Talk:Rapid-onset gender dysphoria controversy

Further Reading

@Snokalok with this edit you reverted the addition of additional reading with the following comment:

The Manhattan Institute is not a reliable source to recommend on trans issues

The deleted source is "Archives of Sexual Behavior", and a specific response to the other listed item in "further reading", co-authored by Lisa Littman.

Please reinstate.

Void if removed (talk) 16:19, 20 December 2023 (UTC)

If that is referring to Manhattan Institute for Policy Research then... yeah, they're probably a bad source to be adding to our article. — The Hand That Feeds You:^Bite 16:24, 20 December 2023 (UTC)

Just to clear, the source  in question is a Letter to the Editor published in Archives of Sexual Behavior. The primary author is affiliated with the Manhattan Institute. RS doesn't really play into the Further reading section. Are there other reasons to exclude it? Firefangledfeathers (talk / contribs) 16:33, 20 December 2023 (UTC)

I'd say it shouldn't be included per WP:UNDUE, WP:FRINGE, and WP:NOTEVERYTHING.

Littman and Biggs are members of the Society for Evidence-Based Gender Medicine. I think this whole article is a testament to Littman being thoroughly FRINGE, Biggs is also behind wonderful things like this, and Sapir is a longtime collaborator of SEGM who pushes anti-LGBT pseudoscience[1]. Also, the Archives of Sexual Behavior has a track record of publishing pseudoscience and is edited by pseuodoscience-pushers. [2][3].

There is no benefit to including it, and plenty of reasons not to. Best, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:00, 20 December 2023 (UTC)

Agreed with YFNS, there's plenty of reasons to exclude this. Loki (talk) 02:33, 21 December 2023 (UTC)

Just because SPLC call things "pseudoscience" some 300 times in that report, doesn't actually make them definitively "pseudoscience", any more than The Heritage Foundation calling the sexual revolution and the work of Kinsey "pseudoscience" makes it true. These are WP:PARTISAN sources using hyperbolic language, not a scientific assessment. SPLC are viable for WP:RSOPINION, so you could quote them describing something as "pseudoscience" if it was WP:DUE but you can't use that as a basis for excluding a source in the first place because this is not the consensus of a broad range of neutral, reliable sources. Void if removed (talk) 22:11, 21 December 2023 (UTC)

You'd treat policy documents and publications by Manhattan Institute with skepticism, but that's not what this is - this is a letter published by "Archives of Sexual Behaviour". From reading the letter, they fund one of the three authors and paid for it to be open access. Two of the three authors are unaffiliated with Manhattan, and on top of that one is the principal named subject of this article, ie Lisa Littman.

The further point is that this is not a source that is being used to make any specific factual claim - rather, it is listed in "further reading", and since it is a specific response to the only other entry in "further reading" - co-authored by the person who coined ROGD in the first place - it would seem relevant.

Now if someone can come up with a better WP:POLICY reason for removing it, fine, but I don't think the stated one is sound. Void if removed (talk) 16:39, 20 December 2023 (UTC)

I guess this one counts as a WP:ELMAYBE (?) but I am inclined to leave it off. External links in articles like this should probably contain neutral and accurate material that is relevant to an encyclopedic understanding of the subject per WP:ELYES. For further information, see WP:EXTERNAL. But if Fire isn't convinced, then it will be fine. Zenomonoz (talk) 01:58, 21 December 2023 (UTC)

According to splcenter.org, as of 12 December 2023, Archives of Sexual Behavior is "one of the top sexology journals in the world." Has it been deemed fringe, for purposes of Wikipedia, though? If not, the letter in question lists methodological flaws it claims to find in a study that is mentioned in the "Further reading" section of this article. If the study is relevant to this article then why wouldn’t the technical criticism also be relevant? Is any technical criticism of a study that claims to find evidence against ROGD by definition WP:FRINGE? Swood100 (talk) 01:59, 21 December 2023 (UTC)

Swood100, were you replying to Your Friendly Neighborhood Sociologist here? Zenomonoz (talk) 02:04, 21 December 2023 (UTC)

Yes, as well as to the others who think this should be excluded. I don't think that the rationale for that has been clearly stated. Swood100 (talk) 02:30, 21 December 2023 (UTC)

I am not confident this paper is really suitable as a WP:EXTERNAL link. On a topic like this, a suitable external link would be: Sites that contain neutral and accurate material that is relevant to an encyclopedic understanding of the subject and cannot be integrated into the Wikipedia article due to copyright issues, amount of detail (such as professional athlete statistics, movie or television credits, interview transcripts, or online textbooks), or other reasons. Is that the case here?

I think this is a 'further research' paper. I guess it could be included there. But, personally, I think all of the 'further research' studies that are not yet covered in secondary sources should be removed. Previously, I argued all of the further research studies should be removed, but that is not longer the case – as some have been covered in secondary sources (news outlets). Zenomonoz (talk) 02:44, 21 December 2023 (UTC)

Are you saying that the Turban paper belongs in 'Further reading' but the criticism of its methodology does not? Swood100 (talk) 05:41, 21 December 2023 (UTC)

Swood100, – no? I am saying both could belong under 'FURTHER RESEARCH', which is a section of the page (different from further reading, please look carefully). Or both could be excluded if they lack secondary source coverage, but I think Turban's one has been covered in secondary sources. Zenomonoz (talk) 03:43, 23 December 2023 (UTC)

The letter in question seems to be a secondary source on Turban. Swood100 (talk) 05:07, 23 December 2023 (UTC)

In the SPLC report you linked, Group Dynamics and Division of Labor Within the Anti-LGBTQ+ Pseudoscience Network, they contextualize the ASB as being headed by Zucker (a prominent conversion therapist) with Bailey and Levine as editorial board members, who are members of the network, along with Littman, sometimes being in the same organizations. It notes the ASB published a now retracted methodologically flawed article on ROGD by Bailey. In fact, every author of the letter to the editor we're discussing are named as members of the network in the report. WP:MEDINDY and WP:FRINGE apply. Not all criticism of FRINGE-criticism is FRINGE, but it is when it's by the proponents of the FRINGE theory in the first place. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:42, 21 December 2023 (UTC)

Why would a letter to the editor ever be included as a due weight source, especially as an EL or Further reading no context link? It's not a published study, what reason does it have to be included? Seems like a clear violation of MEDRS. Silverseren^C 05:57, 21 December 2023 (UTC)

WP:MEDRS seems a better standard than the original rationale given, but I have to wonder how the other reference in there qualifies though - it is a primary source and not a review article. I'd argue for removing both. If the Turban paper is notable for further reading as a critical response to Littman's hypothesis, despite not being WP:MEDRS, then that applies to Littman's critical response to Turban too surely? Void if removed (talk) 11:05, 21 December 2023 (UTC)

MEDRS isn't just a yes/no. See WP:MEDASSESS, with secondary analysis of data generally being more reliable than editorials (of which a letter to the editor is a weak type). If we're concerned about the reliability of letters to the editor, though, we should be scrutinizing the ones actually used as sources in the article, rather than the vastly less important further reading links. Firefangledfeathers (talk / contribs) 13:22, 21 December 2023 (UTC)

Hi FFF, I just reviewed the sources in the article and 2 places stuck out like a sore thumb:

• In a letter to the editor, Littman responded that her methodologies were consistent with those that had been used, without controversy, in widely cited studies supporting gender identity affirmation health care.[28] - WP:UNDUE and WP:MANDY applies
• Some clinicians state that an increasing prevalence of trans youth first presenting in early adolescence, as described in Littman's research, is consistent with their patient population, though they are uncertain as to causes or implications for clinical treatment.[50][51][52]- A letter to the editor, a primary study saying ROGD might be a thing, but needs further research and could have other explanations, and a "Special Section" in the ASB written by Zucker.

I propose we remove these snippets from the article unless independent RS cover them. Best regards, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:39, 21 December 2023 (UTC)

Strongly agree! Firefangledfeathers (talk / contribs) 19:25, 21 December 2023 (UTC)

Hi FFF, just want to note that per my 0RR restriction I can't remove text myself so I'd appreciate you (or another watcher) removing those snippets lol. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:43, 31 December 2023 (UTC)

Sure, but if so, the Turban study is only the next level up the pyramid. A systematic review of the evidence concluded that we don't know, and need more evidence.

Point is that neither are being used to support a factual claim, and are just there for further reading, so I don't see why signposting the weak Turban study is substantially different to signposting the weaker letter in response. Void if removed (talk) 21:59, 21 December 2023 (UTC)

That source has an interesting quote:

We originally set out to study the phenomenon of adolescent- or rapid-onset GD (AOGD) and found an absence of literature, leading to our broader search strategy. There continues debate as to whether AOGD is a genuine phenomenon: Bauer et al. (2022) [61] provided data to suggest it is not, but faced strong rebuttal from both Littman (2022) [62] and Sinai (2022) [63] in terms of the way that AOGD has been defined and clinician experience. It is clear that we simply do not know enough about the observed phenomenon referred to as AOGD, nor do we fully understand the huge increase in numbers of adolescents (and especially NF) presenting for GD intervention in recent years, nor the comorbidities and long-term outcomes.

This seems to be relevant to this article. Has adding it been discussed? Swood100 (talk) 00:23, 22 December 2023 (UTC)

I don't believe so and it is an interesting paragraph, I agree. This is a high quality MEDRS source that - after a review of the literature - does not come down one way or another on ROGD or criticism of it, and says more evidence is needed. I think this should be reflected in the article. Void if removed (talk) 21:31, 22 December 2023 (UTC)

• See my comments below. It's completely inappropriate to try and link a peer-reviewed paper to a letter to the editor in terms of WP:WEIGHT. --Aquillion (talk) 19:14, 21 December 2023 (UTC)

• It should clearly be excluded. It fails WP:ELYES: It's not the official site for the topic or a copy of the work in question (which may be what's confusing people, since that's usually how such non-neutral ELs get included.) And it is obviously not neutral material, a requirement for point three, being a piece of opinion published by someone with massive amounts of stake in the subject. ELs aren't a place to post dump every place people related to the article have expressed their personal opinions as to why they're right. I'm also extremely skeptical of the framing with which it was included (as a "response") - we're not required to include every possible academic response; that would be WP:FALSEBALANCE. What matters is the relative weight given to each source in high-quality sourcing. A letter to the editor is obviously not equal in weight to a peer-reviewed paper and should never be weighed equally in an article by putting it on equal footing in terms of placement, focus, amount of coverage, etc. The fact that this was included via a think tank like the Manhattan Institute is telling because it shows that, beyond not going through peer-review, it has only really received attention from people who are literally "hired guns" whose job is to promote the perspective it advocates, which clearly indicates that it's WP:UNDUE to be weighted equally to the Turban paper. --Aquillion (talk) 19:06, 21 December 2023 (UTC)

Why would a letter to the editor ever be included as a due weight source… It's not a published study, what reason does it have to be included?

This seems a bit excessive. Serious methodological critiques and comments are at least as valid as the studies they critique, more so to the extent they disclose flaws that impact the validity of the study. Here are two that are currently included in this article:

• Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”
• Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

The due weight evaluation is performed by the journal publishing the letter. If a study is relevant to this article then a critique of it serious enough to be published in a top journal cannot be irrelevant.

And it is obviously not neutral material, a requirement for point three, being a piece of opinion published by someone with massive amounts of stake in the subject. ...The fact that this was included via a think tank like the Manhattan Institute is telling because it shows that, beyond not going through peer-review, it has only really received attention from people who are literally "hired guns" whose job is to promote the perspective it advocates, which clearly indicates that it's WP:UNDUE to be weighted equally to the Turban paper.

Not all criticism of FRINGE-criticism is FRINGE, but it is when it's by the proponents of the FRINGE theory in the first place.

These are the classical ad hominem argument: attacking the characteristics or authority of the writer instead of addressing the substance of what is written. Surely it can't be true that a given technical critique will be fringe if written by author A but not if written by author B. What is it about the letter that shows an absence of neutrality?

I'm also extremely skeptical of the framing with which it was included (as a "response") - we're not required to include every possible academic response; that would be WP:FALSEBALANCE.

This is the purpose of reliable sources. We count on them to weed out the minority views, fringe theories, and extraordinary claims that are the gist of WP:FALSEBALANCE. This journal determined that this critique deserved some of its limited space. What better evidence could there be for relevance? Swood100 (talk) 23:51, 21 December 2023 (UTC)

Common criticism and randomness

One of the three legs of the gold standard for clinical trials is "randomized", and I seem to recall from my reading about ROGD back in the day that one of the main criticisms was that the population was essentially self-selected, so the opposite of randomized, but that isn't mentioned in the article. If we have a good RS for that, it probably should be. Mathglot (talk) 11:37, 27 December 2023 (UTC)

I think that's covered under Rapid-onset gender dysphoria controversy#Academic by the WPATH cite. Our article summarizes it as:

The study's focus on parents of transgender youth recruited from communities with skepticism towards gender affirming care presents difficulty in establishing social influence as a possible factor in development of gender dysphoria.

We could definitely expand on this point with more sources, though. — The Hand That Feeds You:^Bite 12:49, 27 December 2023 (UTC)

As far as I read it, we mention that several times:

The author, Arjee Restar, argued that Littman's study was fatally methodologically flawed, beginning with the choice to sample exclusively from users of three websites "known for telling parents not to believe their child is transgender",

In 2022, the eighth edition of WPATH's Standards of Care (SOC-8)—a publication providing clinical guidance for healthcare professionals working with transgender and gender diverse individuals—criticized the study due to its methodological flaws. The study's focus on parents of transgender youth recruited from communities with skepticism towards gender affirming care presents difficulty in establishing social influence as a possible factor

The encyclopedia further states that bias appears to be present at every stage of the study, including its basic premise, the absence of random sampling, self-selection bias in the recruitment process, and the data collection procedure, which was described as "fundamentally flawed in a number of critical ways".

[emphasis mine] Loki (talk) 06:50, 28 December 2023 (UTC)

Yes, you're both right; thanks for pointing out these quotes. Having read our article umpteen times, I got lazy and just skimmed instead of reading carefully and obviously went too fast because obviously the quotes you both provided make the point whether they use the word or not, and in at least one case they even used it. Sorry for being lazy, and thanks again! Mathglot (talk) 06:55, 28 December 2023 (UTC)

Not a problem. Happens to all of us at some point. — The Hand That Feeds You:^Bite 14:54, 28 December 2023 (UTC)

Thompson et al. removed

@LokiTheLiar: You removed the paragraph that described the Thompson et al. study. The removed paragraph disclosed the following:

• Thompson et al. set out to do a systematic review of adolescent gender dysphoria literature in order to study adolescent- or rapid-onset gender dysphoria.
• It found insufficient literature on the subject of adolescent- or rapid-onset gender dysphoria.
• It found a debate as to whether adolescent- or rapid-onset gender dysphoria is a genuine phenomenon—according to this source, unlike others, the question is still open for debate.
• It found that Bauer et al. (2021) was strongly contradicted by Littman (2022) and Sinai, thus according credibility to Littman and Sinai and tending to diminish the credibility of Bauer.
• It found that there is an observed phenomenon that is referred to as adolescent- or rapid-onset gender dysphoria.
• It concluded that not enough is known about that observed phenomenon.
• It stated that there has been a huge increase in numbers of adolescents (and especially natal females) presenting for gender dysphoria intervention in recent years.
• It stated that we do not fully understand that huge increase, thus disagreeing with those, such as Rosenthal (2021), who believe that the increase is only apparent and does not represent an intrinsic rise in the number of cases.
• It stated that do we do not fully understand the comorbidities and long-term outcomes.

You removed the paragraph with the comment: “This is not new information: we already cite all the studies referred to,” but additional reviews of a given study or of a given phenomenon can be valuable in that they can provide unique perspectives, even if they reach the same conclusion that others reached. Can you explain? Swood100 (talk) 16:25, 31 December 2023 (UTC)

I don't agree with the way you phrase some of your conclusions above (e.g. not contradicted, which implies refutation, but disputed, which only means a disagreement); and others) but that said, the wording you used in your edit of 14:56, 28 December was much briefer (diff) and was acceptable. Surveys or literature reviews such as Thompson et al. (2023) are the gold standard for inclusion in articles about biomedical topics and stand at the pinnacle of the most reliable sources available. It should most certainly be included in the article. Mathglot (talk) 20:33, 31 December 2023 (UTC)

As far as I can tell, Swood is mischaracterizing this review pretty severely. It's a review of adolescent gender dysphoria in general, not of studies of ROGD. It only ever mentions ROGD very briefly, and not as part of the actual review itself. In that brief comment in the Discussion section, it says there's not enough studies to do a review of ROGD, which is why they didn't do one. Loki (talk) 20:53, 31 December 2023 (UTC)

Agreed; the most useful thing to say about it, is exactly that: that there wasn't enough evidence to carry out the survey they originally wished to do, and had to rescope their project to GD in general to have enough data to even continue. On the one hand, I can see an argument for dropping it on that basis, however the "negative data point", that is, the mention that "there isn't enough data" is a useful one, because it does provide some backing for the question, "Is there enough data to conclude anything?" so we might include a brief mention on that basis, or perhaps just as a footnote. What do you think? Mathglot (talk) 21:30, 31 December 2023 (UTC)

Yeah, I thought it was really obvious that Thompson isn't about ROGD. It's pretty useless for the purposes of this article since all it says is more studies are needed. And the review itself is focused on completely separate subject matter. Edit Conflict: Is it really useful to just use an aside from a review to say it can't comment on a subject such as this article just yet? Silverseren^C 21:31, 31 December 2023 (UTC)

Maybe, because it was way more than an "aside"; they went through statistical analysis of the data they were able to assemble by the methodology they transparently described, and didn't find enough. It's a key point in unbiased scientific publishing that you don't suppress results that neither support your (hoped-for?) result, nor refute it, but are inconclusive. Inconclusive results are the most boring results, and won't get you an endowed chair, but if based on proper methodology are an important contribution to the literature and should be reported (by them), not swept under the rug, as it debilitates other researchers from seeing all the data available to date on the topic, if they wish to replicate or do other studies. Whether *we* report it or not, is another question; but their conclusion that there isn't enough ROGD data to analyze in a survey just yet, isn't an aside, it's a conclusion validated scientifically by their method. Mathglot (talk) 22:03, 31 December 2023 (UTC)

I'm okay with using it to source something like A 2023 systematic review found there had not been enough studies to do a review of ROGD specifically, but only something similarly brief and inconclusive because that's really all the source says. There's not enough in a brief comment in the Discussion section for anything more WP:WEIGHT-y. Loki (talk) 00:04, 1 January 2024 (UTC)

Yes, or even briefer, if you can still get a full sentence out of it. I'm even okay with this residing in an explanatory note rather than body text, if that seems to work better. Mathglot (talk) 05:03, 1 January 2024 (UTC)

I think the section could be trimmed to properly incorporate the literature/responses. I'd like to know y'all's thoughts on the below proposal (to replace paragraphs 3-5 in the current version of "Further Research"):

Littman[4] and Sinai[5] issued critiques of Bauer et al. Littman noted out that Bauer had used an incorrect definition of 'ROGD', by relating it to having a short history of gender incongruence, whereas it actually refers to not having gender incongruence before puberty.[6] A July 2022 commentary by the European Paediatric Association noted the lack of consistent scientific evidence for the concept and the position of major medical associations that it should not be used; Noting Bauer and the rebuttals, they concluded the issue still open.[7] In August 2023 Thompson et al published a literature review which concluded "there continues debate as to whether [adolescent- or rapid-onset gender dysphoria] AOGD is a genuine phenomenon ... it is clear that we simply do not know enough about the observed phenomenon referred to as AOGD", noting Baueur and the rebuttals by Littman and Sinai; The review had initially meant to focus on literature regarding the phenomenon and found an absence of literature, leading to a broader search strategy.[8]

A 2022 study by Arnoldussen et al found that evidence was inconclusive as to whether ROGD exists but noted that "our results show that there was gender nonconformity in childhood in older presenters, although less extreme than in the younger presenting group, which speaks against this suggested subtype". It also contextualized Littman's study among previous research which had previously identified subgroups within transgender adolescents, stating "Some adolescents with gender incongruence present with a long history of gender nonconformity from early childhood on (pre-pubertal) but other transgender adolescents declare gender incongruence around or after puberty (peri/post-pubertal). It was usually suggested that most adolescents with a request for medical interventions have a history of early childhood-onset gender incongruence and people with late or post-pubertal gender incongruence present themselves to gender services only later in life". [9] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:37, 31 December 2023 (UTC)

I think you're way overquoting here. I don't think we need to include lengthy quotes from any of these sources. None of them is that significant here because all of them basically summarize down to "some researchers think more research is needed". Loki (talk) 00:10, 1 January 2024 (UTC)

I think you're right on that front. I do think Arnoldussen should be trimmed, but his study isn't just "more research is needed", they added "but the results in this study cast doubt on ROGD's validity", so I think it has a place. I also think, since it's not mentioned in the article, it's important to note at least somewhere that "some trans kids are gender nonconforming from a young age, some realize they're trans at puberty" is not some new phenomenon and has been a long established fact.

Per WP:MANDY I'm also inclined to leave out Littman and Sinai's rebuttals. WRT the EPA I think it could go under professional commentary per my comment in the section below, since while I don't think it adds much it is the commentary of a professional org. However, since it's mostly just noting and echoing the U.S. response, I'm also inclined to leave it out as uninformative.

WRT Thompson, I like your trimming above, though per Mathglot maybe it could be shortened further to: A 2023 systematic review attempted to review ROGD but was unable to due to insufficient sources. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 19:18, 1 January 2024 (UTC)

• I don't think it makes sense to include studies that only mention ROGD in passing when we already have sources discussing it more directly, especially one whose only conclusion is that they were unable to draw a conclusion. It was a fairly strange addition in the first place given how little it has to say about the topic and the very brief mention it made. --Aquillion (talk) 22:48, 31 December 2023 (UTC)

"Well, she would say that, wouldn't she?" I don't think we need to have every little rejoinder that Littman made to this or that researcher, because of course she's going to disagree with everybody. We could have a general sort of section mentioning several such collectively, and then pick one representative one to quote or summarize in more detail. If it's this one, then that's okay, I guess, but I think for proponents of her point of view, it's a particularly weak one . Mathglot (talk) 06:25, 1 January 2024 (UTC)

The following points will be left out of the article if the Thompson study is excluded:

1. There is a debate as to whether adolescent- or rapid-onset gender dysphoria is a genuine phenomenon.
2. Bauer said that adolescent- or rapid-onset gender dysphoria it is not a genuine phenomenon. Thompson said that it is an “observed phenomenon.”
3. Bauer faced a “strong” rebuttal from Littman and Sinai. The article had not mentioned anything about Sinai, and it had not mentioned the “strong” characterization with respect to Littman’s rebuttal of Bauer. Thompson, Ferrara and Arnoldussen are the only sources we have commenting on Sinai and Littman's rebuttal of Bauer's study.
4. Thompson stated that there has been a huge increase in the numbers, thereby disagreeing with those who believe that there has been no real increase in numbers.
5. In Thompson’s view, the Bauer study did not dispose of the question (and Littman’s and Sinai’s “strong” rebuttal may have had something to do with this)—we need to know more about both the “observed phenomenon” and the “huge increase in numbers.”
6. There is insufficient literature on the subject of adolescent- or rapid-onset gender dysphoria. We especially need to know more about the increase “in natal females,” as well as “comorbidities and long-term outcomes." This goes to what specific type of “more research” is needed. Also, it contradicts those who believe that no more research is needed.

The fact that Thompson et al. was mostly about something else is irrelevant as long as it does contain commentary germane to this article, which it clearly does. The following are relevant to the article: Thompson expresses the strength of Littman’s and Sinai’s strong rebuttal of Bauer (substantiating the relevance of these sources), that we are dealing with an observed phenomenon (contra Bauer), that Bauer’s study did not resolve the issue (contra those who deny that there is an issue or who say that Bauer resolved it), that there has been a huge increase in the numbers, especially among natal females (contra those who say there is no real increase), and the specific types of additional research that are needed. Swood100 (talk) 18:58, 1 January 2024 (UTC)

I'm sorry, but wrt your first point: nearly the entire content of the article is about whether it is a genuine phenomenon, as the title of the article indicates. I didn't continue to #2 after seeing that one, but if you have one or two of those points that you think are on more solid ground than #1, I'll have another look. Mathglot (talk)

Perhaps it would be helpful if you would read what I wrote a little less combatively, and with a little more willingness to find a non-absurd meaning. The tone of this article could easily lead the reader to conclude that since the major professional associations do not recognize ROGD, and discourage its use, therefore the truth of Bauer’s view that there is no genuine phenomenon receives little or no debate in the scientific literature. One of the points that Thompson et al. makes is that the question has not been foreclosed, and that an article open to considering the alternative viewpoint can get published at a top journal. Swood100 (talk) 06:37, 2 January 2024 (UTC)

I agree with you that the question has not been foreclosed, as scientific questions rarely are. Additional research based on the scientific method would no doubt be welcome at any number of academic journals. Thompson is not the only one to have made this observation, and it's a trope of scientific publications to welcome further research, something which I certainly agree with, and await with interest. I disagree that there is no debate in the scientific literature, and the 60+ citations in the § References section show examples of them.

Regarding your S2, I agree with you that reading the article's content and citations (not TONE) might lead the reader to conclude what professional associations say about ROGD, and that per WP:DUEWEIGHT, that is an accurate impression of the majority view of reliable sources, and therefore the principal view the article should convey. That there are opposing views is clear, and per WP:DUE, those are covered also. Mathglot (talk) 09:55, 2 January 2024 (UTC)

Feel free to disregard item number 1. It was just intended as a lead-in to item number two, anyway. Edited to strikethrough number 1 and add text to number 2. Swood100 (talk) 14:42, 2 January 2024 (UTC)

@Your Friendly Neighborhood Sociologist: Some comments on your suggested replacement paragraphs:

Littman[4] and Sinai[5] issued critiques of Bauer et al. Littman noted out that Bauer had used an incorrect definition of 'ROGD', by relating it to having a short history of gender incongruence, whereas it actually refers to not having gender incongruence before puberty.[6]

This is fine.

A July 2022 commentary by the European Paediatric Association noted the lack of consistent scientific evidence for the concept and the position of major medical associations that it should not be used; Noting Bauer and the rebuttals, they concluded the issue still open.[7]

This attributes the concern about lack of consistent scientific evidence to the European Paediatric Association (EPA) and leaves the objections of the major medical associations unspecified. Actually, it’s the major medical associations that object to RODG for that reason, with the EPA being simply the publisher of Ferrara et al. Also it attributes to EPA the conclusion that the issue is still open whereas that is the conclusion of Ferrara et al.

In August 2023 Thompson et al published a literature review which concluded "there continues debate as to whether [adolescent- or rapid-onset gender dysphoria] AOGD is a genuine phenomenon ... it is clear that we simply do not know enough about the observed phenomenon referred to as AOGD", noting Baueur and the rebuttals by Littman and Sinai; The review had initially meant to focus on literature regarding the phenomenon and found an absence of literature, leading to a broader search strategy.[8]

This omits the conflict between Bauer, who said RODG is not a genuine phenomenon, and Thompson, who said that it is “an observed phenomenon.” Also it omits Thompson’s evaluation of the rebuttal of Bauer by Littman and Sinai (“strong”). Also it omits Thompson’s observation about “the huge increase in numbers of adolescents (and especially NF),” which is a point of disagreement with many, and it omits Thompson’s view of the specific type of additional research that is needed: “in natal females,” as well as “comorbidities and long-term outcomes."

A 2022 study by Arnoldussen et al found that evidence was inconclusive as to whether ROGD exists but noted that "our results show that there was gender nonconformity in childhood in older presenters, although less extreme than in the younger presenting group, which speaks against this suggested subtype". It also contextualized Littman's study among previous research which had previously identified subgroups within transgender adolescents, stating "Some adolescents with gender incongruence present with a long history of gender nonconformity from early childhood on (pre-pubertal) but other transgender adolescents declare gender incongruence around or after puberty (peri/post-pubertal). It was usually suggested that most adolescents with a request for medical interventions have a history of early childhood-onset gender incongruence and people with late or post-pubertal gender incongruence present themselves to gender services only later in life".

This omits Arnoldussen’s observation about the possibility of RODG being one gender development pathway subtype. This attributes to Arnoldussen the general statement that the evidence is inconclusive as to whether RODG exists, whereas what they said was that the data of their study did not allow them to reach a conclusion on this. It omits that Arnoldussen likely agrees with Littman’s criticism of Bauer (Littman “pointed out that…”), though I don’t see any convenient way of including something as indistinct as that short of an awkward sentence construction, but it omits Arnoldussen’s observation of Littman’s criticism of Bauer, indicating that this criticism is related to Arnoldussen’s view that Bauer’s study did not resolve the issue. Also, it omits the additional types of studies Aarnoldussen said are needed (those using both self and parent report measures). I don’t understand what the point is of the quote that begins “Some adolescents with…”

Did you have a response to my observation about the other “Research article” studies we cite without requiring a secondary source to interpret them? --Swood100 (talk) 21:04, 3 January 2024 (UTC)

Cohn’s review of Rosenthal and Littman

@Snokalok: You removed the paragraph that reported Cohn’s review of Rosenthal (2021), Littman (2018) and Littman (2021), with the comment, “One person’s opinion paper does not belong in this section for, a wide variety of reasons. Also this isn’t how you cite on wikipedia.” According to WP:SECONDARY, “For example, a review article that analyzes research papers in a field is a secondary source for the research.” So why doesn’t a review article found in a scholarly journal that evaluates someone else’s original research belong in this section, and where does it belong? Swood100 (talk) 19:44, 31 December 2023 (UTC)

This is Cohn 2023. As should be immediately obvious to anyone reading it, it is not in fact a systematic review or any other sort of review (nor does it claim to be). Rather, it's an attempted rebuttal of another article, Rosenthal 2021. There is no new research or scientific rigor here, and therefore it's just Cohn's professional opinion. Loki (talk) 21:00, 31 December 2023 (UTC)

Review articles in the Journal of Sex and Marital Therapy are marked as such. See here for an example, where it is marked "review article". The one you're citing is a "research article" (primary source) by a member of the Society for Evidence-Based Gender Medicine and is a commentary on an Rosenthal (2021) (an actual review article, which noted multiple critiques of ROGD and it's retraction). The paragraph you added was to the section "Professional commentary", which contains large scale professional reactions such as from WPATH, CAAPS, and GDA (apart from Blanchard & Bailey, which should be moved to the "Advocacy groups" section) - it is not a dumping ground for whatever any one person thinks about a topic.

Analyzing the text you added:

• the rise in the number of cases of gender dysphoria in youth, described as "epidemic-like" by French National Academy of Medicine (2022), has yet to be explained, and has raised questions about a possible social contagion of the type referred to by Littman (2018), Anderson (2022a), Anderson (2022b), and Marchiano (2017).
  • Apart from mention of the National Academy of Medicine, this is just repeating the origins of the ROGD hypothesis and tossing in one persons anecdotal experience.
• Cohn said that this hypothesis of psychosocial influences was generated by Littman (2018) and was subsequently bolstered by Littman (2021), and despite criticism from Rosenthal (2021), (who holds that the increase in cases of gender dysphoria does not correspond to an intrinsic rise in the number of cases but is the result of those with gender dysphoria being now more willing to come forward, because of greater societal acceptance), Littman's hypothesis remains a potentially valid explanation for the rise in youth gender dysphoria cases, citing Arnoldussen et al. (2022) and French National Academy of Medicine (2022).
  • First, repetitive, we know were the ROGD theory originated.
  • Second, Rosenthal didn't criticize ROGD, just reviewed the current literature and said: In addition, a putative phenomenon known as rapid-onset gender dysphoria (ROGD), in which gender dysphoria is first expressed by older youth during or after the completion of puberty, has been proposed[126]. However, methodological concerns have been raised regarding the ROGD report (calling into question the existence of ROGD, itself), including the fact that only parents (recruited from websites) and none of the youth with gender dysphoria participated in the study, and that parents were not recruited from websites supportive of transgender youth[127]. The above-noted methodological concerns prompted publication of a correction by the original author[128].

Considering it's a primary source written by someone from an organization known for spreading misinformation (particularly about this unproven hypothesis) and just the authors opinion, the fact it's largely repetitive with information already covered, and the fact it's ranting about criticisms Rosenthal didn't actually make (just cited) it's completely WP:UNDUE. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:02, 31 December 2023 (UTC)

While we're here, I also think that both the Ferrara source and the Arnoldussen source are getting far too much WP:WEIGHT, considering both of them could be summarized as "some researchers think more research is needed". Right now we're just saying that they each describe the basic facts of the controversy again, in papers that aren't overall about ROGD, and give a non-committal response to it. Neither appears to be doing any actual significant research into the phenomenon either way. Loki (talk) 21:11, 31 December 2023 (UTC)

I would agree with this statement Snokalok (talk) 23:16, 31 December 2023 (UTC)

I would say the Arnoldussen is more robust than that, though not used properly right now in the article (see my suggestion in the section above). They state The aim of this study was to examine whether, ‘younger’ and ‘older’ presenters could be identified in a large cohort of transgender adolescents and if differences exist between the two groups, explore ROGD in the introduction, and in the discussion section compare their study's results with ROGD's hypothesis. Though they state evidence of it's existence is inconclusive, they note their results lean towards it not existing. I feel the Ferrara source merits inclusion, though possibly in "Professional commentary" rather than "Further research" Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:44, 31 December 2023 (UTC)

(edit conflict) That paragraph was properly removed, for multiple reasons. The entire article by Cohn (Cohn (2023)) is focused solely on a rebuttal of Rosenthal's 2021 paper (Rosenthal (2021)) entitled, "Challenges in the Care of Transgender and Gender-Diverse Youth: An Endocrinologist's View" . That this is so should be clear by looking at the title of Cohn's 2023 paper, "Some Limitations of 'Challenges in the Care of Transgender and Gender-Diverse Youth: An Endocrinologist's View'", quoting the title of the Rosenthal paper (which our article never mentioned previously) in its entirety. A single (PRIMARY) paper criticizing another (i.e., not a "study", but merely one author's opinion about another author's conclusions or opinions) is far from a useful addition to the article. The choice of that one response opinion appears cherry-picked because of some of the other papers Cohn cites, such as the French study. What's worse, most of the content of the paragraph appears to be your own assessment of the merits of ROGD as espoused by Cohn, wrapped up with your concluding sentence that '"Littman's hypothesis remains a potentially valid explanation for the rise in youth gender dysphoria cases..." in Wikipedia's voice. That is completely unwarranted, even were Cohn's paper admissible. Cohn's paper should never have been mentioned in our article in the first place, being purely focused on criticizing one other paper that we never mention, and even if it had been, it's an improper source for this article, and your conclusions were POV. Snokalok's revert of your edit was the right move. Mathglot (talk) 21:24, 31 December 2023 (UTC)

Because it’s not a review article, it’s one random person of no established notability ranting about another person’s paper. We might as well start posting tweets from people with Roman statue profile pics as professional input at that point. Snokalok (talk) 23:17, 31 December 2023 (UTC)

Consolidated response below.

…it is not in fact a systematic review or any other sort of review (nor does it claim to be).

You’re calling Cohn’s piece a primary source in order to make it not citable in Wikipedia. You would say the same about any article that cited Cohn, and then the same about any article that cited that article, ad infinitum. The question is whether Cohn is discussing, analyzing, and evaluating others' research, or reporting on his own research. Cohn has no data, no methods, no findings. It is obvious from the very title of the piece that Cohn has set out to discuss, analyze and evaluate the research of Rosenthal, making it a secondary source on Rosenthal, and that’s his purpose. He breaks Rosenthal down into five key points that he sets about to analyze. The references for this article are taken from his evaluation of point 2: “The current sharp rise of youth presenting with gender dysphoria does not correspond to an intrinsic rise in cases.”

One person’s opinion paper… There is no new research or scientific rigor here, and therefore it's just Cohn's professional opinion. …tossing in one persons anecdotal experience

You need to provide a source to that effect. The question of scientific rigor is answered by the article’s acceptance and inclusion in a top journal, not by the personal opinions of Wikipedia editors.

this is just repeating the origins of the ROGD hypothesis

The "epidemic-like" characterization of the rise in the number of cases is not mere repetition of something found elsewhere in the article. Neither are the references to Littman (2018), Anderson (2022a), Anderson (2022b), and Marchiano (2017), which describe and give color to the nature of the social contagion that is being referred to. Each of these sources describes it in a unique way. Cohn’s fundamental point is that Rosenthal errs in his conclusion that “the current sharp rise of youth presenting with gender dysphoria does not correspond to an intrinsic rise in cases.” This is not mere repetition.

First, repetitive, we know were the ROGD theory originated.

Cohn agrees with those who say that RODG was generated by Littman (2018). If that were all it said then maybe that would be superfluous. But he goes on to say that the hypothesis “was subsequently bolstered by Littman (2021).” This is the only reference to Littman (2021) in this article, and it provides an evaluation (“bolstered”). This is not repetitive of something found elsewhere in the article.

Second, Rosenthal didn't criticize ROGD, just reviewed the current literature and said…

Rosenthall’s thesis is that the increase in the number of cases does not represent an intrinsic rise in the number of people. He therefore criticizes the notion of a “social contagion,” which is the characterization that Littman uses with respect to RODG. However, I would be happy to change “criticism” to “disagreement,” if you would prefer that.

Considering it's a primary source…

“A review article that analyzes research papers in a field is a secondary source for the research.” See WP:SECONDARY.

written by someone from an organization known for spreading misinformation (particularly about this unproven hypothesis)

This is the ad hominem logical fallacy. Please just quote from the writing itself.

and just the authors opinion

The question of scientific rigor and importance is answered by the article’s acceptance and inclusion in a top journal.

the fact it's largely repetitive with information already covered

Please list the repetitions.

I also think that both the Ferrara source and the Arnoldussen source are getting far too much WP:WEIGHT, considering both of them could be summarized as "some researchers think more research is needed". Right now we're just saying that they each describe the basic facts of the controversy again, in papers that aren't overall about ROGD, and give a non-committal response to it. Neither appears to be doing any actual significant research into the phenomenon either way.

Ferrara et al. supplied the reason that the major medical associations do not recognize ROGD and discourage its use: lack of consistent scientific evidence for the concept. Then after citing the position of the major medical associations and the Bauer finding, they nevertheless conclude that the issue is still open, citing Sinai and Littman. This provides another reference to the credibility of Sinai and Littman and another indication of what the weaknesses of Bauer have been asserted to be, and makes clear that according to Ferrara et al., the ROGD issue is not closed despite the position of the major medical associations. All of this is pertinent to this article and non-trivial.

Arnoldussen et al. discussed the possibility of different gender identity developmental pathways, with ROGD being possibly one subtype. Arnoldussen also provides another review of Bauer and “points out” the Littman criticism of it. Their use of this phrase, as LokiTheLiar pointed out, implies that in their opinion Littman is correct in her criticism. The tendency of this is to diminish the credibility of Bauer and increase that of Littman. We don’t go that far in reporting Arnoldussen (though perhaps we should), but we do make clear that according to Arnoldussen, Bauer’s finding did not close the question. Specifically, Arnoldussen thinks more studies using both self and parent report measures are called for. All this goes quite a bit beyond its characterization as “some researchers think more research is needed” and “describe the basic facts of the controversy again” and “give a non-committal response to it.”

…merely one author's opinion about another author's conclusions or opinions) is far from a useful addition to the article. …it’s one random person of no established notability ranting about another person’s paper. We might as well start posting tweets from people with Roman statue profile pics as professional input at that point.

The question of scientific rigor and importance is answered by the article’s acceptance and inclusion in a top journal. Such journals do not accept and publish pieces from “one random person of no established notability ranting about another person’s paper.”

The choice of that one response opinion appears cherry-picked because of some of the other papers Cohn cites, such as the French study.

I’m afraid I don’t follow this.

Cohn's paper should never have been mentioned in our article in the first place, being purely focused on criticizing one other paper that we never mention.

In the process of discussing what he called Rosenthal’s point 2 Cohn contrasted it with Littman’s theory of social contagion.

wrapped up with your concluding sentence that '"Littman's hypothesis remains a potentially valid explanation for the rise in youth gender dysphoria cases..." in Wikipedia's voice. …your conclusions were POV.

If you read that sentence carefully you’ll see that this was not Wikipedia’s voice but Cohn’s. “Cohn said that…Littman’s hypothesis remains a potentially valid explanation…” But it was an awkward sentence and I can see how that could be misconstrued. How about this:

According to Cohn, the rise in the number of cases of gender dysphoria in youth, described as "epidemic-like" by French National Academy of Medicine, has yet to be explained, and has raised questions about a possible social contagion of the type referred to by Littman, Anderson, Anderson, and Marchiano. Cohn said that this hypothesis of psychosocial influences was generated by Littman and was subsequently bolstered by Littman's 2021 study. Rosenthal rejected this hypothesis, holding that the increase in cases of gender dysphoria does not correspond to an intrinsic rise in the number of cases but is the result of those with gender dysphoria being now more willing to come forward, because of greater societal acceptance. According to Cohn, Littman's hypothesis remains a potentially valid explanation for the rise in youth gender dysphoria cases, citing Arnoldussen et al. and French National Academy of Medicine. Swood100 (talk) 03:50, 2 January 2024 (UTC)

I do not find this argument convincing at all and oppose the inclusion of Cohn. We don't have any obligation to WP:SATISFY you if you think a random WP:PRIMARY opinion is a reliable source.

Also, please stop including parenthetical years, along with most in-text mentions of specific papers. Wikipedia cites papers with the cite template, not through APA format. If you need to mention a paper inline, use phrases like a 2018 paper by Littman but you should in general not need to do this because the citations already include the specific papers. Loki (talk) 04:42, 2 January 2024 (UTC)

In the future, if you have the occasion to inform other editors about this, a reference to WP:PAREN would probably be appreciated. Swood100 (talk) 05:58, 2 January 2024 (UTC) Modified to remove parenthetical referencing. Swood100 (talk) 15:31, 2 January 2024 (UTC)

Here’s the definition of a research article:

A research article describes a study that was performed by the article’s author(s). It explains the methodology of the study, such as how data was collected and analyzed, and clarifies what the results mean. Each step of the study is reported in detail so that other researchers can repeat the experiment.

To determine if a paper is a research article, examine its wording. Research articles describe actions taken by the researcher(s) during the experimental process. Look for statements like “we tested,” “I measured,” or “we investigated.” Research articles also describe the outcomes of studies. Check for phrases like “the study found” or “the results indicate.” Next, look closely at the formatting of the article. Research papers are divided into sections that occur in a particular order: abstract, introduction, methods, results, discussion, and references.

Regardless, the section of Cohn that is being referred to sets out to discuss, analyze and evaluate the research of Rosenthal, thus performing the function of a review. Accordiing to WP:ALLPRIMARY, “Many high-quality sources contain both primary and secondary material.” What are the characteristics of the Cohn references that tell you this is primary source material which would require a secondary source to Cohn in order to properly interpret? Swood100 (talk) 16:04, 2 January 2024 (UTC) Modified above paragraph. Swood100 (talk) 16:11, 2 January 2024 (UTC)

Even if the portions of Cohn that are referenced were a primary source, according to WP:PRIMARY:

1. Primary sources that have been reputably published may be used in Wikipedia, but only with care, because it is easy to misuse them.
2. Any interpretation of primary source material requires a reliable secondary source for that interpretation.
3. A primary source may be used on Wikipedia only to make straightforward, descriptive statements of facts that can be verified by any educated person with access to the primary source but without further, specialized knowledge.

The references to Cohn are not interpreting Cohn, his methods or his findings. They are reporting, in a straightforward manner, what he said about Littman, Rosenthall, French National Academy, Arnoldussen, Anderson and Marchiano. Swood100 (talk) 16:31, 2 January 2024 (UTC)

WP:MEDRS: Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; and Primary sources should generally not be used for medical content. Standards are stricter on medical articles. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:37, 2 January 2024 (UTC)

WP:SECONDARY says: A review article that analyzes research papers in a field is a secondary source for the research (emphasis added).

Cohn 2023 is not, as you insist, a review article. It is a research paper (primary source) commenting on an actual review article. It says so at the top of the article. Just because he's commenting on others doesn't make it WP:SECONDARY and WP:MEDRS-compliant. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:34, 2 January 2024 (UTC)

But let’s look at the distinction WP:MEDRS makes between primary and secondary sources “in the biomedical literature”:

• A primary source is one in which the authors directly participated in the research and documented their personal experiences. They examined the patients, injected the rats, ran the experiments, or supervised those who did. Many papers published in medical journals are primary sources for facts about the research and discoveries made.
• A secondary source summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies. Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations.

Isn’t it clear that Cohn falls under the description of a secondary source? Furthermore, WP:MEDRS says that primary sources should generally not be used for medical content “as such sources often include unreliable or preliminary information; for example, early lab results that do not hold in later clinical trials.” None of that is relevant to Cohn. And even if the Cohn article is a research article, that doesn't mean that it can't contain secondary source material. Below are the original statements from Cohn that we are citing. Which of them would require a secondary source in order to properly interpret it?

• The “epidemic-like” rise (French National Academy of Medicine, 2022) of gender dysphoria in youth is viewed as an open puzzle
• with questions being raised about possible relations to social contagion (Anderson, 2022a; 2022b; Littman, 2018; Marchiano, 2017).
• [Rosenthal] repeats criticisms of the study (Littman, 2018) that generated this hypothesis,
• This psychosocial contribution hypothesis has since been bolstered by a peer reviewed study with first person reports (Littman, 2021).
• [Rosenthal] calls the rise “a notable change in our understanding of the TGD population” (p. 583), suggesting it is only the understanding, not the population, that is changing. He lists reasons for the rise (as fact) which describe why those with gender dysphoria might now be more likely to come forward or to be diagnosed, e.g., greater acceptance.
• The potential validity of Littman’s hypothesis, possible contribution to the rise in cases, and unclear relation to Rosenthal’s (2021) hypothesized fundamental gender identity remain (Arnoldussen et al., 2022; French National Academy of Medicine, 2022). Swood100 (talk) 17:54, 2 January 2024 (UTC)

This article contains a source called A critical commentary on ‘rapid-onset gender dysphoria’ that is cited five times, including in the opening sentence. If you click on that source you will see that it is classified as a “Research article.” Do we need to remove that source from the article and instead look for a secondary source to interpret it and explain to us what it is driving at? Swood100 (talk) 20:30, 2 January 2024 (UTC)

The same is true of the source The untimeliness of trans youth: The temporal construction of a gender ‘disorder’, cited three times. I’m not going to take the time to go through the entire list but if that is our criterion for inclusion then there are going to have to be some modifications to the sourcing of this article (and probably many other articles as well). --Swood100 (talk) 20:52, 2 January 2024 (UTC)

Ashley 2020 is cited in nearly every review article that discusses ROGD. Her response is almost as famous as the original ROGD article itself. That being said, you could remove citations 1a, 1b, and 1e without changing any text in the article.

Now considering Cohn 2023, he has been cited exactly twice. Once in one primary study[10] that doesn't consider his views on ROGD significant and once in another primary article[11], unsurprisingly by fellow members of known psuedoscience generator SEGM ranting about how gender-affirming care is dangerous. Yes, the fact SEGM is known for spreading misinformation about ROGD is important here.

The first problem with your paragraph is the According to Cohn - put simply, the WP:PRIMARY opinion of one member of a WP:FRINGE group is completely WP:UNDUE. There are no scientific reviews studies saying "he had a point here". It's him ranting about an actual secondary scientific review.

Paraphrasing what you wrote: According to Cohn, the fact there are more trans kids getting medical care these days as described by Littman, a Jungian psycoanalyst, and an opinion piece raise questions kids catch trans from each other. Cohn said that Littman came up with this and helped prove it in another study 3 years later. Rosenthal (an actual secondary scientific review) said there aren't more trans kids, just more social acceptance. According to Cohn, Littman may be right because Arnoldussen et al and the French National Academy of Medicine said maybe she is. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 02:36, 5 January 2024 (UTC)

References

Latest edit to history section

@Equivamp I think you made the right call to revert this edit in the first place and encourage you to do so again. To cut through the mess on this talk page:

1. Swood has not mentioned these sources at all, he's been arguing about including other primary sources editors have repeatedly told him are unnaceptable for the article.
2. The content he added is OR and SYNTH in addition to being dramatic. The first source added doesn't mention ROGD at all as it was published before the original ROGD study. The second source is what the text was based on The meteoric rise of gender dysphoria that the ROGD hypothesis attempts to explain emerged around 2014 [2], coinciding with the explosion of social media, but does not claim to be a proponent of the theory. Both are letters to the editor.
3. The image added was created by Swood100 based on the first letter to the editor. As such I highly question it's relevance and validity.

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 04:28, 5 January 2024 (UTC)

I agree. I just re-reverted it. Loki (talk) 05:25, 5 January 2024 (UTC)

@Swood100 - why on earth is one person's letter to the editor WP:DUE? It is a WP:PRIMARY source and fails WP:MEDRS. I strongly recommend you self-revert. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:03, 5 January 2024 (UTC)

As the talk page consensus is pretty unambiguously against this edit, I've re-re-reverted it.

I don't frankly have a lot to add here: yes, a letter to the editor is a bad source, because it isn't even peer reviewed and so is therefore not reliable for facts. Certainly it's not a WP:MEDRS source. Loki (talk) 22:08, 5 January 2024 (UTC)

• Agree that a letter to the editor is completely inappropriate here. In addition, as far as I can tell, the other source that was added makes no mention of Turban or RoGD; using it here at all, let alone to try and "rebut" someone, is obvious WP:OR / WP:SYNTH. --Aquillion (talk) 20:41, 5 January 2024 (UTC)

I don’t understand what you mean that it is not WP:DUE, or what your motive might be in wanting to keep this information out of the article. This is a letter in a reputable scientific journal that references what I thought was an undisputed demographic fact: the increase in the number of people referred for gender dysphoria. Do you doubt that the numbers shown in the chart are correct? I don’t think there is anyone who disputes the increase in numbers. What they dispute is the reason for it. Do you doubt that this increase was the motivation behind the development of the ROGD hypothesis, or that the increase is relevant to this article? These are simply fundamental facts. What is your objection? --Swood100 (talk) 20:48, 5 January 2024 (UTC)

A letter to the editor doesn't receive any peer-review or fact-checking; therefore, there is no basis to say that the inferences and connections they draw in that letter are based on anything or have any meaningful weight - it is, at most, their attributable opinion, and that only if their opinion is significant enough to mention. In this case the author seems to have no background in gender-based medicine (this letter to the editor is the only thing I could find connecting them to it; all their other work is in totally unrelated fields), meaning their opinion about this topic has no value. Furthermore, in a more general sense, WP:NPOV means that our article's weight and focus on a topic should reflect reliable sourcing in accordance to the quality of those sources and the weight they are WP:DUE. Taking a letter to the editor and treating its author's personal opinions as a defining analysis of the entire topic is giving it undue weight relative to the other, higher-quality sources in the article. This is especially true when you combine it with a graph from an unrelated source, increasing its visual weight further and giving readers the impression that this is a major defining feature of the entire subject. Or, in other words - why are you so insistent that this paper be included? Reasons for including an WP:RSOPINION source like this might include its significance (ie. it has been widely-quoted and cited in high-quality sources) or the expertise of its author (ie. the author is a subject-matter expert who has published peer-reviewed stuff previously on the topic.) Neither seems true here, so I think it'd make more sense to drop this and look for better sources on the subject. --Aquillion (talk) 20:59, 5 January 2024 (UTC)

...there is no basis to say that the inferences and connections they draw in that letter are based on anything or have any meaningful weight ...meaning their opinion about this topic has no value.

The fact that it was accepted for publication in a reputable scientific journal gives it value. The editors of the journal concluded that this person’s scientific opinion deserved to be published in their journal. What references to the contrary do you have?

Taking a letter to the editor and treating its author's personal opinions as a defining analysis of the entire topic is giving it undue weight relative to the other, higher-quality sources in the article.

In the first place I didn’t declare that these facts are more or less important than any other facts in this article. Rosenthal does a whole study related to this increase. Are there other sources in this article or elsewhere who dispute the increase in the numbers or who doubt that the increase was the motivation behind the development of the ROGD hypothesis? What other sources in this article are in conflict with this information? Are you saying that the increase is irrelevant? What’s the issue here? Swood100 (talk) 21:42, 5 January 2024 (UTC)

The fact that it was accepted for publication in a reputable scientific journal gives it value. The editors of the journal concluded that this person’s scientific opinion deserved to be published in their journal. What references to the contrary do you have?

No it does not. Checking their publication policy, there is no peer-review for letters to the editor. This source is so far from WP:MEDRS requirements the distance can be measured in astronomical units. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:59, 5 January 2024 (UTC)

I am really astounded that adding the increase in numbers would provoke such strenuous opposition. I never expected that. --Swood100 (talk) 21:55, 5 January 2024 (UTC)

If you're astounded it's only because of your WP:IDONTHEARTHAT behavior when multiple editors have tried to explain to you how WP:MEDRS works. IE, sourcing something to a letter to the editor is not, never has been, and never will be, MEDRS-compliant. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:03, 5 January 2024 (UTC)

How about answering my questions? --Swood100 (talk) 22:44, 5 January 2024 (UTC)

A valid source doesn't need to be peer-reviewed. The review is done by the editors of the journal. --Swood100 (talk) 22:48, 5 January 2024 (UTC)

Why do you object to including the increase in numbers and that that is the impetus behind ROGD? --Swood100 (talk) 23:00, 5 January 2024 (UTC)