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Talk:Sex differences in medicine

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Wiki Education Foundation-supported course assignment

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This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): SWillow. Peer reviewers: Haileewright.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 09:02, 17 January 2022 (UTC)[reply]

Straw poll on removing side point about transgender identity from bullet point about female reproductive system

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I propose to remove the underlined text from the following bullet point under "Females":

Ovarian cancer, endometriosis and other diseases of the female reproductive system occur mostly in women (except in the rare instances where other genders have said organs, such as trans men.[relevant?][1][2][3])

References

  1. ^ "Ovarian Cancer in Transgender Men". The National LGBT Cancer Network. Retrieved 2021-02-21.
  2. ^ Stenzel, Ashley E.; Moysich, Kirsten B.; Ferrando, Cecile A.; Starbuck, Kristen D. (1 December 2020). "Clinical needs for transgender men in the gynecologic oncology setting". Gynecologic Oncology. 159 (3): 899–905. doi:10.1016/j.ygyno.2020.09.038. ISSN 0090-8258.
  3. ^ Dutton, Lauren; Koenig, Karel; Fennie, Kristopher (1 July 2008). "Gynecologic Care of the Female-to-Male Transgender Man". Journal of Midwifery & Women's Health. 53 (4): 331–337. doi:10.1016/j.jmwh.2008.02.003. ISSN 1526-9523.

None of the sources are about the topic of sex differences. It is just an off-topic tangent of the sort that could be appended to any discussion of sex differences. There is no reason to shout-out different small subgroups like that here. We're obviously not going to add asides about gender identity to every point about sex differences, but keeping this makes it look like some do want that. Removing it in no way implies anything regarding any other text in the article present or future. There are much more weighty discussions going on above, and this text distracts from and confuses all of that. Crossroads -talk- 22:57, 21 December 2021 (UTC)[reply]

I would say the compromise is to not mention gender at all. In fact, isn't that basically your position for other text - to separate sex and gender? Why not just say "female reproductive system" under the Females heading and be done with it? Crossroads -talk- 00:59, 22 December 2021 (UTC)[reply]
If we are talking about sex, then we shouldn't use the term "woman." That's my position. — Shibbolethink (♔ ♕) 15:06, 22 December 2021 (UTC)[reply]
Noting here that Shibbolethink already elsewhere answered "no" to including this. [1] Crossroads -talk- 05:01, 22 December 2021 (UTC)[reply]
Please don't put words in my mouth. I reassess each situation as it comes, and offer compromises to try and achieve consensus, regardless of what I may personally feel about the answer. I would appreciate it if you struck this comment and allowed me to answer on my own. Thanks. — Shibbolethink (♔ ♕) 15:03, 22 December 2021 (UTC)[reply]

Let’s just say female and not mention woman. Saying female just makes things easier.CycoMa1 (talk) 01:54, 22 December 2021 (UTC)[reply]

I suggested this previously except on a wider basis, that this article should only use male/female and avoid usage of man/woman altogether. Needless to say the discussion on that has been long. Sideswipe9th (talk) 02:29, 22 December 2021 (UTC)[reply]
It would adhere to the AMA's guidelines... The sex-gender language is outdated in social sciences (we use sex assignment at birth more often) but it's still normal in medical research. I think I argued for something like this on Wikipedia a long time ago... EvergreenFir (talk) 02:34, 22 December 2021 (UTC)[reply]
As a side point, just noting for the record that while that link does talk about "sex assigned..." in a transgender context, it does also simply state, Which term means the classification of people as male or female? Sex. Crossroads -talk- 05:01, 22 December 2021 (UTC)[reply]
I'm confused. If it already says the diseases occur in the female reproductive system, is any further description necessary? Isn't it understood that only people with female reproductive systems can have those diseases? Female, women, or any other term would be redundant if so. Santacruz ⁂ Please ping me! 10:42, 22 December 2021 (UTC)[reply]
@A. C. Santacruz I think, likely, the issue to some users around here is the use of "female reproductive system" and then immediately after, "women" to refer to the same set of people.— Shibbolethink (♔ ♕) 15:19, 22 December 2021 (UTC)[reply]

It's been removed now per clear agreement above. As I said at the beginning of this discussion, "removing it in no way implies anything regarding any other text in the article present or future". Crossroads -talk- 19:32, 22 December 2021 (UTC)[reply]

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This is with regards to the first sentences in the sections "Females" and "Males"
Options:

(1) - Keep it as it is. (female humans · male humans)
(2) - Link to the sex-based article (subsection on mammals) (1 link). (female humans · male humans)
(3) - Link to the female and human articles (2 links) (female humans · male humans)
(4) - Have no link. (female humans · male humans)
(5) - change the plug to the gender-based term (women · men)
(6) - Use 'females' and 'males' and link to 'Woman#Health' and 'no link'. (females · males)

Feel free to add your own options (directly below these), and please restrict your responses/discussion to this question whenever possible. Thanks — Shibbolethink (♔ ♕) 15:35, 22 December 2021 (UTC)[reply]

Requested move 25 December 2021

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The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: Not moved. There's some support for "Sex differences in health" and variations, but little for the proposed name. (non-admin closure) (t · c) buidhe 01:42, 4 January 2022 (UTC)[reply]


Sex differences in medicine → Sex differences in disease – "sex differences in disease" (1890 hits) is more common than "sex differences in medicine" (223 hits), the scope of the material is identical (look at an article with "sex differences in medicine" in the title). Using "sex differences in disease" will cover sex differences in terms of risk, diagnosis and treatment and makes it easier to cover both sex differences in diseases that both sexes can be diagnosed with as well as "sex specific" diseases that only one sex can be diagnosed with (source like this). You can also find "sex differences in disease" in top-tier source like this but can't find "sex differences in medicine". Current use of "sex-related diseases" in article is not supported by sources; article needs to be coherent with title and "sex differences in disease" makes that much easier to do. Maneesh (talk) 00:18, 25 December 2021 (UTC)[reply]

Oppose Sex differences in disease, Support Sex differences in health and medicine & Sex differences in health.The proposed title would narrow the scope of the article, and, as a rule, it is generally not a good idea to pick new names that change article scope without first changing that scope. Medicine involves more than just diseases. We reassure people about benign conditions, natural variations, etc. We also treat disorders, syndromes, conditions, and yes, diseases. But these things are not interchangeable, they have actual meanings, regardless of how often the words are misused. For example, disease is typically used in medicine to refer to a pathological state for which we have an identified cause [2] [3].
Versus a syndrome, which is a recognizable complex of symptoms and findings which indicate a specific condition for which a direct cause is not necessarily understood (ibid, [4] [5]).
This is as opposed to a disorder which is used to describe a perturbation in the normal functioning of different systems in the body. Some disorders are not considered diseases, as there is not enough of a "smoking gun" to determine the causative process (the prime mover). Psychiatry, for example, rarely, if ever uses the term "disease" and prefers "disorder" as it is more easily and aptly applied to most of its conditions [6] [7].
There are also many syndromes which are more and more being referred to as "conditions" so as to lessen the pathologizing nature of our labels. Many users would agree that many flavors of Autism, Downs, and Klinefelter's are non-pathological and largely benign. Describing these as "diseases" is reductionist and pathologizing, and, truthfully, inaccurate as these are "syndromes" in the technical sense [8].
Here are many other examples where these terms are used in a distinct manner by authoritative sources:
All of which to say, we should not use "disease" in the title because it excludes a great many of the health conditions discussed on the page already. (edited 15:06, 25 December 2021 (UTC)) — Shibbolethink (♔ ♕) 00:48, 25 December 2021 (UTC)[reply]
Shibbolethink - while syndrome has a stable definition, disease and disorder don't (and the stable definition of syndrome gets ignored by everyone anyway, in favour of established naming). For your citations, the first that you gave for disorder is a symposium. It also explicitly notes that disease doesn't have a clear definition (as does the second). Both are attempts to establish a definition. With your examples, you have also ignored the literal standard - the International Classification of Diseases. Which, if you examine the current ICD-11 throughly, contains every single diagnosis and even situation listed in this article. For some further examples, now simply demonstrating that the definition is not as clear as how you've presented it: AHRQ and AIHW do not define distinct scopes for the terms. In fact, of the organisational examples you presented, the CDC, the MO Dept of Health and Hopkins either do not define terms or actively define them as synonymous. And the NIH Cancer Institute doesn't actually define "disease", so you are simply assuming that its inclusion in this list means that the terms used are mutually exclusive whereas they also could've simply chosen to include overlapping or synonymous terms for the purpose of clarification. A more appropriate interpretation of the evidence we have presented would be that there are no real definitions of these terms, and that generally people understand that the use of "conditions and diseases" or often even just "diseases" can cover everything. (also pinging Sideswipe9th as they made the same argument below). --Xurizuri (talk) 05:56, 27 December 2021 (UTC)[reply]
The ICD is not the standard for what counts as a "disease." If it were, then there would be no trauma codes in the ICD, as diseases are physiological disruptions of normal functioning by any of many definitions, trauma (e.g. getting hit by a bus) would not apply. Pregnancy would also not appear, as agreed upon below by other participants here and standards set elsewhere. But it does: Encounter for supervision of normal pregnancy, unspecified, unspecified trimester. (Z34. 90). The ICD has morphed and changed into a system of billing codes, a purpose for which it was not intended, but which it has been manipulated and distorted to fill [9].
You may find that few, if any clinical professionals consider the ICD when making any decisions or writing about health conditions. It is used almost entirely for purposes of epidemiology and business. We laugh about it in the clinic probably on a weekly basis, basically every time we need to hunt down a code for billing purposes, because the options are so overlapping and contradictory and absurd. So I wouldn't personally say it has much, if anything, to do with the medical or clinical definitions of "disease." There's an ICD code for "Accidental striking against or bumped into by another person, sequela" (W51.XXXA) and "Activities involved arts and handcrafts" (Y93.D) and "Problems in relationship with in-laws" (Z63.1) and "Bizarre personal appearance" (R46.1) and I could go on and on. None of these are diseases.
As for the sources in question, I disagree with your interpretations. I think I may have not given enough by just linking, so here are the quotes I noted in particular:
Although the terms syndrome, disease, and disorder are commonly used interchangeably, they are in fact distinct and reflect different levels of conceptual understanding....A syndrome is the most basic and is a constellation of specific signs and symptoms which commonly co-occur but that have no known etiology. A disorder is also a collection of signs and symptoms without a known cause, but it does have associated features that are assumed to play a role in its development. A disease is also composed of signs and symptoms but has a known etiology [10]
  • disease: A physical or mental disturbance involving symptoms (such as pain or feeling unwell), dysfunction or tissue damage, especially if these symptoms and signs form a recognisable clinical pattern." [11]

You are right that disease has (to a degree) a malleable definition. But the most commonly used definition in medicine involves a single pathological process.
Compared with disease, disorder is less restrictive: Merriam-Webster’s defines it simply as “an abnormal physical or mental condition,”2(p360) a definition with which Dorland’s largely concurs.3(p555) The Oxford English Dictionary emphasizes that disorder involves a disturbance of function but again further stresses structural change, this time in negative terms, stating that disorder is “usually a weaker term than DISEASE, and not implying structural change.”1(p449) [12]
These other terms, however, have much more fixed definitions:
Diagnosis of a syndrome (such as Tourette's syndrome or sarcoidosis) depends on identification of possible combinations of signs and symptoms displayed by a patient [13]


These classifications are also per the DSM, which is a direct descendent of the ICD. [14]

Strictly speaking, the terms 'diagnosis' and 'disease' are both best avoided in psychiatric discourse unless they are completely justified. Clinical psychiatrists make few diagnoses in the sense of identifying known abnormalities which underlie the presenting symptoms. Instead, for most patients they have to make do with identifying disorders by assessing the number and severity of individually non-diagnostic symptoms from an agreed list [15]

I was referring to these other sources (MO DoH, CDC, etc) as a way to show how they delineate "Disease" vs other "conditions." Not because I was citing them for any particular definition or quotation. You'll notice this is why I said: examples where these terms are used in a distinct manner not "here are some more quotes or definitions."

Overall, it seems you have misread my comment. I am sorry you disagree with my interpretation of these sources, I do not think that is a matter we will resolve here in any reasonable course of time. — Shibbolethink (♔ ♕) 06:35, 27 December 2021 (UTC)[reply]
Note: WikiProject Medicine, WikiProject Feminism, and WikiProject Women's Health have been notified of this discussion. — Shibbolethink (♔ ♕) 00:50, 25 December 2021 (UTC)[reply]
Oppose. It needlessly narrows the scope of the article, which already contains examples of conditions that are explicitly not diseases. If we are to keep those examples, either we would be pathologising those conditions or we would have to remove content due to the narrower scope. Sideswipe9th (talk) 01:00, 25 December 2021 (UTC)[reply]
Comment comments about the differentiation between notions like "syndrome" etc. are pretty easily shown to be, somehow archaic. Search MEDRS for "sex differences in disease" "syndrome" (948 hits) and you'll easily find sentences like: "...tics, and Tourette's syndrome (TS) display sex differences in disease susceptibility...", "First, there are those diseases, such as WiskottAldrich syndrome....", "Sex differences in Sjögren’s syndrome:..SS is diminished secretory production from the primary exocrine gland and the lacrimal or salivary glands resulting in symptoms of dry eye and mouth. The disease is believed...", ~1/10th number of hits with "sex differences in medicine" "syndrome" (95 hits). EDIT: Look at any specific disease: "sex differences in disease" "Sjögren’s syndrome" (78 hits) vs. "sex differences in medicine" "Sjögren’s syndrome" (6 hits). EDIT AGAIN: Same with "disorder" "In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident in schizophrenia, bipolar disorder, and post-traumatic stress disorder.", "Sex differences in a disease or trait can provide insight into its causes, risk factors, and consequences. The aims of this paper are to: (a) summarize the sex-specific lifetime prevalence of the most common psychiatric disorders among adults and youth; (b) enumerate hypotheses for sex differences in mental disorders; (c) describe the use of the concepts and tools of genetic epidemiology to evaluate...". No "sex differences in medicine" in those articles. The scope of the article is appropriately expanded with "sex differences in disease". Maneesh (talk) 03:16, 25 December 2021 (UTC)[reply]
Comment: SandyGeorgia had previously suggested Sex differences in health and medicine, which I think should be at least considered. Perhaps Sex differences in health as well. Both would enable an expansion in this article's scope, which has long been mostly a couple of lists tied together with a minimal amount of prose. "Sex differences in health" has 5,320 results, FYI. Firefangledfeathers 07:47, 25 December 2021 (UTC)[reply]
Comment "sex differences in health and medicine" has a paltry 3 hits. This page is currently a list of diseases ("disease" or "illness" begins each section) and their relative prevalence between sexes (and the underlying causes). It would be odd to discuss a long list of diseases in with an article titled "health". Risk, diagnosis and treatment are all associated with disease. The fact that you see a lot of google scholar hits for "sex differences in health" doesn't necessarily mean a whole lot here, since e.g.: "sex differences in health" "Sjögren's syndrome" (and even in those 9 hits, the phrasing at the top is: "...sex differences in health and a wide range of diseases". Diseases that have an age association will give you more hits with "sex differences in health" since "health and aging" often come together. That might be a fine article, but it isn't this one. Hard to assess the entire query, but hits I get from the things like "sex differences in disease" cancer match the information here more than "sex differences in health" cancer, the latter doesn't even sound like the right way to find the information here (even though there are more hits in this case). Maneesh (talk) 08:18, 25 December 2021 (UTC)[reply]
@Firefangledfeathers I would support either of these options. (Sex differences in health and medicine and Sex differences in health) — Shibbolethink (♔ ♕) 15:03, 25 December 2021 (UTC)[reply]
Support move to "Sex differences in health". I think this title would be much more appropriate to help the article become more comprehensive and free from many of the issues it currently has (e.g. list style, expert jargon). Santacruz ⁂ Please ping me! 11:04, 25 December 2021 (UTC)[reply]
Comment "health" only occurs once in the body of the article, "disease" occurs ~22 times. How do you figure this article is more about "health" than "disease"? Maneesh (talk) 16:05, 25 December 2021 (UTC)[reply]
I'm not saying that is what the article is, but what I believe it should be. In any case, there are health conditions other than diseases that do not fit the "disease" category that differ either in existence, presentation, or frequency between both sexes and thus renaming to disease would mean there is no place in WP for description of those differences (unless we make an article for sex differences in syndromes, etc.). I think health is an umbrella term that would allow for an article of higher quality. Santacruz ⁂ Please ping me! 16:38, 25 December 2021 (UTC)[reply]
But this is about moving this article, which I don't think you can deny is about "disease". If you think there is an article about sex differences in health, you can just create it (and presumably use the word "health" more than once). See my above comments if you are not familiar with MEDRS, disease/syndrome/disorder are often used syonymously. Maneesh (talk) 17:57, 25 December 2021 (UTC)[reply]
Hi, several editors here appear to disagree with what you believe the scope of the article is, and I would very explicitly disagree with your interpretation of MEDRS and the word "disease." Please do not continue to claim something is obvious when others disagree, it prevents a collaborative editing environment. — Shibbolethink (♔ ♕) 19:18, 25 December 2021 (UTC)[reply]
Hi, actually, I would very strongly argue that collaboration is not a vote. If you disagree with Maneesh, you should respond to the issues they've raised rather than simply saying they shouldn't raise them at all. (I will note that you have responded to the issues raised in this comment, just that the points in Maneesh's other comments haven't been.) --Xurizuri (talk) 05:56, 27 December 2021 (UTC)[reply]
Hi, never said Maneesh shouldn't raise the issue. I said he should not raise it as though it is the obvious only choice, when clearly many different views exist in this discussion. I also never said that this is a vote, I would agree with you that it is not. Both of these appear to be straw men arguments.
Further, it is not my job to refute whatever Maneesh says in every one of his comments, and doing so would be wp:bludgeoning the process. This is not high school/college forensics or policy debate, where spreading is the way to win. In these discussions, arguments are judged on their merits, not how often they go unanswered. For many of the arguments I have encountered on this site (in all manner of places), it is better to not respond at all. Readers can view the arguments made here and decide for themselves what they do and do not find persuasive, and then they can respond accordingly. That is the nature of consensus. — Shibbolethink (♔ ♕) 05:58, 27 December 2021 (UTC)[reply]
Comment the query "sex differences" disease gives all the heavy citation counts for review sex differences across disease areas, analogous to the current content of the article. Maneesh (talk) 13:08, 25 December 2021 (UTC)[reply]
I'd prefer sex differences in health or perhaps sex differences in medical conditions. When you use the word disease, people outside the medical profession often think primarily of infectious diseases, and then maybe it will occur to them that heart disease, diabetes, and cancer probably count, too. But they won't necessarily tell you that their back pain or their need for reading glasses is "a disease". Also, a person's capacity for pregnancy is a medical condition that is dependent upon biological sex, and it's definitely not "a disease". WhatamIdoing (talk) 02:47, 26 December 2021 (UTC)[reply]
This page should also have entries for "sex differences in infectious disease", "sex differences in lower backpain". Pregnancy is not a disease, and is not listed here; it will show up as a common factor in sex differences in disease. "Health" is an oddly inverted way of discussing these things. Maneesh (talk) 03:15, 27 December 2021 (UTC)[reply]
Support changing to "disease" version that makes the scope explicitly match what is in the article. Current title "medicine" is too general (e.g., do doctors dismiss information from female patients) and "health" becomes outright sociological. Maybe in the future somebody will write a great article on a grand unified theory of sex (and gender!) differences in health, medicine, disease, etc but for now it will invite scope creep in a focused article. Less is more. State the actual focus accurately, don't expand it or obfuscate it as all of "medicine". Sesquivalent (talk) 04:59, 27 December 2021 (UTC)[reply]
Comment: the widening of scope being described by many here will significantly duplicate the scope of the existing Gender disparities in health article. I would strongly suggest that everyone look at the scope of the health article before making a decision. I'll also quickly list some alternatives to what has been mentioned already: merge into the health article, merge the health article into this medicine article, merge both articles under a different name, delete this article, or turn this article into a list. I don't overly care what's decided and I'm not necessarily arguing that any of these are good ideas, but this discussion has gotten overly fixated on terms rather than considering alternatives. --Xurizuri (talk) 05:56, 27 December 2021 (UTC)[reply]
Merges cannot be the outcome of a move discussion. Such a decision would need to arise from the consensus built in an AfD or Merge Discussion. Different parameters, different criteria, different closers. We should not muddy the waters with so many options that a consensus becomes impossible. Such ideas can be worked out in future discussions. At this point, we are talking only about article name. — Shibbolethink (♔ ♕) 06:42, 27 December 2021 (UTC)[reply]
Wikipedia:Ignore all rules is still a policy. Merges can be the outcome of any discussion, including this one. WhatamIdoing (talk) 06:29, 31 December 2021 (UTC)[reply]
Perhaps the most important unanswered question about this proposal: This article has existed at this name for almost 19 years. Since February 12, 2003. Per the move log, it has never had another name.
What has changed recently that means this article requires a new name? And why did it change? — Shibbolethink (♔ ♕) 07:24, 27 December 2021 (UTC)[reply]
Actionable side issues frequently come up as a result of other ongoing talk page activity. Now that it has come up, it seems a perfectly reasonable proposal. Are you suggesting there is some problem with that, or is this just further litigation (by insinuation, which only makes it worse) of the campaign now in progress at AE? Sesquivalent (talk) 14:30, 27 December 2021 (UTC)[reply]
I don't see anything wrong with asking why a proposal is necessary. I've usually found such questions help the discussion be more concise and purposeful than before. There is no need to make insinuations about a neutral question.Santacruz ⁂ Please ping me! 14:40, 27 December 2021 (UTC)[reply]
Hey, just a heads up: I never said it was an unreasonable proposal. Simply that I disagree with its conclusions. I think it's a reasonable proposal that deserves to be answered in good faith. I would characterize that part of your comment as a possible straw man.
This comment is also creating a false dichotomy, presenting only two possible choices of what I could be suggesting. The truth is actually neither. I am simply echoing the enduring rule of thumb: if it ain't broke, don't fix it. In this case, I am asking: Is it broke? — Shibbolethink (♔ ♕) 14:46, 27 December 2021 (UTC)[reply]
That is a strange question. There are many things broke on wikipedia, and have been for long periods of time; to find something that has been broke for decades isn't particularly surprising. This article is low quality: there is no real body here, lead doesn't follow the body, the terms used there don't line up with the sources, the sources that support the content are about "sex differences in disease", there is relatively little RS out there for "sex differences in medicine". Maneesh (talk) 22:43, 27 December 2021 (UTC)[reply]
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
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