Talk:Gender-affirming surgery/Archive 4

Requested move 23 November 2022

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

The result of the move request was: Moved. (closed by non-admin page mover) &mdash; Ingenuity (talk &bull; contribs) 18:10, 30 November 2022 (UTC)

Sex reassignment surgery → Gender-affirming surgery – For medicine-related articles, the article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, according to WP:MEDTITLE. WanderingWanda🐮👑 (talk) 07:56, 23 November 2022 (UTC) (Continued below)

For this article, the correct title isn't "sex reassignment surgery", which the Endocrine Society calls a previous term, and GLAAD calls outdated. It's gender-affirming surgery.

"Gender-affirming surgery" is used by...
 * ...a multi-part systematic review which was published this year in the Annals of Surgery, which is a journal with an excellent impact factor. This review is, per the criteria in WP:MEDRS, an Ideal [source] for biomedical information.
 * ...The Endocrine Society, in their latest transgender Clinical Practice Guideline from 2017. This is one of the "two major guidelines for the treatment of transgender individuals".
 * ...The World Professional Association for Transgender Health (WPATH), along with the similar term "gender-affirmation surgery", in their latest Standards of Care from this year. This is the other of the two major trans health guidelines.
 * ...more recent, high-quality, English-language medical sources in general. If you search the titles and abstracts of scientific papers in PubMed, the results are stark: "gender-affirming surgery" has apparently been ahead for about five years. When searching papers from this year, "gender-affirming surgery" returns 121 results, and "sex reassignment surgery" just 15: an 8:1 ratio.

PubMed search results
 * {|class="wikitable"

! rowspan=1|Year!! Proposed title: Gender-affirming surgery !! Current title: Sex reassignment surgery !! Gender-affirmation surgery !! Gender-confirming surgery !! Gender-confirmation surgery !! Gender reassignment surgery !! Transgender surgery !! Sex change surgery ! scope="row" rowspan="1"|2015 ! scope="row" rowspan="1"|2016 ! scope="row" rowspan="1"|2017 ! scope="row" rowspan="1"|2018 ! scope="row" rowspan="1"|2019 ! scope="row" rowspan="1"|2020 ! scope="row" rowspan="1"|2021 ! scope="row" rowspan="1"|2022
 * 1||✅ 41||0||2||2||8||2||0
 * 5||✅ 40||2||4||7||9||5||0
 * 16||✅ 24||6||11||14||19||14||0
 * ✅ 28||23||14||11||18||16||15||0
 * ✅ 56||28||32||11||18||13||10||1
 * ✅ 72||19||23||5||13||15||7||0
 * ✅ 106||28||46||6||13||12||11||0
 * ✅ 121||16||39||3||8||11||9||1
 * }


 * Google Scholar and the Directory of Open Access Journals also show "gender-affirming surgery" ahead of "sex reassignment surgery" in 2022 and 2021.Google Scholar: 1, 2, 3, 4; DOAJ: 1, 2, 3, 4.

The above evidence is overwhelming, but I can anticipate some objections and questions:


 * Is "gender-affirming surgery" NPOV?


 * I think it's reasonably neutral. It just means surgery that matches, or affirms, a person's gender identity. Someone might disagree that surgery can affirm someone's gender. But someone might also disagree that surgery has anything to do with the "reassignment" of someone's sex. Perhaps, say, "transgender surgery" would feel more neutral. But it's not used in enough sources to make it a serious candidate.


 * Last time you said "the term 'sex reassignment surgery' seems to dominate in scientific papers." What changed?


 * I was misinterpreting PubMed search results. You can see where we went wrong if you go to PubMed.gov, type "sex reassignment surgery" into the search bar, change the display to "most recent", and click on some of the results. You'll see papers like this one, which uses the term "gender-affirming surgery".


 * ...The issue here is PubMed's keyword system. Nearly all articles about transgender surgery are put in the category "sex reassignment surgery". As I wrote earlier: this category was named many years ago, before the terminology shifted, and the authors of the papers have nothing to [do] with this categorization. This means that a search for "sex reassignment surgery" will return nearly every single paper about trans surgery! To sidestep this, you need to go into the advanced search settings and limit your search to "title/abstract". (What about article bodies? PubMed unfortunately isn't able to search them.)


 * ''"Gender-affirming surgery" may be more prevalent in recent scientific papers, but doesn't "sex reassignment surgery" appear in more papers overall?


 * Sure. But WP:MEDTITLE specifies we should be going by recent sources. Which makes sense: we shouldn't let Wikipedia fall years out-of-date.


 * ''I've never even heard the term "gender-affirming surgery"!


 * I don't personally encounter either "gender-affirming surgery" or "sex reassignment surgery" much in casual conversation. For a medical topic, that's, I think, fine: take a look at Myocardial infarction.


 * ''What about the related articles Sex reassignment therapy, Sex reassignment surgery (female-to-male), and Sex reassignment surgery (male-to-female)?


 * The first should likely be merged with Transgender health care, and the other two should likely be moved to Masculinizing surgery and Feminizing surgery. But we can deal with those after this move request.

Just one more thing: this title change will also help clarify the scope of the article. The article covers everything from genital surgery to top surgery to face surgery. The term "gender-affirming surgery" is often used for all of these topics. Meanwhile, as author Julia Serano notes, the term "sex reassignment surgery" is most closely associated with surgeries that involve genital reconfiguration, as in many jurisdictions such procedures are required in order to have one’s legal sex officially reassigned (e.g., from male to female, or female to male). There's even one source that draws a distinction between "reassignment surgery" and "facial feminization surgery", while putting both under the umbrella of "gender-affirming surgery".

The sources and guidelines are clear: it's time to move this article.

The Endocrine Society's Guideline uses "gender-affirming surgery" 14 times, "gender-reassignment surgery" 3 times (including 1 time without the hyphen), "sexual reassignment surgery" twice, and "gender-affirmation surgery" 0 times. "Sex reassignment surgery" only appears once, and it's just to point out it is a former term. This count doesn't include the References section.

The WPATH Standards of Care uses "gender-affirmation surgery" 16 times, "gender-affirming surgery" 7 times, "gender-related surgery" 4 times, and "sex reassignment surgery" 0 times. Again, the References section wasn't included. Although "gender-affirmation surgery" is used most often in this source, this isn't true of sources overall.

I should note that the WP:MEDTITLE guideline specifically advises against "counting Google or PubMed results", so feel free to disregard this part of my analysis. I think such counts can be helpful, though, if done carefully.

Both PubMed and Google Scholar seemingly disregard hyphens: "gender-affirming surgery and "gender affirming surgery" return the same number of results.

The Google Scholar results are admittedly closer and less clear-cut than the results from PubMed (or DOAJ). But Google Scholar isn't as good as PubMed, for our purposes, because their results are less likely to be high quality medical sources.

I'm placing a neutrally-worded notice about this to the following relevant places, per WP:APPNOTE: WP:WikiProject LGBT, Talk:Transgender, and WP:WikiProject Medicine.

WanderingWanda🐮👑 (talk) 07:56, 23 November 2022 (UTC)

Discussion
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
 * Support - Fully agree with the thorough rationale above. The proposed title is neutral and follows the guidelines for medicine-related articles. As demonstrated above, it's the term that's been favoured by reliable medical sources for some years now and this is reflected in the up-to-date standards of care. – Scyrme (talk) 08:05, 23 November 2022 (UTC)
 * Support. Seems evident that the most commonly used terminology in high-quality medical sources nowadays is no longer "sex reassignment surgery", and that "gender-affirming surgery" is now more commonly used. Sex reassignment surgery (male-to-female) and Sex reassignment surgery (female-to-male) probably need to be moved also. Since "gender-affirming surgery" may be unfamiliar to some though, I think "sex reassignment surgery" should still appear as a bolded WP:ALTNAME in the opening sentence. Endwise (talk) 08:32, 23 November 2022 (UTC)
 * Support - Agree this seems to be the accepted terminology and meets requirements per the nomination. I also agree with Endwise that after moving SRS needs to remain prominent. |→ Spaully ~talk~ 11:03, 23 November 2022 (UTC)
 * Support. It is high time this was renamed and the detailed nomination successfully anticipates and covers any questions or objections that I might otherwise have raised about the specific choice of new name. --DanielRigal (talk) 14:16, 23 November 2022 (UTC)
 * This is just to add that I don't have any strong opinion over which, if any, of the alternative names should be in bold but that all the alternative names should be redirects, even the obsolete ones. We can not anticipate which terms people will use when they search and we want them to find the right article no matter what they search for. DanielRigal (talk) 14:58, 24 November 2022 (UTC)
 * support per very detailed nomination—blindlynx 15:15, 23 November 2022 (UTC)
 * Support, very thorough and convincing nomination, seems to be most in line with policy and usage. --Cerebral726 (talk) 17:17, 23 November 2022 (UTC)
 * Support; based on the sources this has clearly become the WP:MEDTITLE-compliant WP:COMMONNAME in recent years. --Aquillion (talk) 19:59, 23 November 2022 (UTC)
 * Comment I request if possible, a comparison of the amount of searches for sex reassignment surgery and gender-affirming surgery, Until then I cannot make a !vote on this as I do not know what the better option would be. PerryPerryD Talk To Me 20:11, 23 November 2022 (UTC)
 * You could try looking at something like Google Trends, which shows that for the lay public "gender affirming surgery" has been trading blows with "sex reassignment surgery" for the past couple of years. I'm not aware of a tool that can show the same sort of information for a PubMed or Google Scholar search however.
 * That said, I'm not sure why the trend in search terms is a better metric for determining article titles than what our sources are using. The relevant guideline for determining this article title, as others have linked to, is WP:MEDTITLE. It states plainly The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, rather than a lay term (unscientific or slang name) or an historical eponym that has been superseded. As WanderingWanda has demonstrated, the most commonly used title in recent, high quality, medical sources is "gender affirming surgery". Sideswipe9th (talk) 21:39, 23 November 2022 (UTC)
 * Support - based on the analysis of the sources provided by WanderingWanda, and my own searches prior to this move request, moving to "gender affirming surgery" is the WP:MEDTITLE compliant option. I'm not sure if I wholly agree with Endwise that we should keep the old term in bold after the move, as it is now only used by a ever decreasing minority of sources and none of the current major international clinical guidelines refer to it as, and it has as other editors have stated a slightly different scope in its usage. Keeping it as a redirect makes sense though. Sideswipe9th (talk) 21:46, 23 November 2022 (UTC)
 * I don't see a problem with having it be one of two alternatives listed to avoid astonishing people who might be expecting the current title, particularly after a fresh move. The alt names could always been reviewed and changed again later if needed. That said, the issue of which synonyms to include in the lead should probably be sorted out after the requested move has concluded just to keep things on-topic here for now. – Scyrme (talk) 22:43, 23 November 2022 (UTC)
 * it is now only used by a ever decreasing minority of sources and none of the current major international clinical guidelines refer to it as -- very few people are up to date on current major international clinical guidelines, and the people who are probably wouldn't get much out of reading this article. "Gender-affirming surgery" is a very recent term, basically from the last few years, which many people will be unfamiliar with. A common thought/question many lay people---who are the target audience of this article---will be thinking is "Gender-affirming surgery? Is that like, sex reassignment surgery or something?" The point is just to make sure people know what the topic is about/that they have landed on the right article if they haven't heard the term before. Endwise (talk) 06:09, 24 November 2022 (UTC)
 * support per Sideswipe9th--Ozzie10aaaa (talk) 13:46, 24 November 2022 (UTC)
 * Oppose per WP:COMMONNAME based on the Google Ngrams. Rreagan007 (talk) 22:56, 28 November 2022 (UTC)
 * While those are are the guidelines for most articles the guidelines for medicine-related articles (which this definitely is) are given at WP:MEDTITLE which opens with "article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, rather than a lay term (unscientific or slang name)", as was explained by the nomination (along with evidence demonstrating that that proposed title is the recognised medical name used in recent, high-quality, English-langauge sources). The Ngrams reflect lay usage, not usage in the medical literature, and so are not especially relevant here. At best, they are only a reason to keep "sex reassignment surgery" as an alternative name listed in the lead section, not to keep the current article title. – Scyrme (talk) 23:56, 28 November 2022 (UTC)

"Also known as"
During the move discussion the issue of which names to include in the lead was raised. Generally, per MOS:ALTNAME, up to two alternative names are given. Others have suggested including the previous article title, "sex reassignment surgery"; I don't feel strongly either way, and don't mind leaving the lead as it is. However, I can see the arguments in favour of including "sex reassignment surgery", namely that it remains a common name particularly in lay usage and this move is very recent so someone might be plausibly surprised (WP:ASTONISH) to be redirected to an article with another title. That said, maybe "gender reassignment surgery" is close enough to avoid surprises, idk.

(ping for editors who commented about the alternative names plus the nominator and closer of the move.) – Scyrme (talk) 18:38, 30 November 2022 (UTC)
 * Based on the 2022 PubMed search results, we can put the terms in the following rough order of prominence:


 * 1) "gender-affirming surgery"
 * 2) "gender-affirmation surgery"
 * 3) "sex reassignment sugery"
 * 4) "gender reassignment surgery"
 * 5) "transgender surgery"
 * 6) "gender confirmation surgery"
 * 7) "gender confirming surgery"


 * This is the order I placed the terms in in the terminology section. But I did cut out "transgender surgery", as I feel like more research is needed before using that as a synonym, as well as the straggler "gender confirming surgery".


 * For the lead, I think we should consider both prominence but also uniqueness. "Gender-affirmation surgery" is so similar to "gender-affirming surgery" that I don't think we should include it, so I think the second term should be "sex reassignment surgery".


 * No matter what, I think we are basically compelled to include "sex reassignment surgery" in the lead, and I'm not convinced by the arguments for cutting it out.


 * For the third and final term in the lead, I would be fine with either "gender confirmation surgery" or "gender reassignment surgery". I think you can argue for the former, again on uniqueness grounds: if we include "sex reassignment surgery" we already have a term that uses "reassignment". (On the other hand, you could argue that "confirmation" is similar in meaning to "affirming"). The fact that Merriam-Webster and GLAAD advocate for "gender confirmation surgery" also does sway me a little (though since they're not medical sources you could argue that they should be disregarded). WanderingWanda🐮👑 (talk) 20:17, 30 November 2022 (UTC)
 * Another thing we should maybe discuss is that some sources pointedly use plural terms ("gender-affirming surgeries", "gender confirmation surgeries") to emphasize that there are many different kinds of transgender surgeries. But I'm not sure if there's a natural way to include these plural terms in the article. WanderingWanda🐮👑 (talk) 20:34, 30 November 2022 (UTC)
 * Do the Wikipedia guidelines state that alternative names used in medical sources should be preferred?
 * If not, I'd disagree with disregarding non-academic sources and lay usage. They may be very common even if they aren't favoured in academic sources, and many readers will expect Wikipedia to reflect the most common terminology as it usually does. Practically, it make sense to include them simply because otherwise it's likely someone will try fill in an apparent glaring omission anyway; this is more likely if lay use is ignored.
 * Anecdotally, I feel like the most common term I see in general use (besides SRS) is "gender confirmation surgery". I'm not familiar enough with search result statistics, so I can't offer any hard evidence regarding usage, but my observations do seem to be reflected among past attempts to 'update' or 'correct' this article including the previous unsuccessful requests to move, other attempts to move without a discussion, and multiple attempts to change the lead without moving the article. Every single time it has been to GCS (either "-ation" or "-ing"). This would also seem to be reflected in the examples you gave. (GLAAD, Miriam-Webster)
 * I would go with either SRS and GCS or GRS and GCS as the alternative names. I agree that there's no need to include both a "-tion" and an "-ing"; it's minor difference and doesn't warrant being bolded in the lead. The plural vs singular issue should probably be covered in the "Terminology" section since it likely warrants more explanation than just a "also known as ... surgeries" without context, otherwise many readers would probably miss the point, particularly when the article consistently uses the singular. – Scyrme (talk) 21:33, 30 November 2022 (UTC)
 * The current wording seems reasonable to me. SRS clearly needs to be there as still the most common 'lay' terminology in common use, it has only recently gone out of usage in scientific literature, and books tend to lag further behind. "Gender reassignment surgery" not only is less used in all settings, it is both too similar to and inconsistent with "gender-affirming surgery" to be that useful in the lead. |→ Spaully ~talk~ 10:26, 1 December 2022 (UTC)

Wiki Education assignment: Global Genders
— Assignment last updated by Jlkersey (talk) 22:44, 17 February 2023 (UTC)


 * Glad to see this here in connection to a university course that sounds pretty rad. There's a LOT of discussion on this page and there's surely "university libraries and other scholarly sources" that can be used to update this page! Its interesting because I have actually done some recent edits related to this page on the LGBT rights in Ohio page for the LGBT in the United States work group which might be of interest, as might the recently created LGBT and Wikipedia page, along with anything posted on the LGBT studies WikiProject. As a person who did a course assignment like this, myself, I wish you the best with your editing! Historyday01 (talk) 00:22, 18 February 2023 (UTC)

Wiki Education assignment: Intro to Women's, Gender and Sexuality Studies-16
— Assignment last updated by Jackchen314 (talk) 14:15, 6 April 2023 (UTC)

Split "By country"?
I can make this a formal split proposal if desired, but for now I'll just ask, would anyone objecting to splitting the rather long "By country" section to Legal status of gender-affirming surgery? -- Tamzin  [ cetacean needed ] (she&#124;they&#124;xe) 05:36, 20 May 2023 (UTC)


 * No objections. It is getting to the point where it should have its own article. Sideswipe9th (talk) 01:14, 21 May 2023 (UTC)
 * A positive reason for splitting is that there's definitely scope to increase the number of countries covered within this. There's several I can think of off-hand for which reliable sourcing exists, like Ireland, Australia, Sweden, Belgium, and that should be included in this list(icle) but currently aren't. While we could add them here, the more that we add now the greater the reason to split the content out. Sideswipe9th (talk) 02:57, 21 May 2023 (UTC)
 * Related to the above content, I've just done a terminology update on it, replacing the now archaic sex reassignment surgery with gender-affirming surgery, along with some copy edits, and a rewrite of the Cuban content due to a potential COPYVIO/CLOP issue. I've also tagged several of the countries with update inline, as there was several cases of content not having been updated in the last ten to twenty years. Sideswipe9th (talk) 02:21, 21 May 2023 (UTC)
 * ✅ to Legal status of gender-affirming healthcare. Still need to write a summary-style paragraph here. I did some cleanup during the split process, but the new article could still use a fair bit more, if anyone's up to it. --  Tamzin  [ cetacean needed ] (she&#124;they&#124;xe) 05:18, 29 May 2023 (UTC)

What are the surgeries for agender people like me?
I apologise to ask but I'm from a third world country and I English is not my native language, I'm self-taught. If the topic is "gender affirming surgery", what are the options for agender people like me? In my country trans feminine and trans masculine people no longer need sex reassignment surgery to legally change their names and registral sex and there is awareness of non binary people (yet not recognised legally, if someone wants to bear the "X" reserved for intersex people on their legal documents, they must pay for a civil court case, for trans people is free). As an agender person I never asked myself about surgeries, but now, what are those? Do they even exist? Thanks in advance. 186.34.109.70 (talk) 02:00, 6 August 2023 (UTC)
 * Wrong venue. Please post your question at the Reference desk. This page is devoted exclusively for discussions about how to improve the article Gender-affirming surgery. Thanks, Mathglot (talk) 06:15, 6 August 2023 (UTC)

Further Medical Considerations
The medical considerations section of this article only covers a brief overview of considerations and complications and does not go into detail regarding male/female specifics such as vaginal stenosis, urinary tract issues, tracheal cartilage shaving effecting the diameter of the trachea, just to name a few. Add focus on organ systems of the body and how gender reassignment can affect those, such as the cardiovascular system, respiratory system and the endocrine system. Jlkersey (talk) 15:59, 1 March 2023 (UTC)J.Kersey


 * If you think these issues are common please do the research and cite proper sources, contemplating on what you may think happens does not help marginalized communities like people who underwent GAS. 188.167.251.99 (talk) 18:21, 9 August 2023 (UTC)

New JAMA Randomly Controlled Trial
September 7, 2023

Early Access to Testosterone Therapy in Transgender and Gender-Diverse Adults Seeking MasculinizationA Randomized Clinical Trial

Question:  What is the effect of testosterone therapy compared with no treatment on gender dysphoria, depression, and suicidality in transgender and gender-diverse adults seeking masculinization?

Findings:  In this 3-month open-label randomized clinical trial of 64 transgender and gender-diverse adults, there was a statistically significant decrease in gender dysphoria in individuals with immediate compared with delayed initiation of testosterone therapy. A clinically significant decrease in depression and a decrease in suicidality also occurred with immediate testosterone therapy. Meaning The findings of this trial suggest that testosterone therapy significantly decreases gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.

Conclusions and Relevance: In this open-label randomized clinical trial of testosterone therapy in transgender and gender-diverse adults, immediate testosterone compared with no treatment significantly reduced gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.

Ocaasit &#124; c 17:31, 7 September 2023 (UTC)


 * Thank you! I'll add this to the Masculinizing hormone therapy article. Lastchapter (talk) 19:18, 7 September 2023 (UTC)

Nullification surgery for agender people.
The article lacks information about Nullification surgery for agender people, as Gender-affirming surgery. I can't edit since the article is closed and I do not own an account. Thanks in advance. 186.34.109.70 (talk) 23:00, 11 September 2023 (UTC)


 * Any WP:MEDRS about the topic?  Eve rgr een Fir  (talk) 23:11, 11 September 2023 (UTC)
 * Indeed. The article is quite complete regarding binary gender identities (masculine and feminine) and some of those procedures are used by non-binary people, but it lacks information about nullification surgery, which is used by some non-binary amab and agender people currently, it's becoming available in the US. 186.34.109.70 (talk) 17:38, 12 September 2023 (UTC)