Jump to content

Talk:Cass Review

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia

sources for consideration

[edit]

Two minor errors in subsection header captions

[edit]

"Adult Clinics" should be "Adult clinics" (capitalisation). "Other government bodies actions" should be "Other government bodies' actions" (apostrophe), or "Actions by other government bodies". 2A00:23C5:FE1C:3701:947F:B029:98CA:1E06 (talk) 14:16, 16 November 2024 (UTC)[reply]

See Also

[edit]

@Snokalok and @Raladic You have added and reinstated a link to the page 21st-century anti-trans movement in the United Kingdom which you have been busily creating for the past few weeks.

That page has a somewhat inflammatory title to suggest an association with the Cass Review.

It also is justified by you because it contains the following:

In 2024, the publication of the controversial Cass Review of youth gender services led to a criminal ban on puberty blockers, and a general shift in NHS policy towards gender exploratory therapy, which many experts say is a form of conversion therapy. The review's recommendations were generally welcomed by the British medical community, however the international medical and academic communities generally criticised or rejected the review on grounds of both methodology and findings.

Which of course is not a reflection of the language on this page. I suggest this material is a WP:POVFORK and the relation to this page tenuous at best, especially the weasel-worded material on conversion therapy, which is itself flatly contradicted by the Cass Review. Void if removed (talk) 18:18, 4 December 2024 (UTC)[reply]

Please remember that Wikipedia is WP:NOTCENSORED and while you may take personal issue with the topic, it is a well sourced and neutral article that summarizes the anti-trans movement in the United Kingdom.
The article discusses the Cass Review in context, in fact it is mentioned 18 times in the article, so it is entirely appropriate as a related article link. Raladic (talk) 18:22, 4 December 2024 (UTC)[reply]
It’s a highly controversial government report that was used to justify a ban on puberty blockers and the mainstreaming of GET, which is widely recognized but everyone but the Cass Review as a form of conversion therapy. How is that not highly relevant to a major sociopolitical movement which has for a long time made both of those goals a centerpiece of itself? Snokalok (talk) 18:54, 4 December 2024 (UTC)[reply]
I don't think your repeated comments about GET are helpful.
In the final report, I find this:
"Terms such as ‘affirmative’ and ‘exploratory’ approaches have been weaponised to the extent that it is difficult to find any neutral terminology... 11.6 The intent of psychological intervention is not to change the person’s perception of who they are but to work with them to explore their concerns and experiences and help alleviate their distress, regardless of whether they pursue a medical pathway or not. It is harmful to equate this approach to conversion therapy as it may prevent young people from getting the emotional support they deserve."
It sounds like the twin goals are:
  • "not to change the person’s perception of who they are" – which means not conversion therapy – and also
  • "explore their concerns and experiences and help alleviate their distress".
Do you have a preferred term for this combination of not trying to change people's identities while still letting them have what one GIDS specialist calls "an open space for exploration of what this means to the individual, and what support they need in order to live a happy and fulfilled life"? The GIDS staff said they considered this to be compatible with the affirmative model, which they described in the report as "respecting the young person’s experience and sense of self whilst still exploring the meaning of that experience in a non-directive therapeutic relationship". Do you believe that this is a non-affirming approach? I could imagine someone (e.g., on social media) agreeing that this is actually an affirming approach, and agreeing that it is literally the approach recommended by the final report, but worrying that there will be a bait-and-switch scam: The Cass report might say not to change the clients' identities, but all of us smart people know that means exactly the opposite. WhatamIdoing (talk) 08:23, 5 December 2024 (UTC)[reply]
This goes back to the points I made here and the continual refusal to actually balance that material with the Cass Review over the past year. Unpicking this is hard, because it means an assessment of both the included and excluded sources over there. Which I did. But I am in a minority, and so this will keep spilling over onto this page.
Eg. Clayton et al (2024) says:
In contrast, Cass notes that alongside biological factors, psychosocial circumstances (such as trauma, homophobia, social influence) and mental health conditions might contribute to the development of youth GD/GI, rather than just being secondary or coincidental. Under the Cass model, the multidisciplinary assessment is geared towards identifying elements in these various domains relevant to the individual patient’s GD/GI. Cass notes the critical importance of a formulation to inform an individualized management approach which is developed by a collaborative process considering patient values, clinical expertise, and research evidence.4 In this model, GD/GI may well resolve with maturity, treatment of any co-existing psychiatric conditions, and/or supportive psychosocial care or psychotherapy – such as trauma-informed therapy or family therapy as indicated for each individual case. Importantly, this type of therapy does not aim to ‘change someone’s identity’ but validates a young person’s experience while opening space for self-reflection about their experiences and help with alleviating distress. This is not conversion therapy.
This could scarcely be clearer. However, since all three authors are associated with SEGM, and since editors have already decided SEGM are really espousing "conversion therapy" and are therefore fringe, the chances of my successfully citing this over such objections is nil, as with the arguments against the various BMJ sources that have been excluded from this page. Ie, it does not matter that this is a high quality peer-reviewed source, saying explicitly that it isn't conversion therapy, editors seem to already know it is (largely based on the current state of Gender exploratory therapy and SEGM), and that these authors can't be trusted, and thus it is excluded.
Likewise, Roberto D'Angelo, president of SEGM, writing in September:
Further, the current dominant understanding of trans identification in young people entails a very specific way of formulating (I would argue distorting) psychological distress, described in The Cass Review as “diagnostic overshadowing”. In effect, what this means is that any suffering, manifesting as anxiety, depression, eating disorders, etc, is subsumed under the diagnosis of gender dysphoria or “massive gender trauma”. This reconfiguration effectively trivialises and even erases these problems and their meaning, viewing them as secondary phenomena that will evaporate once gender transition has occurred. This clinical process reshapes psychic pain, which is difficult for both patient and analyst to bear, into a concrete problem with a concrete solution. Those who raise concerns about the quality of the evidence base for this concrete solution present a threat to this defensive phenomenon and are attacked with the same ferocity encountered when a patient becomes aware of dissociated material or “not-me” states. The net effect is that both analyst and patient can avoid and deny the psychic pain that is “humming” beneath the experience of gender dysphoria, maintaining a powerful prohibition on knowing.
Again, these are by my reading legitimate perspectives expressed in respectable, peer-reviewed journals. But if you start from the position that it is conversion therapy and cannot be legitimate (and is therefore fringe) then it creates a self-perpetuating cycle where no balancing sources are ever acceptable, because by saying the "wrong" thing they are fringe, something that has been applied even to sources as weighty as the Cass Review. It is WP:EXTRAORDINARY to claim the Cass Review espouses conversion therapy.
Do you have a preferred term
There is no preferred term. There cannot be one. The split is between the affirmative model, and anything else. If it isn't the affirmative model, then it is considered de facto conversion, and any labelling is mere obfuscation, is the reasoning. Exploratory therapy, gender exploratory model, psychotherapy, psychoanalysis, psychodynamic psychotherapy, ethical exploratory therapy, non-directed exploration - these have all been used and every single one has been collapsed into "conversion therapy". Cass drew attention to this as part of the reason GIDS was overwhelmed and failed - because clinicians didn't want to risk engaging in bog standard psychotherapy themselves and just dumped patients to GIDS. Void if removed (talk) 09:52, 5 December 2024 (UTC)[reply]
Diagnostic overshadowing could use some work. I wonder if the outrageous experience some trans people have reported, of having a provider ask to look at their genitals when they have a broken ankle, could be a case of this.
I suspect that it's mostly meant to cover cases of "He's screaming again so that's just his Level 3 Autism, not a sign of physical pain", but I haven't looked for sources that would show how narrow or wide it's usually understood. WhatamIdoing (talk) 17:29, 5 December 2024 (UTC)[reply]
Well quite, and in the context of the Cass Review the refusal of the adult clinics to provide follow-up information makes much of this unfortunately poorly understood. The outcome data is so poor it's hard to say with certainty. Void if removed (talk) 20:56, 5 December 2024 (UTC)[reply]
Ok, but regardless of what SEGM may or may not be saying on this particular subject, they are still a fringe group that hold scientifically unsupported positions, so they & those closely affiliated with them should not be cited as reliable sources for medical/scientific topics. Butterscotch Beluga (talk) 20:35, 5 December 2024 (UTC)[reply]
@Butterscotch Beluga, can you point me to the policy or guideline that says if someone holds a fringe position that nothing they write, and nothing written by anyone closely affiliated with them, can be cited as reliable sources for medical/scientific topics?
If you are looking for an example from another field, Linus Pauling won a Nobel for chemistry, and part of that work developed into proving that Sickle cell disease is genetic. He also advocated for fringe-y positions on Vitamin C megadosage. Now, according to what you've said, there's a policy or guideline that says Pauling can't be cited "for medical/scientific topics". Which policy or guideline is it, and what's the exact wording in it? WhatamIdoing (talk) 20:52, 5 December 2024 (UTC)[reply]
I feel that's a poor example.
Linus Pauling has some ideas that are very well accepted, and others which have been dismissed as quackery. Same with other semi-quacks such as John Ioannidis.
I think if multiple folks state that Linus Pauling's views on medical info post 1960 is inflammatory, his statements should be given attribution, alongside the appropriate criticism. If he is well respected in electrochemistry, and pre1960-ish, it would be undue not to include him.
We can include SEGM as long as we attribute to them, and if there is sufficient criticism, we provide the WP:DUE amount of context around them. Bluethricecreamman (talk) 21:06, 5 December 2024 (UTC)[reply]
That's not what Butterscotch Beluga was saying. WhatamIdoing (talk) 21:36, 5 December 2024 (UTC)[reply]
That actually was what I was saying. When I said "for medical/scientific topics", I did indeed mean in the context that they are considered fringe.
This I hope properly conveys why I don't think those who are members/have close relations with SEGM are reputable, nor should their positions related to SEGM's subjects of advocacy carry much weight. Butterscotch Beluga (talk) 22:00, 5 December 2024 (UTC)[reply]
I wonder occasionally if it would be worth setting up a section similar to the Talk:Donald Trump#Current consensus section (which, in general, I think is a terrible idea), in which we record some things that we all agree on, e.g., that citing something written by an SEGM-tainted person does not automatically violate any policy or guideline, or that the Integrity Project's paper is not peer-reviewed, or whatever little facts we've discussed more than once or twice.
Butterscotch Beluga, I don't really care why you/we/anyone consider them disreputable. What I care about is whether Wikipedia editors post non-existent, made-up rules, which are then read and sincerely believed to be The Truth™ by less experienced editors. If you write something like "The policy says SEGM can't be cited for medical/scientific topics", then even if most of us know that this is just a quick thing, to get the general gist across, someone is eventually going to read that and believe that there is an actual WP:Policy that actually says this. This is a consequence of our method of teaching Wikipedia's rules, which is basically the telephone game. That's not your fault, but it is something you can help with. So I ask: Please (everyone), be careful about what you describe as being required or prohibited by policies and guidelines. It'll save everyone a lot of hassle and drama in the end. WhatamIdoing (talk) 22:33, 5 December 2024 (UTC)[reply]
I didn't say "The policy says SEGM can't be cited for medical/scientific topics" & as such, I'm not sure why you're putting it in quotes.
I'm saying that if someone works with a group with controversial views on conversion therapy, we shouldn't cite them uncritically on what is/isn't conversion therapy. Butterscotch Beluga (talk) 00:30, 6 December 2024 (UTC)[reply]
Right. Your exact words above were they & those closely affiliated with them should not be cited as reliable sources for medical/scientific topics.
Quotation marks in English have multiple uses; marking exact quotations of prior speech is only one of the multiple uses. WhatamIdoing (talk) 00:44, 6 December 2024 (UTC)[reply]
Ok. Personally, I don't like using quotation marks if I'm not quoting someone/something specifically, as it may lead to miscommunication, but that's neither here nor there. Butterscotch Beluga (talk) 00:47, 6 December 2024 (UTC)[reply]
This is a non-independent source, engaged in legal action in the US in opposition to SEGM so should be taken with a pinch of salt, especially in light of this peer-reviewed critique of the Yale team in the BMJ.
Which has of course been discussed here previously, and been derailed - again - by one of the co-author's relation to SEGM, never mind that the others are not.
The problem here is that on the balance of sources, we have a difference of opinion.
But if you start from the position of SEGM are fringe, that balancing of sources never happens. Void if removed (talk) 22:33, 5 December 2024 (UTC)[reply]
This might seem like a tangential response, but I'm looking at the BMJ critique you linked & was wondering if you could help clarify something for me.
It says "Various versions of McNamara et al have already been introduced into evidence in at least two high-profile court cases", but despite the two citations they supply, I'm having issues finding any mention of McNamara in either case.
Citation 16's google scholar link only finds the original BMJ critique & citation 17 does link to a case (Specifically this), but I don't see where McNamara et al is being used as evidence.
I'm probably just misunderstanding how google scholar works/am missing something obvious, but I wanted to check if you knew what the issue I'm having is. Butterscotch Beluga (talk) 23:56, 5 December 2024 (UTC)[reply]
Google Scholar does not track documents in lawsuits. Try searching a specialist website like this one: https://www.courtlistener.com/docket/63252064/eknes-tucker-v-marshall/?page=4 Or just try your favorite web search engine.
The SCOTUS case documents are here: https://www.supremecourt.gov/search.aspx?filename=/docket/docketfiles/html/public/23-477.html WhatamIdoing (talk) 00:52, 6 December 2024 (UTC)[reply]
RE: the first, the Yale critique of the Cass Review was filed as an amicus brief in Boe vs Marshall the day it came out, you can read it here: https://storage.courtlistener.com/recap/gov.uscourts.almd.77755/gov.uscourts.almd.77755.629.7.pdf
From here:
https://www.courtlistener.com/docket/63252064/boe-v-marshall/?page=4 Void if removed (talk) 16:25, 6 December 2024 (UTC)[reply]
If the article is indeed a WP:POVFORK of something you should propose merging or nominate it for deletion instead of removing links. Flounder fillet (talk) 18:16, 5 December 2024 (UTC)[reply]
I think it's unrelated, inflammatory, and adds nothing to this page. It shouldn't be in see also. I the idea that I cannot simply say the link shouldn't be there, but must instead be drawn into wider content arguments about a page I have no interest in and that has no bearing on this one. Void if removed (talk) 21:03, 5 December 2024 (UTC)[reply]
Bandying claims of POVFORK then saying it is entirely unrelated to this page are not compatible arguments. Bluethricecreamman (talk) 21:07, 5 December 2024 (UTC)[reply]
I disagree. The subject is nothing to do with this page. It also contains POV descriptions of the Cass Review. These are orthogonal concerns.
Not every page that mentions the Cass Review belongs in See Also, that's what "what links here" is for. The fact is the principal subject of that page has nothing to do with this one, and suggesting it does is inflammatory. Void if removed (talk) 21:27, 5 December 2024 (UTC)[reply]
No, the article discusses the Cass Review against the wider backdrop of the anti-trans movement in the UK and how it is being weaponized by anti-trans fringe groups, so this connection between the articles is very clear and the See Also is appropriate. This opposition appears to be a clear case of WP:IJUSTDONTLIKEIT. Raladic (talk) 21:46, 5 December 2024 (UTC)[reply]
According to MOS:SEEALSO articles linked should be related to the topic of the article or be in the same defining category.
21st-century anti-trans movement in the United Kingdom is unrelated to the topic of this article.
I can't find any decent independent sources making such a connection. There's this (which is not a reliable source), there's this (which is a garbage source that contains outright misinformation from the headline onwards) and there's this (which talks about the anti-trans movement in the US, not the UK).
The premise of your inclusion of the Cass Review in this article seems to be your own POV that it belongs there, and now you're reasoning backwards to say it is relevant, because your article says so. Void if removed (talk) 23:04, 5 December 2024 (UTC)[reply]
They both share several defining categories , most prominently Category:LGBTQ-related controversies in the United Kingdom and Category:Transgender topics in the United Kingdom and Hillary Cass's own statement in the article In an interview with The New York Times in May 2024, Hilary Cass expressed concern that her review was being weaponized to suggest that trans people do not exist... - this is the weaponization of the Cass Review that anti-trans groups are doing that she's referring to.
Again, the other article has several citations and links to the Cass Review, there is a clear link of the topics, so this see also link is entirely reasonable. Raladic (talk) 23:12, 5 December 2024 (UTC)[reply]
The Cass Review has been a corner stone of anti-trans advocacy since its release, and has been cited as the primary motivator for anti-trans policies such as Victoria Atkins puberty blocker ban. The link between the Cass review and the anti-trans movement is evident, and there is no scarcity of references which can be cited. Here is one example, which cites a government barrister saying that "Atkins “acted on the basis of her personal views about the conclusions of the Cass Review” : https://www.independent.co.uk/news/uk/crime/victoria-atkins-nhs-high-court-secretary-of-state-london-b2578759.html HenrikHolen (talk) 01:53, 6 December 2024 (UTC)[reply]
A page having POV issues is not equivalent to it being a WP:POVFORK. Flounder fillet (talk) 01:22, 6 December 2024 (UTC)[reply]
This comment feels like it falls into the category of WP: I Just Don't Like It.
The Cass review has motivated significant rollbacks of transgender rights in the UK. It is undeniably pertinent.
HenrikHolen (talk) 22:04, 5 December 2024 (UTC)[reply]

Enforced BRD

[edit]

Just so nobody misses this: There's a thing called 'enforced BRD', and it now applies to this page. That means that the rules used to be:

  • Make your edit
  • Get reverted
  • Maybe restore your edit (but never to the point of edit warring)

and they are now:

  • Make your edit
  • Get reverted
  • Start a discussion on the talk page (or just decide to never restore your edit)
  • At least 24 hours after starting that discussion, you can maybe restore your edit (but never to the point of edit warring, nor if the discussion on the talk page has active opposition. Silence is not active opposition).

See User:Awilley/Enforced BRD FAQ and User:Awilley/Consensus Required vs Enforced BRD for more information.

WhatamIdoing (talk) 04:04, 11 December 2024 (UTC)[reply]

Glad to see this - is it wrong that I think this should be mandatory on GENSEX? Void if removed (talk) 18:06, 11 December 2024 (UTC)[reply]
I think you would be surprised how cumbersome it can be, especially for problems like subtle vandalism. WhatamIdoing (talk) 18:29, 11 December 2024 (UTC)[reply]
Retrieved from "https://en.wikipedia.org/w/index.php?title=Talk:Cass_Review&oldid=1262491437"