease area stands in adequately for the domain of MEDRS? Because that ain't so, and your claim seems pretty ridiculous, given the topics (including topics related to gender) on which MEDRS sources exist. Newimpartial (talk) 22:58, 20 December 2021 (UTC)

Re Klinefelter, no. They are intersex. Their gender identity is a separate discussion and a distraction.

As for the Nature paper's exclusion criteria, there were multiple exclusionary criteria of which transgender and intersex were explicitly one. I would happily quote the others here, but they aren't at all relevant to this discussion. So no Gish gallop for you. Sideswipe9th (talk) 00:33, 21 December 2021 (UTC)

You clearly do not have the ability to interpret such scientific work correctly. People like Klinefelter males are not excluded from that study, you can't pull any evidence that they were and mere familiarity with clinical science would let you know why. It's clear you have no intent on learning any basics. "Not represented" means something very different than "not included"; what a shame if editors with such embarrassing interpretation skills are not corrected here. Maneesh (talk) 00:44, 21 December 2021 (UTC)

The insistence that Kleinfelter males are not males is a form of scientific illiteracy. Maneesh (talk) 00:49, 21 December 2021 (UTC)

Hi, I'm a guy who has studied sex differences and, in particular, Klinefelters in an academic medical setting. In the setting of genetic differences of infectious disease response.

Klinefelter "males" are not strictly "males" for the sake of academic study. For our purposes, they are indeed on the "intersex" spectrum. They are excluded from most clinical trials for that very reason, because the variations in hormone expression they have affect their physiology. [3] [4]

However, it is also true that members of the Klinefelter/XXY community do not usually consider themselves "intersex" in the modern meaning of that term. [5] This contradiction is evident here. To square this, on Wikipedia, we go with academic definitions when discussing studies and science etc. And then we go with societal RS-supported definitions when discussing anthropology and culture and so on. In this article, it would be appropriate to include Klinefelter individuals as "intersex" for that reason. — Shibbolethink ^{(♔ ♕)} 00:58, 21 December 2021 (UTC)

I don't think you did very deep "academic study". I've already linked to 100s of papers that use "Klinefleter male". You'll notice "intersex' is generally absent in clinical work on Klinefelter males. You'll find 1000s with "XXY males". You don't have much expertise here, it is obvious. None of your reasoning makes much sense. Maneesh (talk) 01:03, 21 December 2021 (UTC)

On wikipedia, we operate via consensus. Not via personal attacks. Linking to older studies which were written and published before more recent academic consensus statements is not very useful in this discussion. We also use terms like "internally male" and "externally male" with some intersex patient cases, but that does not make those patients "male," strictly speaking. — Shibbolethink ^{(♔ ♕)} 01:08, 21 December 2021 (UTC)

You have fictitious notions of intersex and Klinefleter. Your claim about clinical trials is ficticous, we don't usually karyotype for clinical trials; many men who are Klinefleter's don't know that they are since presentation is "often subclinical". You have no expertise here. Maneesh (talk) 01:12, 21 December 2021 (UTC)

We don't actually need a karyotype to diagnose Klinefelter's (adult males are usually presumptively diagnosed, and only karyotyped if they wish to get a truly "definitive" answer or if they want to seek fertility treatments which would be harmful to their health). I'm not sure where you got the idea that I was suggesting anyone was doing karyotypes in clinical trials (although such studies have been done). — Shibbolethink ^{(♔ ♕)} 01:16, 21 December 2021 (UTC)

Are you for real? "Chromosome analysis. Also called karyotype analysis, this test is used to confirm a diagnosis of Klinefelter syndrome"

Likewise, you have often referenced WP:MEDRS in this discussion. "Academic consensus statements" from "professional organizations" are held in very high regard by that guideline. So we should respect statements by organizations like the APA and AMA. — Shibbolethink ^{(♔ ♕)} 01:13, 21 December 2021 (UTC)

This is again descending into madness. Please quote in your link where it says Klinefelter males are not males. Any prevalence estimate of Klinefelters is an estimate out of the set of males: "Klinefelter Syndrome (47, XXY) is a chromosomal variation in males...47, XXY (KS) is the most common human sex chromosome disorder and occurs in approximately 1 in 500-1,000 males.". I do not believe you did any serious work anywhere near this condition. Maneesh (talk) 01:19, 21 December 2021 (UTC)

Any prevalence estimate of Klinefelters is an estimate out of the set of males. Yes, because most Klinefelter individuals are raised as "men" culturally-speaking, and are presumed male until they are diagnosed. And many of these individuals continue to identify as "men" thereafter. It does not mean the condition is not on the "intersex" spectrum. It is. — Shibbolethink ^{(♔ ♕)} 01:21, 21 December 2021 (UTC)

Nothing you say is supported by clinical science, you seem determined to be ignorant of it despite having links put in front of you that explain it clearly. "Intersex" does not preclude one from being a male or a female, almost all "intersex" conditions are sex specific and the overwhelming numer of people with intersex conditions are just male or female and the conditions have prevalence estimates out of males and females. How people are raised has nothing, absolutely nothing, do with these estimates which are done via objective tests like karyotypes. Maneesh (talk) 01:26, 21 December 2021 (UTC)

I suggested in the section prior that, as this is an article titled "Sex differences in medicine", we should consistently use male/female language throughout as that is unambiguously a sex related descriptor. Man/woman have contextually different meanings, and it isn't immediately clear whether or not it is being used as a sex descriptor or a gender descriptor in this article. The lead and causes sections for example use "male" and "female" throughout. The first instance of the words "men" or "women" is in the women subsection. Sideswipe9th (talk) 19:00, 20 December 2021 (UTC)

as this is an article titled "Sex differences in medicine", we should consistently use male/female language throughout as that is unambiguously a sex related descriptor.

Yes, I agree with this and I think it is a relatively uncontroversial opinion. There is nothing gained by using "men" instead of "male" in an academic scientific article. Such terms are less precise. The fact that some authors use them interchangeably does not change their vague quality, and does not make them permissible for the article. — Shibbolethink ^{(♔ ♕)} 00:59, 21 December 2021 (UTC)

Based on your comment above, I was about to ask for clarification on that as I suck at reading between the lines. But you've already addressed the question here. Thanks. Sideswipe9th (talk) 01:07, 21 December 2021 (UTC)

Just as a courtesy note encase anyone was unaware, Maneesh has put out a notice over on WikiProject Medicine. Although it is decidedly non-neutral and a misrepresentation of this discussion.Sideswipe9th (talk) 00:33, 21 December 2021 (UTC)

digression.— Shibbolethink (♔ ♕) 01:25, 21 December 2021 (UTC)

I would encourage you to remove this part of this comment: Although it is decidedly non-neutral and a misrepresentation of this discussion. That may be true, but it does not do anyone any better to continue that trend of non-neutrality here. Notices of other postings placed in the original discussion should also be neutrally worded, per WP:CANVAS. — Shibbolethink (♔ ♕) 01:00, 21 December 2021 (UTC) Just to confirm, do you want me to strike that just here or over at WikiProject Medicine as well? How do you address a non-neutral notification potentially colouring the perspective of incoming editors in this sort of situation? Sideswipe9th (talk) 01:07, 21 December 2021 (UTC) I would encourage you to strike it here, and just place a matter-of-fact neutral description of this discussion over at WT:MED instead of any indictments, etc. — Shibbolethink (♔ ♕) 01:18, 21 December 2021 (UTC) Done here. And I've removed my reply over there and replaced it with the template. Sideswipe9th (talk) 01:23, 21 December 2021 (UTC) Thanks, I'll go ahead and collapse this digression — Shibbolethink (♔ ♕) 01:24, 21 December 2021 (UTC)