Talk:Irreversible Damage/Archive 10

RfC: Should rapid-onset gender dysphoria be described as "fringe"?
Should the article describe rapid onset gender dysphoria as "fringe"? Crossroads -talk- 07:00, 12 December 2021 (UTC)

Survey

 * No. The status quo of contentious concept...which is not recognized as a medical diagnosis by any major professional institution more accurately represents the reliable medical sources (WP:MEDRS) as demonstrated below. The word "fringe" is not found in peer-reviewed medical papers or statements by professional bodies. It is WP:Synthesis on the part of Wikipedia editors, and states a degree of pejorativeness and rejection that is not representative of the MEDRS.
 * This paper cited as justification presents an original argument (rather than purporting to be an unbiased review) and thus seems to be a WP:PRIMARY source regarding the author's views. It is a sociology paper by an author without expertise in psychology or psychiatry. WP:MEDSCI states, Be careful of material published in journals...which report material mainly in other fields. Even then, it does not use the word "fringe".
 * Here are numerous high-quality medical sources that pointedly do not treat or describe ROGD as fringe, but rather as an alternative theoretical formulation worth considering seriously, while at the same time acknowledging that it is not the most recognized view (as the status quo text puts it). Emphasis added below.


 * it is critical to consider the societal changes that have occurred over time in relation to transgender people. Given the increase in visibility of transgender and gender diverse identities, it is important to understand how increased awareness may impact gender development in different ways (Kornienko et al., 2016)....Another phenomenon is adolescents seeking care who have not apparently experienced and/or expressed gender diversity during their childhood years. One researcher attempted to study and describe a specific form of later-presenting gender diversity experience (Littman, 2018 [the ROGD paper]); however, the study contained significant methodological challenges which must be considered as context for the findings: 1) the study surveyed parents and not youth perspectives, and 2) recruitment included parents from community settings in which treatments for gender dysphoria are often characterized as pathological or undesired. The phenomenon of social influence on gender is salient, however, as some who have changed their thoughts about their own gender identity have described how social influence was relevant in their experience of their gender during adolescence (Vandenbussche, 2021). For a select subgroup of young people, in the context of exploration, social influence on gender may be a relevant issue and an important differential. This phenomenon is neither new nor surprising for health professionals working with adolescents; however, caution must be taken to avoid assuming these phenomena prematurely in an individual adolescent, as well as from datasets that may have been ascertained with potential sampling bias (WPATH, 2018). - World Professional Association for Transgender Health (WPATH) Standards of Care 8 draft version (finalized edition to be released spring 2022).
 * it constitutes nothing more than an acronym created to describe a proposed clinical phenomenon that may or may not warrant further peer-reviewed scientific investigation. - WPATH 2018 position statement on ROGD.
 * The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). Therefore, “ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings. - 2019 AusPATH position statement on ROGD.
 * While some of us have informally tended toward describing the phenomenon we witness as “adolescent-onset” gender dysphoria, that is, without any notable symptom history prior to or during the early stages of puberty (certainly nothing of clinical significance), Littman’s description resonates with our clinical experiences from within the consulting room. In our experience, it is commonplace for clinicians to engage in conversations regarding this phenomenon (Churcher Clarke & Spiliadis, 2019). Furthermore, from speaking with international colleagues, it seems to us that this phenomenon is also being observed in North America, Australia, and the rest of Europe. In addition, we are witnessing high levels of distress and comorbidity. Bechard, VanderLaan, Wood, Wasserman, and Zucker (2017) carried out a cohort study of referrals made for adolescents into a gender identity service which showed a high level of comorbid psychological difficulty as well as psychosocial vulnerability. They concluded that this supported a “proof of principle” for the importance of a comprehensive psychological assessment extending its reach beyond gender dysphoria. This is consistent with a previously published paper from Finland (Kaltiala-Heino, Sumia, Työläjärvi, & Lindberg, 2015) which identified the phenomenon of an over-representation of adolescent females with particularly complex needs presenting at gender clinics. - 2019 letter to the editor by 3 authors in Archives of Sexual Behavior.
 * However, authors of case histories and a parent-report study warrant that gender identity development is diverse, and a new developmental pathway is proposed involving youth with postpuberty adolescent-onset transgender histories.6–8 [source 7 is Littman's original ROGD paper.] These youth did not yet participate in the early evaluation studies.5,9 This raises the question whether the positive outcomes of early medical interventions also apply to adolescents who more recently present in overwhelming large numbers for transgender care, including those that come at an older age, possibly without a childhood history of GI. It also asks for caution because some case histories illustrate the complexities that may be associated with later-presenting transgender adolescents and describe that some eventually detransition.9,10 - 2020 Commentary in Pediatrics.
 * With regards to the referrals, in line with international trends [9–12], Italian’s population of trans* youths seem to be growing, particularly with respect to AFABs. Some respondents depicted referrals with traits of the so-called “rapid onset” [15] of gender incongruence, especially when describing AFABs, with pressing requests to start soon hormone therapies and an (apparent) lack of history of gender incongruence. However, this is a very complex phenomenon that needs further exploration. - 2020 paper about youth gender clinics in Italy
 * More recently, expert professionals have seen an ever-increasing number of post puberty cases of GD in birth-assigned females with rapid-onset clinical manifestations. This apparent new phenomenon, termed “rapid-onset gender dysphoria” (ROGD), has been described by parents who have reported that their child displayed a sudden or rapid onset of GD in adolescence without having had a history of gender variance during childhood (11, 12). Of note, clinical features suggestive of GD were observed in adolescents within a group of peers, with several members becoming gender nonconforming. A survey of 256 parents showed that the majority of adolescents with ROGD were birth-assigned females (82.8%), with a mean age of 16.4 years. In addition, there were a high percentage of mental health disorders and developmental disorders, as well as several psychosocial stressors, which preceded the onset of GD. The survey received mixed support, and warrants future studies to help understand if ROGD as a distinct entity or as a variant presentation of GD (12-15). - 2020 paper by 3 authors in Acta Biomedica.
 * There has been a 3264% rise in referrals to the national gender identity service at the Tavistock and Portman NHS Trust in London over the past 10 years (from 77 in 2009–2010 to 2590 in 2018–2019).1 The profile of referrals has also undergone a major transformation: we have seen a reversal of the gender ratio from two-thirds male:female to two-thirds female:male, with a recently described clinical phenomenon of as yet uncertain diagnostic significance making up a substantial proportion. This gender dysphoria of recent onset among adolescents (sometimes termed ‘recent-onset gender dysphoria’ or ROGD, ‘rapid-onset adolescent dysphoria’2 or‘adolescent-onset transgender history’3) lacks an agreed name or established diagnostic criteria, but its emergence has been documented by a number of gender clinics worldwide.4 - 2021 "Special Article" in BJPsych Bulletin.


 * As shown, it would be cherry-picking and POV to take those few who condemn ROGD as not just unproven, but as disproven, and treat their word as gospel. Crossroads -talk- 07:00, 12 December 2021 (UTC)


 * No, but it should be described as unproven hypothesis. I think describing it as fringe would be too dismissive of the medical literature on the issue. However, it cannot be described as anything more than one possible, hypothesized phenomenon with insufficient research supporting it (per the sources above). Yes. We should not give it more credit than it is due, and that is not much. This theory has the capacity of being used to deny or discredit young trans people's experiences, and so we have to be extra-careful when describing it or writing about it to make it clear that a) it is not supported by current research consensus, outside of b) studies with important methodological flaws (e.g. as described by WPATH) which affect the strength of the hypothesis and which c) are focused on certain regions of the world and so may not be representative of a global situation and be specific to the socio-cultural movements within one or few countries as access to and information about trans healthcare is significantly increased. It will probably receive more research in the next few years, upon which this theory can be revisited in wiki, but for now it fits the description of WP:FRINGE. Santacruz  &#8258;  Please ping me!  08:59, 12 December 2021 (UTC) Changed vote from no to yes on 18:18, 12 December 2021 (UTC)
 *  Strong skepticism Clear rejection of the book's claims should be foregrounded in the article. The wiki article Rapid-onset gender dysphoria controversy appears to have a useful overview, in which ROGD is widely discredited. I don't edit in MEDRS so I'm not sure what it means to officially declare something "fringe". (But surely it does not require finding sources that literally use the word "fringe"?) But it is not a complete or effective book article if it does not fully address this context and the book's highly negative reception. ~ L 🌸  (talk) 09:03, 12 December 2021 (UTC)
 * More from the book coverage perspective: the wide condemnation of this book appears to actually be its primary notability claim. This should be foregrounded. It is not necessary for this article to address the entire ROGD controversy or review the literature on ROGD itself (as noted, an article already exists on that topic): this article needs to contextualize this book. And that means alerting readers to its wide rejection. I am not aware of any coverage of this book which describes it as presenting widely-accepted views, even in the case of positive coverage from those who consider its minority views to be correct. Those who praise the book for its transgessive boldness reinforce the book's status as existing outside the mainstrem. A source table collecting direct coverage of the book itself will, I believe, make clear that WP:BALANCE requires describing the book as entirely lacking in wide acceptance. ~ L 🌸  (talk) 22:57, 12 December 2021 (UTC)


 * Yes. I understand this comment is long, so I will attempt to summarize. Everything below and including the collapsed points responding to Crossroads' is a more thorough form of this paragraph. If ROGD cannot be described as a "fringe theory", I am unsure of what can. A collection of lukewarm acknowledgements, none of which are from respected or representative figures, the majority of which are not MEDRS, does not a legitimate theory make. The hypothesis of ROGD, that gender dysphoria can be socially induced (i.e. it's "contagious") deviates radically from the current scientific consensus of the diagnosis and our understanding of gender identity. There is little empirical evidence supporting it, the original 2018 paper was criticized for it's methodological flaws, as it suffered from significant sampling bias, recruiting parents of trans people, not the children themselves, from a trans "skeptical" forum. The only subsequent study, a clinical trial, found no evidence to support the theory. ts originating paper was widely criticised for its methodological flaws, No major bodies recognise the diagnosis, with the two APAs and WPATH calling for its "elimination" from clinical and diagnostic use, stating that it does not align with the lived experiences of trans people. The only mention in medical literature, beyond the two studies previously discussed, are two mentions reporting that several parents of trans children believed their children to have "rapid-onset" gender dysphoria. A lack of support by any respected figure, combined with a total lack of credible supporting empirical evidence, makes ROGD a fringe theory. Having (hopefully) established weight for the categorization, that leaves the several sources that can be summarized or quoted as describing ROGD as fringe or similar. See "Medical sources supporting the analysis that ROGD is fringe or debunked" for the various options, although I prefer "disproven" as a synonym of "refuted" in the APS statement. It avoids ambiguity, is eloquent, and is less jargon-y than the alternatives.


 * World Professional Association for Transgender Health (WPATH) Standards of Care 8 draft version - I have multiple problems with Crossroads' citation and interpretation of this text. Firstly, their conclusion relies on original analysis - an interpretation of an implicit statement within the text. This is not necessarily an issue in and of itself, except that WPATH (through CAAPS) has released a position statement that contradicts this interpretation, explicitly rejecting the theory and calling for its "elimination" entirely. That is not how organisations treat "alternative theoretical formulations", and an editor's subjective interpretation of a text is overshadowed by a concrete authorial voice. As for their interpretation, it is founded on the fallacious understanding that any mention of gender having a social influence is implicit support for ROGD specifically. Reading the highlighted passage beyond a first glance reveals that they are, in fact, largely talking about entirely different aspects of gender than ROGD. Littman's paper specifically advances a form of gender dysphoria that is induced socially, and the only sentence explicitly referencing her theory dismisses it for its methodological flaws. The next sentence is as follows: The phenomenon of social influence on gender is salient, as some who have changed their thoughts about their own gender identity have described how social influence was relevant in their experience of their gender during adolescence (Vandenbussche, 2021). Although it is understandable how one may interpret this to be discussing ROGD, it is in fact talking about social influences over gender identity (which, for clarity, is entirely distinct from  gender dysphoria). The proof is in the pudding, for one it says "gender", but also the cited source (found here), discusses how social influences, such as internalised homophobia and misogyny, may have led some individuals to falsely or mistakenly identify as trans. It is discussing a different aspect of gender and a different way in which it has a social influence. Vandenbussche makes no mention of any kind of social inducement of gender dysphoria. The next quote, For a select subgroup of young people, in the context of exploration, social influence on gender may be a relevant issue and an important differential. This phenomenon is neither new nor surprising for health professionals working with adolescents..., again, bears no actual relevance to ROGD beyond a surface resemblance in that they both talk about how gender is socially influenced. It makes no reference to gender dysphoria, qualifies the attribute as only belonging to an individual's exploration (which, while obviously related to gender dysphoria, has no relation on its development), and most closely resembles the idea that often trans, and also some cis people, will "experiment" with presenting as different genders socially to find (or confirm) the role they feel most comfortable inhabiting. If this sentence conveyed the meaning Crossroads is claiming, then, considering it is "neither new nor surprising for health professionals", he should be able to find a reputable source that explicitly accepts Littman's hypothesis. On the other hand, I can find plenty of reputable sources that are familiar with gender experimentation in the context of social roles.  It's clear to me that this entire passage is not in fact an exclusive discussion of the merits of Littman's paper, but rather an attempt to cover in brief the major proposed ways in which gender is socially influenced: inducement of gender dysphoria (which is rejected), misdiagnosis of gender dysphoria, and the political and social component of transition. You would expect nothing less from a text such as this. The only part specifically discussing Littman's paper dismisses it entirely on its methodological flaws, and it is an overly generous reading to attempt to claim the rest of the passage shows WPATH supports ROGD as an "alternate theoretical formulation", especially when they have made concrete statements to the contrary.
 * WPATH 2018 position statement on ROGD - The quotation of this particular statement is extremely misleading, as it is outdated and has been superceded by the previously mentioned CAAPS statement. Additionally, the WPATH position statement was released just 24 days after the publication of the initial Littman paper, before the subsequent published methodological reviews, clinical trial, or even the revised version of the paper. What may have been a proposed phenomenon within a month of its release is not necessarily considered such later, following more thorough studies. Crossroads also seems to be ignorant of the fact that a fringe theory is also a "proposed phenomenon".
 * 2019 AusPATH position statement on ROGD - The quote attributed to AusPATH is cherrypicked and also misleading, as it is itself a quote of the outdated WPATH 2018 position statement, and the novel content, including the explicit rejections of ROGD are omitted entirely. The statement outright rejects ROGD in the phrase AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender (emphasis mine). They furthermore state that All TGDNB people are deserving of gender-affirmative, evidence-based care. This concept, that all TGDNB should receive gender-affirming care is mutually exclusive with ROGD, since ROGD is a diagnosis in which a TGDNB person cannot be treated in that manner (something explicitly stated in Littman's original paper).
 * 2020 Commentary in Pediatrics; 2019 letter to the editor - Neither the cited letter to the editor, nor the commentary are peer reviewed and do not meet WP:MEDRS. A handful of citations to or mentions by individuals is not remotely enough to establish ROGD as a mainstream theory.
 * 2020 paper about youth gender clinics in Italy; 2020 paper by 3 authors in Acta Biomedica - Both the Italian and the Acta Biomed paper are inconclusive as to the legitimacy of ROGD as a theory, merely stating that participants in the study self reported an occurence of ROGD. These "cases" have not been diagnosed or even verified by any medical professionals, and if these examples count as rigorous evidence of the existence of ROGD, you may as well also quote the parents on crackpot anti-trans forums. Additionally, in light of the negative findings of the aforementioned clinical trial, these mentions do not amount to much. See Newimpartial's comment for a more thorough discussion.
 * 2021 "Special Article" in BJPsych Bulletin - The 2021 article published in BJPsych Bulletin is similarly inconclusive. Furthermore, Marcus Evans, the author of the article, is fairly well known as a controversial figure who himself holds fairly extreme views. Again, see Newimpartial's comment for a more thorough discussion.


 * Australian Psychological Society (APS), in a statement about ROGD - Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence, as a form of ‘social contagion’
 * The American Psychological Association (APA), American Psychiatric Association (APA) and World Professional Association for Transgender Health (WPATH), through a CAAPS position statement - [CAAPS] supports eliminating the use of Rapid-Onset Gender Dysphoria (ROGD) and similar concepts for clinical and diagnostic application given the lack of rigorous empirical support for its existence... There is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents.
 * The Society for Research in Child Development, in this statement, endorsed the CAAPS position statement.
 * Australian Professional Association for Transgender Health (AusPATH), in a 2019 position statement - The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves... AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender.
 * Canadian Professional Association for Transgender Health (CPATH), in a 2020 position statement - CPATH supports gender diversity as a natural and healthy part of the human experience and strongly discourages use of any terminology, including "rapid onset gender dysphoria", to pathologize or invalidate diverse gender experience. The president of CPATH further cosigned a statement describing ROGD as "bad science".
 * Florence Ashley, 2020, the only secondary scientific source that doesn't focus on the methodological flaws of the original paper - Characterizes ROGD as Circumventing science through pseudoscience. Additionally states that Despite attempts to shift it onto proponents of gender-affirmative care, the burden of proof lies squarely on proponents of ROGD since they are seeking to displace the empirically backed consensus approach. Evidence only counts as supporting the existence of ROGD if it excludes the possibility of non-pathological, non-epidemic explanations something that has yet to be offered. Unsurprisingly given the dearth of supporting evidence, many leading experts have rejected ROGD as lacking empirical support.
 * Bauer et al, 2021, the second study of the theory and the only clinical trial - Our results did not support the rapid onset gender dysphoria hypothesis
 * Statement by the Gender Dysphoria Affirmative Working Group (GDAWG) - The Littman (2018) study has been widely contested as methodologically flawed and unethical, proceeding from an overt ideological bias.


 * Something considered an "alternative theoretical formulation" by respected members of a field is not called to be "eliminated". It is not rejected by every relevant professional organisation (the two APAs and WPATH (under CAAPS), CPATH, SRDC, GDAWG, APS, and AusPATH) and reputable expert. The best evidence other editors have found to support their claim that ROGD is an alternative theory is an interpretation of a quote that is explicitly contradicted by the author, outdated and misrepresented position statements, a few non-MEDRS articles by controversial figures, and two passing acknowledgements that parents self-reported cases of ROGD. ROGD is not outright opposed and treated as junk science because it is being "censored", it is treated that way because it is junk science. That makes it a fringe theory, and the complete lack credible empirical support further supports this conclusion. Its original paper was widely criticised as being "fatally methodologically flawed", and the only subsequent study, a clinical trial conducted in 2021, found no evidence to support the theory. To once again quote the APS statement, "Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence".
 * The sources I've discussed could point to various phrases and terms. The previously discussed Florence Ashley paper characterises ROGD as Circumventing science through pseudoscience, and also makes the analysis that ROGD lacks empirical evidence and mainstream support, which can be summarized as describing ROGD as "fringe". A PsychCentral article by the same author references various experts calling ROGD "bad science". Pseudoscience, bad science, and refuted/disproven (as discussed by the APS) theories all fall under the category of a fringe theory. If editors feel that term to be too pejorative, then "pseudoscientific" (Ashley), "disproven" (APS), and "consistently refuted by empirical evidence and mainstream organisations" (APS, Ashley) can all be supported as either direct quotes or as synonymous paraphrases from mainstream and respected sources.
 * To wrap up a few minor points, firstly Crossroads' insistence that "fringe" be a direct quote of a source, lest it be WP:OR and WP:SYNTH runs directly counter to WP:SYNTHNOTSUMMARY, and would mean the the vast majority of content on Wikipedia would in fact be breaking policy. It is an arbitrary bar that does not reflect the standards of any other article. Establishing weight for a position in this discussion, and then whether a given summary is an accurate reflection of the content and spirit of a singular source is not WP:SYNTH.
 * Additionally, the status quo of "contentious" actually breaks Wikipedia policy. It is not supported by any source, and appears to have been an original analysis on multiple sources. Unless a source can be found to support the phrase, and it is established that the source has sufficient weight, a different description must be used.
 * Edit (16 January 2022): I've done a little more research and reflection into the topic and I support my position even more strongly. I do concede that this issue may be a little more subtle than I gave it credit for and I apologize to Crossroads specifically for my hot-headedness. However it's clear to me that the material facts point towards ROGD as being closer to fringe than not. ROGD has no credible evidential support. Its original paper was criticised for methodological flaws, and the only other study found no evidence to support it. No major organisations recognise the theory. I still cannot find any "respected minorities" either. There are credible sources describing the theory as "consistently refuted", "bad science", and "pseudoscience". All these are well sourced quotes that accurately reflect the state of the theory in scientific literature. Bravetheif (talk) 09:13, 12 December 2021 (UTC)
 * That these MEDRS are "inconclusive" is entirely the point. WPATH, AusPATH, and the APA all treat it as unproven, not disproven, and acknowledge the need for more research. And when quoting the CAAPS statement signed by the APA and others, you left off that this applies to clinical and diagnostic application given the lack of rigorous empirical support for its existence. The status quo already says that it is not recognized as a diagnosis, but to imply greater disprovenness is not accurate. Crossroads -talk- 19:39, 12 December 2021 (UTC)
 * I understood your meaning, my point was that, in light of more conclusive evidence rejecting the hypothesis, these mere acknowledgements of the theory do not hold much weight. Setting the requirement for a theory to be thoroughly disproven before it can be described as "fringe" is an arbitrary bar that does not reflect the actual meaning of the word. All that is required for it to be called "fringe" is that it be outside the mainstream. WPATH, AusPATH, and the APA all reject the hypothesis, with the APA calling for it's elimination entirely, and AusPATH explicitly rejecting the foundations of the study. That is not how mainstream alternate hypotheses are treated. Bravetheif (talk) 22:27, 12 December 2021 (UTC)
 * The APA called for its elimination from diagnostic use, which is not the same as calling for its elimination from scientific research. The WPATH, AusPATH, and the APA-signed official statements on ROGD all encourage further research; while they do stop short of specifically calling for research on ROGD, those phrases are in statements about ROGD and it is clear that they are not saying it should be rejected from scientific research (which they could have easily said were they certain that would be a dead end). Crossroads -talk- 06:27, 13 December 2021 (UTC)
 * Crossroads, I apologize for being short with you, but what does "elimination from scientific research" mean in your mind? It is blatantly ridiculous to suggest that the threshold for "fringe" be that no one is capable of or permitted to perform research on the topic. That would mean flat-eartherism, anti-vax research, and every other textbook fringe theory is actually, mainstream. The cited WPATH position statement is outdated, as they signed the more recent CAAPS one, so it can be disregarded entirely except perhaps as evidence of a historical position. Both remaining statements call for research generally into gender-affirming care, not into ROGD. CAAPS states evidence-based clinical guidelines for gender-affirming care that support child and adolescent gender identity development, and AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship. All TGDNB people are deserving of gender-affirmative, evidence-based care that is underpinned by contemporary, adequately endorsed and community engaged standards of care and clinical guidelines. It is frankly misleading to claim this is support of further research into ROGD. Bravetheif (talk) 06:44, 13 December 2021 (UTC)
 * That other stuff has numerous peer-reviewed sources in the relevant fields calling it fringe, and no treatment as plausible in mainstream journals. Comparing this with that is night and day. And ROGD is not necessarily incompatible with the broad concept of "gender-affirming care", regardless of what later non-experts may have claimed. I was very clear on what they did and did not say about further research. Also, note what AusPATH says about "censorship" - have non-ROGD papers ever been threatened with censorship? In this area claims of censorship of research only exist as accusations that activists have tried to censor research regarding ROGD itself. Crossroads -talk- 07:04, 13 December 2021 (UTC)
 * ROGD is entirely incompatible with the statement all TGDNB people are deserving of gender-affirmative, evidence-based care (AusPATH), because it creates a diagnosis in which gender non-conforming individuals should not be treated with gender-affirming care. It is not possible to reconcile those two positions. You incorrecly attributed a call for further research into gender-affirming care into one for ROGD, when those are not synonymous. ROGD has been dismissed in muliple, reputable journals (despite your insistence that they are "not experts"), and it has position statements outright calling for its elimination and rejecting its core foundations. The CAAPS statement does not even treat it as a theory, just as straight up false.
 * have non-ROGD papers ever been threatened with censorship? Yes, of course they have. Are you serious? The Nazi's literally burned the Institut für Sexualwissenschaft to the ground. Donald Trump gagged the EPA. This is not the appropriate platform for espousal of your persecution complex and personal conspiracy theories. It is not relevant to this discussion, and I frankly couldn't care in the slightest. Bravetheif (talk) 07:26, 13 December 2021 (UTC)
 * AusPATH is obviously not talking about Nazis or the EPA; these have nothing to do with present-day research into GD. Crossroads -talk- 06:32, 15 December 2021 (UTC)
 * You asked if any other paper has ever been threatened with censorship, a transparantly ridiculous statement I was providing counter examples of. It's a false premise anyway. You may not have noticed, but an extremely successful book was written about the theory and paper. Bravetheif (talk) 09:05, 19 December 2021 (UTC)


 * Yes. The professional views referred to are plain enough, as long as we quote explicit independent judgements that plainly reject the validity of the book. Leaving the non-professional reader to assess quackery in published works of this nature amounts to betrayal of WP's function. Fringe authors hold all the cards in selling their ideas to fuel public hysteria, and as long as WP can directly quote, or clearly and honestly paraphrase, professional rejection in terms that Joe Public can understand, quibbling about an expressive term is counter-productive. If not "fringe", I would call it "quackery", but that might be seen as even more tendentious. JonRichfield (talk) 11:18, 12 December 2021 (UTC)
 * Comment. The sources criticizing ROGD, particularly the ones using more strident language, are written by people and organizations with an axe to grind.  For WPATH this "affirmation only or else" position is described on its Wikipedia page, other PATH organizations likely similar politically.  Ashley and Restar are graduate students, self identified trans activists and one of them is trans herself.  While their opinions are not invalidated by that fact, they are more accurately viewed as a sample of opinion from  "trans affiliated" academia and medical organizations, which is a different population than the relevant areas of academia or medicine as a whole.  A narrow, involved and COI (for grants etc) subgroup cannot represent expert opinion in its entirety even if it purports to speak for the entire field. Sesquivalent (talk) 12:20, 12 December 2021 (UTC)
 * But if the releveant medical and academic establishment is "trans affiliated" in the sense you have suggested, then these expert perspectives are the prevailing views or mainstream views in its particular field, in the language of WP:FRINGE, or the academic and professional books written by experts in the relevant fields and guidelines or position statements from national or international expert bodies referred to in WP:MEDRS. Your attempt to cast doubt on the relevant experts as A narrow, involved and COI (for grants etc) subgroup is an inversion of WP sourcing policy and a re-enactment of the arguments we used to hear from climate-change skeptics, trying to discredit mainstream climate science on the basis of dissidents who were, err, not climate scientists. This rhetorical move is not a policy-relevant consideration on WP. Newimpartial (talk) 13:55, 12 December 2021 (UTC)
 * Absolutely not. If the basic claim of ROGD is that large numbers of gender dysphoria diagnoses in adolescent girls are factitious, then various areas in, e.g., child psychology are implicated and the opinion of experts in those areas are relevant. Even considering only the field of (for lack of a better term) "trans medicine", the opinion of trans and non trans persons, and of advocates vs non advocates, are likely to be rather different statistically.  People whose funding, careers or self conception are to some degree dependent on accepting and promoting the paradigms and approaches criticized by ROGD, are a small minority, and using their statements as authoritative indicators of the mainstream is classic cherry picking.  Sesquivalent (talk) 14:35, 12 December 2021 (UTC)
 * Why not dismiss the opinions of everyone who has promoted ROGD because their funding, careers or self conception are to some degree dependent upon it? XOR&#39;easter (talk) 15:40, 12 December 2021 (UTC)
 * If anyone here had quoted ROGD proponents as authorities on whether the theory they are personally tied to is fringe then yes, obviously that would fail the laugh test too and for the same reason that I gave. A very clever hypothetical observation!  In the real discussiom we are having, people are seriously quoting trans activists as objective and uninterested authorities on the official universal and definitely scientific academic consensus.  Just trust them; they even almost have PhDs. Sesquivalent (talk) 16:30, 12 December 2021 (UTC)
 * In the real discussion we are having, one set of sources is being arbitrarily designated as not having an axe to grind. XOR&#39;easter (talk) 16:39, 12 December 2021 (UTC)
 * Is there a source being used here to argue against fringeness, that has an axe problem like that of WPATH, or the two graduate student trans activists, or the doctor paid by litigants and sellers of hormone treatments? Sesquivalent (talk) 17:07, 12 December 2021 (UTC)
 * What reliable sources are being used here to argue against fringeness? I haven't seen any - Crossroads' reading of his sources is highly tendentious, and I haven't seen anything better put forward. Newimpartial (talk) 17:27, 12 December 2021 (UTC)
 * Sesquivalent, who is a small minority of what group, according to you? It seems to be that anyone claiming that large numbers of gender dysphoria diagnoses in adolescent girls are factitious - rather lurid even as a statement of the premise of ROGD - would be the small minority of qualified professionals and academics, according to the sources available.
 * Also, dismissing scholars who publish peer-reviewed work in this field, and national and international expert bodies, as trans activists is not how WP sourcing is assessed; whether or not a particular scholar is transgender is not a policy-relevant criterion no matter how much you disagree with their findings.Newimpartial (talk) 16:35, 12 December 2021 (UTC)
 * "trans activist" is (as stated above) literally their public self description, and is relevant as such. Both the ROGD proponents and opposing activists are a small minority from the larger population of relevant experts in child psychiatry and other areas of psychology and medicine, both have axes to grind and incentives that are incompatible with objectivity, and neither is a reliable source of information on what is fringe and what is consensus. Sesquivalent (talk) 17:07, 12 December 2021 (UTC)
 * I haven't been using (or referring to) Ashley and Restar as sources. Are these the only ones you are referring to? Right now what you are setting is a pure FALSEBALANCE position, since we have many high-quality sources that are critical or skeptical about ROGD, and literally no good sources supporting the hypothesis. But your lurid paraphrase of it above suggests that you just WP:LIKEIT. Newimpartial (talk) 17:27, 12 December 2021 (UTC)


 * No. It should be described as not being an established diagnosis. Per WP:FRINGE, I would not label ROGD as "fringe".  The 2018 study was not debunked; PLOS ONE republished it to clarify that it was not a clinical diagnosis, and that the results were based on data from reports by parents of teen and young adults who identified as transgender -- but it did not change the results. (The study led to the creation of the Pique Resilience Project.)  There have been howls, pushback, and armchair opinions since the publication of the Littman research, but I am not aware of another ROGD research published by a major university that completely invalidates the Littman study (the 2021 study conducted by professor Greta Bauer and her Trans Youth CAN! project team at Schulich School of Medicine & Dentistry should be taken with a grain of salt because ... duh ... what different conclusion was frankly expected).  Until ROGD is absolutely discredited by highly-regarded scientific research, labeling it "fringe" is OR.  Pyxis Solitary   (yak) . L not Q. 13:36, 12 December 2021 (UTC)
 * Are you suggesting that the ongoing Bauer et al. study is not research published by a major university? If not, why not? Also, labelling ROGD as "fringe" cannot be WP:OR because Jack Turban - regardless of how you personally might feel about his work - has already done the original research for us, and applied the "fringe" label. Newimpartial (talk) 13:44, 12 December 2021 (UTC)
 * There are two Turban documents, a Psychology Today review panning the book, and an expert witness report submitted as part of ongoing litigation. Only the latter calls ROGD a "fringe view".  Are you proposing to take expert witness reports as a source for anything except the position of the litigant who paid for the report?  This case is still in process, no judgement has been made on the arguments in the expert reports, and the opposite side has its own expert saying that this is a emerging area of "unsettled science" for which no consensus exists. Sesquivalent (talk) 15:22, 12 December 2021 (UTC)
 * I was responding to Pyxis' claim that "fringe" is WP:OR, which it manifestly isn't. Whether it is WP:DUE depends on the overall weight of the high-quality sources available, but she seems reluctant to take those into consideration. Newimpartial (talk) 16:35, 12 December 2021 (UTC)
 * Having deep methodological issues (most significantly biased sampling, as described by WPATH) means that the onus is still on it to be proven, rather than being "debunked". If I may paraphrase Hitchen's razor, the burden of proof lies on those making the claim that ROGD is an actual phenomenon. As far as I know (per sources in this discussion), no proper research without major methodological issues has actually done so. Thus, the claim is unfounded, and its opponents need not argue further in order to dismiss it.
 * On another note, mentioning the Pique project is completely irrelevant to a discussion on medical issues,, and I'd appreciate it if you didn't do so in the future. Four de-transitioned women sharing their story has no influence on whether a theory making general claims on the whole transgender teenage population within a medical context is correct. Otherwise, I'll go right ahead and quote students at my local bar on alcohol having no negative effects on the body. Santacruz  &#8258;  Please ping me!  18:07, 12 December 2021 (UTC)
 * Let me save you any further wasted wordage ... I don't listen to, nor give an ounce of consideration, to the opinions of anyone who believes that they can disparage Wikipedia editors with impunity, as you did with your across-the-board accusation posted in a User talk page:  Pyxis Solitary   (yak) . L not Q. 09:14, 13 December 2021 (UTC)
 * You can't just dismiss peer reviewed clinical trials out of hand simply because you personally believe them to be biased to the point of fabrication. That study is the most comprehensive to date and, reading through, it I fail to find any methodological flaws (unlike Litman's original paper). If you think it is untrustworthy, please provide actual evidence, rather than conjecture. EmilyIsTrans (talk) 12:43, 22 December 2021 (UTC)
 * I opened a subsection on this, where you can find plenty of actual evidence of fatal flaws in the study. In short, that paper ain't no clinical trial; it piles up error upon obvious error in an attempt to test claims that do not follow from ROGD and were not made anywhere by Littman. Sesquivalent (talk) 22:47, 24 January 2022 (UTC)


 * No. "Fringe" is an unnecessarily pejorative term that associates it with the likes of "ancient astronauts" and QAnon. The article should truthfully state that the theory is not currently accepted as a diagnosis by the mainstream, but it is the subject of heavy debate (with lots of ideology and culture-warring involved). &#42;Dan T.* (talk) 14:47, 12 December 2021 (UTC)
 * I currently agree with you that perhaps fringe is a mischaracterization (see above), but the idea we shouldn't label things as "fringe" because of the connotations of the term feels wrong to me. We call things fringe when they depart significantly from mainstream scholarship. Not when they are similar to QAnon. Santacruz  &#8258;  Please ping me!  18:09, 12 December 2021 (UTC)
 * No. It's contentious and not presently established as a diagnosis, and should be described as such.  — SMcCandlish ☏ ¢ 😼  15:22, 12 December 2021 (UTC)
 * Yes since that's a decent one-word summary of the state of the available sources, and I can't for the life of me see how it's inconsistent with the status-quo text, which is not recognized as a medical diagnosis by any major professional institution. "Marginal" would also work as a fair summary of the situation. "Fringe" covers a broad territory and thus isn't pejorative. A "fringe" concept might be a coherent idea that have been empirically discredited but maintain a minority of diehard supporters; e.g., I don't think anyone would blink if we called the Aquatic ape hypothesis "fringe". By the same token, I wouldn't want it to be the entirety of the description, but it's not going to be, so no problem there. "Contentious" is actually worse; like "controversial", it gives no indication of what the problem is or where the weight of the evidence lies. XOR&#39;easter (talk) 15:40, 12 December 2021 (UTC)
 * Yes As per XOR&#39;easter & Bravetheif. The original study was "methodologically flawed and unethical", saying it proceeded from "an overt ideological bias" based on  parents of trans youth from "websites openly hostile to transgender youth". It is not recognized by any major professional association as a valid mental health diagnosis.  ~ BOD ~ TALK 17:46, 12 December 2021 (UTC)
 * Yes per XOR&#39;easter and Bravetheif. The only clinical study into the theory found [no] support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence and [a]mong adolescents under age 16 years seen in specialized gender clinics, associations between more recent gender knowledge and factors hypothesized to be involved in rapid onset gender dysphoria were either not statistically significant, or were in the opposite direction to what would be hypothesized. In light of the other strong statements by WPATH, AusPATH, and others mentioned previously it is absolutely fringe. Sideswipe9th (talk) 18:14, 12 December 2021 (UTC)
 * Yes per WP:FRINGE. It is a reasonable summary of the best sources available on the topic as described above, which is what the lead should attempt to provide. Calling it contentious implies that it has a meaningful level of support in the medical community or that it is somehow an open question still under debate, which is absolutely not true and is unsupported by the article's sources. The (very few) sources people are trying to present arguing that it is not fringe - letters to the editor, fringe sources writing in an area where they have minimal or no expertise, etc. - are largely comparable to the sources people try to present to dispute the scientific consensus on climate change.  Similarly, the arguments above (that the best parts of the medical establishment covering the topic have "an axe to grind" because they support mainstream science on trans issues) is essentially identical to the argument people try to use to dismiss sources in that topic area, establishing a standard under which no source could ever be acceptable; and the argument that we should not "take a side" by reporting the mainstream consensus is likewise identical. WP:FRINGE requires us to do exactly that - to describe a theory as fringe if that is an accurate summary of the best sourcing and its overall academic reception. --Aquillion (talk) 18:26, 12 December 2021 (UTC)
 * The comparison to climate change is a faulty analogy. There are numerous sources in that field specifically calling climate change denial fringe and documenting via detailed surveys that it has extremely high rates of outright rejection as disproven. Not the case with this. None of the relevant sources I presented above are from outside the field of expertise, though one of the opposing sources is. Mainstream sources are not still giving any credence to the possibility that climate change is not human caused, while the sources I listed above in fact do so about ROGD; the two ideas are not comparable. Crossroads -talk- 19:55, 12 December 2021 (UTC)
 * Re: do so: do what? Give credence to the possibility that the ROGD hypotheses are valid? No. Give credence to the possibility that ROGD describes an empirical phenomenon? Not really. If you think detailed surveys are required to demonstrate that multiple RS explicitly reject ROGD as an empirical phenomenon and a framework for theory or professional practive, and that no RS offer actual support for it, then I believe you are mistaken. Newimpartial (talk) 20:15, 12 December 2021 (UTC)
 * For most of the medical sources I quoted above, I find it impossible to read them as doing anything other than giv[ing] credence to the possibility that ROGD describes an empirical phenomenon. Possibility being emphasized - I'm obviously not claiming it is accepted as fact, but it isn't rejected widely enough either. Crossroads -talk- 06:01, 13 December 2021 (UTC)
 * I think you are eliding a key distinction, here. Several sources allow the possibility that the presentation of GD in young people is changing, and encourage research into that. But the MEDRS you have cited don't even support your claim that this change follows the descriptive pattern that ROGD assumes, much less offer any endorsement at all of the ROGD hypotheses. Please see my longer dissection of your evidence here (copy-edited version here). Newimpartial (talk) 14:16, 13 December 2021 (UTC)


 * No, but we should be spelling out that ROGD is not a diagnosis, not a medically recognised phenomenon and not presented accurately by Shrier. It is simply an idea that has been tentatively suggested by methodologically limited initial research and not been found replicable. I agree most with SMcCandlish's summary: It's contentious and not presently established as a diagnosis, and should be described as such. It seems to me that the article already does this, and attention should be focused on better coverage in the body, rather than the addition of the word "fringe" as an un-nuanced summary. — Bilorv ( talk ) 21:29, 12 December 2021 (UTC)
 * No, and agree with SmcCandlish's formulation. Sesquivalent (talk) 21:47, 12 December 2021 (UTC)
 * No - it's hardly surprising that a theory that's only three years old, and based on a phenomenon that itself is only about about ten years old, has not yet gained any official recognition. (And that's even ignoring the extreme political sensitivity of the topic.) It says nothing about mainstream views of the theory. Korny O&#39;Near (talk) 05:31, 13 December 2021 (UTC)
 * Korny O&#39;Near ROGD is not just unrecognised, peak bodies, including the APA and WPATH, have called for the elimination of it and similar concepts as a term, stating their is no empirical support and that it doesn't "align with the lived experiences of transgender children and adolescents". AusPATH, another peak body in the field, explicitly rejects the core implications and assumptions of the theory. The only clinical trial into the theory so far found no evidence to support the hypothesis. Bravetheif (talk) 02:15, 14 December 2021 (UTC)
 * That's a rather unscientific view from these supposed "peak bodies" - of course ROGD doesn't "align with the lived experiences" of transgender people; the whole point of ROGD is that the people said to experience it are not actually transgender at all. Korny O&#39;Near (talk) 17:09, 14 December 2021 (UTC)
 * Which might be relevant if those people actually existed, but the basis of the ROGD "hypotheses" is in online gatherings of parents who are having difficulty with their children's gender announcements. Not much there, there. That these parents don't believe their children to be trans is essentially the basis for their selection in the first place; the Littman study just takes the parents' assertions at their word. Talk about affirming therapy, and no wonder this "scholarship" can't be reproduced by anyone else. Newimpartial (talk) 17:23, 14 December 2021 (UTC)
 * That is a blatant mischaracterisation of the meaning and spirit of the AusPATH statement. They also state that all gender-diverse presenting people are deserving of gender-affirming care, something not compatible with ROGD, which creates a diagnosis in which gender-diverse presenting people shouldn't recieve gender-affirming care. Bravetheif (talk) 12:49, 22 December 2021 (UTC)


 * No. Mostly agreeing with Crossroads's and Sesquivalent's comments. It is a well-defined, clearly observable, new phenomenon. Opposition seems to be made more on moral/ideological than on medical/scientific grounds. Should be described as controversial, not generally accepted. VdSV9• ♫ 11:55, 13 December 2021 (UTC)
 * Re: a well-defined, clearly observable, new phenomenon - says who? No reliable sources for this statement have been provided - it is pure WP:POV, as presented here. Newimpartial (talk) 13:13, 13 December 2021 (UTC)
 * From its definition, which is not at all ambiguous, therefore, well-defined. Clearly observable in the sense that, given the definition, one can look at the data and observe, again, without much ambiguity, if the "onset" has been "rapid" or not. This is a discussion page, not an article. As for the POV: pot, meet kettle. VdSV9• ♫ 22:28, 14 December 2021 (UTC)
 * You aren't seriously arguing that, though no WP:RS have offered clear definitions or empirical evidence for ROGD in alignment with clear definitions, that nevertheless ROGD seems plausible to you because WP:OR? I don't see how that argument should have any WEIGHT according to WP policy. Newimpartial (talk) 22:34, 14 December 2021 (UTC)
 * I'm surprised you speak so confidently about "the data" when all professional and medical associations have deemed the studies made on the subject as methodologically flawed. Additionally, it isn't for us to decide what is a "well-defined, clearly observable, new phenomenon". It is for us to reflect what the RS say. And right now I haven't seen a single RS brought up by you or anyone else in this thread that is either in agreement with or optimistic about ROGD. However well-defined or clear or observable it is, the question posed here is whether it is a fringe theory or not. In essence, is it accepted by the professional and medical mainstream or not. Santacruz  &#8258;  Please ping me!  22:38, 14 December 2021 (UTC)
 * I would very much dispute the claim that no RS have been shown here that are at least "optimistic" about ROGD. Also, there is a whole spectrum between "the mainstream" and "fringe", as noted by guideline recognition of alternative theoretical formulations. Crossroads -talk- 06:32, 15 December 2021 (UTC)
 * Please link the sources you feel are optimistic about ROGD, . In regards to alt theories: In other cases an alternative theoretical formulation lacks significant evidence to show its validity, but when such evidence is produced, the theory can become mainstream. There is currently no evidence that shows its validity. Pseudoscience [...] relies on weak evidence such as anecdotal evidence or weak statistical evidence. The evidence of ROGD is terribly weak due to significant methodological issues. It would be like theorizing the existence of alien UFOs by surveying people who claim to have been abducted. Santacruz  &#8258;  Please ping me!  07:00, 15 December 2021 (UTC)
 * I have dealt with Crossroads' supposed "optimists" here and here. In terms of MEDRS, they amount to two "optimistic" papers, one of which is extremely controversial. Newimpartial (talk) 18:54, 15 December 2021 (UTC)
 * The main opposition is that there is no methodologically sound proof for it and it is not accepted by any association/group of medical experts in the field, not ideological grounds. Santacruz  &#8258;  Please ping me!  13:55, 13 December 2021 (UTC)
 * Yes The theory is more about politics than science particularly the way Shrier employs it in Irreversible Damage. Voiceofreason01 (talk) 15:27, 13 December 2021 (UTC)
 * For those describing ROGD as a "new" theory it's not. The Littman study may be from 2018 but the homophobic trope of "concerned" parents accusing peer groups of "turning their kid gay" has been around for decades and the websites the Littman study drew their participants from had existed for years. Voiceofreason01 (talk) 15:32, 13 December 2021 (UTC)


 * No, This is an impenetrably long discussion about a very straightforward matter. EDIT: Just to add clarity, the attempts to cast ROGD as FRINGE are not at all legitimate, the idea has been described in a paper cited in other papers by reputable authors in a positive sense etc. Maneesh (talk) 19:15, 13 December 2021 (UTC)
 * Yes: According to WP:FRINGE, In Wikipedia parlance, the term fringe theory is used in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. It doesn't mean the theory is crazy or that it must be obviously false, it means it's not accepted by the field in question. And we have a statement from the American Psychological Association, the American Psychiatric Association, and WPATH, among many other professional psychiatric and psychological associations, that There are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. Further, there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents. This is definitionally what we view as a "fringe theory" here, so we should call it a fringe theory. Loki (talk) 05:56, 14 December 2021 (UTC)
 * no per Maneesh--Ozzie10aaaa (talk) 13:31, 14 December 2021 (UTC)
 * Ozzie10aaaa Maneesh VdSV9 Korny O&#39;Near etc Wikipedia is clearly lost in anti scientific Orwellian 1984 bubble ... the discussion really ought to be short when the evidence is so abundantly straightforward that the scientifically, medically and socially unproven ROGD political ideological theory is overwhelmingly   " not recognized as a medical diagnosis by any major professional institution,"  leading associations  or  group of medical experts,  or any international medical bodies working in the field. It is therefore  outside "the prevailing views or mainstream views in its particular field" and therefore is undoubtedly WP:FRINGE.  ~ BOD ~ TALK 16:51, 14 December 2021 (UTC)
 * "Not recognized" is not the same as "fringe", especially for a theory that as far as I can tell is only three years old. Korny O&#39;Near (talk) 17:06, 14 December 2021 (UTC)
 * Just because it is new and not recognised, does not mean that it can not be correctly identified as Fringe, a "not recognised theory" is not somehow correct until proven fringe, badly researched medical pseudoscience is not regarded as true until confirmed to be false. WP:FRINGE We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support. WP:FRINGELEVEL WP:CRYSTALBALL Articles which cover controversial, disputed, or discounted ideas ...should document...the current level of their acceptance among the relevant academic community...Wikipedia primarily focuses on the state of knowledge today. A unrecognised theory certainly can be FRINGE, especially when the research behind the theory utterly failed to meet basic "evidence-based clinical guidelines," but is based on unscientific political/moral opinions of a selected sample that was known to have "an overt ideological bias" who are not even the subjects of the theory. ~ BOD ~ TALK 11:52, 15 December 2021 (UTC)
 * We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support. (from WP:FRINGE) sounds basically identical to not recognized by any major professional institution. I'm not entirely sure what your definiion of fringe is, but I'd appreciate you outlining it, . Santacruz  &#8258;  Please ping me!  21:43, 14 December 2021 (UTC)
 * That quote from WP:FRINGE is about defining the term as used in Wikipedia guidelines. It in no way exempts the term in article space from policies like WP:NOR. Crossroads -talk- 06:32, 15 December 2021 (UTC)
 * I'd appreciate some explanation as to how describing ROGD as fringe if RS show it is outside the mainstream would be OR, . I am terribly confused as to how that could be. Santacruz  &#8258;  Please ping me!  06:51, 15 December 2021 (UTC)
 * I'm not sure what represents the "mainstream" in this rather niche, and extremely politicized, field. But tell me, what is the "mainstream" explanation for the spike in teenage girls (or whatever you want to call them) identifying as transgender in the 2010s? Or is the mainstream view that there was no such spike? Korny O&#39;Near (talk) 17:49, 15 December 2021 (UTC)
 * The most recent paper I've seen is this from August 2021. As I said in a reply on another talk page, while there is a huge relative increase in rates of AFAB trans diagnoses, it is still a small number in absolute terms and more accurately represents an evening in rates between AFAB and AMAB, with AFAB historically being underrepresented in terms of trans people. As for who represents the mainstream, that would be WPATH, AusPATH, Endocrine Society, both APAs (American Psychological/Psychiatric Association), and other similarly well regarded institutions/organisations. Sideswipe9th (talk) 18:00, 15 December 2021 (UTC)
 * You didn't really answer the question - unless it's a given that trans identification should be the same across men and women. Korny O&#39;Near (talk) 18:32, 15 December 2021 (UTC)
 * I did answer the question. It is in that paper, see the discussion section and specifically the Incidence trends subsection. If you need further understanding, I would recommend the citations within that paper as further reading. Sideswipe9th (talk) 18:43, 15 December 2021 (UTC)
 * As visibility of transgender identities have increased in recent years, so too has the prevalence of GCS. As trans people are increasingly visible, more people seek gender affirming healthcare. The Tavistock clinic, as the only one in the UK to provide such care, has seen a "spike" in patients. However, it is clear that increased admissions is not representative of an increase in people identifying as trans, as that data is immensely hard to get. Studies thus base themselves off of online surveys or admissions to clinics, both of which present issues at measuring the trans population at-large. In any case, I'm not entirely sure what the point is with your questions and how that is relevant to classifying ROGD as fringe, . I'd appreciate you clarifying that point. Santacruz  &#8258;  Please ping me!  18:54, 15 December 2021 (UTC)
 * Sure. The point is, if there has been a spike, but only among those born female, and mainstream scientists have no clear consensus as to why, then it's hard to see how ROGD, which does offer a coherent explanation, could be considered fringe. Korny O&#39;Near (talk) 19:35, 15 December 2021 (UTC)
 * ...because it is not accepted or endorsed by mainstream MEDRS? Santacruz  &#8258;  Please ping me!  19:48, 15 December 2021 (UTC)
 * Have they accepted or endorsed any alternate theory? Korny O&#39;Near (talk) 20:28, 15 December 2021 (UTC)
 * Whether the are other accepted or endorsed any alternate theories is irrelevent as far as this discussion is concerned. However, while study behind ROGD remains methodologically flawed and unproven, the supposed spike increase in rates in trans men seeking medical support, specifically [a]mong adolescents under age 16 years seen in specialized gender clinics, associations between more recent gender knowledge and factors hypothesized to be involved in rapid onset gender dysphoria were either not statistically significant, or were in the opposite direction to what would be hypothesized. ~ BOD ~ TALK 23:13, 15 December 2021 (UTC)
 * @Korny O'Near, please respect the gender identity of the transgender individuals to which you are referring. EmilyIsTrans (talk) 00:39, 23 December 2021 (UTC)
 * I would support Bilorv's suggestion that the article include language discussing how Shrier talks about ROGD in Irreversible Damage and in subsequent press is very different that the way the term is used by people like Littman. Voiceofreason01 (talk) 15:53, 14 December 2021 (UTC)
 * No, because I'm pretty happy with the second sentence as it stands: "The book endorses the contentious concept of rapid onset gender dysphoria, which is not recognized as a medical diagnosis by any major professional institution."  I could see several alternatives to contentious concept (e.g., strongly disputed idea; I'd prefer to avoid the word theory, as it sounds more scientific), but overall what we have now seems pretty good to me.  I wonder if the word fringe resonates more strongly with Wikipedians who are familiar with WP:FRINGE than to normal readers, for whom fringe is a hairstyle, instead of a pejorative power word used when you disagree with someone's ideas.  WhatamIdoing (talk) 21:35, 14 December 2021 (UTC)
 * Or what a surrey has on top. &#42;Dan T.* (talk) 21:48, 14 December 2021 (UTC)
 * Yes: if you can't describe ROGD as fringe, then we might as well just get rid of the guideline; it's a cod diagnosis that no medical body recognises and no reputable clinical study exists to confirm it. The idea that we're even entertaining the idea that it isn't fringe shows that we have a lot of work to do to remediate the rot set in because people like James Cantor (who I was pleasantly surprised to find out was banned recently) knew how to work around our policies. Sceptre (talk) 09:53, 15 December 2021 (UTC)
 * @Sceptre, I don't see anything in the FRINGE guideline that says that the exact word fringe needs to be used. Do you? WhatamIdoing (talk) 17:27, 15 December 2021 (UTC)
 * No WP:FRINGE has been used too widely in too many spaces to designate things that aren't currently predominant, but which are disputed and held by reasonable minorities. ROGD is contentious and not endorsed by large medical societies. That doesn't mean it falls into the same category of flat earth and ancient astronauts. If you want to label THEM fringe and something in the middle as "unproven and contentious" in a non-pejorative way, that would probably be an appropriate bucket into which ROGD should go. Jclemens (talk) 21:25, 16 December 2021 (UTC)
 * Yes, absolutely. If I were unfamiliar with editing I would be surprised that an issue that is so clear-cut in the sourcing has been drawn out to such an extent here, but alas, such is the environment here on Wikipedia. There are two questions here which are still a bit entangled, which are: (a) do Littman's/Shrier's "ROGD" claims fall under the  guideline, and (b) is it a valid paraphrasing of the sources to denote their claims as fringe in the article text. These are two different questions, as describing something as WP:FRINGE is different from describing it as fringe. However, in this case the answer to both of these questions is very clear. The first one is obvious, and I think uncontroversial. Even some of the users who most vehemently oppose including this language seem to concede that Littman/Shrier/etc's claim of "ROGD" is not broadly supported by scholarship in its field. Some editors seem to distrust the medical and professional organizations that make up the field of transgender health (WPATH, the two APAs, etc.), but luckily accusations of trans-affiliated political bias don't change which sources are  (see also ). The second question is also quite clear. Claims of "ROGD", especially in the context of this book, have been dismissed or outright rejected by practically every relevant medical organization, have been contradicted by clinical studies, are constrained to a small minority of public figures. Anything but an incredibly motivated reading of the relevant sources will give this conclusion. If this doesn't count as fringe, I don't know what does.  Sr ey Sr os talk 00:17, 17 December 2021 (UTC)
 * Don't know what does? That would be all the theories that require overturning long-accepted fundamental laws of nature, or the things where sources widely call it such specifically. But when a significant portion of sources are ambivalent or somewhat receptive to the possibility, as here, it's very different. Crossroads -talk- 06:32, 17 December 2021 (UTC)
 * Oh my, that's quite the strange definition of the English word fringe. For something to be fringe, in your mind it must require overturning long-accepted fundamental laws of nature? That definition does not even come close to lining up with the word's usage in recent general English RS, academic English RS, or English dictionaries.
 * Let's be clear about the situations in which we as Wikipedia editors are permitted to use a word to describe something. The first is if RSs use that word themselves; that's an easy one. I'm glad we agree there. The second, which is far more applicable, is if the word is a valid paraphrasing of what the RSs say. And how do the RSs describe Littman's/Shrier's claims of "ROGD"?
 * "...not recognized by any major professional association as a valid mental health diagnosis"
 * "...supports eliminating the use of Rapid-Onset Gender Dysphoria"
 * "...there are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. Further, there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents."
 * "'methodologically flawed and unethical'... [proceeding] from 'an overt ideological bias'"
 * "...[no] support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence"
 * "...associations between more recent gender knowledge and factors hypothesized to be involved in rapid onset gender dysphoria were either not statistically significant, or were in the opposite direction to what would be hypothesized"
 * I'd argue that these quotes even support a word much stronger than fringe. Of course, if you were right, and the commonly-accepted English definition of the word fringe was a theory that require[s] overturning long-accepted fundamental laws of nature, then your argument would hold. Perhaps I'm out of touch with the modern English language, and the sources I've found are anomalies. But it certainly seems to me that practically nobody defines fringe the way you want to.
 * However, I do agree with above that this entire discussion, narrowly construed, is likely a waste of effort. To see this much heat generated over a single word is, well, unfortunately unsurprising but rather disappointing. But I do think that the fact that there is this much opposition to merely describing the book's claims as fringe does not bode well for long-term improvement of the article, so this apparent waste of time seems to be a necessary one.  Sr ey Sr os talk 00:12, 18 December 2021 (UTC)
 * I don't think it is necessary,, just a waste of time. The RfC cannot even determine whether ROGD is fringe, just whether we should use the term "fringe" in the article. Better would be to discuss coverage of ROGD in the body of the article. — Bilorv ( talk ) 02:13, 18 December 2021 (UTC)
 * It was you who said that If this doesn't count as fringe, I don't know what does, thus implying it belongs in the same category as flat-earth-ism and other such things, which is clear exaggeration. I quoted other sources which are not so negative, and regardless, the status quo of 'not recognized as a diagnosis' matches most of those much better. Crossroads -talk- 06:22, 18 December 2021 (UTC)
 * That makes the (incorrect) assumption that "fringe" is the strongest word that can be used to describe those "theories". They can be described as fringe, but they're more accurately described as conspiracy theories, pseudoscience, or plainly incorrect. Bravetheif (talk) 23:26, 19 December 2021 (UTC)
 * No. for reasons well explained by Crossroads above at the beginning of the RfC. We need to be careful to be calling something a fringe theory based on the scientific consensus, not political consensus of certain activists.Pengortm (talk) 05:12, 18 December 2021 (UTC)
 * Isn't it a good thing that the scientific consensus on this is so consistent, then? Newimpartial (talk) 18:12, 18 December 2021 (UTC)
 * No, for me one of the defining characteristics of fringe theories is existing in it's own literature that is not interacting with the rest of the body of science. This is one of the big problem with fringe theories - no one cares enough even understand them or develop a carefuly theory. I don't really think this is going on here. I would also distinguish between "big consensus" and small consensus. The consensus I think matters is "everyone who actually publishes on the topic" not "what randon organizations say about social issues and inclusion". These two things can be quite different, as the further you get from research, the more social and "consistency" factors come into play. I can't help but feel on this topic there's a bit of shaming organizations and people who don't really study the field into compliance and then using them as an authority. Talpedia (talk) 12:08, 20 December 2021 (UTC)
 * I'd appreciate if you could expand on your points about a) shaming organizations b) what you consider experts in this topic and c) what you mean by consistency factors. I don't think I understood your point, . Santacruz  &#8258;  Please ping me!  12:14, 20 December 2021 (UTC)
 * a) The policy of organizations may well be more related to trans acceptance, than the nitty gritty of the research. There may be lobbying involved and the opinion might really mean much for the organization so just act as a rubber stamp more or less equivalant to "research for which there is not sufficient evidence yet to change our policies does not change our policies" in a way that makes people happy. These arguments are fuzzy, my opinion is more... one should dig into the research publications rather than taking the opinion of broad medical groups as definitive.
 * b) I would say things like treating gender dysphoria directly preferably with some sort of quatitative research going on at the same time which you publish, or doing qualitative research looking at service users experience of outcomes would both make you experts.
 * c) By consistency, I mean think like "my part of medicine is like this, so yours must be as well", "the world is like this, so this issue is like this". People can just fill in the gaps in their knowledge with assumption Talpedia (talk) 12:34, 20 December 2021 (UTC)


 * Yes As someone with autism, I have learned to be extremely sceptical of "rapid onset X" claims, as it is very often a matter of when something is possible to discover rather than when it actually appears. Gender dysphoria, like autism, isn't possible to discover at birth, and like autism, it will only be discovered at the age where a child starts to develop their advanced communication skills and sometimes much later than that. It is extremely easy to mistake this sudden recognisableness for a sudden appearance. For these reasons, I believe we should be extremely sceptical of any rapid onset claims in cases where being old enough to communicate is a prerequisite for diagnosis.--Licks-rocks (talk) 17:02, 20 December 2021 (UTC)
 * Yes Scanning through most of the "no"s, it would appear that most reject the description on the ground that it is pejorative, not that it is inaccurate. I'm not well versed in Wikipedia policy, but I doubt it calls for avoiding otherwise accurate phrasing because it may cause offense? The evidence very clearly points to ROGD being completely fringe. I cannot think of any other term for a theory unsupported by evidence or large orgs. EmilyIsTrans (talk) 10:53, 21 December 2021 (UTC) — EmilyIsTrans (talk&#32;• contribs) has made few or no other edits outside this topic.
 * It's not "unsupported by evidence". Just the spike in case numbers is strong evidence that something is different in the composition of the current wave.
 * The historical rate of transgender cases was roughly 1 in 10K, give or take a factor of 5, which is of the same order as the rate of suicide throughout the world. If the number of cases rises by two orders of magnitude as it did in the UK, then if the underlying nature of those cases is biologically and neurologically the same as the historical transgender population (with its extremely high rate of suicide) then nearly all suicides in history would have been from unrecognized trans cases that were hidden until the recent spike in numbers and the rise of the very concept of trans.  But  without leaving a hint in thousands of associated suicide notes and prior etiology, that it had anything to do with matters of sex and gender.
 * Of course the ROGD proponents provide other indications. But the basic fact of a rapid and gigantic increase is the thing that needs explanation and there is every reason to believe it is not the same old, same old. Claims of "no evidence" are a shifting of the standard to exclude the actual evidence.Sesquivalent (talk) 13:10, 21 December 2021 (UTC)
 * could you rephrase your point? I'm not sure I understand it. Santacruz  &#8258;  Please ping me!  13:24, 21 December 2021 (UTC)
 * Also, Sesquivalent, could you give a source for your numbers? You seem to be citing the rate of change in a cross-tab, but it's hard to assess than without a source. Newimpartial (talk) 13:33, 21 December 2021 (UTC)
 * In the US, estimates of the transgender population in the sources of that article vary in the 0.1 to 1 percent range with typical estimates around 0.5, and higher at younger ages (as the numbers are rising over time). The same article cites 41 percent as the fraction of trans population having attempted suicide, any such figure being a small or large underestimate to the extent that the attempts "succeed". If you assume that only 1 in 40 of those who tried, died that's 1 percent of transgenders, so 1 in every 10K to 100K persons.  At the historical US suicide rate of about 1 in 10000 in recent decades that's between 10 and 100 percent of the total. Whatever reasons lead to suicide attempts today would have been stronger in the past as recognition and tolerance were nonexistent, hostility higher, and emergency medical technology and suicide hotlines that reduce the death rate on attempts also did not exist until recently.  So even under conservative assumptions you get a very large proportion of suicides that would have had to come from unrecognized transgender cases, throughout history, if the current youth numbers (which, again, are rising) represent the true incidence rate of true transgenderism.
 * That's just one quantitative reality check. Another is that it's known in psychiatry since at least the 1970's that self reports are unreliable, and usually less reliable than reports by others who know the patient (such as their parents).  Statistically, if a rare trait (such as trans, or a rare disease, or genius level intelligence) is detected by an even slightly imperfect method (such as self report, or a mostly accurate disease screen, or an IQ test) then the majority, often a near totality, of detections are false positives.  This means that under "affirm only" conditions, the number of people classified as transgender will be extremely sensitive to any changes in how welcome or unwelcome the self reports are, incentives and disincentives, etc.  A slight change to the parameters of the system will move the needle considerably in number deemed to qualify.  So when there is a rapid giant change in the numbers the default assumption is that it is probably driven by more permissiveness in the reporting or diagnosis, which is essentially the ROGD thesis.  This isn't some weirdo theory, it is the null hypothesis, broadly construed.  Whether social media or peer groups are the specific mechanism is secondary and does not really bear on the general question of whether it makes sense. Sesquivalent (talk) 14:54, 21 December 2021 (UTC)
 * That is all very interesting, but it doesn't really support The historical rate of transgender cases was roughly 1 in 10K, give or take a factor of 5 ... If the number of cases rises by two orders of magnitude as it did in the UK ..., which were the statistical claims I was asking about.
 * As far as the minor premise that the underlying nature of those cases is biologically and neurologically the same as the historical transgender population (with its extremely high rate of suicide), that seems unsubstantiated (and not clearly relevant to the current discussion).
 * Finally, in explaining the alleged phenomenon (for which you have not actually produced evidence), you say the default assumption is that it is probably driven by more permissiveness in the reporting or diagnosis, which is essentially the ROGD thesis. But "permissiceness in reporting" would explain the phenomenon equally well if we understood this shift, in line with mainstream explanations for shifts in expressions of diverse sexuality under rapidly liberalizing social conditions, without bringing in the "unreliability of self-report measures" as an explanation. For those who lived through the proliferation of gay villages and pride parades in the 1980s and 1990s, the idea that the proliferation of diverse sexualities had resulted from "unreliable self-reporting" sounds like a bizarre counterfactual; if you have acrual evidence supporting the idea that the situation with trans identities is different, the methodological issues with IQ self-reporting do not provide clearly relevant support for your position. Newimpartial (talk) 15:42, 21 December 2021 (UTC)
 * Sesquivalent An increase in rates of genderqueer presentation is not evidence that the specific, clinical diagnosis of ROGD is correct. ROGD does not generally represent the idea of increased genderqueer presentation, it is a specific theory on the transmissibility of gender dysphoria. You understand that, as it is an attempt at explaining those increased rates, it cannot be proven by that same phenomena right? There is no other evidence in the theory's favor. EmilyIsTrans (talk) 04:54, 22 December 2021 (UTC)
 * Extremely rapid exponential growth is in fact evidence of "contagion" style social transmission effects, especially when the growth is faster than the increase in any known nonsocial contributing factor. That is, the number of new GD cases and transgender announcements next year cannot plausibly develop independent of the number of existing (visible) trans people, trans institutions, trans media, trans clinics, etc, and as in all exponential growth is more or less proportional to all those.  It's actually hard to come up with alternative nonsocial explanations that account for such growth without having a lot of easily noticed side effects that can be falsified.  Anti ROGDer Florence Ashley puts it this way: "More and more teenagers are coming out. ... As trans realities become more and more widely known, it becomes easier for trans people to understand their internal turmoil and open up about the fact that they are, indeed, trans. As we make friends who are trans, they help us understand ourselves and support us through the coming-out process. ... trans visibility is helping more people realize they are trans — ourselves included, a few years ago."  The trans medicine community seems rather incurious about the growth, and Ashley is possibly the only one to attempt an explanation.  But she does not even try to account for the pattern noted by Littman of a super rapid rise in female (A.F.A.B.) cases beyond the general exponential growth, which appears to require a social transmission vector (or other cause) that only applies to adolescent girls without a similar rise in adult cases.  Again, something like ROGD is the natural null hypothesis here in the absence of such an explanation, which none of the critics have even tried to give. If the rise is largely socially mediated there is no reason to think all of this mediation must be benign and never of the variety that Littman or Shrier posit. Sesquivalent (talk) 09:36, 28 January 2022 (UTC)


 * I think this is a good point. I don't think there is a strong argument against "fringe" on the grounds of perjorative. Bravetheif (talk) 06:06, 16 January 2022 (UTC)
 * Yes. I would also accept "Marginal" per @XOR'easter. It is not an accepted diagnosis by any medical professional organization. It is not supported by mainstream scientific review articles or studies. It has no ICD billing code. It is not accepted by mainstream science/medicine. It is, by definition, FRINGE. — Shibboleth ink  (♔ ♕) 15:53, 22 December 2021 (UTC)
 * , as a reasonable summary of the best sources available in this area. Marginal would also be fine with me, or alternative formulations that are more accurate than the current contentious. As the phenomenon is so universally unrecognized by the experts, understating the fringiness would be an NPOV problem. Firefangledfeathers 17:33, 22 December 2021 (UTC)
 * "Unrecognized" is also part of the status quo. Crossroads -talk- 02:28, 23 December 2021 (UTC)


 * Yes - "fringe", "marginal", "discredited" or "debunked" could each be used, based on the sourcing given here, but "fringe" has the advantage of being used in one of the reliable, secondary sources on the topic. Newimpartial (talk) 17:38, 22 December 2021 (UTC)
 * And that source is? Crossroads -talk- 02:28, 23 December 2021 (UTC)
 * Jack Turban's review, as I believe you know. Newimpartial (talk) 03:17, 23 December 2021 (UTC)
 * Ah yes, his Psychology Today blog post where, as Sesquivalent noted in a lower thread, Turban's review used the word "fringe" once, to describe some organizations and not ROGD. Crossroads -talk- 06:00, 23 December 2021 (UTC)
 * The argument that the review was only intended to label the orgs supporting ROGD, but not ROGD itself, as FRINGE is making a distinction unintended by the author, as the blog post legal filing makes clear. This is a great example of an appropriate use of an SPS - to help interpret an author's independently published work.Newimpartial (talk) 11:56, 23 December 2021 (UTC) Corrected Newimpartial (talk) 14:40, 25 December 2021 (UTC)
 * If the author "intended" to call it that, he would have done so. Crossroads -talk- 05:07, 24 December 2021 (UTC)
 * Which he did, explicitly, in the SPS. Newimpartial (talk) 13:55, 24 December 2021 (UTC)
 * Which SPS? The blog post? No. Crossroads -talk- 06:50, 25 December 2021 (UTC)
 * The legal filing. Corrected, above. Newimpartial (talk) 14:40, 25 December 2021 (UTC)


 * Yes, per especially Bravetheif and SreySros. This seems like a rather straightforward case where 1) a concept is considered fringe by mainstream science, and 2) the clearest way to explain the concept to the reader is to present it explicitly as a fringe concept. As Pengortm reminds us, We need to be careful to be calling something a fringe theory based on the scientific consensus, not political consensus of certain activists. In this case, a careful reading of the WP:MEDRS sources makes it apparent that ROGD is indeed considered fringe by the scientific community and only taken to be a real phenomenon by certain activists. Generalrelative (talk) 21:53, 22 December 2021 (UTC)
 * No. The main argument for seems to be that it's a good summary of the best sources. Since the word is clearly pejorative, I think we should not use it unless there are several good sources which explicitly use it. Alaexis¿question? 13:34, 23 December 2021 (UTC)
 * Forgive me if I am misunderstanding your argument, but surely that "fringe" is a good summary of reliable sources is all that matters? Would softening the language, against a more accurate summary, not be introducing a POV? Also, if ROGD does meet the criteria of WP:FRINGE, then MOS:LABEL explicitly states that it should not be described with vague terms like "controversial" and "contentious", like in the status quo. EmilyIsTrans (talk) 14:21, 23 December 2021 (UTC)
 * Sorry, probably I wasn't clear enough. I've read the justifications of a few Yes votes and their main argument seems to be that "fringe" is a good summary of the best sources, even though they don't say it explicitly. I don't agree with this reasoning as it smacks of WP:OR. Why is using the wording that reliable sources use not good enough here? Alaexis¿question? 21:15, 23 December 2021 (UTC)
 * Some of the sources do use fringe, so this seems to reflect a faulty premise. Newimpartial (talk) 21:33, 23 December 2021 (UTC)
 * As has been pointed out to you above, you have not a single source that calls ROGD "fringe". Crossroads -talk- 05:07, 24 December 2021 (UTC)
 * Jack Turban's review of this book refers to ROGD'S backers as "fringe". His self-published expert source commentary clarifies that ROGD itself is "fringe", not just its backers.
 * Crossroads, this has all been pointed out to you before, so when you say you have not a single source that calls ROGD "fringe" you are knowingly making a false statement. Pure WP:SEALION tactics on your part, and I find them tiresome. Newimpartial (talk) 14:01, 24 December 2021 (UTC)
 * He refers to groups opposing gender-affirmative care as fringe, which is not the same thing as ROGD, obviously. Crossroads -talk- 06:50, 25 December 2021 (UTC)
 * And the legal filing clarifies that Turban applies the "fringe" label to ROGD itself, and not just the groups promoting it. Stop sealioning, please. Newimpartial (talk) 14:43, 25 December 2021 (UTC)
 * Ah ok, I follow you. I understand much of the black and white of Wikipedia policy, but I will admit I'm not super well versed in the subtleties, but my reading of WP:SYNTHNOTSUMMARY is that if we have a reliable source that can be accurately summarized as describing ROGD as "fringe", then it is entirely acceptable to use it as a citation for the phrasing. Looking at User:Bravethief's contribution, it would appear that the Florence Ashley paper is that source, with the rest simply attempting to establish that this is in fact the prevailing view and therefore DUE. EmilyIsTrans (talk) 03:54, 24 December 2021 (UTC)
 * Florence Ashley article says that "ROGD “is not a medical entity recognized by any major professional association”" which is how the article describes it now. This is a clear and simple statement which is (as far as I can see) supported by other sources and is not controversial. I haven't seen solid arguments why we need to add descriptions not found in the majority of reliable sources and what benefit the reader would derive from it. Alaexis¿question? 09:15, 24 December 2021 (UTC)
 * If ROGD is fringe, then it is a false balance to soften the language to "contentious".
 * Your quotation is itself a quotation of the now outdated 2018 WPATH position statement on ROGD, which has been superceded by the CAAPS co-statement. That document states that there are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. Further, there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents. It calls explicitly for the "elimination" of the use of Rapid-Onset Gender Dysphoria (ROGD) and similar concepts for clinical and diagnostic application. It does not, like the 2018 WPATH statement, even state that it supports further research into the subject, instead calling for further research into evidence-based clinical guidelines for gender-affirming care, something that is entirely incompatible with ROGD (since ROGD explicitly creates a diagnosis of gender dysphoria that is not treated with gender-affirming care).
 * I also wasn't talking about the PsychCentral article, rather this one. To my reading, an accurate summary of the analysis that paper makes of the state of ROGD is that it is calling the theory is fringe. Specifically, I am referring to the phrase The burden of proof lies squarely on proponents of ROGD since they are seeking to displace the empirically backed consensus approach. Evidence only counts as supporting the existence of ROGD if it excludes the possibility of non-pathological, non-epidemic explanations something that has yet to be offered. Unsurprisingly given the dearth of supporting evidence, many leading experts have rejected ROGD as lacking empirical support (it proceeds to cite WPATH and AusPATH). That states, in no uncertain terms, that there is little to no empirical evidence to support ROGD, and that it is outside the mainstream. EmilyIsTrans (talk) 13:36, 24 December 2021 (UTC)


 * Yes - not in accordance with the scientific consensus, based on an incredibly narrow set of dubious data, fails WP:MEDRS in general; meets all the usual tests for fringery. -- Orange Mike &#124;  Talk  14:19, 23 December 2021 (UTC)
 * Maybe - So long as we're using sources talking about the book, and not talking about the concept in the abstract. This article on a book is not a WP:COATRACK for us to hang broader social commentary not related to the book.  G M G  talk  15:08, 23 December 2021 (UTC)
 * I'm not sure I really follow your argument. Irreversible Damage is entirely founded upon the theory of ROGD; providing proper context to the theory - what it proposes, its origin, and its position in scientific discourse - is imperative to a reader gaining a truthful and complete impression of the book. I don't see how the use of sources that solely discuss ROGD are any more WP:COATRACK than those that only describe the author's background. Despite the fact they do not directly reference the book, these kinds of sources provide context core to its understanding. I certainly agree that the word count of the article shouldn't bias towards these subjects, but this is an RfC for the change of just a singular word. Bravetheif (talk) 14:59, 26 December 2021 (UTC)
 * No, I believe SmcCandlish's summary covers the topic aptly. Halbared (talk) 16:50, 23 December 2021 (UTC)
 * No per User:WhatamIdoing. This discussion seems to be muddling the word "fringe" as used in Wikipedia jargon with the word "fringe" as used in normal language. WP:FRINGE isn't relevant – that's a guideline on how to give due weight to different viewpoints, not instructions about when to use the word "fringe" in article text. ROGD may be FRINGE in Wikipedia terminology, but in the article's text let's use a description that non-Wikipedians will understand clearly. —Mx. Granger (talk · contribs) 17:30, 23 December 2021 (UTC)
 * It would appear that many of the "no's" agree that ROGD is in the general ballpack of a fringe theory, but reject the use of that specific term (at least, that's my interpretation, please correct me if I'm wrong). That begs the question of what term would convey a similar meaning in a less "perjorative" manner? I still support the use of "fringe" as an accurate summary of the consensus, but I feel it would be productive to discuss alternative phrasing. Bravetheif (talk) 19:34, 23 December 2021 (UTC)
 * I'm not so concerned about whether it's pejorative, but rather that using Wikipedia jargon in an article may not be as clear to our readers as it is to us. Possible terms that come to mind (with varying levels of strength) include "dubious", "highly controversial", "strongly disputed", "unsupported by evidence", "debunked", "disproven", or "false". I don't know the state of the literature, though, so I don't know which of those terms are appropriate if any. What terms are commonly used in reliable sources about ROGD? —Mx. Granger (talk · contribs) 08:09, 24 December 2021 (UTC)
 * Just a small quibble. "No evidence found for X" is not equivalent to "X is disproven." After all, there is no good evidence that parachutes work. On a serious note, we should stick to the terms used by RS. Alaexis¿question? 09:26, 24 December 2021 (UTC)
 * I fully agree, which is why I asked what terms are commonly used in RSs. Like I said, I don't know which of the terms I listed are appropriate in this case. —Mx. Granger (talk · contribs) 09:50, 24 December 2021 (UTC)
 * I follow you. Most literature on the subject is focused on enumerating the methodological flaws of Littman's original paper, however, probably the most thorough secondary source discussing ROGD (that meets WP:MEDRS) is this paper by Florence Ashley. The other relevant sources are the position statements of AusPATH and CAAPS, signed by the APA and WPATH. CAAPS is particularly harsh, calling for ROGD's "elimination" from clinical and diagnostic application given the lack of rigorous empirical support for its existence. It states the theory does not reflect the lived experiences of trans people, and terms, such as ROGD, that further stigmatize and limit access to gender-affirming and evidence-based care violate the principles upon which CAAPS was founded and public trust in clinical science. The statement ends with a call for further research, not into ROGD, but "gender-affirming care", which is incompatible with ROGD since it cannot be treated in that manner.
 * Ashley's paper is long, without a specific term describing ROGD. However, I believe the following excerpt can be summarized, in good faith, as describing ROGD as "fringe": Evidence only counts as supporting the existence of ROGD if it excludes the possibility of non-pathological, non-epidemic explanations something that has yet to be offered. Unsurprisingly given the dearth of supporting evidence, many leading experts have rejected ROGD as lacking empirical support. The post-publication clarification that Littman’s article is merely hypothesis-generation rather than hypothesis-testing, besides its various flaws, further confirms this conclusion.
 * Apologies if this answer is too long, avoids the question, or is unhelpful. I am drunk and I didn't intend it that way (Merry Christmas by the way {). Bravetheif (talk) 11:13, 25 December 2021 (UTC)
 * I've made less sense sober, ^u^  Santacruz  &#8258;  Please ping me!  11:48, 25 December 2021 (UTC)
 * Thanks for that response. What about "the contentious concept of rapid onset gender dysphoria, which lacks evidence and is not recognized as a medical diagnosis by any major professional institution"? I see that CAAPS also discusses the ROGD concept's "likelihood of contributing to harm and mental health burden" – potentially we could indicate that in some way. (And merry Christmas!) —Mx. Granger (talk · contribs) 15:20, 25 December 2021 (UTC)
 * I think this is an interesting suggestion. Personally, my ideal state of that sentence would still be to drop the entire second half (after the comma) and change "contentious" to something less weasel-y and vague. "Contentious" just smacks of a lack of editorial consensus, which is how it was added in the first place IIRC. However, if we do go the route of expanding the description, I think the addition of an explicit acknowledgement of a lack of evidence (and the likelihood of harm) is a good idea. The lack of recognition could be rephrased to "rejected by major professional institutions", with reference to the CAAPS statement (or maybe something even harsher to reflect their call to "eliminate" the term). Likewise "which lacks evidence" could be made more concrete with the phrase "which has failed to be reproduced in a clinical context" in reference to this clinical trial (I'm not as attached to that suggestion though). Bravetheif (talk) 01:36, 26 December 2021 (UTC)


 * Yes It is in conflict with the existing scientific consensus, and there are no published articles supporting this hypothesis afaiaa. It is, therefore, by definition "fringe", which isn't necessarily an insult. It is not pseudoscience, however. Tewdar (talk) 18:40, 24 December 2021 (UTC)
 * Yes - Merely because I've never heard or read of it, until seeing this article. GoodDay (talk) 16:32, 25 December 2021 (UTC)
 * No MOS:LABEL instructs us not to use controversial labels like "fringe" unless they have been used by reliable sources. I admittedly did not bother reading this entire discussion, but a few users mentioned that no source has specifically used this word. Therefore, we should not use it either. Mlb96 (talk) 21:10, 25 December 2021 (UTC)
 * Those people are entirely incorrect. As Newimpartial stated, Jack Turban has used "fringe" to describe the groups and theories surrounding Irreversible Damage, clarifying in a later statement that ROGD is included in their company. Additionally, this paper, one of the few secondary WP:MEDRS that discusses the theory, describes ROGD as "Circumventing science through pseudoscience". The same author described it as "bad science", in both a co-signed statement and a PsychCentral article. The co-statement was signed by several prolific figures representing peak bodies in the field, such as the President of the Canadian Professional Association for Transgender Health. PinkNews also reported on the statement, along with an article describing ROGD as "debunked", based on the position statement of AusPATH and the following quote from the Australian Psychological Society about ROGD: Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence, as a form of ‘social contagion’. I'm more than happy to hear arguments to the contrary, but I consider the category of "fringe theory" to also encompass those that are pseudo-scientific and debunked. Bravetheif (talk) 11:15, 26 December 2021 (UTC)
 * Doesn't matter, but actually No.  "Fringe" is used a lot in Wikipedia, we have a guideline and a noticeboard for it, but in the real world, it is not used as much because it is not as useful a term as others. What does it even mean? The word suggests that something is on the border between science and non-science defined by the demarcation problem. But actually, even things that are really far-out and far away from the border are called fringe here. It is better to avoid the term and use clearer ones, and that is what the world outside does. The original Littman paper used a pretty wakefieldish method for collecting data: specifically asking a question to selected people who you expect to give the answer you want. That, together with the lack of real confirming evidence, makes it clear that the whole idea is crap. Forget fringe. We have enough good sources who say other mean things about the idea and about the book, and we can use those other mean things to quote. There is no need to force a word into the article that is rarely used, and, contrary to the feeling I get from many Yes voters, rejecting that specific word does not mean "the bad guys have won". Relax, this is just a style question blown out of proportion. --Hob Gadling (talk) 11:51, 27 December 2021 (UTC)
 * ROGD should not be confused with the well established refractory condition ROWD (Reminders Of Wikipedia Daily), in which the afflicted feel a powerful compulsion to insert terms of art like "citation needed", "bludgeon" and "FRINGE!!" into ordinary language. The only cure is said to be a switch from Talk: to talk for no less than a month. Sesquivalent (talk) 12:55, 27 December 2021 (UTC)


 * @Hob Gadling: What wording would you suggest instead? — Shibboleth ink  (♔ ♕) 13:08, 27 December 2021 (UTC)
 * I have no opinion on that. Pick a few from the sources, probably better not in Wikipedia voice. But Arjee Restar's wording "fatally methodologically flawed", quoted in Rapid-onset gender dysphoria controversy, sounds good. --Hob Gadling (talk) 14:14, 27 December 2021 (UTC)
 * I think that is a reasonable summary of Littman's 2018 paper, not so much the entire theory. There are direct quotations to support "pseudoscientific" (Florence Ashley), "debunked" (PinkNews) and "refuted" (Australian Psychological Society). Bravetheif (talk) 22:57, 27 December 2021 (UTC)
 * To be honest, "fatally methodologically flawed" seems like good wording to both cover what we mean by wp:fringe and what readers that are not as familiar with that term can understand. Some might argue "fatally" is overkill, but I think it is important to drive home just how unsound the research is. Santacruz  &#8258;  Please ping me!  23:15, 27 December 2021 (UTC)
 * Yes, I like this wording. I think it's fair to describe it simply as methodologically flawed or deeply methodologically flawed as well. — Shibboleth ink  (♔ ♕) 17:40, 28 December 2021 (UTC)
 * I have to add that several No votes here show an outstanding lack of any skill at discerning good science from bad, and that yes, it clearly is fringe and not an "ongoing dispute" at all because one side has no leg to stand on. To distance myself from that dogmatic fence-sitting and false-balancing, although I still think there are better words than "fringe", I am striking the "actually No" part. Fence-sitting is alright when there is an actual scientific dispute, but not when there is not. See WP:CIR. --Hob Gadling (talk) 16:43, 29 December 2021 (UTC)
 * No per SMcCandlish. New and not accepted seems reasonable but not fringe at this point in time.  Springee (talk) 16:08, 28 December 2021 (UTC)
 * Yes per Aquillion et al. I always understood WP:FRINGE and fringe theory to mean "an idea or a viewpoint which differs from the accepted scholarship of the time within its respective fields", which appears to be the case and no one seems to deny. In fact, the only reason to reject it is the fact that this is not a work of scholarship (Shrier holds degrees in philosophy from Columbia College New York and the University of Oxford, and a law degree from Yale Law School.[15][16] She is a freelance journalist[17] who writes for The Wall Street Journal[18][1] and The Federalist,[16] and has published multiple opinion pieces on trans issues[19] including gender pronouns[20] and trans women's participation in women's athletics.[21]) and was not published by the academic press or even a mainstream non-academic press but by Regnery Publishing, a politically conservative book publisher based in Washington, D.C. We should actually use even stronger words, if fringe implies a scholarship work that has not gained acceptance, or has been rejected, among the scientific community, but I am fine with using fringe or a similar wording. Davide King (talk) 16:35, 28 December 2021 (UTC)
 * I think maybe the best way to go about it is for this RfC to decide if there is consensus to label it as wp:fringe, and then (and only then) have a follow-up RfC on how to word that label in layman terms, . I like the wording proposed above but I'm sure there are many options on how to go about it. Thoughts?  Santacruz  &#8258;  Please ping me!  16:57, 28 December 2021 (UTC)
 * I did not mention you, but I think your !comment was also very good. While I respect and can personally somewhat agree with Hob's point, I think FRINGE support 'Yes' and our arguments, and for 'No' to be supported, it should actually be changed to reflect this; it literally says "In Wikipedia parlance, the term fringe theory is used in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field." For what Hob said, there should actually be first consensus to change this, in particular the "very broad" usage; as things stand, 'Yes' is well-supported by FRINGE. In the end, I think fringe is justified, but certainly I would also want a proper sentence to contextualize this, hence your proposal is good. Davide King (talk) 17:16, 28 December 2021 (UTC)
 * I also agree that it would be totally correct to eventually label this supposed theory by a non expert (published in non specialist source) as not only fringe but also completely methodologically flawed. ~ BOD ~ TALK 17:32, 28 December 2021 (UTC)
 * No. This is an ongoing, unsettled disupute in society and in MEDRS. Wikipedia should not take sides or attempt to settle the question. WP:IMPARTIAL Sennalen (talk) 15:42, 29 December 2021 (UTC)
 * And this is an opinion, voiced by an editor without evidence or policy support, by an editor engaged in WP:WIKIHOUNDing. Newimpartial (talk) 16:06, 29 December 2021 (UTC)
 * please provide evidence or retract the accusation of hounding. please provide evidence that it is an ongoing dispute in RS and/or discuss the sources already provided, as the RS provided by various editors indicates that there is no sides to be taken as no one is defending ROGD in MEDRS.  Santacruz  &#8258;  Please ping me!  16:17, 29 December 2021 (UTC)
 * In the context of this RfC, this isolated demand for rigor is anomalous. The sources I am looking at are the ones in the collapsed box at the top of the section. None come out in support of ROGD as an established medical diagnosis, but neither do they appear to say things like "fringe", "debunked", or "wrong". The general tenor is that it is a novel speculative idea about which data is still being gathered. The policy support is again, still WP:IMPARTIAL.
 * As for the accusation of hounding, easily disproven: Sennalen (talk) 16:35, 29 December 2021 (UTC)
 * The sources in the collapsed section were hand-picked to fit Crossroads' POV, and do not represent the other sources presented in this discussion. And no, you can't disprove a hounding accusation by making one edit that doesn't fit the pattern. Please see the contributions page for context. Newimpartial (talk) 16:47, 29 December 2021 (UTC)
 * To spell it out, this morning I went through the RfCs at Requests_for_comment/Maths,_science,_and_technology. Even if this were not obviously the case, This is an RfC. The purpose of RfCs is to attract input from previously uninvolved editors. Immediately personalizing my contribution here reflects a battleground mentality. Sennalen (talk) 17:20, 29 December 2021 (UTC)
 * Crossroad's sources are cherrypicked and largely misleading. Their citations are to outdated position statements (the WPATH 2018 one), selectively and incorrectly quoted texts (they quoted AusPATH both excluding the explicit rejections of ROGD and failing to mention that his except was itself a quote of the outdated 2018 WPATH statement). Their evidence that WPATH considers it a legitimate alternate theory relies on a contested OR interpretation of the SoC document, ignoring their more concrete CAAPS statement that calls for the elimination of the term. The remainder of their citations are to mere acknowledgements and non-MEDRS sources, none of which contribute more weight than the outright rejections by the APA, APS, WPATH, and AusPATH. The Ashley paper (which is a MEDRS), characterizes the theory as "Circumventing science through pseudoscience". The APS describes ROGD and theories like it as "consistently refute[d]". These are strong statements from reliable sources directly rejecting the theory, with no mainstream support to counter it. Bravetheif (talk) 02:31, 30 December 2021 (UTC)
 * Elimination in a clinical setting. Consistently refuted the idea that gender identity is "directed" by peers. Ashley is a work of sociology. These are all important points, but just as much as Crossroads has overplayed their hand, you have also. It's enough to just go with what the best sources actually say rather than spin as hard as you can. "Consistently refuted" is getting closer than "fringe" to reasonable phrasing to use in wikivoice. Sennalen (talk) 02:53, 30 December 2021 (UTC)
 * You’re in a desert walking along in the sand when all of the sudden you look down, and you see a tortoise, it’s crawling toward you. You reach down, you flip the tortoise over on its back. The tortoise lays on its back, its belly baking in the hot sun, beating its legs trying to turn itself over, but it can’t, not without your help. But you’re not helping. Why is that? Sennalen (talk) 04:21, 30 December 2021 (UTC)
 * I don't particularly appreciate your implication that I am a robot because I accidentally replied to you twice. Bravetheif (talk) 09:14, 30 December 2021 (UTC)
 * Elimination in a clinical setting. As opposed to what? What else could they call for its elimination from? They are, in no uncertain terms, rejecting the theory. They don't even call for further research on the topic like the previous WPATH statement.
 * Consistently refuted the idea that gender identity is "directed" by peers. What point are you trying to make here? That is the basis of ROGD, and this was placed in a statement about ROGD. They are stating that it is consistently refuted by empirical evidence.
 * Ashley is a work of sociology. And? MEDRS simply advises caution, not rejection out of hand. Her's is the only peer reviewed secondary source on the theory (as opposed to the original Littman paper), she has expertise in the field, and she has association with many of the peak bodies. Leading experts also seem to agree with that analysis, as several, including the President of the Canadian Professional Association for Transgender Health, signed a similar statement describing ROGD as "bad science".
 * "Consistently refuted by empirical evidence and peak bodies in the field" would be a more accurate summation of the APS's statement. Now, some would say that is what a fringe theory is. Bravetheif (talk) 09:07, 30 December 2021 (UTC)
 * I do not agree that the opposition cited makes it fringe. It does not conflict with any fundamental principles of biology; emprical research so far is merely inconclusive with no reason to be certain that additional data could never confirm the hypothesis; and there's no reason to condemn seeking that data as an unprofessional or bigoted activity. It's unproven, contested, opposed, not accepted, etc. There is a lot of good phrasing you can use from these sources, so why not use something that is in the source instead of something half of the community considers to be WP:OR? The WP:ONUS is to justify inclusion of "fringe", not to justify exclusion. Sennalen (talk) 14:37, 30 December 2021 (UTC)
 * Exactly which comunity are you on about? the Wikipedia Community or the relevent medical specialist commmunity or some other community? ~ BOD ~ TALK 15:18, 30 December 2021 (UTC)
 * The Wikipedia community is the only one I know that would deliberate on WP:OR. Sennalen (talk) 17:49, 30 December 2021 (UTC)
 * It does not conflict with any fundamental principles of biology. That is often a feature of a fringe theory, but it is not part of the definition. A fringe theory is one that radically departs from the mainstream position and is not supported by a respected minority. A lack of empirical evidence is another sign. ROGD is both those things, and opposing editors in this thread have yet to cite a respected figure in the field who supports the theory. The outright rejection by every leading body further speaks to this fact.
 * emprical research so far is merely inconclusive... The only clinical trial on the subject concluded that We did not find support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence. That is about as conclusive as a primary source can be. Every other source, beyond Littman's original paper and those that critique it, merely mention the theory. A more accurate way to state it would be something like Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence, which just so happens to be a direct quote of the APS statement on ROGD. You are completely ignoring these sources to arrive at your conclusion.
 * unprofessional or bigoted activity. I don't recall claiming that researching ROGD is unprofessional or bigoted. In fact, it's provably false, as I believe the authors of the previously mentioned clinical trial to be neither bigoted or unprofessional. It is also entirely irrelevant to this discussion - researching a fringe theory makes you neither of those things by itself.
 * something half of the community considers to be WP:OR Looking over this discussion, Crossroads appears to be the only editor to have claimed that describing ROGD as fringe is WP:OR. You would presumably be the second. They did so on the basis that summarizing a singular source is WP:SYNTH, which runs directly counter to WP:SYNTHNOTSUMMARY. They have not provided any further argument. It is an overstatement to claim that "half" the community considers it OR. Bravetheif (talk) 01:20, 31 December 2021 (UTC)
 * I fail to understand how if there are no sources in support of ROGD that you can say it is a dispute. Santacruz  &#8258;  Please ping me!  16:59, 29 December 2021 (UTC)
 * After reviewing additional links provided by editors other than Crossroads, I still do not see MEDRS that use terms along the lines of fringe, debunked, or wrong. I see no disagreement that the absolute quantity of gender identity disorder diagnoses has dramatically increased or that the demographics of age and sex at first presentation have shifted. On the question of whether these changes are driven by a distinct etiology, there is not enough evidence to reject the null hypothesis. That is the strongest form of rejection I have seen in MEDRS. There are less reliable sources that make stronger rejections, which can be included as WP:RSOPINION, and it would certainly be WP:DUE to do so. Sennalen (talk) 17:20, 29 December 2021 (UTC)
 * On the question of whether these changes are driven by a distinct etiology, there is not enough evidence to reject the null hypothesis - this is not at all what most of the MEDRS offered above actually say. This sounds very much like a personal opinion, and the attempt to dismiss the MEDRS on the field (including the relevant national professional bodies) as RSOPINION is not compliant with policy. Newimpartial (talk) 18:24, 29 December 2021 (UTC)
 * Yes, of course it's my opinion. Everything here is the opinion of editors about sources and policy. Having reviewed the sources, I do not find support in high quality sources for the kind of language proposed. This includes the statements from professional bodies, which oppose use of ROGD in a clinical setting but do not support "fringe" or similar language. Earlier in this thread you have indicated that the best support for your point of view comes from a self-published legal finding. It is not my responsibility to find better sources for you. Sennalen (talk) 19:58, 29 December 2021 (UTC)
 * You appear to be conflating the distinct questions that I have disentangle in the discussion section, below. There is a good deal of MEDRS evidence that ROGD is FRINGE in the sense of WP policy, even without using the word "fringe". The relevance of the legal brief only concerns that latter aspect. Newimpartial (talk) 20:05, 29 December 2021 (UTC)
 * @Sennalen Please do not use outdated and inaccurate terminology in your arguments. Gender dysphoria is no longer considered a disorder and many trans people, myself included, do not appreciate the label.
 * As for the rest of your argument, the APS statement on ROGD says that Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence. That is a MEDRS describing ROGD as "consistently" proven incorrect. There is also already a status quo explanation for the increased presentation of TGDNB people: Whilst many have a clear picture of their gender from a very early age, for others the journey towards understanding their gender is more prolonged. The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. (AusPATH statement on ROGD). Bravetheif (talk) 05:38, 31 December 2021 (UTC)
 * Gender identity disorder is a standard ICD-10 code. That changes with ICD-11 effective tomorrow, but historical GID diagnoses were still GID diagnoses. Stop foruming at me. I have heard you on what these sources say, and I still do not agree that's enough to WP:LABEL as fringe. Accept language that's closer to the sources. Sennalen (talk) 16:04, 31 December 2021 (UTC)
 * Gender dysphoria is now the preferred term, and I'm politely asking you to not use stigmatizing language that may make participants in this discussion feel excluded or unwelcome.
 * Language closer to the sources would be "refuted by empirical evidence and mainstream organisations". The first part with a citation to the APS statement, the second to CAAPS (although both are encompassed by the Ashley article). That could be further summarized as "fringe" (with reference to Ashley, not APS and CAAPS), but you seem to insist on watering down the language in this article. Bravetheif (talk) 01:00, 1 January 2022 (UTC)


 * You appear to be requesting citations for a exact word when evidence is so abundantly clear cut that the concept has been totally rejected by the relevant scientific community
 * ""...not recognized by any major professional association as a valid mental health diagnosis"" working in the field.
 * The relevant expert associations "...supports eliminating the use of Rapid-Onset Gender Dysphoria"
 * "...there are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. Further, there is no evidence that ROGD aligns with the lived experiences of transgender children and adolescents."
 * "'methodologically flawed and unethical'... [proceeding] from 'an overt ideological bias'"
 * "Empirical evidence consistently refutes claims that a child’s or adolescent’s gender can be ‘directed’ by peer group pressure or media influence, as a form of ‘social contagion’"
 * "...associations between more recent gender knowledge and factors hypothesized to be involved in rapid onset gender dysphoria were either not statistically significant, or were in the opposite direction to what would be hypothesized"
 * "Circumventing science through pseudoscience"
 * It is therefore outside "the prevailing views or mainstream views in its particular field".
 * WP:FRINGE Guides us In Wikipedia parlance, the term fringe theory is used in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. .... We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support. It is the stated goal of Wikipedia to mirror the current consensus of mainstream scholarship – in the words of WP:NOT, "accepted knowledge". Claims of "ROGD", especially in the context of this book, have been dismissed or outright rejected by practically every relevant medical organization. Normally the key threshold for including material in Wikipedia is that it is verifiable. This is only here because it is verified because as an unscientific theory that became notable not that it has any scientific merit. The are ZERO reliable and independent sources substantiating claims that ROGD exists. There is not one such source. There are no serious scholars and reporters with reputations of responsibility and reliability in the field that support the ROGD. In an article on a fringe topic, if a notable fringe theory is primarily described by amateurs and self-published texts,   then  verifiable and reliable criticism of the fringe theory need not be published in a peer reviewed journal. No where does it say the exact word Fringe must be used. To call ROGD Fringe is a perfectly reasonable accurate one-word summary of the existing high quality mainstream expert academic responses working in the field. All that is required for it to be called "fringe" is that it be outside those mainstream specialists. WPATH, AusPATH, and the APA all reject the hypothesis. The clearest way to explain the concept to the reader is to present it explicitly as a fringe concept, to suggest that this political false theory is anything but Fringe ill informs the reader, it is a  FALSEBALANCE position, that amounts to a betrayal of Wikipedia's core function.  ~ BOD ~ TALK 21:29, 31 December 2021 (UTC)
 * ROGD clearly falls under the definition of alternative theoretical formulation. It is not contrary to any known scientific principal. Social contagion of many behaviors is a known phenomenon, and just as much as there is not enough evidence to confirm the existence of ROGD, there is similarly not enough evidence to support a biological cause of transgender identity. There is no reason, other than political motivation, to believe a study with a larger sample size or some variation of experimental design would not confirm a separate etiological subpopulation exists. "Unproven" is a perfectly good word that tells the reader what they need to know. Sennalen (talk) 22:51, 31 December 2021 (UTC)
 * I'm sorry but it is just so heavily criticized by all reputable experts that the idea it is an "alternative theoretical formulation" or "unproven" is giving it way, way too much credit for what it deserves. Putting ROGD, a theory with absolutely no methodologically sound proof for it, in the same category as the double-bubble Milky way (which was only proved recently after almost 50 years from the date the first simulations backing the theory were published) is insane to me. Santacruz  &#8258;  Please ping me!  23:10, 31 December 2021 (UTC)
 * There is no reason, other than political motivation, to believe a study with a larger sample size or some variation of experimental design would not confirm a separate etiological subpopulation exists - nonsense. There is a "reason, other than political motivation" - namely, that strongly motivated researchers have tried to assemble evidence that ROGD (or something like it) exists, and they have all failed. You can't make an argument equivalent to "the globalist cabal isn't a fringe theory; it unproven, but could be confirmed tomorrow by new research" and not expect to be laughed out of the discussion. This is precisely equivalent. Newimpartial (talk) 23:12, 31 December(UTC)
 * There's an idea, consider the example of Anti-globalization_movement. Lack of evidence can be called simply lack of evidence. Sennalen (talk) 00:10, 1 January 2022 (UTC)
 * You do realize that you silently shifted from the conspiracy theory, which I was using as an example, to a broad social movement that does have a (contested) empirical basis. That's such a perfect example of shifting the goalposts, I think I'll use it in my upcoming textbook. Newimpartial (talk) 13:28, 1 January 2022 (UTC)
 * Just because it is new and "Unproven", certainly does not mean that it must not be correctly identified as Fringe, medical science is not proven true until confirmed to be false, especially when the existing supposed research behind the theory utterly  failed to meet basic "evidence-based clinical guidelines," but is based on unscientific political/moral  opinions of a selected sample that was known to have "an overt ideological bias"  who are not even the subjects  of the theory. "Wikipedia primarily focuses on the state of knowledge today" not next year when another bad theory might or might not be proposed. WP:FRINGELEVEL WP:CRYSTALBALL Informs us that topics that "cover controversial, disputed, or discounted ideas ...should document...the current level of their acceptance among the relevant academic community" not what we as editors think...ROGD is absolutely contrary to all known qualified expertise and knowledge in the field. This article is not the place to question the prevailing medical approach to Trans people.
 * To be honest There is no reason, other than political motivation, to believe a study, with a larger sample size or some variation of experimental design would not confirm a separate etiological subpopulation exists. Sounds like something a Fringe supporter might say? You appear to be unreasonably attempting to water down language and push a minority view well beyond the requirements of NPOV, and giving undue equal weight to the unproven ROGD conjecture. ~ BOD ~ TALK 23:33, 31 December 2021 (UTC)
 * Controversial, disputed, discounted - all very good words! Sennalen (talk) 00:10, 1 January 2022 (UTC)
 * Controversial, disputed etc would be a WP: False balance they wrongly suggests that the unproven ROGD supposition by a non specialist might be on the same level as the existing professionl mainstream international medical expertise and practice in the field. That is absurd, as absurd as folks who blame tech billionaire for Covid and expect Wikipedia to include that quackery equally in Wikipedia. ROGD is "...not recognized by any major professional association as a valid mental health diagnosis" you can not provide any evidence that ROGD has any crediable scientific substance. If a conjecture is considered universly fringe by mainstream science, then the simplest most accurate way to explain the concept to the reader is to present it clearly as a fringe concept.  ~ BOD ~ TALK 01:05, 1 January 2022 (UTC)
 * We have sources with sufficient weight to support stronger language. Language such as "disproven" or "not accepted by mainstream organisations" (i.e. fringe). WP:LABEL specifically warns against using vague terminology, like "controversial". Bravetheif (talk) 03:00, 1 January 2022 (UTC)
 * The gish galloping is too much, so I won't continue to respond individually. There are many phrases to choose from that are better sourced, more precise, and without perjorative connotation. Mistaking the onus in this situation, no one has made a case for why we ought to use a word that is less sourced, less precise, and perjorative. Sennalen (talk) 04:27, 1 January 2022 (UTC)
 * Are you seriously claiming that "disproven" or "fringe" is less precise than "controversial", "disputed" and "discounted"? Those terms convey almost no information to a reader, like why it is controversial, or who has discounted it. They are also entirely unsourced, one of the problems with the status quo article is that "contentious" was itself introduced as a SYNTH of sources. It has no citation or quotation to support it.
 * Editors in this thread are not mistaking the "onus" of proof, they've already provided arguments and evidence as to why they believe their terminology is due. They're criticizing the fact you have outright ignored or rejected many of the MEDRS sources that disagree with your position, and your apparent bias to soften language that is well supported by those sources. For example, you claimed earlier that There is no reason, other than political motivation, to believe a study with a larger sample size or some variation of experimental design would not confirm a separate etiological subpopulation exists, which (a) violates WP:CRYSTALBALL (we don't consider something accepted because we anticipate it to be proven correct), and (b) is entirely untrue - it has been pointed out in this thread, and to you specifically, that a clinical trial of the theory has been performed, that found no evidence for "a separate etiological subpopulation". You've also been thoroughly unconstructive, calling me a bot and using inaccurate, pejorative terminology to refer to trans people. Bravetheif (talk) 06:14, 1 January 2022 (UTC)


 * No, agree with SmcCandlish's summary and the currently stated caveats in the article. Agree with Alaexis that inserting the word “fringe” seems OR.  Also think it’s just not worth saying more WEIGHT about that part than is already said, and would just start to look like a rant.  Cheers Markbassett (talk) 04:41, 3 January 2022 (UTC)
 * No per SMcCandlish, WhatamIdoing, and Bilorv above. <span style="padding:0 1px 0 1px;text-shadow:-2px -3px 3px #ee7f2d,2px 2px 3px #F70;">Lwarrenwiki (talk) 17:32, 9 January 2022 (UTC)
 * No per Crossroads.  Spy-cicle💥   Talk? 06:56, 10 January 2022 (UTC)
 * Yes, because it is more precise than "contentious" and explicitly but shortly states the important fact that major professional institutions have overwhelmingly rejected or condemned the concept. "Contentious" may misleadingly imply that the two sides of the controversy are of equal professional backing, which is something to avoid under WP:NPOV. "Fringe" is not inherently pejorative, but any word which, accurately and without sugarcoating, describes the fact that a theory is fringe and has been condemned by reliable sources may be perceived as negative. PBZE (talk) 03:27, 16 January 2022 (UTC)
 * No per Crossroads. WP:FRINGE means something very specific, "is used in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field."  Given that several researchers are studying it and discussing it (in addition to those quoted by Crossroads, there are a few others), it is a phenomenon currently under study.  Dr. Littman also refers to it not as a diagnosis, but to ROGD hypotheses (a summary is "that psychosocial factors (such as trauma, mental health conditions, maladaptive coping mechanisms, internalized homophobia, and social influence) can cause or contribute to the development of gender dysphoria in some individuals").
 * Zucker 2019 "Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues": "This article provides an overview of five contemporary clinical and research issues pertaining to adolescents with a diagnosis of gender dysphoria: (1) increased referrals to specialized gender identity clinics; (2) alteration in the sex ratio; (3) suicidality; (4) “rapid-onset gender dysphoria” (ROGD) as a new developmental pathway; (5) and best practice clinical care for adolescents who may have ROGD."
 * Levine 2019 "Informed Consent for Transgendered Patients," Pubmed review (secondary). "While this question is starkly evident among cross-gender identified children contemplating puberty suppression and social gender transition and young adolescents with rapid-onset gender dysphoria,[...]"
 * Littman 2021 "Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners" which found support for the ROGD hypotheses.
 * This is in addition to all the peer reviewed references Crossroads quoted. Combining all the references, one sees this topic has appeared as describing a phenomena or hypotheses in several medical journals: Pediatrics, Archives of Sexual Behavior, Int J Environ Res Public Health, Acta Biomedica, BJPsych Bulletin, Journal of Sex and Marital Therapy. Jdbrook talk 05:26, 20 January 2022 (UTC)


 * Yes. Fringe does not mean disproven, it simply means it is not widely accepted, and that is certainly the case here. It's not listed in the DSM or ICD and it's discouraged by the American Psychological Association, the American Psychiatric Association, the World Professional Association for Transgender Health, and other medical organizations due to a lack of reputable scientific evidence for the concept. The fact that Rapid-onset gender dysphoria has been studied by reliable sources is not proof that it's not fringe. As has been mentioned, if we go by WP:MEDRS, it is absolutely fringe. –– FormalDude  talk  00:50, 28 January 2022 (UTC)
 * No per WP:MOS: "Value-laden labels ... may express contentious opinion and are best avoided unless widely used by reliable sources to describe the subject." In addition the current description is completely clear and using the fringe label would not add anything to the meaning of the text. Marcocapelle (talk) 12:25, 29 January 2022 (UTC)

Discussion
Notified the WikiProjects listed above, as well as WP:MED, WP:FTN, WP:NPOVN, and WP:ORN. Crossroads -talk- 07:45, 12 December 2021 (UTC)


 * Comment:
 * a) It seems the article is about a book, I prefer word book in the title when article is about a book.
 * b) Once I realized the article is about book then I did not get proper context of the RfC. Usually if article is about a book or an author then we are supposed to give book's or author's opinion as is even if that turns out to be a fringe or minority opinion.
 * c) We can not express our ow opinion.
 * d) If any third credible source is criticizing general concept as fringe but not this book or authorship then that need not be included in the article. Since such introduction is coming from Wikipedian side.
 * e) Where Book or authorship is not directly criticized but contrary general sources exist can be included in See also, external links bibliography etc.
 * e) If any third credible source is criticizing this book or authorship in particular   that book author  theory is fringe  then  that criticism be mentioned in the article.


 * Resolving seems simpler to me in above manner unless I am not missing on some context I am unaware of.


 * &#32;Bookku, &#39;Encyclopedias &#61; expanding information &#38; knowledge&#39; (talk) 08:05, 12 December 2021 (UTC)
 * One of the reviewers of the book, Jack Turban, refers to the theory as "fringe" while reviewing this book. Perhaps this is the context you were missing? Newimpartial (talk) 09:54, 12 December 2021 (UTC)
 * Jack Turban has come under some criticism himself. &#42;Dan T.* (talk) 15:04, 12 December 2021 (UTC)
 * Don't think that's a reliable source, brah. Newimpartial (talk) 20:20, 12 December 2021 (UTC)
 * Turban's review used the word "fringe" once, to describe some organizations and not ROGD. Sesquivalent (talk) 15:35, 12 December 2021 (UTC)
 * And the legal brief applies the word "fringe" to ROGD itself. Are you trying to split the hair between what is "fringe" in the review and what is "fringe" in the brief, when talking about the same construct (ROGD)? That seems like a rather fine hair to split. Newimpartial (talk) 20:20, 12 December 2021 (UTC)
 * The brief is a category of document, expert witness reports, that as paid shilling for a litigant is in the STUDIOUSLY DISREGARD pile; the Psychology Today blog is not RS; and even if both sources were acceptable, the inference that Turban's descriptions of the organizations as "fringe" is a comment on ROGD is classic SYNTH guesswork. He says they are fringe due to opposition to the dominant approach of "gender affirming care", but such opposition isn't an inevitable consequence of ROGD unless any change to the status quo clinical procedures is taken as oppositional by definition.  That Turban personally does think it's fringe and says that in an expert witness report is irrelevant to any matter except "what does Jack think?", which does not concern us here. Sesquivalent (talk) 17:33, 12 January 2022 (UTC)
 * No; the reason the brief is relevant is (1) to validate that it is not WP:OR to state that ROGD is "fringe" and (2) to clarify that this is indeed Turban's view (since editors have disagreed about whether or not that is what he meant in the review) - in other words, to document "what does Jack think?", since you and other editors have quibbled about this. The brief is entirely sufficient to make these points, and your argument against Turban's reasoning is completely irrelevant to the discussion we are actually having here.
 * The MEDRS show that ROGD is what WP calls "FRINGE". Turban's writing about the book applies the term "fringe", and he means the term to apply both to ROGD and its supporters. You seem to be arguing that Turban's reasoning is flawed, but arguing against our sources isn't really how we, as an editing community, are supposed to settle RfCs. Newimpartial (talk) 17:43, 12 January 2022 (UTC)
 * These are highly idiosyncratic interpretations unique to you, in the face of apparent SYNTH and weak sourcing. I haven't argued with (or accepted, or otherwise judged) Turban's reasoning other than to note that he is an ROGD opponent with vested interests. My argument, and that of Crossroads and maybe some others here, is against the fallacies in your reasoning about Turban's writing, and specifically your apparent claim of oracular powers to know what he meant in his Psychology Today post beyond what is written there. Sesquivalent (talk) 18:01, 12 January 2022 (UTC)
 * Believe me, no volcanic fumes were involved in reading Turban's other comments on the same topic, for content. But your idea that mainstream scholarship on gender dysphoria is riven with vested interests might perhaps be best attributed to "oracular" inspiration - it certainly doesn't reflect WP policy. Newimpartial (talk) 18:13, 12 January 2022 (UTC)
 * This RfC is about how to best introduce the theory this book advocates, Rapid-onset gender dysphoria. Specifically, how to summarize the the scientific consensus discussed in position statements such as the one released by CAAPS (signed by the APA), or AusPATH. Bravetheif (talk) 12:13, 12 December 2021 (UTC)
 * On (a), we don't use parenthetical disambiguation unless there's another topic with the same name. On (d), this goes directly against WP:FRINGE: the proper contextual relationship between minority and majority viewpoints must be made clear. This is because we would be promoting misinformation if we were to, say, host an article uncritical of a book promoting climate change denial. Luckily, the premise of (d) does not apply here anyway as there are reviews critical of the scientific claims made in Irreversible Damage. — Bilorv ( talk ) 21:42, 12 December 2021 (UTC)


 * Comment: Crossroads I would like to remind you that simply summarizing a source is not WP:SYNTH (per WP:SYNTHNOTSUMMARY). It is not required to have a direct quote describing the theory as "fringe", provided a source can be summarized (in good faith) as making that assessment. Editors are entirely within their rights to use WP:SYNTH when making an argument, providing they are not advocating its use as a citation in an article. Bravetheif (talk) 12:13, 12 December 2021 (UTC)
 * Such a summary cannot have a stronger condemnation than its source, nor can it be based on cherry-picked sources. Crossroads -talk- 05:51, 13 December 2021 (UTC)
 * I'm getting very frustrated at your repeated inappropriate crying of "breach of policy" and "cherry-picked", particularly when the most egregious example of that behaviour is yours. You continue to cite WPATH's position statement that was released 24 days after the initial paper, when that is explicitly no longer their position. They (along with the APA) have signed the CAAPS position statement, which specifically calls for the elimination of the term and concept altogether. At no point in that statement do they even acknowledge ROGD as a proposed theory. It is cherry-picking to ignore this explicit and total rejection. You misattributed a quote to AusPATH that was in fact AusPATH quoting WPATH, and ignored the remainder of the statement that rejected the core foundations of ROGD. That is cherry-picking. You found a handful of papers that mention the theory or, more accurately, the phenomena and pretend that outweighs the dearth of evidence against it. Bravetheif (talk) 06:31, 13 December 2021 (UTC)
 * Editors can and will have good faith disagreements about the sourcing and about how to apply policy, and you should WP:AGF more. AusPATH cited WPATH there, but was not quoting them. It is their own position too. Now, as I said above, CAAPS specifically called for its elimination in diagnostic settings, not from all research. More on this above in our exchange under "Survey". Crossroads -talk- 06:51, 13 December 2021 (UTC)
 * You have received multiple warnings from editors beside myself of inappropriate tagging and behaviour in, and obviously this thread. The policy is to assume good faith, not assume good faith against all evidence contrary. I do not understand exactly what you mean by eliminating ROGD from "all research". If you do not define it, I'll just assume it's not a real thing and thus, cannot be achieved by any theory. Bravetheif (talk) 07:39, 13 December 2021 (UTC)
 * Nothing said there about tagging, and those are from disputants in this very matter, one of whom has less than 100 edits in the last decade, and they have already been addressed above. Crossroads -talk- 06:41, 15 December 2021 (UTC)


 * The lead of ROGD itself describes the theory as controversial. Why would we use stronger wording on an article about a book about the same theory. Air<b style="color: green;">corn</b> (talk) 20:01, 12 December 2021 (UTC)
 * The lead sentences of Rapid onset gender dysphoria currently read, Rapid-onset gender dysphoria (ROGD) is a controversial proposed socially mediated subtype of gender dysphoria.It is not recognized by any major professional association as a valid mental health diagnosis. That goes beyond your controversial, in noting that it is only proposed and that it is not recognized by any authority. Which is not to say that that lead should not be stronger, given the more recent sources that are more roundly critical of the ROGD hypotheses. Newimpartial (talk) 21:29, 12 December 2021 (UTC)
 * It literally says controversial. It doesn't go as far as fringe, which has a specific meaning - especially here. I think there is probably better wording out there, but can't think of what at the moment. Air<b style="color: green;">corn</b> (talk) 19:52, 15 December 2021 (UTC)
 * I agree with your conclusion, though not your reasoning ("controversial" is an understatement and the other article lead needs updating IMO) - which is why I haven't !voted yet.Newimpartial (talk) 20:00, 15 December 2021 (UTC)
 * Same here. I am waiting to see if anyone comes up with any good alternatives. I dislike controversial in general as it really tells you nothing about how it is controversial. Air<b style="color: green;">corn</b> (talk) 20:04, 15 December 2021 (UTC)
 * Is anyone disagreeing with putting this up at Requests for Closure? Like that once the 30 days pass someone can come in here and finish this mess. It's barely legible at this point and I doubt any new eyes will feel compelled to sift through the immensely long RfC + side-discussions. Santacruz  &#8258;  Please ping me!  23:14, 31 December 2021 (UTC)
 * Yes, me; there are plenty of opinions still coming in. Adding one's thoughts on the Rfc merely requires reading the Rfc statement at the top, and predicating one's response on Wikipedia policies and guidelines; there is no requirement or need to read any of the comments in the discussion left by other users. Mathglot (talk) 08:37, 2 January 2022 (UTC)
 * Thanks for the response, . I disagree with the plenty of opinions part. At this point I'm pretty sure it's just and  ping-pong-ing with .  Santacruz  &#8258;  Please ping me!  10:44, 2 January 2022 (UTC)
 * I also oppose rushing to close. The sheer amount of bludgeoning has left a lot of items that deserve response but some of us cannot reply as quickly as others. The thread is long, but sprawl can be reduced by moving some blocks of comments into new subsections. Sesquivalent (talk) 22:56, 3 January 2022 (UTC)


 * Comment: the word "fringe" has been conflated with "disproven" above. However, a theory can be on the fringes without being "disproven" per se. Collins Dictionary says The fringe or the fringes of an activity or organization are its less important, least typical, or most extreme parts, rather than its main and central part. WanderingWanda🐮👑 (talk) 08:25, 27 January 2022 (UTC)

Diagnosis or social phenomenon
A lot of this discussion revolves around weakness of the evidence for ROGD as its own psychiatric diagnosis to prove the concept is fringe. Maybe that argument applies to Littman's publications, her bio article or the page on ROGD. However Schrier's book is concerned with a rapid increase in female adolescent gender dysphoria (self reports, cases, treatments) as a social phenomenon, regardless of whether its causes should be viewed as mental illness within those females. She uses terms like "social contagion" and "cultural fad". The paradigm is not that girls who falsely present as dysphoric are in need of a new edition of the DSM that certifies them as cases of a psychiatric condition called ROGD, any more than belief in QAnon or satanic ritual abuse or membership in a cult are labeled as mental disorders. The idea is rather that these are socially and culturally induced beliefs and behaviors regardless of any psychological etiology. Some psychological profiles (insecure girls and autist spectrum) are more likely to manifest the syndrome according to Schrier, but they don't define it.

To say it another way, for Schrier ROGD is a diagnosis of society and not the individuals in it. To refute this looser sense of ROGD would be to show that either the huge spike in adolescent female cases did not happen, or that it has explanations unrelated to fads, peer pressure and social media. The published support for that is quite a bit weaker than for "doesn't meet criteria for a new DSM diagnosis". Sesquivalent (talk) 20:30, 12 December 2021 (UTC)
 * I hope you didn't take classes in the philosophy of science. It is not the case that anyone has to show that ... the huge spike in adolescent female cases did not happen (though the evidence for it is not strong) or that it has explanations unrelated to fads, peer pressure and social media. For ROGD not to be FRINGE, it has to plausibly demonstrate (1) that there is some kind of phenomenon to be explained - and what would that be? Your huge spike in ... cases from 20:30? Your previous paraphrase from 14:35, that large numbers of gender dysphoria diagnoses in adolescent girls are factitious? - and (2) that the supposed phenomenon can be explained through "social contagion". Unless both of these claims have evidentiary support, and unless qualified scholars or practitioners accept this explanation as plausible - at least some reasonable minority of them - there is no there there, and ROGD is effectively "fringe".
 * Also, nice doubling down in the editorial change from those adolescents to those females. You don't prefer to bother with NPOV, do you? Newimpartial (talk) 20:44, 12 December 2021 (UTC)
 * She says, for example, that US cases quadrupled from 2016 to 2017 (reversing the historic pattern in which male to female cases predominate) and grew by almost 2 orders of magnitude in England over a decade. So either those numbers are way off, or some explanation is needed because those ratios are huge.  Littman and Schrier have one proposed explanation which is not self evidently fringe and overlaps with a number of other known facts. The critics attack the methodology such as the survey of parents, but do they have an alternative account of the giant rate increases?   It's easy enough to dismiss anything in quasiempirical social science by pointing to methodological defects that are often inherent, such as causal experiments being impossible, or by artificially raising the standards of proof (say to "new DSM diagnosis justification" level).  But all this at most shows ROGD is unproven, not that the underlying phenomena don't exist, or that data from parents tell us nothing, or that the whole idea is discredited and cannot be proven using similar data with better methodology.  In the absence of such demonstrations it is misleading to use language that presents the idea as already discredited. Sesquivalent (talk) 21:18, 12 December 2021 (UTC)
 * Who is She? Littman? Sheier? Neither is a usable source per WP:MEDRS. Newimpartial (talk) 21:24, 12 December 2021 (UTC)
 * Speaking for the UK stats, two orders of magnitude on a small number is still a small number. The most recent National LGBT survey from 2019 reports 3.5% of respondents as trans women, and 2.9% as trans men. An increase of two orders of magnitude starts to equalise the amount of trans men to trans women. As for why it's increased over time, while I don't have a source handy at this time I would liken it to increased diagnoses of neurodiversities like autism and ADHD, or the increase in left-handedness as awareness and suppression of those diminished. As for why female-to-male, again I don't have a source to hand right now but I'll try to find one, but it's very likely similar to historic under-reporting of autistic women. Sideswipe9th (talk) 21:29, 12 December 2021 (UTC)
 * Per the discussion section in this paper: We have now reached the point wherein we are seeing at least as many FTM initiating sex hormone therapy as MTF and Contrary to the prevailing view, however, we have also seen a significant increase in the percentage of FTM compared with MTF, such that the incidence rates appear to be equalizing. We hypothesize that increasing social acceptance of the LGBTQ community and decrease in barriers to care are a significant factor in these temporal changes. Sideswipe9th (talk) 21:33, 12 December 2021 (UTC)
 * The very fact they "hypothesize" it contradicts the claim that that view is The Truth with anything else being fringe. Crossroads -talk- 05:47, 13 December 2021 (UTC)
 * Crossroads, you have already been repeatedly warned about your unconstructive contributions in this discussion. Do not attribute arguments to Sideswipe9th that they did not make. No one on this thread has claimed that a given hypothesis is "The Truth" which proves every alternate theory fringe. They're calling it fringe because it is not accepted by any mainstream organisations, with no empirical evidential support, with the American Psychological Association calling for it's elimination entirely. Bravetheif (talk) 06:10, 13 December 2021 (UTC)
 * How about you WP:AGF and cease casting false WP:ASPERSIONS about me being "warned"? Look closer and you'll see I never attributed that argument to her. I was commenting on a general idea that has popped up elsewhere. Crossroads -talk- 06:15, 13 December 2021 (UTC)
 * You know what, I apologize. I will try to keep a cooler head going forward. Bravetheif (talk) 10:00, 13 December 2021 (UTC)
 * Thanks, appreciated. Crossroads -talk- 06:41, 15 December 2021 (UTC)
 * To add onto Newimpartial's comment, the AusPATH position statement proposes an alternate theory to explain the increased presentation of genderqueer individuals as The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. Bravetheif (talk) 02:34, 13 December 2021 (UTC)


 * Just as a point of order, this is an article on a book. This isn't an article on ROGD. Let's try to confine ourselves to sources about the book, and broader discussion about ROGD can move to the main article on the topic.  G M G  <sup style="color:#000;font-family:Impact">talk  21:15, 12 December 2021 (UTC)
 * For good or for ill, this RfC asks how "ROGD" should be characterized in the context of the book. One review characterizes ROGD (or its advocates - a distinction without a difference since the same author applies the same characterization to the disorder in another piece written around the same time) as "fringe". It would thus be difficult to determine what the DUE, NPOV terminology would be to use for ROGD in this article without placing these reviews in the context of a larger scholarly community and community of practice. Newimpartial (talk) 21:22, 12 December 2021 (UTC)
 * If you are referring to this subsection, that was its purpose as well. This RfC is about ROGD, but for purposes of an article on Schrier's book (rather than, say, Littman or her theory) the question of whether evidence for ROGB meets the level needed to rewrite the DSM is superfluous, or a way of artificially raising the standard of proof for not being fringe. Sesquivalent (talk) 21:29, 12 December 2021 (UTC)
 * Nobody is asking whether evidence for ROGB meets the level needed to rewrite the DSM; the relevant authorities are asking whether there is any evidence of an ROGD-type phenomenon at all, and generally concluding that there isn't. Which isn't surprising for something that was constructed through interviews with parents who were unhappy with their children's gender identity announcements, and who encouraged their children to abandon transition or detransition. I know this is strictly irrelevant, but honestly, a more appropriate proposal would have been Parental "rapid onset gender dysphoria" reaction disorder, based on Littman's actual data. Newimpartial (talk) 21:34, 12 December 2021 (UTC)
 * Per the sources I quoted at the beginning of the RfC, quite a few researchers do indeed concur that there is some evidence of an ROGD-type phenomenon. Crossroads -talk- 05:47, 13 December 2021 (UTC)
 * Not really. Throughout this discussion, you keep making these assertions that are not backed up by the evidence you yourself have presented.
 * After going through all of the (cherry-picked) sources you included when launching this RfC, the strongest positive statement I found from a MEDRS was the 2020 paper that said of Littman's piece The survey received mixed support, and warrants future studies to help understand if ROGD as a distinct entity or as a variant presentation of GD. That's it. I wouldn't call even that ringing endorsement of an ROGD-type phenomenon, but that seems to have been as close as you could find.
 * The MEDRS professional sources you offered don't even go that far, noting for example a proposed clinical phenomenon that may or may not warrant further peer-reviewed scientific investigation (2018) or a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings (2019). These don't concur that there is evidence of an ROGD-type phenomenon; your suggestion that they do, and that therefore the ROGD hypotheses are less than FRINGE, is laughable - and more recent professional position statements have become more rather than less skeptical.
 * You also included a 2020 paper that says Some respondents depicted referrals with traits of the so-called “rapid onset” of gender incongruence... However, this is a very complex phenomenon that needs further exploration. No "concurrence" from researchers there, either, that I can see, and no statement that the very complex phenomenon they do recognize is ROGD-type - they attribute that depiction to others.
 * Other than that, you presented a three-author letter (2019) and a single-author commentary (2020), neither being subject to peer review, and the infamous "Special Article" from BJPsych, which you included as supporting your position without acknowledging that its publication (in its initial version), was so controversial that it forced the journal to revise its peer review process, as documented here. If that is your idea of MEDRS documenting that researchers  concur that there is evidence of an ROGD-type phenomenon and that the "contagion" hypothesis is not WP:FRINGE, then I am forced to conclude you may not understand medical sourcing as well as you lead on. Newimpartial (talk) 14:03, 13 December 2021 (UTC)
 * This is mostly either addressed elsewhere, simple differences in reading the text, or handwaving, but I'll address the BJPsych matter. The changes they made to the way they present certain things is completely irrelevant to my point. It was pointedly not retracted, because it does not meet that criteria. Crossroads -talk- 06:57, 15 December 2021 (UTC)
 * In spite of your galloping gish, all you have actually presented in terms of MEDRS is two sources finding that there is reason to investigate an ROGD-type phenomenon, one of which was so controversial that, while not retracted, it was the reason BJPsych revised its editorial policy. Compared to the many, many MEDRS that are critical of the ROGD hypothesis and the methodologies employed by the only study that found support for it, your point that there is evidence of an ROGD-type phenomenon is quite literally WP:FRINGE - WP policy specifying that an idea that departs significantly from the prevailing views ... in its particular field are FRINGE. That is exactly what we see here. Newimpartial (talk) 18:45, 15 December 2021 (UTC)
 * When things get "controversial" in this area, rage mobs of activists do their best to bully publishers into memory-holing the offending work. It is to this journal's credit that, although they did a few gestures toward the activists, they refused to retract the paper because it had no retractable flaws. &#42;Dan T.* (talk) 19:41, 15 December 2021 (UTC)
 * The article about the controversy outright reveals that the "controversy" was due to people claiming it caused "distress". No research allowed except that which supports the pre-approved narrative for those folks! I mean, science has always been about telling people want they want to hear right? 🙄 Needless to say, I consider this "controversy" irrelevant. As for the claim that only two of the sources that I listed give some credence to the concept, I don't consider that accurate at all. Crossroads -talk- 07:00, 16 December 2021 (UTC)


 * It's an article on a book, whose premise is built on the concept of ROGD, and is somewhat responsible for the increase in awareness of it outside of the medical community. Sideswipe9th (talk) 21:36, 12 December 2021 (UTC)
 * To say "female adolescent gender dysphoria" is to beg the question. Shrier is not interested in "girls who falsely present as dysphoric", but primarily in transgender men and non-binary people, who she views as female. To refute ROGD according to your own logic is then to simply say that there has not been any evidence presented that a hugely increased number of people are falsely identifying as transgender, and as such there's no reason such a claim should be taken seriously. — Bilorv ( talk ) 21:37, 12 December 2021 (UTC)
 * I am not offering an opinion on whether Shrier is right or on the ground truth of what these cases "really are", but trying to efficiently paraphrase her position, which means using language similar to hers. As other people have pointed out up above on this talk page, criticizing the evidence is not the same as refutation (which is what people are in effect trying to add to the article). A giant (UK) or meteoric (US) rate jump, if not well explained by natural causes, is reason to not dismiss such a claim. That is the normal state of social science: the question is open, totally satisfactory all-resolving data are hard to get, partial evidence stands (pointing in several directions), legitimate differences of opinion persist until better data become available. Sesquivalent (talk) 22:06, 12 December 2021 (UTC)
 * The fact the question is somewhat open on what is driving the increase in people seeking transition doesn't mean we need to make all hypotheses equivalent in merit. ROGD has no basis in sound data, and as such should not be given much merit unless relevant experts agree or support it. As far as I am aware, the overwhelmingly dominant hypothesis is that the increased exposure to and acceptance of trans people in society (in large part thanks to the internet) is the main driving force. Santacruz  &#8258;  Please ping me!  22:18, 12 December 2021 (UTC)
 * At the same time, researchers have also noted that doesn't explain the sex ratio being so lopsided, and that being so among youths when greater social acceptance would seem to have equal effects on all ages. Crossroads -talk- 05:47, 13 December 2021 (UTC)
 * When it is the internet driving that acceptance, age groups that are native to the internet will be much more affected than other age groups. In terms of the sex ratio, I'd appreciate it if you could share some sources describing that ratio (the ROGD study had sampling issues so it can't be relied on for that). Santacruz  &#8258;  Please ping me!  09:38, 13 December 2021 (UTC)
 * Despite my disagreements with your positions, I'm very much in agreement on wanting to see solid numbers on exactly what the phenomenon being discussed is; by what amount has the number of transitioning people changed over the years, and how has the sex ratio changed in that time period. Facts are what is needed to get more light than heat on the subject. &#42;Dan T.* (talk) 14:38, 13 December 2021 (UTC)
 * Off-topic, but this is an instance where our reactions reveal our priors/underlying assumptions. For example, for people who see trans identity as rooted in the underlying diversity of human genetic potential, it is expected that AFAB and AMAB people would express trans identity to a somewhat similar extent, and enduring differences would be surprising. On the other hand, for those who see trans identity as based in psychopathology, there is no particular reason to expect such a pathology to develop among AFAB people to parallel what they see as the pathologies of AMAB people that cause gender dysphoria, so increases within the AFAB population are seen as a new and unwelcome development. Newimpartial (talk) 14:49, 13 December 2021 (UTC)
 * I think you'll find it's more complicated than that. @Dtobias, I haven't looked up these stats for years, but if memory serves, then back in the 1980s and 1990s, the (biological) sex ratio was generally estimated at about 4:1 MTF.  The 4:1 male predominance has been explained as being expected because it's the same skewed sex ratio seen in autism.  (The people who expected this presumably support the model of of trans identity as being a type of congenital neurodiversity.)   In recent years, I've seen news reports that (some?) clinics have a substantial majority of afab clients, but I've never bothered to look up proper stats myself.  WhatamIdoing (talk) 20:58, 14 December 2021 (UTC)
 * CrossroadsI'm not sure I agree with your summaries of your own sources. Most of the sources you've posted seem to disagree with you that ROGD is a thing. Voiceofreason01 (talk) 18:37, 13 December 2021 (UTC)
 * My point has never been that ROGD is definitely "a thing", just that many MEDRS consider the possibility that it is "a thing" and remain open to further research on that possibility, and that therefore its status shouldn't be negatively exaggerated. Crossroads -talk- 07:04, 15 December 2021 (UTC)
 * You clearly have some very strong opinions on this topic and a lot of the opinions you've posted here are wp:or and not well supported by reliable scientific sources or even necessarily your own sources. I still have some serious concerns about the tone and weighting of the article and I'd like to work to build a consensus to improve it. Voiceofreason01 (talk) 16:04, 15 December 2021 (UTC)


 * I dispute the characterisation - characterisations, there's been multiple, from multiple editors, and the vast majority of them were colourblind pots screaming at a red kette - that Crossroads has strong opinions on this topic. Crossroads is probably the LEAST emotionally caught up participant in this discussion; I suppose at cursory glance, one would just see the walls and walls of impassioned text and it would be reasonable to assume equal heat applied from both sides. I will point out one thing, though, to you and all the other editors that trotted out the particular argument (some of whom I'm almost certain know better), that WP:OR only applies to materialvadded to articles; it does not apply to talk pages, and we are free to use original research in determining (through consensus) which RSed material to include or not include, and how much weight should be given to what. What we're NOT allowed to do is, for example, use OR to justify calling a thing "fringe" when not one RS says it is that.
 * Now, listen, folks: about   the wording of the comment Sesquivalent made above about dismissing this thing outright for not rewriting the DSM - one, regarding the other editors' reaction toll in response to that - have y'all NEVER heard of, seen, or yourself used hyperbole? And two, immediately after you got done telling at him because you (apparently) thought he was being literal and that 'nobody was doing that', you then (2) continued to berate him for that exact same thing (I suppose   because you didn't inveterstand their point the first time around. The point was v for the purpose of THIS BOOK, ROGD is proposed to be a social phenomenon. Sociology is not medicine. Incidentally, the demographic most heavily affected by mass socially induced contagions just HAPPEN to be the exact same demographic that seem to be the ones affected here, in mass numbers, and nearly overnight (figurately). I would like to think that - and I think that most of us genuinely do care about the well being of these kids, no matter how they identify; I do find it troubling, though, why so many here seem to want to pretend this Shis situation doesnt exist, prevent any kind of further inquiry into it - that is, they seem to be advocating that it shouldn't be examined to verify or falsify the claim. That seems to say that, if it were true, they would prefer to keep that indormation from being known. And, I'm going to come right out and say what the possible danger of that is (since the other side has also expressed their, likewise legitimate fears, there's no reason to suppress the possible flip side of this): hundreds of thousands of kids that ARE NOT actually trans - and most of whom are likely gay - brig being medically transitioned, i.e. permanently sterilized, possibly undergoing surgery, before they've even had a chance to hit puberty. If the statistical data is correct, that IS the most plausible explanation. What good can come from preventing any further research into this? 2600:1702:4960:1DE0:907D:4451:8F72:3CE1 (talk) 09:47, 18 December 2021 (UTC)

Concerning the IP "opinion", I would like to draw attention to this:

I draw attention to this because it illuminates the elephant in the room, and the fear behind the ROGD moral panic (and not just on behalf of the IP). There is a lot of nonsense in this, and without actually talking about it, the discussion of this topic (the book and other ROGD discussion on WP) will never move forward. I would draw attention to the following: By the way, IP, I would appreciate a reply to this comment I placed on my Talk page, if you can find the time. Newimpartial (talk) 16:16, 18 December 2021 (UTC)
 * in spite of non-RS claims to the contrary, I haven't seen any RS support for the claim - which people holding this POV take for granted - that hundreds of thousands of kids that are NOT ACTUALLY trans are showing up at clinics and being diagnosed with gender dysphoria. The data from population self-report surveys on gender identity simply cannot be used as evidence of clinical diagnosis; that is an elementary methodological error.
 * there is also no evidence that any significant number of kids that ARE NOT actually trans - and most of whom are likely gay are being medically transitioned. Yes, detransitioners exist and need to be respected, but (1) I am not aware of any jurisdiction allowing patients to be permanently sterilized, possibly undergoing surgery, before they've even had a chance to hit puberty. (2) Even puberty blockers are not actually administered before they've even had a chance to hit puberty, and the general medical consensus is that puberty blockers are reversible and don't "sterilize" anyone. (3) Actually existing detransitioners have made their choices about hormones and surgery after the age of 16 and generally after the age of 18; there is simply no connection between self-reported trans identity in the mid-teens and detransitioning later, at least not in any MEDRS that I've seen.
 * finally, outside of the quote I gave here, there is the question of how much of this is sociology and how much is medical science. I don't find that question all that interesting, however, since the actual RS from sociology, social work, psychology and medicine are all essentially in consensus on the facts as I have set them out here; I have not noticed any pattern that would make ROGD less controversial in the higher-quality literature coming out of any of these fields. If the real argument is "this is sociology, so we can rely on op-eds and broadsheets for verifiability" that isn't really the direction WP:RS is pointing to, but I would appreciate if editors could at least make that argument rather than implying that social science scholarship points in a different direction on this than medicine - which it manifestly does not.
 * ROGD doesn't just mean whatever we decide it to mean here. It refers to a specific clinical diagnosis. The evidence of increased genderdiverse presentation is not evidence of the specific theory of ROGD, and it is utterly ridiculous to suggest so. EmilyIsTrans (talk) 12:30, 22 December 2021 (UTC)
 * ROGD as a "specific clinical diagnosis" is a strawman, a word game based on the resemblance to the name of an actual clinical diagnosis (GD). Not only do ROGD's proponents agree, and state, that it is not a diagnosis, they present it as an antidiagnosis. i.e., a claim that a large proportion of clinical "affirmation" diagnoses of GD/transgender in (physiologically) female adolescents are bogus.  The article says clearly, as it obviously should given the potential confusion stemming from the name, and the unanimity of all sources, that ROGD is not a diagnosis. Mission accomplished!  But to try to leverage that unanimity as evidence against the actual, nondiagnosis, form of ROGD is, just as obviously, a misrepresentation of the literature. Sesquivalent (talk) 15:23, 5 January 2022 (UTC)
 * Re: to try to leverage that unanimity as evidence against the actual, nondiagnosis, form of ROGD is, just as obviously, a misrepresentation of the literature - where is the MEDRS support for this "actual, nondiagnosis, form of ROGD"? You keep writing as though this "literature" exists (and is being misrepresented), but I haven't seen any good sources that say anything to this effect. Newimpartial (talk) 17:29, 5 January 2022 (UTC)
 * You're avoiding the point. Littman's 2018 paper proposes a theory in which two novel hypothesis are expressed: that Social influences can contribute to the development of gender dysphoria, or that Maladaptive coping mechanisms may underlie the development of gender dysphoria for some AYAs. You are attempting to redefine ROGD, not as a specific theory, but instead a vague description of the increased presentation of gender non-conforming people. You have not provided any sources using it in this manner, the book does not use it with that meaning, and you are seemingly (trying so hard to assume good faith) ignorant of the fact it will confuse readers into thinking the specific hypotheses defining ROGD are the subject of discussion. EmilyIsTrans (talk) 09:54, 7 January 2022 (UTC)
 * This is a recent article by a former WPATH board member expressing belief in the possibility that social contagion is influencing the trend to a greater number of young people expressing trans or nonbinary identities. &#42;Dan T.* (talk) 19:20, 8 January 2022 (UTC)
 * That is entirely irrelevant to this discussion. Some ex-WPATH board member believes gender dysphoria is a social contagion? Great, good for her. From a quick search she's been banging that drum for years. But it does absolutely nothing to establish that anyone besides you and Sesquivalent understand ROGD, not as referring to the theory it describes, but instead some vague phenomenon where more PFAB people are presenting as trans. EmilyIsTrans (talk) 05:02, 9 January 2022 (UTC)

FRINGE and "fringe"
As I think ahead to the task of the closer, I thought it might be helpful to disentangle the two distinct questions that are at issue in this filing, and how the !voting and policy-relevant discussion above relates to them.

Question 1: ''is ROGD a "fringe" perspective in the sense of WP:FRINGE? Question 2: is "fringe" a (i) permissible and (ii) optimal term to use in this article?

It seems to me that a substantial supermajority of the evidence-based and policy-compliant votes has answered the first question as Yes. For the second question, there have been two arguments been put forth in favor - the argument deom paraphrase, that "fringe" is the most appropriate term to clarify for readers the status of ROGD (relating to sub-question ii), and the argument from sourcing, that unlike some competing terms, we do have a reviewer of this book who refers to the backers of ROGD, and ROGD itself, as fringe (relating to sub-question i). Neither of these arguments, however, has the level of support for Question 2 that the answer to Question 1 has received, so I do not envy the job of the closer. Newimpartial (talk) 14:11, 24 December 2021 (UTC)
 * I would argue that per policy, if the answer to question 1 is "yes," then we have no choice but to accept question 2 part (i) as also "yes." But I would agree that question 2 part (ii) is open to interpretation. — Shibboleth ink  (♔ ♕) 15:36, 24 December 2021 (UTC)
 * I'm a fan of liberally adding subsections to clarify discussion, and was literally about to add a section called "FRINGE vs 'fringe'" then saw you already did (thanks).
 * Question 2 is pretty simple. To say in Wikivoice that something is "fringe", or a similar term (debunked, discredited, disproven, in disrepute, marginal, ...) falls under RS/AC and here we don't even have it in RS.  If Psychology Today blogs are in fact RS, even SYNTHing that RS with a second non RS (the author's expert opinion in a pending court case), which is what you keep insisting on doing, is insufficient because the question here is not what Dr Turban thinks; I'm sure he would use even stronger language privately but that is neither here nor there.  The question, assuming it is not disqualified entirely as SYNTH, is what opinion he (and possibly other experts commenting) would have expressed if he did happen to write a RS/AC worthy piece in a "reliable, independent, secondary source with a reputation for accuracy and fact checking", subject to peer and editorial review and exposed to replies.  Would he have modulated his language? How independent is he of the controversy, anyway? Would the editors have solicited rebuttals? You cannot just fantasize the same "fringe" wording into place by comparison with what he writes in the ex cathedra blog space (no comments allowed) or the court case where an opposing expert has in fact contested it. I would argue that the Turban pieces taken together are at best  RSOPINION, but regardless of that, they don't meet RS/AC separately or together. Sesquivalent (talk) 16:03, 24 December 2021 (UTC)
 * I'm glad I was capturing the mood in the room:) but I disagree with you about how Question 2 is to be decided, by policy. It seems to me that only Question 1 is an WP:RSAC question. If that question is answered in the affirmative based on the available sourcing (which does not have to use the term "fringe" for WP:FRINGE to apply), then that offers prima faciae support for Question 2 (which amounts to, is "fringe" the best term to express the fact that ROCD is WP:FRINGE).
 * In any event, I see no argument why RSAC would apply to Question 2, particularly for an article about a book that itself would not meet MEDRS requirements, nor would its author be a qualified expert for anything but her own opinions about gender dysphoria. Your attempt to drag down Turban with a dog-whistle likw, How independent is he of the controversy, anyway? and dismissing the views of a published expert in the field as no more than RSOPINION strike me as assertions of POV and nothing more.
 * My point about the Turban sources is not thwt they establish by themselves that "fringe" is due, but they do overcome the specific objection to Question 2 (i) that we should not be using a term about ROGD in discussing the book that isn't used in sources discussing the book (see the whole WP:OR red herring in prexious Talk page sections. The term is, in fact, used in this context by a scholar with relevant subject-matter expertise. Newimpartial (talk) 16:23, 24 December 2021 (UTC)
 * I certainly agree that RSAC is applicable to all "is it fringe" RfCs on academic topics, including question 1, though that somehow hasn't come up until now on this page. It looks to me like there are practically no secondary independent (ie., no vested interest) RS on the matter, which is not surprising considering the topic is 3 years old, data to settle the issue (rather than generate noise) are hard to acquire, and there is a disincentive to research the "pro" ROGD side of the question as response to Littman and others showed.
 * With the Turban sources your position seems to boil down to claiming an exception to SYNTH (and RS) when it comes to combining multiple works by one author. I can imagine situations where such combinations could work to interpret one source in light of another without any guesswork involved, but that is not the case here.
 * Dr Turban is about as interested or uninterested as Abigail Shrier is on ROGD matters. Both had prior opinion pieces published (on opposite sides of course) on trans issues, both have vested interests, including financial and career outcomes. This is at least your fifth vague claim of "dog whistles" or the like in my direction, which I think falls under WP:ASPERSIONS.  Your ear seems to be finer than that of actual dogs, though, hearing phantoms instead.  Sesquivalent (talk) 17:40, 24 December 2021 (UTC)
 * As a side matter, the Wikipedia notion of RS focuses on publishers and editorial process, so it is not clear to me that an expert opinion in a case is a publication in itself, or is only one section in the publication of the entire case record. If the latter then the opposing expert reports are also included in the source material, and until the court issues a ruling that might compare the merits of the dueling reports, it's not clear to me that Wikipedia can take one side's experts as a source and ignore the experts from the other side. Sesquivalent (talk) 18:02, 24 December 2021 (UTC)
 * Since you have previously characterized the mainstream authorities on gender dysphoria and trans health - including national professional bodies - as "trans affiliated" academia and medical organizations and A narrow, involved and COI (for grants etc) subgroup, without providing any evidence from sources or policy that we should treat them as COI, I don't think my ears are overly sensitive on this matter. If you actually intend to argue that all scientists accepting grants to work on a topic are therefore COI on that area of expertise, that is a high-level policy question not to be answered on this Talk page, as it would not apply only to research in this field.
 * There is no SYNTH in accepting Turban's plain statement that ROGD is fringe, as a statement that ROGD is fringe. I'm not sure what you think you are arguing against, there.
 * Finally re: Dr Turban is about as interested or uninterested as Abigail Shrier is on ROGD matters - this seems like ridiculous BOTHSIDESism to me. One is a qualified professional in the field; the other is, at best, a journalist. And, just to be clear, no evidence has been presented in this discussion supporting the idea that there are two sides on ROGD within the professional community. No MEDRS whatever has lined up on the "side" of the Littman study and ROGD as a valid hypothesis. Newimpartial (talk) 18:28, 24 December 2021 (UTC)
 * You've made the point about peak bodies on transgender health having vested interests, or being biased several times. For one, it's incorrect, the Australian Psychological Society and American Psychological Association have made concrete statements refuting the theory, ditto with Florence Ashley, who went through independent peer review. It's also nonsense. We don't dismiss the statements of peak climate change bodies out of hand because they are "affiliated" with climate change research, and transgender health is no different. Bravetheif (talk) 15:29, 26 December 2021 (UTC)
 * I'm inclined to agree with @Shibbolethink, if the answer to question 1 is "yes" (which there appears to be consensus on accepting), then the answer to question 2 is also yes. That's not to say I'm not open to suggestions, I just believe that "fringe" summarizes both the lack of empirical evidence and mainstream recognition fairly eloquently. Bravetheif (talk) 13:52, 25 December 2021 (UTC)


 * There does not need to be a community consensus about whether something is WP:FRINGE. The guidelines in fringe derive from WP:N, WP:V, WP:NPOV, and WP:NOT, which are always in effect. Separate guidelines are not activated by declaring something to be fringe. Sennalen (talk) 20:59, 29 December 2021 (UTC)

"Peer reviewed clinical trial", Bauer et al 2021
Opening a section to address the ~15 comments on this page citing the recent paper by Bauer et al (top item in the reflist) as a "clinical trial" supposedly refuting ROGD. Representative example:
 * "... peer reviewed clinical trial .... That study is the most comprehensive to date and, reading through it I fail to find any methodological flaws (unlike Litman's original paper). If you think it is untrustworthy, please provide actual evidence, rather than conjecture."

The paper is short and easy to read, so this is not at all a difficult challenge. There's very little content in the paper except methodological flaws; its sole purpose is to test ROGD but every analysis either is consistent with ROGD, mildly supports ROGD, or is irrelevant to ROGD.

The premise of the study is the authors' idea that if ROGD is true then, because Littman's paper (and Shrier's book) associated ROGD with elevated rates of mental illness, parent conflict, depression, and other traits, then the theory predicts that those rates should be higher in transgender adolescents with recent onset of "gender knowledge" than in adolescents with earlier knowledge of transgender identity. The most basic problem with the study is that this is not what ROGD would predict. Many of the same sorts of mental health problems were known to be common in "classical" (pre 2010) GD cases, so the correct prediction would be high rates of those traits in both the recent and early onset groups but no implication as to which group has more than the other. An exception might be some specific conditions highlighted by Littman as unusual features of ROGD, such as autistic spectrum disorders, but the Bauer et al clinical study does not examine those and looks only at differences on some relatively general items, as well as suicide attempts which are a high risk in all categories of GD whether "rapid onset" or not.

If one accepts the faulty prediction and does the analysis anyway, the study design is wrong for the purpose and basically turns the data into random noise, which is then reported as a null result.

1. ROGD is predominantly about explaining unusual recent patterns in adolescent TG in natal females, but Bauer et al don't test that population directly, they mix together boys and girls (to use their term), whose distribution of birth sex assignments is not given, into one sample of "trans youth". This introduces noise into the analysis and can undo or reverse whatever patterns may be there.

2. Only 25 or so of these trans boys and girls had "recent gender knowledge", i.e., attained within the past year or less. The authors say that allowing the past 2 years (doubling the number of "recent" TGs) arrives at similar results, which they oddly did not include in the article. But there is a more basic problem, that this definition of "recent" is wrong for their sampling method, in a way that sabotages the analysis:

3. The authors got their sample by surveying 173 adolescents at the time when first referred to a clinic for hormone treatment. If "recent gender knowledge" is defined by counting backward from the referral to when gender knowledge appeared, that wipes out whatever signal is in the data, because there is no reason to expect the progression from gender knowledge to appearing at a clinic to be much faster or slower in ROGD cases compared to the rest. Surveying people at the same point in the process tends to equalize (or make closer to equal) all of their traits including time elapsed since Gender Knowledge was acquired, conflict with parents, mental health etc. Again the signal they want to detect is made smaller and noisier.

4. A better proxy for Rapid Onset, i.e., the ROGD subset of interest, is age at which gender knowledge appeared, which the authors had in their data (by subtracting years of gender knowledge from age at time of referral). Instead, they used age as a control when trying to detect the influence of recency of knowledge on the examined outcomes. Controlling for something that correlates with the thing you should have been testing is another way to suck out whatever signal might have been there, further destroying the analysis.

5. Because they used the wrong proxy for Rapid Onset, the effect is to scramble the ROGD and non ROGD groups, yet again diluting the signal.

If despite this one continues anyway with the multiply sabotaged analysis, then taking the authors' regression results at face value, what they found is that mental health is generally a little better for the ROGD group (as they wrongly defined it) and other traits are about the same. Which is to say that mental health was troubled in both groups, as ROGD theory would predict; and that the groups might be distinguishable statistically, supporting the ROGD idea that there is some difference in the origin of the two populations. But personally I would be wary of treating the results as anything but noise from all the modeling errors.

Finally, about the WP:PUFF language used in the comments promoting this paper, the study isn't remotely a "clinical trial". There is no control arm, preregistration, treatment, randomization or other defining feature of a real medical trial. Calling it a "peer reviewed clinical trial" presents it as a gold standard refutation when there is no refutation at all and everything is made from tin foil held together by bits of string. Sesquivalent (talk) 22:44, 15 January 2022 (UTC)


 * Your analysis of the study is 800+ words of, and thus irrelevant to editorial discussions on WP. Note that this talk page is for discussion of editor's personal thoughts and feelings about ROGD. The Journal of Pediatrics is certainly a reliable source. You're correct that this study does not technically fit the definition of a clinical trial, but the editors citing it are correct that this paper is the only analysis of clinical data testing Littman's hypotheses, and it is published in a highly reputable peer-reviewed journal.  Sr ey Sr os talk 00:00, 16 January 2022 (UTC)
 * Determining due weight of sources, especially as part of a FRINGE RfC that examines the literature, necessarily involves editors' competing assessments and "talk page OR and SYNTH" which is a different animal from "article OR and SYNTH". What I provided are not particularly "editor's thoughts and feelings", they are assertions about the content and mathematics in the paper that anyone qualified can verify by looking at the article. Nobody has to take my word for anything, which is a lot better than what can be said for most of the argumentation in this RfC.   This is a 2 month old study; if this month it is used to conclude ROGD is FRINGE, but next month another study knocks it down with the same reasons that I provided, I suspect you or those agreeing with you will not be so inclined to reopen the case, and words like "relitigation" will appear on the talk page should it be broached. Academic RECENTISM that rushes to embrace a personally preferred source without addressing the actual merit of the study, when easily verified problems have been identified, is at odds with the purpose of the RfC, of getting a reasonable stable decision. Sesquivalent (talk) 01:01, 16 January 2022 (UTC)
 * In a choice between the analysis of a peer-reviewed study by the best-qualified currently active research team in Canada, and the opinion of a Wikipedia editor, WP policy leaves us no choice but to follow the peer-reviewed analysis. The study in question may not be perfect, but it is ''much, much better than the Littman study that "launched" ROGD, so it is more than sufficient for the purposes of present discussion.
 * Anyway, the supposed "methodological issues" identified by Sesquivalent say much more about their own POV than they do about the Bauer et al. study. Newimpartial (talk) 00:10, 16 January 2022 (UTC)