Talk:Transgender health care

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Ellenberkley, Kim05.rosario, Jhpham, Rxbpherrera. Peer reviewers: Alexuang.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 04:23, 18 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 August 2019 and 7 November 2019. Further details are available on the course page. Student editor(s): Trueradical.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 04:23, 18 January 2022 (UTC)

29 October 2016
Hi everyone! I have updated this redirect page into a child article for the Transgender page. Let me know if you have any comments to make about my work! Brookeenglish (talk) 04:18, 29 October 2016 (UTC)

Peer Review
Hi, I had a few thoughts about how to improve your article. First, I wanted to say that the structure of your article looks really good, and I think it will do great with expansion. As for things to improve upon, I think you could work a little bit on making your article more readable, like explaining concepts before you go into them, or really talking about what some of these medical things are. Also, I felt like your writing could have been a little more neutral. But overall, I'm excited to see where this article goes and how it grows. Good luck! Kmwebber (talk) 17:02, 29 October 2016 (UTC)Kmwebber

Peer Review
Hi! I think this is a great start to the article. I would definitely work on neutrality (be careful how you frame every sentence). Also, I think it would be great if you could talk about transgender people's lack of access to health care in general. Overall, great job! I look forward to seeing where this goes!! Venkam (talk) 19:25, 30 October 2016 (UTC)

Room for expansion
There are a few obvious options for expansion that apply to most articles (e.g., adding information about the state of trans health care in more countries).

I think that the biggest hole might be described as "plain old health care for people who happen to be trans", like problems getting smoking cessation, broken ankles, and irrelevant genital inspections. WhatamIdoing (talk) 02:15, 10 December 2016 (UTC)
 * WAID brings up several good points additionally as I had posted this might be useful in the Hormone replacement therapy subsection as it is a review --Ozzie10aaaa (talk) 21:27, 10 December 2016 (UTC)

Any use?
One of my students from a previous semester put together a version of this article together in their sandbox: User:Brookeenglish/Transgender healthcare. I didn't know if anything could be used in this article, but wanted to link to it here. Shalor (Wiki Ed) (talk) 21:04, 8 January 2018 (UTC)

Source: suicide risk
Here's a source that could be useful for : —Sangdeboeuf (talk) 01:48, 7 February 2019 (UTC)

From User:Carwil
This article feels well-organized and broad-ranging. Here are some suggestions for further improvement: ¡Fuerza! --Carwil (talk) 15:09, 15 April 2019 (UTC)
 * The lead is too short for the article's current length and should not just define the term, but anticipate the main subjects of the article: transition, mental health related to transition and to trauma/discrimination, and care in different health systems.
 * Either geographically or historically, there should be acknowledgement of how health systems have ignored or erased transgender people or constrain(ed) them to not transition.
 * In countries, like the US, where health care is contingent on employment, widespread employment discrimination limits the quality of health care for trans people.
 * In many countries, there have been active private and public initiatives to improve health care for trans* people and these should be mentioned.
 * Some parts of Sexing the Body by Anne Fausto-Sterling may help with the historical background.
 * Some link to reproductive options for transgender people should be included on this page. See also Transgender pregnancy.
 * You might briefly define gender variance when you introduce it.
 * And you might explain why some regard "gender incongruence" diagnoses as positive for trans people. It's primarily bc it designates incongruence as a medical condition and confirms that sex reassignment, hormonal therapy etc. aren't "cosmetic" or "experimental" procedures, right?

UCSF Foundations II Course Wikipedia Project Group 3c
Our group of Doctor of Pharmacy candidates propose the following edits for this article: Feel free to reply with suggestions and feedback. Rxbpherrera (talk) 21:10, 1 August 2019 (UTC)
 * renaming Health Risks into "Issues affecting transgender patients" to include points in caring for transgender patients (particularly for non-endocrinology specialties)
 * experiences and perspectives (including proper and appropriate terminology)
 * keep violence and mental health

Foundations 2 2019, Group 3B Peer Review
Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”?
 * Yes it does, as it helps to give statistics about the health experiences that this group has and can lead to more information being added in the future. -- Brendado425 (talk) 21:29, 5 August 2019 (UTC)


 * Yes, the statistics on issues affecting transgender patients and health experiences can open up discussion for more data to be contributed in the future --Dannymrowr (talk) 21:11, 5 August 2019 (UTC)


 * The group's edits improve the article by adding properly-cited information about health experiences and fixing the headings/organization of the article for easier navigation.--Mparagas18 (talk) 21:25, 5 August 2019 (UTC)


 * Edits improve the structure of the article by adding in a 'Health Experiences' section under 'Issues affecting transgender patients'. Edits are balanced, neutral, and backed up by a secondary source. --Alexuang (talk) 17:01, 6 August 2019 (UTC)

Has the group achieved its overall goals for improvement?
 * The group did rename their Health Risks into "ISsues affecting transgender patients" and they included how a majority of transgender patients feel in health experiences. They haven't edited or added a section about HRT therapeutics.


 * Therapeutics section was not added, but sections were named more appropriately and health experiences section was expanded upon --Dannymrowr (talk) 21:11, 5 August 2019 (UTC)


 * The group achieved their goals of organizing and adding the health experiences section. --Mparagas18 (talk) 21:25, 5 August 2019 (UTC)


 * Proposed goals as of 8/6/19 have been achieved by the edits. -- Alexuang (talk) 17:29, 6 August 2019 (UTC)

Person A: Are edits something something neutrally presented?
 * Yes, information was presented neutrally with no opinions by the editor. --Dannymrowr (talk) 21:11, 5 August 2019 (UTC)

Person B: Are the points included verifiable with cited secondary sources that are freely available? If not, specify…


 * Yes, they are consistent with Heng et al 2018. --Alexuang (talk) 21:31, 5 August 2019 (UTC)

Person C: Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify… Yes, it is. Brendado425 (talk) 20:45, 5 August 2019 (UTC)

Person D: Is there any evidence of plagiarism or copyright violation? If yes, specify...

No, the systematic review Brian added information from was properly cited. Neither direct copying nor close paraphrasing were used in the added section.--Mparagas18 (talk) 21:08, 5 August 2019 (UTC)

Planned addition to section 2.2 Mental Health
Greetings Wikipedians! After reviewing the page, I've gather necessary sources to make an addition to the section regarding mental health. Specifically, these additions will be about the following: I will be drafting and building upon this addition within my sandbox. Those wishing to review my work is invited to visit my sandbox and to engage me within the sandbox's talk page. Currently the talk page is full of sources on the topic at hand, of which I will be narrowing soon. --Trueradical (talk) 01:53, 15 October 2019 (UTC)
 * General mental health quality of the transgender population.
 * Anxiety and Mood Disorders in transgender individuals, (This addition will be an improvement on what's mentioned)
 * Autism Spectrum Disorders and their occurrences in transgender individuals.
 * Eating disorders in transgender individuals.
 * Mental health relative to support received from loved ones.
 * Difficulties and Improvements in psychiatric counseling for transgender individuals.


 * You may want to review WP:MEDRS. I'm not fully familiar with editing health topics myself, but as far as I know, you should prioritize systematic reviews when they exist, prefer indexed journals, avoid journals without peer review, etc. For example, from your list, (Khatchadourian, 2014) has 50 citations and is published on The Journal of Pediatrics which is indexed on JCR, while (Ximena, 2016) has 7 citations and is published on Pediatrics in Review which seems to be unindexed. Folks at WikiProject Medicine might be able to help assessing sources. --MarioGom (talk) 07:34, 15 October 2019 (UTC)


 * Thank you for the advice, ! I've taken note to review WP:MEDRS and to assess my gathered resources accordingly, likely within the next two days. Once I've completed this review of the material, I'll post such on this talk page, in case any other contributors would be interested in checking my work. --Trueradical (talk) 13:39, 15 October 2019 (UTC)


 * I've constructed what I believe to be a good addition to the article. It's over at my sandbox. If anyone would like to read or critique my work, then I invite them to do so, just leave the commentary on my sandbox's talk page and I'll take a gander. Thanks! --Trueradical (talk) 18:07, 23 October 2019 (UTC)


 * After submitting my draft to a few collegues of mine, I've posted my update. I'll still be around for any critiques, so feel free to message me! --Trueradical (talk) 13:08, 24 October 2019 (UTC)

Merge from sex reassignment therapy to transgender health care
Sex reassignment surgery was recently moved to Gender-affirming surgery (as were the MTF and FTM articles), making sex reassignment therapy inconsistent. While this inconsistency could be fixed by moving the article, WanderingWanda suggested that a better outcome would be to merge the article with transgender health care.

Notably transgender health care includes "gender-affirming care" as an "also known as" in bold in its lead and gender-affirming therapy has been a redirect to transgender health care since September 2022. – Scyrme (talk) 15:04, 4 December 2022 (UTC)


 * Support it doesn't look like there's anything that wouldn't belong if these articles were merged. LarstonMarston (talk) 18:24, 4 December 2022 (UTC)
 * Comment Shouldn't the "Transgender health care" article also cover how trans people in general are treated in a medical setting? Isn't there a lot of discrimination even when the issues present are not related to the person's transness?★Trekker (talk) 21:04, 19 December 2022 (UTC)
 * Support: for the reasons stated by Scyrme and LarstonMarston. --Xurizuri (talk) 04:36, 2 January 2023 (UTC)
 * Support. The current situation is confusing, and there is too much overlap. Hist9600 (talk) 02:44, 10 February 2023 (UTC)
 * I've gone ahead with the merge. Some cleanup of the copied text is still required, I'm sure. I did not merge the "Psychological treatment" section as it seems wholly outdated, or "Ethical, cultural, and political considerations" since it looks like a combination of WP:FRINGE, things already covered here, and things covered in other articles. I'll paste the bibliography below in case someone finds it useful.
 * Pfäfflin, Friedemann & Astrid Junge -Sex Reassignment. Thirty Years of International Follow-up Studies After Sex Reassignment Surgery: A Comprehensive Review, 1961–1991 (translated from German into American English by Roberta B. Jacobson and Alf B. Meier)
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
 * Pfäfflin, Friedemann & Astrid Junge -Sex Reassignment. Thirty Years of International Follow-up Studies After Sex Reassignment Surgery: A Comprehensive Review, 1961–1991 (translated from German into American English by Roberta B. Jacobson and Alf B. Meier)
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
 * Pfäfflin, Friedemann & Astrid Junge -Sex Reassignment. Thirty Years of International Follow-up Studies After Sex Reassignment Surgery: A Comprehensive Review, 1961–1991 (translated from German into American English by Roberta B. Jacobson and Alf B. Meier)
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government
 * Xavier, J., Simmons, R. (2000) – The Washington transgender needs assessment survey, Washington, DC: The Administration for HIV and AIDS of the District of Columbia Government

■ ∃ Madeline ⇔ ∃ Part of me ; 14:24, 1 April 2023 (UTC)

Proposed changes to Section 4 based on the New England Journal of Medicine citation
I was curious about the findings in the NEJM article cited in the Health care for transgender youth section so I ended up reading the article and the protocol document for the study. There were a couple items that stood out to me that contradicted the current summary on the wiki (which is from the Abstract, not the actual paper). First item was that the variables discussed in the article (depression scores, anxiety scores, scores for life satisfaction) changed positively among trans males but not trans females. There's no explanation offered for this, although according to Figure 2 the overall changes in scores are relatively small so it might just be a sample size issue. Second item would be that two of the participants committed suicide after beginning the study - and this is after disqualifying individuals from the study who were suicidal at the beginning of the study (or "visibly distraught", Section 4.6 of the study's protocol). Would it be fair to reword the section to say that the findings in the study are mixed, and expand the discussion on it on the wiki to add some of the findings from the paper? I think it's definitely worth leaving in given its apparent profile - there are a plethora of articles about the findings.

As an FYI, the NEJM site is paywalled, but if anyone else is interested they allow access to 2 free studies/articles per month. I'd highly recommend reading through the article and the linked protocol document.--Bayou Tapestry (talk) 02:38, 21 March 2023 (UTC)


 * Seem to have stumbled into a bit of a rabbit hole here. Given what I saw in the NEJM article, I read over the previous citation that was used here for "In a 2018 review, evidence suggested that hormonal treatments for transgender adolescents can achieve their intended physical effects. The mental effects of GnRH modifiers are positive with treatment associated with significant improvements in multiple psychological measures, including global functioning, depression, and overall behavioral and/or emotional problems." One study in the evidence review measures the physical effects (the others did not measure it), so if this is discussed at all that study should be linked, not the evidence review. As for the portion regarding the mental effects, there are some serious issues with the studies linked by the evidence review (which is why the paper says "observed to be associated with" instead of "positive with treatment associated with" as the wiki says). The main one is the enormous lost-to-follow up rate in these studies - Table 5 in the evidence review reports this, saying the majority of the studies had a "high" attrition rate. Costa et al, which was one of the papers cited for the GnRH modifiers (aka puberty blockers) improving global functioning and that the evidence review said had a "medium" attrition rate, had a lost-to-follow up rate of 70% between when patients eligible for puberty blockers received them and the end of the trial. One of the studies cited saying that puberty blockers showed improvements to depression/emotional/behavioral scores, de Vries et al says in Table 3 that the data was not significant; the measurements for Depression/Anger/Anxiety all had high P-scores which while not invalidating the data means that that it can't support the conclusion that we've assigned it. In fact, if it was significant then there's some pretty contradictory information here, including that anxiety scores got worse over time for the MtF population and depression scores got worse after GRS. From that foundation we've somehow gotten to "significant improvements in multiple psychological measures".


 * I think it's worth rewriting this section, at the very least to remove or reword the parts about the NEJM study or the AAP evidence review. I think it's worth linking to the writing around the Dutch Protocol, adding in some of the history and maybe discussing the areas of ongoing research and study.--Bayou Tapestry (talk) 05:42, 23 March 2023 (UTC)

Wiki Education assignment: Equitable Futures - Internet Cultures and Open Access
— Assignment last updated by Th4td4nc3r13 (talk) 19:47, 12 April 2023 (UTC)

About WPATH SOC version 8 and the accuracy dispute template in the Eligibility section
I am translating this article to Chinese and I saw the accuracy dispute template in the Eligibility section. So I checked the newest SOC (version 8) and its description of gender dysphoria says the following:

"GENDER DYSPHORIA describes a state of distress or discomfort that may be experienced because a person’s gender identity differs from that which is physically and/or socially attributed to their sex assigned at birth. Gender Dysphoria is also a diagnostic term in the DSM-5 denoting an incongruence between the sex assigned at birth and experienced gender accompanied by distress. Not all transgender and gender diverse people experience gender dysphoria."

Whereas version 7 says this:

"Gender dysphoria: Distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)"

So the main difference here is that one line mentioning DSM-5. I think this is because they want to make sure people know about the different wording in DSM-5 and ICD-11. The following entry from SOC version 8 talks about gender incongruence:

"GENDER INCONGRUENCE is a diagnostic term used in the ICD-11 that describes a person’s marked and persistent experience of an incompatibility between that person’s gender identity and the gender expected of them based on their birth-assigned sex."

But there is no entry about gender incongruence in SOC version 7. So they most likely added that one line in their definition for gender dysphoria to acknowledge the change in ICD-11, and to make sure people don't get confused by the differences in DSM-5 and ICD-11, but the basic definitions about gender dysphoria is the same in both SOC version 8 and 7. So think we could remove the template. --LT1211 (talk) 01:22, 4 June 2023 (UTC)
 * I updated the content from the SOC to reflect the version 8 wording. Nosferattus (talk) 00:16, 10 July 2023 (UTC)

Wiki Education assignment: Crime and Media
— Assignment last updated by Dmaccartney (talk) 04:10, 30 October 2023 (UTC)

Wiki Education assignment: Legal Research
— Assignment last updated by User78632 (talk) 15:34, 10 November 2023 (UTC)

Canadian Blood Donation section outdated
I was translating this page to Chinese and I noticed that the section under "Blood Donation" is outdated. This section says that transgender blood donors would be asked question based on their AGAB had they not received any bottom surgeries. But on the website referenced in this section it says that now transgender blood donors could register under their real gender, although only a binary one. This probably means that Canadian Blood Service changed their criteria on trans donors at one point. But when I checked wayback machine I found out that the earliest snapshot was from 2022 after the (assumed) change, and googling also doesn't return any useful result that can indicate a time of that (assumed) change for me. Does anyone know anything about this (assumed) change? --LT1211 (talk) 20:57, 14 November 2023 (UTC)

European info is very inaccurate
Can you update (preferably unlock) this article? It is very outdated. Transgender health care in Europe is very different from USA and UK only. UK had the Tavistock-scandal causing a major shift in opinion how to treat transgender youth. Finland, Norway, Sweden, Denmark no longer provide gender affirming care under 18. They focus more on only psycho therapy. Only under highly exceptional cases. UK tends to bend to that sytem too due to the scandal. Germany, Austria, Switzerland, Spain, Italy never fully adopted the Dutch protocol system of gender affirming care for teenagers and had stronger age limits. Here a good link to see the differences: https://tgeu.org/trans-health-map-2022/ 2A02:A443:5030:1:F53D:5093:D65E:6E72 (talk) 11:39, 14 December 2023 (UTC)

Criticism
I also miss a paragraph about criticism on the system. For instance concerns about Iatrogenesis, the controversy about psychotherapy and conversion therapy, what happened at the clinic of Kenneth Zucker and why it go shut down, what happened at the Tavistock clinic and why it got shut down. 2A02:A443:5030:1:F53D:5093:D65E:6E72 (talk) 11:44, 14 December 2023 (UTC)

"Sex reassignment therapies" listed at Redirects for discussion
The redirect [//en.wikipedia.org/w/index.php?title=Sex_reassignment_therapies&redirect=no Sex reassignment therapies] has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at  until a consensus is reached. Raladic (talk) 17:02, 17 March 2024 (UTC)