Talk:Sex differences in medicine/Archive 2

Should this article also be about gender?
Right now, the title of this article is "Sex differences in medicine." But then we cite a great many articles which investigate gender differences in medicine. This is not a rename proposal, but simply opening the door to this discussion. Maybe a rename is in order (e.g. "Sex and gender differences in medicine") or a pruning of gender-related content from this article, except where WP:DUE. We should not use studies which are about gender differences when discussing sex differences, and vice versa. There are many impacts of the societocultural and political aspects of gender on health. But they are distinct from the differences caused by anatomy and genetics.

Wherever possible, researchers often attempt to examine the smallest scope of a question, to get the most accurate answer. Usually, that means excluding trans people and other gender-nonconforming individuals from studies, and stratifying individuals by age and income and race, to avoid the effects these have on health conditions. Unfortunate, and a systemic barrier to improving the health of these atypical individuals, but it is an undeniable fact. It doesn't mean we need to ignore studies which include these individuals, it just means we need to talk about them separately, and in a WP:DUE manner. — Shibboleth ink  (♔ ♕) 14:29, 21 December 2021 (UTC)
 * Some sex differences in outcome are a result of societal factors (i.e. "gender"). Just because they are not the exact same thing does not mean they are separable like that. There is a greater than 99% overlap in the population between sex and gender. Crossroads -talk- 14:38, 21 December 2021 (UTC)
 * "Some sex differences in outcome are a result of societal factors (i.e. "gender")." This statement confuses me. Just because we cannot precisely measure the contribution of societal factors to separate them completely from chromosomal, anatomical, genetic differences, does not mean that we do not discuss them as distinct entities. "sex differences" in outcome are intended to be entirely separate from gender differences. Not measuring them precisely does not mean that the definitions and terms are interchangeable, and it does not mean that we should pretend they are the same.E.g. We still study "ethnicity" as separate from "race." And these have different articles on wikipedia. — Shibboleth ink  (♔ ♕) 14:41, 21 December 2021 (UTC)
 * While I agree with Crossroads' statement above that some (measured) sex differences result from (causal) gender factors, I also agree that pretending they are the same is not the way to go. Which is why I believe that careful, contextual reading of sources is required, rather than dogmatic assertions of the form "this is what MEDRS always mean by" male/sex/women/gender. Newimpartial (talk) 14:47, 21 December 2021 (UTC)
 * Yes, I would say we should not include studies of gender and pretend they are about sex, and vice versa. That would be an unfortunate and ill-advised consequence of choices A and B in my RfC above, if we did not remove many citations/sentences from this article. So I would say probably not a good plan.A better plan would be to separate these things into different sections in ONE article, such that we are discussing sex and gender differences separately, with their appropriate sources. — Shibboleth ink  (♔ ♕) 14:50, 21 December 2021 (UTC)
 * Well, this comment confuses me. I doubt you'd dispute that there are numerous sources about differences in outcomes between males and females, and that many such sources investigate and express uncertainty whether those differences arise from physiological differences, social effects, or both interacting in a complex manner. Something like that can't be split into sex and gender. Crossroads -talk- 14:52, 21 December 2021 (UTC)
 * Something like that can't be split into sex and gender. This is a misunderstanding of what those statements are saying. That we cannot easily separate such effects, does not mean that we do not study them with the intention of isolating physiological effects. We do. All the time. We isolate wherever possible, but cannot remove entirely the possibility that societal effects are present. Such a statement would be analogous to saying to that mouse research and cell culture studies are meaningless and have contributed nothing to the field of medicine... — Shibboleth ink  (♔ ♕) 14:55, 21 December 2021 (UTC)
 * I agree with Crossroads here (except for the "greater than 99% overlap" statement, which seems to me to be a red herring, or perhaps a dead cat). Newimpartial (talk) 14:47, 21 December 2021 (UTC)
 * Crossroads, you say here "Just because they are not the exact same thing does not mean they are separable like that". But we spend a great deal of time attempting to figure out which is which in medicine, because it changes the way we try to fix it. It is not so easy to use genetic modification or pharmaceuticals to fix problems introduced by society (psychiatry be damned). But it is quite easy to use such interventions to fix problems of physiology. Such as recognizing the impact of breast feeding post-partum on breast cancer risk (it prevents it), and using pharmaceuticals to reproduce this effect in individuals who cannot breast feed.Is there likely an impact of being able to breast feed on cancer risk, psychologically? culturally? sociopolitically? Yeah, sure. It probably makes you happy and feel better. Reduces stress, etc. But when we examine such effects in cell culture "organoid" models or in breastfeeding mice that do not live in groups, we are attempting to insulate the study from such effects and ignore whatever "leaks through" temporarily. The same is true of human studies which stratify by economic class, race, geographic region, age. And which exclude trans men (and any intersex individuals, as much as possible) from the study population. It isn't maleficent, and it isn't a political statement. It's good science. And it deserves to be discussed separately from studies which are studying the overall effect of gender on health. — Shibboleth ink  (♔ ♕) 14:58, 21 December 2021 (UTC)
 * Suppose we have a review article about "Sex Differences in Schizophrenia". It examines both biological and cultural factors. It says not one word about trans people. Where are you proposing to classify such an article? Crossroads -talk- 15:17, 21 December 2021 (UTC)
 * I would propose that citations to this article discussing biological differences be placed in a section about sex differences, and citations to this article discussing cultural factors be placed in a section about gender. As we are told to do by professional body statements, which are some of the highest quality MEDRSes. — Shibboleth ink  (♔ ♕) 15:19, 21 December 2021 (UTC)
 * Please answer the question. Where are you proposing to classify material sourced to that article? Crossroads -talk- 15:21, 21 December 2021 (UTC)
 * I think you misunderstood entirely my statement. I answered your question. Where we place such statements depends on what is said and sourced to the article, not on the source itself. As such a review clearly covers both aspects. — Shibboleth ink  (♔ ♕) 15:27, 21 December 2021 (UTC)
 * So even though the source article itself says it is about sex differences, we as editors can just decide they're wrong, and to split their article into separate subjects because that part is not sex differences but gender differences. Never mind that they treat "gender" as directly relevant to sex differences. Crossroads -talk- 15:32, 21 December 2021 (UTC)
 * nope, we are not "deciding they are wrong." Titles are not everything. see WP:HEADLINE for example. Often titles are imprecise. We have plenty of high quality MEDRS sources which are telling us to separate discussions of biology from discussions of society. That the entire field is not actually doing that yet is a sad consequence of the way science progresses. But as an encyclopedia, we are beholden to figure out lots of contradictory things. I'm not proposing original research, I'm proposing we use the highest quality sources to determine how we talk about all other sources. — Shibboleth ink  (♔ ♕) 15:36, 21 December 2021 (UTC)
 * I never said it was just the title framing it that way. Sources about how to write other academic articles - of which there are many which contradict each other - do not apply on Wikipedia. This is because we are not writing research here, we are summarizing secondary research by the experts in the field. They decide how to define what counts as sex differences. Crossroads -talk- 15:44, 21 December 2021 (UTC)


 * The AMA style guide and National Academy of Medicine report are not just about how to write academic articles. They are about how these terms should be discussed in all scientific/medical contexts. See below:
 * This explainer discusses how the AMA style guide has grown from originally just for editors/authors, to now for many different contexts, all about how to discuss/write about science: Each chapter has been extensively revised and updated to reflect best practices and developments in scientific research, writing, and publishing, with numerous new examples, updated references, and for the first time, full-color graphics.
 * The preface to that National Academies of Science and Medicine report says this: This committee was charged with evaluating the current scientific understanding of the answers to these questions with respect to their influence on human health Specifically, the committee was charged with considering biology at the cellular, developmental, organ, organismal, and behavioral levels. The goal, as in all studies of biology, is to understand the organism in terms of all of the interactions that occur between levels within the organism as well as the mutual interactions between the organism and its environment. This was a broad charge, which required a committee made up of individuals drawn from a wide range of subfields of biology and medicine.
 * It is a large group of experts who write these professional guidelines and vote on their acceptance, versus individual experts who write these reviews. That's why MEDASSESS places these guidelines so highly in its "hierarchy of evidence."'' — Shibboleth ink  (♔ ♕) 15:55, 21 December 2021 (UTC)
 * Again, Wikipedia is not bound by these style guides because we do not produce WP:Original research. We follow what other sources say. And it is WP:SYNTH to take general guides and use them to overrule sources by specialists on specific topics like, say, schizophrenia. There are numerous sources about sex differences that express uncertainty about and explore whether "gender" (social factors) are driving those sex differences. Because gender is highly linked with one's sex for the vast majority of people, it is not the case that one can write as though it is some completely separate thing which has nothing to do with sex. Crossroads -talk- 19:31, 21 December 2021 (UTC)
 * No one is saying we should write as though it is some completely separate thing which has nothing to do with sex. I am advocating for this page to be less confusing by not putting hyper-focused biological sex based research about "males" directly next to not controlled, not stratified, not strictly criteria-bound research studies about "men." We can describe the exact discrepancy, there are reviews about how difficult it is to control this research. We can go into detail about the distinction and when it matters and when it likely doesn't. But ignoring the difference isn't just bad science. It's bad wiki-ing.Are you advocating for this page to make no distinction between "men" and "males" ? Only the AMA is a style guide. The NAM statement is a policy statement for professionals, researchers, physicians, for how to understand and describe these issues. Look at the author list. It's essentially all experts in this field. — Shibboleth ink  (♔ ♕) 19:44, 21 December 2021 (UTC)
 * No one is saying we should write as though it is some completely separate thing which has nothing to do with sex. I am advocating for this page to be less confusing by not putting hyper-focused biological sex based research about "males" directly next to not controlled, not stratified, not strictly criteria-bound research studies about "men." We can describe the exact discrepancy, there are reviews about how difficult it is to control this research. We can go into detail about the distinction and when it matters and when it likely doesn't. But ignoring the difference isn't just bad science. It's bad wiki-ing.Are you advocating for this page to make no distinction between "men" and "males" ? Only the AMA is a style guide. The NAM statement is a policy statement for professionals, researchers, physicians, for how to understand and describe these issues. Look at the author list. It's essentially all experts in this field. — Shibboleth ink  (♔ ♕) 19:44, 21 December 2021 (UTC)

Shibboleth, you are literally asking Crossroads to evaluate a source based on the authority of its authors/authorizing body, rather than the position it takes in a dispute. That would violate the first rule of WP:BATTLEGROUND. Newimpartial (talk) 19:49, 21 December 2021 (UTC)
 * Shibboleth, you are literally asking Crossroads to evaluate a source based on the authority of its authors/authorizing body, rather than the position it takes in a dispute What you've just described is fundamentally how WP:MEDRS works. Trust the scientific consensus, as gleaned from professional body statements, govt bodies, etc. See WP:MEDSCI. Judging a source by whether or not it agrees with your view rather than how reliable it is, is exactly not what is encouraged per WP:NPOV. — Shibboleth ink  (♔ ♕) 19:53, 21 December 2021 (UTC)
 * Ignoring that. Shibbolethink, the very National Academies source you keep pointing to - which I agree is an excellent source - uses "men" and "males" interchangably. Regardless of intention, if you completely detach content about differences derived from social perception/life as a particular sex ("gender") from that which derives directly from sex-related biology, the effect is to make it seem like there is no link there. Crossroads -talk- 19:56, 21 December 2021 (UTC)
 * do as I say, not as I do. I would tell you that trying to calculate out how often a source uses "men" vs "males" and structure our articles the same way is, in essence, WP:OR. Rather than doing what the source says is the consensus of how these things should be framed. besides, different parts of this statement were likely written by different people. Nowhere does it say "these things should be used interchangeably." Instead it says, past studies used this interchangeably, and it was really confusing. Stop doing that."— Shibboleth ink  (♔ ♕) 19:59, 21 December 2021 (UTC)
 * Where exactly does it say not to use "men" for adult male humans? Where does it say differences in the sexes derived from social factors are not sex differences but gender differences? Quotes please. Crossroads -talk- 20:03, 21 December 2021 (UTC)
 * Page 176 of that report:RECOMMENDATION 7: Clarify use of the terms sex and gender.
 * Researchers should specify in publications their use of the terms sex and gender. To clarify usage and bring some consistency to the literature, the committee recommends the following:
 * • In the study of human subjects, the term sex should be used as a classification, generally as male or female, according to the reproductive organs and functions that derive from the chromosomal complement.
 * • In the study of human subjects, the term gender should be used to refer to a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation.
 * • In most studies of nonhuman animals the term sex should be used.
 * Page 1: 'The committee defines sex as the classification of living things, generally as male or female according to their reproductive organs and functions assigned by the chromosomal complement, and sender as a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation. Gender is shaped by environment and experience.Also, you said above that this report uses "male/female" and "men/women" interchangeably. Where? I can't find that... In most places, it uses almost exclusively "male/female." I'm not saying it's not there, I just can't find it.Just to add to this, no one is saying "don't use "men" for adult male humans." I am saying don't use "men" when you are referring exclusively and entirely to people born male. Just say "males." — Shibboleth ink  (♔ ♕) 20:08, 21 December 2021 (UTC)
 * That does not support what I asked about. What you are advocating for goes far beyond that. Stuff about use of the specific terms "sex" and "gender" in no way implies that social influence does not affect sexes (only "genders"). The source itself treats social environmental factors as highly relevant to sex differences (see page 3: and 14: ) There is zero justifcation in the source for splitting off "gender" differences from sex differences. Nor does it say we can't use e.g. "women" in reference to sex. They themselves do so sometimes (see pages 120-121: ) as do numerous review articles to this day. The sources do not justify but contradict the sweeping changes you are asking for. Crossroads -talk- 21:25, 21 December 2021 (UTC)


 * Crossroads, we have MEDRS articles pointing out that MEDRS sources do not always use the terms "sex" and "gender" consistently (viz. the fad a few years ago for reporting what were actually sex variables as gender). It isn't WP:OR to read the sources carefully. Newimpartial (talk) 15:50, 21 December 2021 (UTC)
 * I have no intention of editing this article, because my knowledge of medicine is slight, and is skewed towards my own medical history. But I am astonished to hear that breast-feeding prevents cancer (rather than reducing the risk) and that pharmaceuticals are used to ‘reproduce this effect in individuals who cannot breast feed’. I am deliberately childless; no-one has ever offered me such pharmaceuticals. This might have prevented the small case of breast cancer I had some years ago (I’m fine now, thank you). My question is – are you sure you know enough about medicine to edit this article? Sweet6970 (talk) 15:23, 21 December 2021 (UTC)
 * Yes it reduces risk. I apologize if my quick and dirty use of the language was misleading. The mechanism is believed to be via certain hormones which are released during the process of remodeling the breast to mature lactation ducts. The extracellular matrix which organizes cells into a 3D structure in the breast is a barrier to cancer cells moving around, and the process of having a baby reorganizes this tissue. Breastfeeding releases factors which control this maturation process and organize this extracellular matrix. That being said, it's also even worse risk-wise to have a baby, and then not breast feed, than it is to never have a child at all. Most of these studies are about women who have had children in the first place. It's complicated and there's still a lot to figure out about this. I'm sorry to hear you had a breast cancer diagnosis, and I'm glad to hear you're doing okay. The pharmaceuticals I mentioned are still investigational, and are not FDA approved. They are a part of small scale clinical trials, most are phase I. — Shibboleth ink  (♔ ♕) 15:24, 21 December 2021 (UTC)
 * Hi, I would encourage you to visit my user profile page and ask yourself again, "does this user know enough about medicine to edit this article." Thanks. Besides, prior medical knowledge is not a prerequisite to editing around here. — Shibboleth ink  (♔ ♕) 15:25, 21 December 2021 (UTC)
 * Apologies to all for oversharing my medical history – I thought I had deleted that sentence before I pressed ‘Publish’. Sweet6970 (talk) 16:08, 21 December 2021 (UTC)

Perhaps the article needs to be split into two articles. Gender differences in medicine & the other Sex differences in medicine. GoodDay (talk) 15:54, 21 December 2021 (UTC)
 * Yes I would agree with this. either split into two articles (the more onerous choice) or just split into multiple sections (my preferred solution, as it requires less work). Plus, these are very related things, as already described above. Extremely related things often belong in the same article. — Shibboleth ink  (♔ ♕) 15:57, 21 December 2021 (UTC)
 * My view is that restructuring the article could simplify the terminological issues; it might even be worth working on that aspect of the article before a future terminology RfC, since the pain points may appear in different places after doing this work. Newimpartial (talk) 16:01, 21 December 2021 (UTC)


 * Honestly I’m not sure making a separate articles would be ideal to be honest. Mean isn’t gender a sociological thing and varies from culture?
 * Like I’m aware that there are medical sources out there on medical differences for age or body type. But, I don’t see medical sources for things like religion, political, or nationality differences in medicine.CycoMa1 (talk) 20:37, 21 December 2021 (UTC)
 * Well, there are MEDRS sources about cultural determinants like smoking, but I think the main point raised here is gender in relation to trans and nonbinary health. Newimpartial (talk) 20:42, 21 December 2021 (UTC)
 * I actually agree that two separate articles is a bad idea. But I would also tell you we have the articles: Jehovah's Witnesses and blood transfusions and Traditional Chinese medicine and Medicine in China. But your point overall is well taken. I think separating them into two articles would indeed be a bad idea. — Shibboleth ink  (♔ ♕) 20:42, 21 December 2021 (UTC)


 * I am aware that culture can affect health. Like there are certain religions that are against certain medical practices. But, medical differences in that area exist due to what certain individuals believe in or consider taboo.


 * Medial differences in things like age are a result of a person’s body. Like elderly people have a higher chance of dying from diseases like the flu because when you get older your immune system becomes weaker.
 * That’s the same case for sex differences in medicine. There are many medical sources out there that say the reason women live longer than men is due to things like hormones or genetics.(There is some culture to it as well. But, a lot do mention genetics and hormones are involved.)CycoMa1 (talk) 21:01, 21 December 2021 (UTC)


 * also with regards to health in trans and non-binary people. Maybe we could make an article on health for trans and non-binary people instead. Or a Wikipedia article on health for LGBTQ+ people overall.CycoMa1 (talk) 21:05, 21 December 2021 (UTC)


 * Or medical differences in LGBTQ+ individuals or medical differences in trans people could be a good idea. I just realized there are already articles on health for Lgbt people.CycoMa1 (talk) 21:07, 21 December 2021 (UTC)
 * Short answer to original question: no. We need stop muddying the water with off-topic gender stuff, and put that in some other article where it belongs.  — SMcCandlish ☏ ¢ 😼  22:30, 21 December 2021 (UTC)
 * So would you support removing any content pertaining to gender differences in medicine? — Shibboleth ink  (♔ ♕) 23:43, 21 December 2021 (UTC)
 * Stuff about separate gender identities within a sex is off-topic here. Material about differences between those genders which correlate strongly with the sexes is on-topic, because sources on sex differences treat those "gender differences" as part of this topic. Crossroads -talk- 05:22, 22 December 2021 (UTC)
 * Right.  — SMcCandlish ☏ ¢ 😼  17:25, 22 December 2021 (UTC)
 * Stuff about separate gender identities within a sex is off-topic here - surely the validity of this statement depends on what the RS on this topic actually say, rather than one editor's opinion? Newimpartial (talk) 17:35, 22 December 2021 (UTC)


 * If the question is should the article "Sex differences in medicine" be retitled "Sex and gender differences in medicine" -- my response is No. It's unfortunate that sex and gender have been conflated and that gender is more often than not used when referring to sex, but the two are not the same, and confusion has been the result.  Adhere to science and let the article continue to be known by its established title.  Pyxis Solitary   (yak) . L not Q. 08:45, 22 December 2021 (UTC)
 * Would you support removing gender-based terminology from this article? — Shibboleth ink  (♔ ♕) 15:16, 22 December 2021 (UTC)
 * All these years, I had always thought 'sex' (not the act) & 'gender' were the exact same thing. Now (in 2021), I've been informed otherwise. GoodDay (talk) 17:03, 22 December 2021 (UTC)
 * I think you're a bit behind the curve on that. Anyway, the situation is complex, and "gender" has multiple meanings, which include "sex", and "socially constructed gender identity" (most of what this continual disputation is about), and "gendered noun or verb class" (in linguistics), among several other definitions. See Gender (disambiguation).  — SMcCandlish ☏ ¢ 😼  17:24, 22 December 2021 (UTC)
 * Rather than have me do the explaining (because it will be cut-and-dry), the following might provide a better result: . Pyxis Solitary   (yak) . L not Q. 10:06, 23 December 2021 (UTC)
 * Behind the curve indeed. Gotta be a generational thing. Or as the Monkees sang "That was then, this is now". GoodDay (talk) 17:45, 22 December 2021 (UTC)

Straw poll: Should Klinefelters syndrome be included as an example of a male-specific disease?

 * Support as proposer. Klinefelters is the most common sex chromosome aneuploidy, associated with infertility and high quality MEDRS describes it in explicit words as "Klinefelter syndrome and the subsequent infertility phenotype caused by it are specific to males." A female *cannot* suffer from Klinefelters. There is a mountain of MEDRS that uses "XXY males", "Kleinfelter males" and "Klinefelter men". High quality sources always describe prevalence out of the male population. Despite what is claimed outside of MEDRS, you don't often find the term "intersex" inside MEDRS on KS. This is, in my mind, an entirely uncontroversial addition under the male list. Maneesh (talk) 23:53, 22 December 2021 (UTC)
 * Support - Go for it. GoodDay (talk) 01:28, 23 December 2021 (UTC)
 * Support. Agree entirely with Maneesh on this.  — SMcCandlish ☏ ¢ 😼  23:59, 23 December 2021 (UTC)
 * Support putting klinefelter's under males. It's predominantly a male-specific disease. No comment on the rest of this. — Shibboleth ink  (♔ ♕) 00:06, 24 December 2021 (UTC)

How should the Klinefelter's entry in the list read?
Clarifying edit summary where I reverted back to the changes I made: " but needs to clearly state sex *specificity* (not merely that it is "predominantly" "male specific"), too details many on the condition are unwarranted since it can be clinically silent). Maneesh (talk) 04:29, 24 December 2021 (UTC)
 * Just to confirm that it is easy to find sources that state it can asymptomatic (they mean modulo infertility). Maneesh (talk) 04:34, 24 December 2021 (UTC)
 * You can also see that details on each disease in the lists in this article are quite sparse, that is appropriate as the articles can describe things like prevalence etc. Maneesh (talk) 04:38, 24 December 2021 (UTC)
 * Maneesh, you cannot decide a source is not suitable because it does not fit YOUR definition of what is needed to be accurate. We go off of the sources, not off of our opinions. We accurately summarize what the best available most recent sources say, per WP:PAG. The text I introduced makes it clear that the prevalence is only in males, and it does so exactly in the way the source does it. I am using the source's language, in a way that is not plagiarism, that is also a fair summary. This is wholly within the policies and guidelines. You also cannot revert an edit because in the past you have disagreed with what the editor said (me). To quote: edits add new source without quote to make it clear that this condition is specific to males, edits were performed by editor who claimed that klinefelter males were not really males. happy for a more recent source, but needs to clearly state sex *specificity* (not "prevalence"), too many on the condition are unwarranted since it can be clinically silent I never said what you've put in here. — Shibboleth ink  (♔ ♕) 04:45, 24 December 2021 (UTC)
 * Sex specificity is key here, exactly what this straw poll is about. You didn't even include a quote the way I did to support that point. Copied from my talk page: My quote in edit summary: klinefelter males were not really males your quote cut and pasted from talk page: Klinefelter "males" are not strictly "males" for the sake of academic study. Your right in that it is not an exact quote, it was not intended to be I was paraphrasing and did not use quotation marks. I do not see a meaningful difference between my edit summary paraphrasing and your exact quote. Maneesh (talk) 04:55, 24 December 2021 (UTC)
 * "are not strictly "males" for the sake of academic study" is different from "Klinefelter males are not really males" " not strictly " in this context means "not just" or "they are this, but also other things" — Shibboleth ink  (♔ ♕) 04:57, 24 December 2021 (UTC)
 * as to clinical "silence", we should simply incorporate that into the entry. When you find an edit you disagree with, but the source is a quality source, you should not remove the source. You should incorporate whatever you want into it to make it complete. collaborate to build an encyclopedia. WP:DONOTREVERT good changes. — Shibboleth ink  (♔ ♕) 05:03, 24 December 2021 (UTC)
 * Ah so you've always agreed that Klinefelter males are males then (please make this very clear in your reply)? If that's the case this has been nothing more than (I think) very understandable misinterpretation of your use of "strictly". I am curious as to why you never clarified that above when I was responding so emphatically with google scholar queries and quoting that very same quote from you. Please do address the other points (specific quote, and sparse summary). Maneesh (talk) 05:05, 24 December 2021 (UTC)
 * This hyper-focus on dispute and winning is not constructive: Ah so you've always agreed that Klinefelter males are males then (please make this very clear in your reply)?... I am curious as to why you never clarified that above. Additionally, I believe it is called griefing . I'm not interested in arguing beliefs. We've gone through this, and such discourse has not been productive. This talk page is not about arguing beliefs. I'm interested in discussions about this article and how we're going to word it with the WP:BESTSOURCES. — Shibboleth ink  (♔ ♕) 05:06, 24 December 2021 (UTC)
 * When you're ready to edit collaboratively, here's a draft: Klinefelter syndrome (karyotype XXY) is the most common sex chromosome aneuploidy (occurring in ~152/100,000 births, in males). It is often subclinical, but can causes infertility, tall stature, gynecomastia (enlargement of the breast tissue), limited facial and body hair, and small firm testicles. — Shibboleth ink  (♔ ♕) 05:10, 24 December 2021 (UTC)
 * Compare all the details you have (and the fact that it can be clinically silent) with all the other lines. E.g., Is any other disease listed with a prevalence? Might that be too specific to do here and tricky given all the caveats that come with prevalence estimates that are better left to the article on the condition? Maneesh (talk) 05:16, 24 December 2021 (UTC)
 * Sign your posts. These features are WP:DUE, as they address the sexually dimorphic traits that Klinefelter's alters. They are precisely part of why it is notable that Klinefelter's is sex-specific. That other entries do not have it does not matter. The project is never done. If those other diseases have features that are notably distinct in their sex phenotype alterations, they should also be listed. As the single most notable facts about Klinefelter's, they are WP:DUE in almost any mention of the disease. Indeed, your recently added entry about Turner Syndrome includes clinical features (heart defects). —  Shibboleth ink  (♔ ♕) 05:17, 24 December 2021 (UTC)
 * If you look at the history of the page I believe I signed it before you made your comment. There is a clear (and appropriate) style present in those lists, I am just adhering to it, your edit does not. The pathological aspect focuses on infertility, the other symptoms aren't necessarily pathological (small testes etc.). There are too many diseases to list here, better to have a short summary and leave details (which are often difficult to explain) to underlying article. If you keep wanting to open up straw polls on fairly obvious writing issues, feel free to. You keep materially editing your posts without strikeout. I've seen you do it before, but it is really annoying now (it isn't clear if you are accusing me of trolling or not now). You aren't being clear if you agree that Klinefelter males are males. That's why my line has a cite with a quote about the condition being specific in males. That's key to understanding why your edit is not an improvement. Maneesh (talk) 05:33, 24 December 2021 (UTC)
 * In fact, looking at the lists again, they only describe relative sex ratios and next to no details on each disease, so the KS line should only say it is specific to males. Maneesh (talk) 05:40, 24 December 2021 (UTC)
 * the other symptoms aren't necessarily pathological (small testes etc.) microorchidism is absolutely pathological. — Shibboleth ink  (♔ ♕) 05:40, 24 December 2021 (UTC)
 * You keep materially editing your posts without strikeout Editing your posts is absolutely permissible (generally up until someone replies, and then after that only for style and typos). There is actually a PAG on this: WP:TALK. From now on, address issues of editor behavior on my talk page, not on article talk pages. Such discussion is off topic here, no matter how much either of us engage in it. — Shibboleth ink  (♔ ♕) 05:40, 24 December 2021 (UTC)
 * You had an accusation of trolling in there, that isn't a "'correct mistakes, add links or otherwise improve them". In any case, where did you use ""microorchidism" in your proposed edit? My testes may be small and firm right now, that does not necessarily indicate pathology. If you want to *change the convention of each disease entry on this page* go ahead and propose it. I think it should be concise and focused on sex ratios; too many details better left to underlying pages. Maneesh (talk) 05:48, 24 December 2021 (UTC)
 * You aren't being clear if you agree that Klinefelter males are males. That's why my line has a cite with a quote about the condition being specific in males. That's key to understanding why your edit is not an improvement. We don't write wikipedia articles to win arguments with other editors. That isn't what "improvement" means. My edits include the fact that klinefelter's is present in males. The point of my discussion with you is that you should be editing this draft in a way we BOTH find agreeable. Not unilaterally reverting content. — Shibboleth ink  (♔ ♕) 05:49, 24 December 2021 (UTC)
 * @Maneesh If you want to edit the draft to say " only in males", be my guest. That's why I called it a draft. Or " specific to males." however you want to say it. let's collaboratively edit the page together. That means neither of us gets 100% of what we want. We compromise to build CONSENSUS. Right now, I need to go to sleep. — Shibboleth ink  (♔ ♕) 05:51, 24 December 2021 (UTC)
 * If you want to keep casting my critical assessment of your edits this way, I don't think you'll get very far. Why don't you go ahead and put up another straw poll here with your version, I'll shorten my KS line in the article now. This is a very clear case of adhering to a sensible style in the article. Maneesh (talk) 05:55, 24 December 2021 (UTC)
 * I have no interest in putting up a straw poll at this time. As you said, we should not put up every small matter to a straw poll, it's onerous and unnecessary. I'll wait and see if a consensus forms in any particular direction. If not, we can revisit this matter with WP:dispute resolution. — Shibboleth ink  (♔ ♕) 14:32, 24 December 2021 (UTC)
 * I support the draft as proposed by . We definitely do not need a straw poll, or RfC, or some other heavy handed bureaucracy for every single small change proposed to the article. It is tiring and tendentious. Sideswipe9th (talk) 23:56, 24 December 2021 (UTC)
 * I support the draft as proposed by . We definitely do not need a straw poll, or RfC, or some other heavy handed bureaucracy for every single small change proposed to the article. It is tiring and tendentious. Sideswipe9th (talk) 23:56, 24 December 2021 (UTC)

I'm going to preregister my belief for Shibbolethink's straw poll of our two versions for the KS line. My line: Klinefelter syndrome is specific to males. with the appropriate cite, is concise and (while it may not be perfect) matches the style of the existing lines for each disease in the current section. There is clearly an implicit consensus in those sections that each disease should just be mentioned with few details only focusing on relative sex prevalence. The current lines rely on the underlying wp article for details (makes a lot of sense since details can be very tricky in this area and need to be made uniform across disease and maintained). I believe my line is clearly *currently* (I can see this whole article changing very significantly in the future) preferable over Shibbolethink's draft which has many more details in it, making it stick out like a sore thumb amongst all the other diseases. Maybe I am wrong. Maybe consensus will show me that my inference that the line should be concise and focused is just bonkers. If the consensus shows that Shibbolethink's line is preferable I will happily stop and reflect on my contribution abilities, and generally defer to Shibbolethink for any related edits since my prediction about the consensus preferred edit was so wrong. Maneesh (talk) 09:17, 24 December 2021 (UTC)

Background section
I have introduced a background section that should eventually be used to replace the severe deficiencies in the lead. All of the high quality, broadest sources on sex differences in medicine use "women" and "men" to communicate clearly and most accessibly, the first para should do the same. An explicit sentence about mapping women and men to females and males can be made at the end to keep language consistent. Maneesh (talk) 23:09, 23 December 2021 (UTC)
 * This edit is explicitly bad grammar and bends over backwards to use the title in its opening sentence, which is explicitly opposed by WP:BOLDTITLE. This sentence makes no sense: Sex the differences in medicine describes the differences between women and men in terms of their disease risk, diagnosis and response to treatment.Compare to my version: Females and males exhibit many differences in terms of risk of developing disease, receiving an accurate diagnosis, and responding to treatments.MOS tells us to A) avoid redundancy, B) don't bend over backwards to restate titles, and C) use consistent grammatical tense. —  Shibboleth ink  (♔ ♕) 23:38, 23 December 2021 (UTC)
 * There is a clear typo in there that is an easy fix (which I've applied). Where do you get "explicitly opposed" from? WP:BOLDTITLE says "If an article's title is a formal or widely accepted name for the subject, display it in bold as early as possible in the first sentence...". You must mean MOS:BOLDAVOID, which is conditional on "If the article's title does not lend itself to being used easily...", the title is easy to use even if it takes a few typo corrections etc. Maneesh (talk) 23:46, 23 December 2021 (UTC)
 * First of all, this is not the first sentence of the article, so there is no importance to using the title whatsoever. Second, using it requires a repetition of "differences" which is bad style (see the MOS entry in the linked BOLDAVOID on redundancy). Third, explaining the background of a sex differences article with "Sex differences are differences..." is unnecessarily simplistic. This is not Simple English Wikipedia . We do not need to explain which differences are being discussed when that is already adequately explained in the lead. — Shibboleth ink  (♔ ♕) 23:50, 23 December 2021 (UTC)
 * *You* are the one who cited WP:BOLDTITLE! You can see the lead is already unsourced with "sex-related disease" as is the body of the text (this problem is unaddressed by you in the earlier talk section), clear evidence that we need to be precise about what is meant by the term "sex differences in medicine". My sentence can almost surely be improved, but we should define that phrase clearly to avoid unsourced and unconventional (incorrect in my eyes) terms like "sex-related". Maneesh (talk) 23:58, 23 December 2021 (UTC)
 * I have no opinion on "sex-related disease" as a wording. — Shibboleth ink  (♔ ♕) 00:02, 24 December 2021 (UTC)
 * It is unsourced, search for the term in the cite. Maneesh (talk) 00:21, 24 December 2021 (UTC)
 * Again, I have no opinion on whether or not that should be the wording. But I would remind you: that isn't what unsourced means. We should not always use the exact terminology present in our sources, as that would be plagiarism. As well, we should not use the exact terms and formulations in our sources, as that would be too technical for a lay-audience encyclopedia. We should summarize and abbreviate and recombine what is in our sources to be more readable and understandable. — Shibboleth ink  (♔ ♕) 00:43, 24 December 2021 (UTC)
 * The use of 'sex-related disease' is not supported by a source, that's plainly what I mean. The suggestion of plagiarism here is silly. Maneesh (talk) 01:44, 24 December 2021 (UTC)

And now with the edit warring again (despite me opening the talk section here). I'll describe the basic elements that need to be in the background section : Use "sex differences in medicine" (existing text in lede shows how bad things can be messed up by using closely related but incorrect phrases). Open with men and women. Chromosomes + hormones are the key differences between male and female bodies. Male and females exist in differentiated social envs, these also have effects. Figuring out which of these is responsible for the sex difference is generally difficult. Map women/men to females/males, there should be no mealy mouthed discussion about identity, women/men is used throughout MEDRS but this article will only benefit by being consistent, and I don't think anyone is opposed female/male throughout article.Maneesh (talk) 00:21, 24 December 2021 (UTC)
 * It isn't edit warring if many editors believe it should be one way, and you open a talk page section about it. You didn't follow WP:BRD. You reverted my reversion. — Shibboleth ink  (♔ ♕) 00:43, 24 December 2021 (UTC)
 * I am not sure which order things occurred in, but I'll assume I did not follow BRD, but we're here now. Please explain which of these basic ideas you disagree with. At worst we can each craft a bg section and put it up for a YASP. Maneesh (talk) 01:44, 24 December 2021 (UTC)
 * Under BRD, the WP:ONUS is on the editor who is making the proposed changes to show why it is DUE. Sideswipe9th (talk) 23:53, 24 December 2021 (UTC)

The more sources I look at, the more I think that this page should be called "sex differences in disease". That is much more common than "sex differences in medicine" and easily subsumes it. Make the narrative of the Background much more sensible (easier to include "sex specific diseases", which is harder than you think under the current title). Maneesh (talk) 02:19, 24 December 2021 (UTC)
 * A RM is required? GoodDay (talk) 03:49, 24 December 2021 (UTC)
 * I think so. Maneesh (talk) 04:09, 24 December 2021 (UTC)
 * I don't think an article rename is in order. The proposed rename would make the article fit what one editor apparently wants it to be, and not what it currently is. Sideswipe9th (talk) 23:50, 24 December 2021 (UTC)