Talk:Transgender youth/Archive 1

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Portraits of Transgendered Children
I'd like to add this external link from the NY Times that has portrayed transgendered children according to how they view themselves.


 * Beautifully photographed Dutch transgendered youth — Preceding unsigned comment added by Rachelmann54 (talk • contribs) 17:13, 29 August 2012 (UTC)

Gender Spectrum Family
I'd like to add the following external link, but am employed by Gender Spectrum.


 * Gender Spectrum Family - Support and information site for families of transgender youth.

Zapote (talk) 06:32, 12 January 2008 (UTC)


 * I've reviewed the site and appears to meet the requirements, so I've added it. Since the home page was the most "advertising" page on the site, I've linked to the "What is Gender Variance" page instead. --AliceJMarkham (talk) 11:19, 12 January 2008 (UTC)

Good idea. Thanks, Alice. Zapote (talk) 06:47, 13 January 2008 (UTC)

Neutral POV
Hi, can we please have a few more people read over the article and help to resolve some of the points that are bordering as original research? Wikipedia should endevour to maintain a neutral point of view, and statements like "Puberty is often considered to be a difficult time for everyone in many ways. But unlike their peers, who may be excited about bodily changes and thrilled with growing up, transsexual teenagers are appalled by the changes that take place" are overly generalised and unencyclopedic, and for a subject of this sensitive nature we should definitely strive to ensure the language used is neutral and impartial. Thanks. Justin.Parallax (talk) 10:06, 11 January 2014 (UTC)


 * The answer is no. Things like gender are not scientific in any way. Mannerisms attributed to male vs female is completely subjective to how you were raised and how someone dresses, talks and acts is all learned behavior not in-born. In other cultures for instance men wear what we would call a dress. — Preceding unsigned comment added by 24.207.130.18 (talk • contribs) 20:09, July 20, 2014


 * Do you realise you just totally invalidated transgender identity and gender dysphoria? Quote: "how someone dresses, talks and acts is all learned behavior not in-born" Okay so sexual reassignment surgery is totally unnecessary -- these people were obviously inadequately educated by their parents in the norms of their gender and we can just ship them off somewhere for a while until they are re-educated..... Would you suggest a Gulag or a Kamp?


 * Um, just because they view gender as largely sociological doesn't mean that they've invalidated trans identities. Race and ethnicity are constructs as well, but we see the very real and very powerful impacts they have. Gender dysphoria is real. The struggles of trans people are real. Gender, however, may not be a biological thing. The assumption that gender is biological seems to imply that it mirrors sex, which potentially invalidates some nonbinary people. Learning and enacting gender isn't about simple education. It's far more complex than that. I don't think anyone in gender studies who prefers the sociological view of gender believes that anyone should be shipped off to camps; rather that gender is more malleable and complex than a male/female switch in the brain. Just because something is a construct doesn't mean it's meaningless. Don't be stupid. 72.181.110.248 (talk) 15:43, 3 February 2016 (UTC)


 * Having said that, the part in the current correct language that bothers me is use of expressions like "assigned male at birth" or "assigned female" -- it makes transgender identity sound like a bureaucratic error or a malicious abuse committed at birth. It isn't. Assignment as a fe/male only makes sense in the context of intersexed anatomy, where there is no clear gender. Even this should become a thing of the past with genetic tests which should reveal the presence of the Y chromosome no matter how dubious the anatomy may appear at birth before assignment is made.


 * The move to treat adolescents with sex reassignment procedures should be concerning. Is medicine now saying, in effect, we can do away with homosexuality by reassigning every dysphoric child of the next generation? It is human nature to be fretful about ambiguity of any kind. If society is saying it prefers a surgical solution to the homosexual "problem" then it is hoping for a future in which the number of men who prefer to be with men or women who prefer to be with women is minimised, by relabelling homosexuals as candidates for surgery..... Something to ponder. 76.67.127.235 (talk) 07:57, 18 June 2015 (UTC)


 * This is a really weird slippery slope argument. Sexuality and gender are not the same thing. Just because a cis man likes men doesn't mean he should be reassigned to a woman. It should be clear to any health professional educated on the topic, and I can tell you that lgbt issues are becoming more studied in the academy, and will likely continue to be studied as assimilation continues. I wouldn't worry about that. 72.181.110.248 (talk) 15:43, 3 February 2016 (UTC)


 * Exactly. There are tons of lesbian trans women and gay trans men, who were seemingly straight before transition and therefore didn't gain anything in the way of heterosexuality through their transition, quite the opposite, and gender transition is such a radical act that it isn't exactly a convenient solution to the comparatively minor issue of homosexuality. Not to mention all the other possibilities such as bisexuality, asexuality, or even more complicated orientations.
 * Moreover, "assigned female/male at birth" is a supremely neutral term. It doesn't imply anything about the correctness of the assignment. And the presence of a Y chromosome doesn't really mean much at all, since it is in itself fairly unimportant (see the ISNA website). Why should a girl with CAIS who feels completely fine living as a girl forcefully reassigned to male just because she happens to have invisible Y chromosomes in her body?
 * Also, transsexuality is a lot more than a sociological problem. It does not simply involve changing clothes, hairstyle, habits, name and pronoun, but also (usually) hormonal balance and (often) surgeries of various kinds. Few adults are androgynous enough to not need either to "pass" as the gender they identify with (it's easier for teenagers and no problem for children; to be fair, "passing" is not equally important for every trans person), and most of them experience various degrees of dysphoria (unease) about aspects of their body that are not so easily fixed and cannot be filed under the purely sociological aspect of gender. --Florian Blaschke (talk) 03:50, 13 March 2017 (UTC)

To: Justin.Parallax - I could not agree more that the state of the NPOV is in a bad place here at Wikipedia. As I discuss: research writing does not use language such as "overwhelmingly" and this is wholly inappropriate, unscientific editorialization without a source, and this is in no way neutral. "Evidence suggests" or "It is well established" is the language of research writing. But the opinion of NorthBySouthBaronof seems to trump the standards and practices in peer reviewed journals because it is 'better' in their eyes. I really see it as unjustifiable to endorse a wholly impartial stance regarding scientfic claims.Kkeeran (talk) 20:03, 15 December 2021 (UTC)


 * , I encourage you to post a new section instead of resurrecting a four-years-dead thread. Firefangledfeathers 20:14, 15 December 2021 (UTC)
 * Is there a rule that I have broken, given that my addendum to the topic of NPOV is time-stamped, and related to the section?Kkeeran (talk) 20:21, 15 December 2021 (UTC)
 * No rule, as far as I know. Editors who come here looking to join discussions are likely to start at the bottom of the page. While your concern and this thread both involve NPOV, the specific nature of the content complaints are different. This is just advice, take it or leave it. Firefangledfeathers 20:30, 15 December 2021 (UTC)

Suggested edits to page
Hello! I'm currently in a Global Youth Studies class where we're editing articles on Wikipedia to make them more accurate and inclusive. I've chosen this article to edit for a number of reasons-- mainly that it's very underdeveloped and lacks a neutral POV. I've begun drafting these edits in my sandbox. So far I've been working on the section about vulnerability-- common issues that trans youth face I've removed the section "puberty" because it was very not neutral, and i also removed the section "Suicide attempt rates" because it overlaps with my suicide subsection. I plan on adding much more, especially about transgender youth in various countries, and expand on/ edit many of the sections that are currently there. I'll post here occasionally with updates on changes I've made to my draft. Any feedback/ criticisms/ suggestions are welcome and appreciated! Nativ32 (talk) 06:00, 27 October 2014 (UTC)

Outcomes
Are there any statistics actually comparing different treatment methods? How do effeminate men/masculine women who do not undergo transgender conversion therapy compare in terms of suicide rates with those who do attempt to transform? — Preceding unsigned comment added by 24.207.136.200 (talk • contribs) 07:50, November 14, 2014‎

Hello! I'm currently in a Global Youth Studies class where we're editing articles on Wikipedia to make them more accurate and inclusive. In my attempts to add more global perspective to the living conditions of youth around the world, I added the nation of Malta who is known for their strides in creating a more inclusive society through legislation for transgender youth. I have also fleshed out various existing sections in the article such as homelessness, healthcare, and suicide. In order to give more specific examples of transgender youth, I brought in a few examples of living transgender youth activists. I felt this was important in order to see that there are narratives and role models of what it looks like to be a transgender youth in this day and age. Let me know what your thoughts are on my additions and if you think anything needs to become more neutral. Thanks! Kkaltenheuser (talk) 04:30, 9 December 2015 (UTC)

School environment section
Hi there, I'm a student getting my MA in sociology and my thesis is on school support and staff training for transgender children/youth who are questioning or transitioning. I'm thinking there needs to be a section dedicated to the school experience of transgender youth that extends beyond just discussing bullying/harassment and popular topics about which bathrooms or locker room transgender students have to use. Since youth spend 6+ hours a day in school 5 days a week (assuming they're going to school), it is worth noting how influential school environment and support from peers/teachers/staff is to their well being. Additionally, the topic of how school administrations and teachers are trained (or not trained) on how to support transgender youth should be discussed in some way. Just some food for thought, let me know what you think! — Preceding unsigned comment added by KMonderine (talk • contribs) 18:46, 6 February 2016 (UTC)

Additions to current sections on page
Hi, I'm a student at LSU taking a Women's Gender Studies class which requires that we edit Wikipedia pages in order to add adequate information to support the page. I would like to add to the section "Coming Out" in which I would add to the definition and connotation as to what it means to come out and a brief history of the term as it relates to the youth. I would also like to add to evidence to prove how teens are seen as being more vulnerably than compared to those who are not transgendered.

Joyrucker5 (talk) 16:12, 25 February 2016 (UTC)joyrucker5

Legal rights and issues of those under the age of majority
It would be great if this page talked more about the problems that those under the age of majority face, including legal forms of abuse. I feel that not enough attention is given to these issues, and that as a particularly vulnerable group of society that it deserve more attention. — Preceding unsigned comment added by Rcl725 (talk • contribs) 18:34, 10 September 2016 (UTC)

Lead summary on best care
Regarding this, this, this, this, this, this and this, I want to be clear about correctly interpreting WP:MEDRS. WP:MEDRS tells us that "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." And as for guidelines? One of the things the WP:MEDORG section of WP:MEDRS states is the following: "Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines. [...] The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature." In other words, WP:MEDRS is clear that we follow the general literature rather than just what an organization (like the WHO), or manual like the DSM-5, or a diagnostic code like the ICD-11 states. This was also made clear years ago at WP:Med: Wikipedia talk:WikiProject Medicine/Archive 36. The general literature, for example, supports desistance (which is not the same as detransition) rates as ranging from 60 to 80%, and that includes what recent reviews relay. This is despite discussion in some of the literature that the 80% (or 90%, or above 90%, in other cases) number may be inflated. That stated, I don't see that desistance rates need to be in the lead, not unless significantly covered lower first.

I reverted the IP because, like I stated, World Professional Association for Transgender Health (WPATH) is not broad consensus. It's what their organization believes. And views on puberty blockers are very varied among professionals. The IP worded it as "broad consensus" and as something that is definitely always the best care. We know from the desistance rates, which are substantial enough for professionals to consider when treating children with gender dysphoria, that the best care isn't always social transition and puberty blockers. What many professionals do agree on as best care is supportive mental health care. For example this 2015 "Psychopathology: Foundations for a Contemporary Understanding" source, from Routledge, pages 464–465, is clear that supportive care involves clinicians advising children and their parents to avoid goals based on gender identity and to instead cope with the child's distress by embracing psychoeducation and to be supportive of their gender variant identity and behavior as it develops. A clinician may suggest that the parent be attentive, listen, and encourage an environment for the child to explore and express their identified gender identity, which may be termed the true gender. This can remove the stigma associated with their dysphoria, as well as the pressure to conform to a gender identity or role they do not identify with, which may be termed the false gender self. Since Rab V removed the "Although groups opposed to transgender rights continue to challenge the morality of providing identity-affirming care to transgender children" POV and used "may" when restoring the IP's text, I won't revert. But unless the sources state "broad consensus", we should not either. And even then, WP:In-text attribution should be used if it's just WPATH stating that. Flyer22 Frozen (talk) 00:19, 19 July 2020 (UTC) Tweaked post. Flyer22 Frozen (talk) 00:37, 19 July 2020 (UTC)

Revert
Please see the Ristori & Steensma review article I added, which does support the content about desistance in the lead. Zucker offers additional commentary here; please see in particular the table on page 4. Cheers, gnu 57 23:05, 17 February 2021 (UTC)
 * I'm not able to gain access to the paper unfortunately. Does it counter the other RS that note if gender dysphoria persists into puberty it is likely to continue into adulthood? If not I think the lead statement should be qualified to clarify that as well. Also would like to know if it is about gender dysphoria or gender variance. Several RS combine children who want to express their gender differently than the norm but do not identify with a different gender than their assigned one and it is useful to clarify the distinction when making claims about trans youth. Rab V (talk) 23:32, 17 February 2021 (UTC)
 * In addition to the issues Rab points out, which need to be clarified, I would also point out on a procedural level that the lead is supposed to summarize the contents of the body relative to their weight, and the body never mentions "morality", "informed consent", or "permanent" changes at all; the simplest thing to do might be to make the necessary qualifications and move the statement from the lead down into the body. -sche (talk) 00:41, 18 February 2021 (UTC)
 * Verified by the source: And as a review article, it is the cream of the crop WP:MEDRS-wise. I see no reason to remove the statement from the lead; major aspects of a topic belong there and any deficiency in the body can simply be addressed. Crossroads -talk- 03:46, 18 February 2021 (UTC)

Multiple issues with this statement
"most doctors are reluctant to provide medical treatments to them, transgender youth face different challenges compared to adults. There is a broad consensus among experts and professional associations that appropriate care may include supportive mental health care, social transition, and puberty blockers"

These two statements completely contradict each other. Furthermore, the citation for the latter statement (which is filled with weasel phrasing) cites only special interest groups. If most doctors are reluctant to provide the services that these people want, then how is there a consensus that the services are appropriate?

I've changed the weasley phrase of "experts and professional associations" to "special interest groups" as it reflects what the citation contains and specifies more thoroughly the types of people who support the procedures. Innican Soufou (talk) 22:06, 27 February 2021 (UTC)
 * I have reverted the BOLD change. To the best of my knowledge, the American Psychological Association is not normally considered a Special interest group, but rather a professional association. Newimpartial (talk) 22:12, 27 February 2021 (UTC)


 * Looking at the sources, that language isn't in them at all. So I've removed it. Innican Soufou (talk) 00:04, 28 February 2021 (UTC)

Edits to Sections on Education and Health Care
Hello! I'm currently in an LGBTQ Politics and Policy class where we're editing articles on Wikipedia to make them more accurate and inclusive. I'm interested in editing the sections on 'Lack of Access to Healthcare' and 'Accommodation in School' to include a discussion of recent bills passed by state legislatures targeting transgender youth such as by barring or criminalizing healthcare for transgender youth, barring access to the use of appropriate facilities like restrooms, restricting transgender students’ ability to fully participate in school and sports. I was inspired to contribute to this article because this past week The New York Time's podcast The Daily did an episode covering how in 2021 alone there have already been more than 80 bills, introduced in mostly Republican-controlled legislatures, that aim to restrict transgender rights, mostly in sports and medical care. By adding to these sections, readers will understand the recent wave of anti-transgender legislation.

I plan to make these changes this week but wanted to receive feedback first. Any criticisms/ suggestions are welcome and appreciated! — Preceding unsigned comment added by Sedeboer (talk • contribs)
 * Hi, the most important things to keep in mind is to avoid WP:Editorializing and to WP:STICKTOSOURCE, so as to keep a WP:Neutral point of view. No claim or implication not in a source should be inserted into the article. This means sticking to WP:Reliable sources, preferably academic sources, per the WP:SOURCETYPES heading of that guideline page. Crossroads -talk- 04:41, 3 May 2021 (UTC)

Numbers, please
How many children identified as transgender in each year, in which countries, since this issue became a subject of mainstream discussion? How many children (again, country-by-country) took medical or surgical transition-treatment? Why do I have to post this question? This is not my subject of expertise, but some work needs to be done here (IMHO). The article is badly incomplete without numbers. HandsomeMrToad (talk) 04:08, 5 May 2021 (UTC)
 * I can answer one question right off the bat - no country will allow gender confirmation surgery on the genital area for under 18s, I believe, so the answer there is zero. Not sure where the best source for the other questions is. Amekyras (talk) 17:09, 19 May 2021 (UTC)
 * Note, however, that the number for "top surgery" for under-18s is not zero, though it is likely to be vanishingly small. I dare say that no reliable statistics are available for most of these questions, though if anyone finds citations available we can of course include them in articles as is DUE. Newimpartial (talk) 17:31, 19 May 2021 (UTC)

High Desistance Rates
High desistance rates among transgender youth is not a fact and we should not be presenting it as such. At the moment, the "fact" desistance rates are high among transgender youth is presented in the lead. This is based on the results of 2 review studies.

Recently, an edit I made was reverted containing the following changes:


 * 1) I updated the lead to include criticism of the studies: "Some studies have claimed that most children with gender dysphoria end up identifying with their biological sex after reaching puberty, though if gender dysphoria does continue into adolescence it is far more likely to persist into adulthood. These statistics have been used to justify more cautious approaches to trans healthcare. However, the evidence offered to support this has been criticized for its ties to studies employing conversion therapy which actively discouraged social and medical transition. Previous participants in the studies stated they were traumatizing. In addition, the definition of gender dysphoria used in the studies only required gender-nonconformity. They did not require a child to state a transgender identity or have desire for medical transition. As such, these studies have been labelled as misleading and irrelevant to trans healthcare for conflating transgender youth with gender-nonconforming youth.


 * To not include the criticisms of the studies (and many have been made) is WP:UNDUE. The fact that the patients did not meet DSM-V criteria, or often even DSM-IV criteria should point to that. The studies conflated any kind of gender-noncomformity with being trans, then used that as evidence to prove there are high rates of "desistance". If we presented studies interviewing self-identified transgender youth and their persistence rates and/or the persistence rate of children seeking medical transition, we'd have a much more accurate story (for a start persistence rates are much higher).


 * To give an analogy, I could say gay people love musical theater. Then, I interview children who love musical theater and ask them whether they're gay. In a few years, I ask them again. I then publish an article stating that kids who are gay mostly "desist" based on the fact most children who like musical theater (not those who said they're gay) aren't gay. The study doesn't track kids who said they were gay, it just tracked those who said they like musical theater. That's a ridiculous study and conclusion. It shouldn't be any less ridiculous when we replace gay with trans and musical theater with gender noncomformity.


 * 2) I included a peer reviewed paper published in 2021 analyzing "desistance", and reviewing the evidence and criticisms of the previous studies. This was removed, I'm not sure why.


 * 3) The article currently states only that the original authors issued a rebuttal. I included details from the rebuttal, which were also removed. Researchers who believe that desistance rates are high have in turn rebutted some of these arguments, though acknowledging the methodological flaws present in their research and overly binary "desistance"/persistance dichotomy which doesn't leave room for fluidity.


 * I suppose I should have just quoted the original rebuttal instead of paraphrasing:Having responded to the many comments of Temple Newhook and colleagues we want to stress that we do not consider the methodology used in our studies as optimal (as previously indicated and discussed by ourselves in Ristori & Steensma, 2016), or that the terminology used in our communications is always ideal. As shown, it may lead to confusion and wrong inferences. We also agree that the persistence/desistence terms suggest or even induce binary thinking. In the last few years many terms in our field have changed. Evidently, we need to look for better terms covering the various possible outcomes and better indicating possible fluidity in the “desisting” group.

In short, we should not be presenting "most children desist" as a fact. If we are to include it as a claim in the lead, we must also present the criticism, the main one being the study did not explicitly study transgender youth. TheTranarchist (talk) 21:47, 23 January 2022 (UTC)TheTranarchist
 * I concur with the good advice gave you on your talk page.
 * I'll address the numbered points briefly: (1) The WP:LEAD exists to give a summary of the body. The detailed reasons for why the figures are criticized by some are not necessary there - and neither would the response to that be. (2) While that paper can be included, it is one academic opinion of many, and so it shouldn't be treated as though it is the only correct view around which the rest must be framed. (3) This can be expanded, but that should mean explaining their criticisms of those to whom they are responding, not just acknowledging their own past flaws.
 * Regarding the point of this section in general, review articles on the topic of gender dysphoria in children are clear in noting the desistance rates as factual much like we do. The current WPATH Standards of Care states, Rather, in follow-up studies of prepubertal children (mainly boys) who were referred to clinics for assessment of gender dysphoria, the dysphoria persisted into adulthood for only 6–23% of children...Newer studies, also including girls, showed a 12–27% persistence rate of gender dysphoria into adulthood. More recent reviews on the topic likewise repeat the statistic. This 2020 review states, Indeed, gender incongruence will desist by early adolescence for the majority of them [11, 12]. Several studies have shown that the percentage of “persisters” lies between 10 and 39% [7, 13]. This 2019 review states, Retrospective studies suggest gender dysphoria persists from childhood into adulthood in the range of 12%–27%.12 This 2018 review states, Evidence from the 10 available prospective follow-up studies from childhood to adolescence (reviewed in the study by Ristori and Steensma28) indicates that for ~80% of children who meet the criteria for GDC, the GD recedes with puberty. That's in addition to the two reviews currently cited here.
 * While a few researchers have attempted to negate these findings, many remain unconvinced by those attempts, and other researchers have challenged those criticisms directly, as is cited. The idea that they have to just throw out all the existing statistics on desistance because of diagnostic criteria tweaks (supposedly most of these kids so distressed they were brought to a clinic and diagnosed with the same diagnosis then given to adult medical transitioners can just be waved off?) - is the one explicitly or implicitly rejected by many researchers (because they continue to the cite the figures as authoritative regardless). The researchers who reject these figures are all proponents of the most intensive treatment approaches to such children and tend to be quick to label any other approach as "conversion therapy", even when the approach is to just wait and see how the child's gender develops. Their opinions are not shared by all other researchers.
 * This 2017 review states, Thus, many professionals remain critical about the puberty-blocking treatment (e.g.25,41,42). The Royal Australian and New Zealand College of Psychiatrists states in 2021, However, evidence and professional opinion is divided as to whether an affirmative approach should be taken in relation to treatment of transgender children or whether other approaches are more appropriate. A 2018 article quotes Diane Ehrensaft, a member of this camp: Diane Ehrensaft, the San Francisco Center’s mental health director and a leading proponent of early social transitioning, acknowledges this approach has been controversial. “There are some people that think folks like myself, and the people at our clinic, have fallen off the deep end,” she told me. She wasn’t just talking about the religious right, either. She was referring to other mental health professionals.
 * It would not be in accord with WP:NPOV and WP:DUE to treat the views of this faction as though they are automatically correct and all the other sources must be framed around them. Rather, the secondary WP:MEDRS that are reviewing the topic as a whole state the figures as fact, and so should we. Some sources note that the figures have been challenged, and we note that briefly in the lead and in more detail - and should be describing both sides - in the body. Crossroads -talk- 07:05, 25 January 2022 (UTC)
 * I agree that we should not move the article text ahead of the evidence, but let's also not make statements that the evidence doesn't support. The parenthetical supposedly most of these kids so distressed they were brought to a clinic and diagnosed with the same diagnosis then given to adult medical transitioners isn't backed up by any source that I know of, and neither is, The researchers who reject these figures are all proponents of the most intensive treatment approaches to such children and tend to be quick to label any other approach as "conversion therapy" - "all proponents of the most intensive treatment approaches" is a rather emotive generalization, and this discussion should be grounded in facts, not feelings. Newimpartial (talk) 12:37, 25 January 2022 (UTC)
 * And I would also opine, Crossroads, that your edits on this topic appear to be WP:STONEWALLING (and not in a good way). Newimpartial (talk) 13:34, 26 January 2022 (UTC)


 * So we're all on the same page, here are the 2 papers in question we have supporting the high desistance claim on wikipedia at the moment.


 * 1) "Buying time or arresting development? The dilemma of administering hormone blockers in trans children and adolescents" - Guido Giovanardi (doi: 10.1016/j.pbj.2017.06.001)
 * To support it's claim of high desistence, the paper cites "Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study." (Steensma et al; 2011) and "A follow-up study of girls with gender identity disorder." (Drummond et al; 2008)


 * 2) "Gender dysphoria in childhood" (Steensma et al; 2016)
 * This paper describes statistics regarding desistance rates. It references 10 studies, Bakwin (1968), Lebovitz (1972), Zuger (1984), Money & Russo (1979), Davenport (1986), Kosky (1987), Green (1987), Drummond et al. (2008), Wallien & Cohen-Kettenis(2008), Singh (2012). However, it also acknowledges earlier participants would not fit the modern DSM diagnosis. Also acknowledges that those who said they were members of the other sex were more likely to persist than those who simply engaged in gender noncomforming behavior and expression.


 * One of the papers that rebutted these claims: "A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children"
 * This paper analyzes 4 studies frequently used to support the claim of high desistance published after 2008, namely Drummond et al. (2008), Wallien et al. (2008), Steensma et al. (2011), and Steensma et al. (2013). It also gave brief mention of studies before 2000, (e.g., Green, 1987; Money & Russo, 1979; Zucker & Bradley, 1995; Zuger, 1984), which had the explicit aims of preventing transsexuality or homosexuality and focusing on targeting feminine behavior in AMAB children.


 * Long story short, the studies before 2000 are indeed mostly conversion therapy. I've actually had a fun time updating Richard Green (sexologist) with descriptions of his practices, as emotionally painful and stressful as many of his experiments and notes were to read. Considering the studies published after 2008, none were conducted using DSM-V criteria, which requires a child to explicitly state a transgender identification. In both Steensma (2011) and Drummond (2008) about 40% of participants were sub-threshold even for the DSM-IV standards. In 3 of those paper's those who dropped out of the study were considered desisters. In addition, the classification of desister falls apart when one considers that many trans people are reported as coming out much later in life after suppressing dysphoria at a young age.


 * To respond to the claim that most other sources agree with high desistance rates, I'll do a brief review of the studies you mentioned. The evidence pool for this claim is small and recursively cited, but the original studies they're built off have all been acknowledged to have serious flaws, even by those who support the claim of high desistance.


 * 1) That is the WPath SOC 7, the new SOC 8 is being released shortly and should contain more up to date information. As such, the sources supporting desistance among AMAB youth are from prior to 2000 in that study, (Green, 1987; Money & Russo, 1979; Zucker & Bradley, 1995; Zuger, 1984). For AFAB youth, the studies rely on Drummond et al (2008) and Wallien et al (2008).
 * 2) That 2020 review cites [11] Drummond et al (2008), [13] Steensma et al (2011); However, it also notes that severity of GD and if children explicitly claimed a trans identity the persistence rates were much higher.
 * 3) The 2019 Review states that some people claim desistance rates are high, then cites many issues people have raised about that claim, and ends with a note of support for the affirmative model
 * 4) That 2018 Review backs up it's high desistance claim by citing Steensma et al (2016)


 * Many researchers have negated the claim that desistance rates are high. Some remain unconvinced the earth is round but it doesn't mean it's false. It's not just "Diagnostic Criteria tweaks", the kids were brought in by parents not sure of what gender non-conformity meant, not kids actively saying they're transgender. Those diagnostic criteria tweaks are incredibly substantial. Previously anyone who was gender noncomforming could be labelled dysphoric (old definitions include not playing more with kids the same gender, not enjoying sports as much as a normal boy, not liking dresses enough and sports too much for a normal girl, and other stereotypical criteria). The new criteria means that trans kids refers to kids who say they are trans and/or are seeking medical or social transition, not kids who don't conform to stereotypes and still consider themselves cisgender. Conclusions drawn from conflating the population of trans children and noncomforming cis children can certainly just be waved off as fundamentally irrelevant to each other. In short, these studies don't reflect transgender identification so to claim the desistance rates for trans children are high based of them is inaccurate. Even the supporters of high desistance rates acknowledge that the studies cast too wide a net and that kids who said they were trans were a lot more likely to report being trans later than kids who did not say they were trans. Who would have guessed.


 * This is to clarify the difference between "just wait-and-see" and the "intensive treatment" affirmative model. The affirmative model supports a child by affirming their gender identity. If a kid says I'm a feminine boy, they're considered a feminine boy, nobody is forced to transition. If a kid says she's a trans girl, she is supported and allowed to be called by a name and pronouns she chooses. Puberty blockers and HRT are administered as appropriate for developmental/pubertal stages if and only if the patient wants it. The actually intensive model is the wait and see one. It's not a neutral approach, because it explicitly frames transitioning as something best avoided and often is against as an argument against prepubertal social transition. To back up this claim, inflated desistance rates such as above are used to claim possible adult regret. The wait and see approach means if a kid says they're trans, one should assume they're wrong and try and steer them away from that. If they say they're cis, you accept it at face value. Inherent is a value judgement that kids can know they're cis easily but can't know they're trans and must be protected from themselves. A quick look at conversion therapy should confirm this approach is indeed closer to conversion therapy than the affirmative, since historically conversion therapy involved those supportive of adult transition simultaneously trying to prevent young kids from growing up gay or trans. The evidence also shows that social transition is associated with better mental health outcomes while invalidating their identity is associated with worse ones.


 * The 2017 Review is the one by Gio Giovardini already mentioned in the Wikipedia article, and start of this breakdown, and is based on the same small pool of studies with inherent methodological flaws. The statement from the Royal Australian and New Zealand College of Psychiatrists notes the controversy (that is to say, references the WOC7 Adolescent statement already mentioned), and states it's support of affirming approaches and more research into their effectiveness. The final article does indeed acknowledge Ehrensaft knows some people are against the affirmative model, but that is not a reflection on the validity of the model itself. Especially considering the article highlights the case of young children put through "wait and see" model by parents who were hoping their trans girl would stop saying she was a girl. They actively discouraged her socially transitioning and tried to make her conform to male stereotypes, just to wait and see, and now deeply regret it because their actions made their daughter ashamed of who she is. They recognized she suffered when they tried to "wait and see" if she was really trans and refused to acknowledge her own identification in the meantime.


 * In short, is not within WP:NPOV WP:DUE to claim desistance rates are high based on the current evidence, since the current evidence doesn't actually refer to trans kids (an undeniable fact), it's only been framed to seem like it does. If we are to include it in the lead it should include the caveat that the results are disputed for not actually referring to transgender children, so as not to mislead people about the validity of that claim. Of course, it would be even easier not to include the unproven claim in the lead at all.


 * @Mathglot Would appreciate you weighing in on this!


 * TheTranarchist (talk) 22:48, 25 January 2022 (UTC)TheTranarchist
 * , responding to your ping since you asked, but can only respond briefly just now. I have to be honest and say I've only skimmed what you wrote, and not tried to read any of the sources,  so it wouldn't be fair for me to try to assess anything at this point. All I can really say for now, is thanks for all your work on this, and if not already familiar with it, please refamiliarize yourself both with the difference between WP:PRIMARY sources, which all or most of these appear to be, and WP:SECONDARY sources. I think you already know this. Primary sources should be used sparingly, if at all; perhaps to quote a specific line out of the conclusion or abstract of one of the studies which happens to agree with the majority opinion of all of the studies as described in a broad survey or a textbook. With respect to evaluating sources for WP:MEDRS, the gold standard is literature reviews or surveys and not individual studies, the point being, we (i.e., we Wikipedia editors) are not the ones who should be evaluating what published studies say or mean, even collectively; that's for literature surveys, and medical textbook writers to do, so you should target those as much as possible. (One of those reviewed four studies, so it is a review, but not a very broad one.  Perhaps there simply isn't enough information out there yet, to do a broad review, which leaves us having to be very tentative in what we say in Wikipedia's voice.) Feel free to ask questions at WT:MED if you're not sure if something you're looking at fits the bill or not. Perhaps  may be able to help further, if they have time.  I hope to be able to fill in a bit more at some later point, if your questions haven't been answered by then. Hope this helps, Mathglot (talk) 23:19, 25 January 2022 (UTC)

arbitrary break hdr1

 * @Crossroads, @Newimpartial, @Mathglot, I've broken down my recent changes to the lead here. I included the old version of what I wrote for context as well as a new version which I edited for a more WP:NPOV.


 * 1) Original: "Some studies state that most children with gender dysphoria end up identifying with their biological sex after reaching puberty, though if gender dysphoria does continue into adolescence it is far more likely to persist into adulthood;"
 * Updated: "Gender dysphoria in adolescence is very likely to persist into adulthood. Some studies state that most prepubertal children with gender dysphoria identify as cisgender after reaching puberty."
 * The reordering of children vs adolescents is because the statement regarding adolescents is agreed upon by the majority of researchers and medical organizations and disambiguates that the controversy is not over adolescent persistence. The addition of prepubertal is to make more explicit what the studies mean by children. The biological sex section was changed to cisgender for style/shortening.


 * 2) Original "these statistics have been used to justify more cautious approaches to trans healthcare."
 * Updated: "These statistics have been used to justify more caution around pubertal social transition to prevent transition regret."
 * As per the linked sources in the body, these statistics have indeed been used to justify arguments against prepubertal social transition.


 * 3) Original: "However, the evidence offered to support this has been criticized for its ties to studies employing conversion therapy which discouraged social and medical transition, and participants in the studies stated they were traumatizing"."
 * Updated: "However, the evidence offered to support this has been criticized for citing studies which have been labelled conversion therapy for discouraging social transition and trying to prevent a transgender outcome."
 * I made clear the controversy and arguments without claiming either as fact. I removed the experiences of past participants since those complaints fall under the same umbrella and are explored in the body. Many researchers have remarked upon the ethical considerations of these studies and used the definitions of conversion therapy provided by established medical organizations. Richard Green's studies being used as evidence comes to mind.


 * 4) Original: "In addition, the definition of gender dysphoria used in the studies only required gender-nonconformity, and did not require a child to state a transgender identity or a desire for medical or social transition, conflating transgender youth with gender-nonconforming youth."
 * Updated: "In addition, the diagnostic criteria for gender dysphoria used in the studies only required gender-nonconformity, and did not require a child to state a transgender identity or a desire for medical or social transition."
 * The conflation part was repeating the main argument of the sentence so I removed it. I included a link to the DSM-5 Gender Dysphoria section to provide more context.
 * This distinction is drawn repeatedly in the papers included in the article highlighting the flaws in "high desistance", which are all already in the body.


 * [Here] is a link from the APA explaining the changes and how they were made to be more conservative with diagnosis. [Here] is another breakdown of those changes.


 * Here is the [DSM-IV] and here is the [DSM-V] diagnosis. Note that according to the DSM-IV "Gender identity disorder in children" includes 1) together a boy who prefers to play with girls and dolls instead of "rough and tumble" play and dresses femininely, 2) a girl who prefers to dress in "stereotypical masculine clothing" instead of "normative feminine clothing" and prefers to play with boys and play sports, and 3) a child who says they're transgender, reports body dysphoria, and wish for medical intervention. One of these is not like the other. On the other hand, the DSM-V requires the child to actually say they're transgender and suffering distress in their assigned gender identity. It also adds a post-transition specifier to highlight that the dysphoria diagnosis refers to distress over current gender and that after transition gender dysphoria doesn't necessarily apply since the distress caused by living as the wrong gender has passed.


 * Finally, to quote a few passages from the original authors' [rebuttal]:
 * "we do agree with the authors that the persistence rates may increase in studies with different inclusion criteria. The classification of GD in the Wallien and Cohen-Kettenis (2008) study was indeed based on diagnostic criteria prior to DSM-5, with the possibility that some children were only gender variant in behavior."
 * "The broadness of the earlier DSM criteria was also acknowledged by the American Psychiatric Association and World Health Organization. This was, among other things, a reason to tighten the diagnostic childhood criteria for DSM-5 and the proposed criteria for ICD-11. As we have stated elsewhere (Hembree et al., 2017; Steensma, 2013), we expect that future follow-up studies using the new diagnostic criteria may find higher persistence rates and hopefully shed more light on developmental routes of gender variant and transgender children."
 * "Unlike what is suggested, we have not studied the gender identities of the children. Instead we have studied the persistence and desistence of children's distress caused by the gender incongruence they experience to the point that they seek clinical assistance. As stated in our 2008 paper, we wanted to know more about the development of the children to find guidance in our clinical work. "
 * "Using the term desistence in this way does not imply anything about the identity of the desisters. The children could still be hesitating, searching, fluctuating, or exploring with regard to their gender experience and expression, and trying to figure out how they wanted to live"
 * "Having responded to the many comments of Temple Newhook and colleagues we want to stress that we do not consider the methodology used in our studies as optimal (as previously indicated and discussed by ourselves in Ristori & Steensma, 2016), or that the terminology used in our communications is always ideal. As shown, it may lead to confusion and wrong inferences. We also agree that the persistence/desistence terms suggest or even induce binary thinking. In the last few years many terms in our field have changed. Evidently, we need to look for better terms covering the various possible outcomes and better indicating possible fluidity in the “desisting” group."
 * Once again, many children in the studies were sub-threshold even by the DSM-IV.


 * Putting it all together: "Gender dysphoria in adolescence is very likely to persist into adulthood. Some studies state that most prepubertal children with gender dysphoria identify as cisgender after reaching puberty. These statistics have been used to justify more caution around prepubertal social transition to prevent transition regret. However, the evidence offered to support this has been criticized for citing studies which have been labelled conversion therapy for discouraging social transition and trying to prevent a transgender outcome. In addition, the diagnostic criteria for gender dysphoria used in the studies only required gender-nonconformity, and did not require a child to state a transgender identity or a desire for medical or social transition."


 * For the conclusion, a quick recap of some salient points in [WP:NPOV]
 * "Wikipedia aims to describe disputes, but not engage in them."
 * "Avoid stating seriously contested assertions as facts."
 * "Neutrality assigns weight to viewpoints in proportion to their prominence. However, when reputable sources contradict one another and are relatively equal in prominence, describe both points of view and work for balance. This involves describing the opposing views clearly, drawing on secondary or tertiary sources that describe the disagreement from a disinterested viewpoint. "


 * In short, these updates to the lead are all within reason and present a more balanced view of the topic. As per WP:NPOV, those criticisms are necessary so as not to support only the one side claiming high desistance. We are required to describe the dispute and both side's arguments and avoid stating one side's assertion as a fact or giving it WP:UNDUE weight. Therefore, it is POV editing to state as fact the assertion "Most children with gender dysphoria end up identifying with their biological sex after reaching puberty" when 1) the studies conflated gender dysphoria with gender noncomformity, 2) this discrepancy has been recognized/critiqued by multiple other researchers and reviews, and 3) even the original authors clarified their findings were not absolute, did not explicitly track/refer to trans youth and/or gender identity, and that future studies were necessary and would probably find lower desistance rates among trans identified youth due to the updated diagnosis.


 * I apologize for POV language in the original edit, and I've attempted to rectify them to the best of my ability. Naturally, updates to further improve WP:NPOV and help Wikipedia give a fair portrayal of the controversy are welcome and appreciated. But, I repeat that to state one side's assertion as fact is in flagrant violation of Wikipedia's editorial procedures and maintaining a NPOV. As such, edits should improve our coverage of the controversy rather revert to a POV assertion. If we are to regard one side's assertion as factual given the evidence we possess, it should be noted that the assertion that the studies do not adequately reflect the experiences of transgender youth is a claim supported by both sides and it therefore has more right to be stated as fact than the alternative. Food for thought. However, considering the relevance the debate of these statistics has in the field of trans healthcare at the moment, NPOV is best and provides the most information to readers.


 * TheTranarchist (talk) 07:29, 27 January 2022 (UTC)TheTranarchist


 * Deserves more time than I've got, so just one question: where did you get
 * ...to prevent transition regret
 * from? That sounds like motive; is that summarizing something sourced in the body and if so what?" Mathglot (talk) 08:23, 27 January 2022 (UTC)


 * I felt that phrase was the most succinct way to cover the articles, but you're right and there may be better terminology to handle the nuance. "Transition regret", which focuses more on the adult regret of past transition, may not fully cover the concept since the main arguments are around whether a child is incapable of making choices regarding social or medical transition, and is mostly conjecture of possible future regret or increased likeliness of transgender identification. I could incorporate more elaboration into the body if you believe it's appropriate, and here are the sources currently in the lead so we can discuss better phrasing. My latest update was "These statistics have been cited to justify caution around prepubertal social transition and access to puberty blockers due to the possibility the children may identify as cisgender in future or may have done so if not permitted to transition.", which I hope is more balanced and supported.


 * [The Giovanni Review] covers the main arguments against early usage of puberty blockers. Here are some:


 * In regards to starting puberty blockers: "At Tanner stage 2 or 3, the individual is not sufficiently mature or authentically free to take such a decision.[25,41] "
 * In regards to diagnoses for adolescents: "It is not possible to make a certain diagnosis of GD in adolescence, because in this phase, gender identity is still fluctuating.[25,41,42]"
 * In regards to early somatic treatment: "Considering the high percentage of desisters, early somatic treatment may be premature and inappropriate. [25]"
 * The relevant quote from source 25: In both guidelines, "the diagnostic process is lengthy and takes place in several stages. This is important because 80–95% of the prepubertal children with GID will no longer experience a GID in adolescence [11–13]".
 * Some argue against children's right to access puberty blockers on the basis they may end up cisgender, this is backed by claims of high desistance rates (which didn't track children's interest in puberty blockers). Thus, treatment is extended into stages to weed out possible desisters.


 * In regards to sexual orientation: "The impact on sexuality has not yet been studied, but the restriction of sexual appetite brought about by blockers may prevent the adolescent from having age-appropriate socio-sexual experiences.41 In light of this fact, early interventions may interfere with the patient's development of a free sexuality and may limit her or his exploration of sexual orientation.41,42"
 * Here, we see another thought along the similar vein. Children may actually just be cisgender but not heterosexual and blockers should be prevented because they may not explore their sexuality.


 * And finally the conclusion "On the other hand, the treatment risks hindering the individual's development of a free personality, sexuality and identity, thus disconnecting the young person from the typical experiences of her or his age, with no certainty of the long-term effects on physical health. Suppression of puberty may suggest that the person is deprived of adolescence – the crucial time to deal with identity issues, experiment and pursue unstable convictions regarding the self."
 * Pretty self explanatory, puberty blockers may interfere with a child's development and prevent them thinking about their identity/sexuality. To say it may deprive them of adolescence (a cisgender puberty) is to say they may have been more comfortable going through cisgender puberty than they thought.


 * Steensma (2018) compares 3 approaches: conversion therapy, wait and see, and the affirmative model.


 * "The first approach focuses on working with the child and caregivers to lessen cross-gender behaviour and identification, to persuade the child that the ‘right gender’ is the one assigned at birth (Giordano, 2012), to decrease the likelihood that GD will persist into adolescence, and prevent adult transsexualism. Critics of this approach have linked it to ‘reparative therapy’, a term more commonly used to describe efforts to change same sex attraction to heterosexuality in gay adults or ‘pre-homosexual’ children (Drescher, 2013)."


 * Wait and see: "In practice, the child and parents are encouraged to find a balance between an accepting and supportive attitude toward GD, while at the same time protecting the child against any negative reactions and remaining realistic about the chance that GD feelings may desist in the future. Parents are encouraged to provide enough space for their child to explore their gender dysphoric feelings, while at the same time keeping all future outcomes open (e.g., de Vries & Cohen-Kettenis, 2012; Di Ceglie, 1998, 2014)."


 * "Critics of [the affirmative] approach believe that supporting gender transition in childhood may indeed be relieving for children with GD but question the effect on future development. The debate thereby focuses on whether a transition may increase the likelihood of persistence because, for example, a child may ‘forget’ how to live in the original gender role and therefore will no longer be able to feel the desire to change back; or that transitioned children may repress doubts about the transition out of fear that they have to go through the process of making their desire to socially (re)transition public for a second time (Steensma, 2013)."


 * The clinical irrelevance of “desistance” research for transgender and gender creative youth explores the relevance of desistance statistics to the field and the critiques of it's relevance.
 * "In both the scholarly and popular literature, desistance research has played a central role in debates surrounding clinical models of care for trans youth (Bewley et al., 2019; de Vries & Cohen-Kettenis, 2012; Drescher & Pula, 2014; Ehrensaft et al., 2018; Evans, 2020; Griffin et al., 2020; Marchiano, 2017; Soh, 2015; 2020; Steensma & Cohen-Kettenis, 2011; Turban et al., 2018). The significance of desistance research was enshrined in the Standards of Care Version 7 of the World Professional Association for Transgender Health (WPATH), which cites desistance research as a factor to be weighed when deciding on prepubertal social transition (Coleman et al., 2012, p. 176). Implicitly or explicitly, the suggestion is that the high rate of “desistance” warrants conservatism about prepubertal social transition or peripubertal medical transition."
 * "The argument for conservatism toward social and/or medical transition based on desistance research goes roughly as follows: (a) a majority of children referred to gender identity clinics will grow up cisgender and not pursue medical transition; (b) social and/or medical transition among youth who will grow up cisgender causes significant distress meaningfully comparable to the one experienced by trans youth whose transition is delayed; (c) therefore, professionals have reasons to delay social and/or medical transition—and perhaps even to actively discourage it, according to some (Bewley et al., 2019; Green, 2017; Marchiano, 2017; Soh, 2020; 2015; Steensma & Cohen-Kettenis, 2011). Premise (b) is often implicit but must be included insofar as the distress associated with retransition only gives prudential reasons to delay or discourage transition if it is meaningfully comparable to the distress associated with such delays or discouragement. One of the clearest expressions of the premise comes from Steensma and Cohen-Kettenis (2011; see also Soh, 2015; Green, 2017), who argue in favor of delaying social transition because “[i]t is conceivable that the drawbacks of having to wait until early adolescence (but with support in coping with the gender variance until that phase) maybe less serious than having to make a social transition twice.”"
 * "Desistance research plays a central role in the theoretical apparatus of two clinical models of care, namely the corrective model and the wait-and-see model (de Vries & Cohen-Kettenis, 2012, pp. 307–308; Green, 2017; Meadow, 2018, pp. 80–81; Pyne, 2014b; Zucker et al., 2012, p. 375). The clinical goal of the corrective model is to reduce the persistence rate of gender dysphoria and thus discourage adult trans outcomes (Zucker et al., 2012). I term the approach ‘corrective’ following Jake Pyne (2014b); it is also known as the therapeutic or pathology response approach (Lev, 2019; Zucker et al., 2012). Because it seeks to reduce the persistence of gender dysphoria and discourage adult trans outcomes, many consider it a form of conversion therapy (Ashley, 2021; Madrigal-Borloz, 2020; Temple Newhook et al., 2018). Unlike the corrective model, the wait-and-see model does not actively seek to encourage identification with one’s gender assigned at birth. However, it favors delaying prepubertal social transition out of fear that children who would grow up to be cisgender may socially transition (de Vries & Cohen-Kettenis, 2012, pp. 307–308; Steensma & Cohen-Kettenis, 2011)."
 * "Increasingly, desistance research has been relied upon by clinicians and laypersons to argue more broadly against medical transition before late adolescence or adulthood, in favor of lengthier assessments, and in favor of conversion therapy (Bell v. Tavistock, 2020; Bewley et al., 2019; Evans, 2020; Griffin et al., 2020; Marchiano, 2017; Soh, 2020). Although desistance research emerges from gender identity clinics, it is often extrapolated to other populations such as transgender youth in general. In Canada, desistance research featured prominently in briefs opposing the inclusion of gender identity in the government’s proposed ban on conversion therapy (Standing Committee on Justice & Human Rights, 2020). These positions share in the wait-and-see model’s investment in delaying transition and/or the corrective model’s investment in discouraging adult trans outcomes but extend them beyond their traditional focus on prepubertal intervention."


 * A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children also explores the relevance of desistance studies and critiques of them.
 * "Desistance studies are often drawn on to suggest that delaying a young person’s social transition is justified because it may prevent them from having to transition back in the future. There is an assumption that a second transition would be distressing. Steensma et al. (2013) write: “the percentage of transitioned children is increasing ...which could result in a larger proportion of children who have to change back to their original gender role, because of desisting GD, accompanied with a possible struggle” (pp. 588–589). Yet we note that this projected struggle is acknowledged only as “possible” rather than certain (p. 589). Similarly, in a letter to the editor entitled “Gender Transitioning before Puberty?”, Steensma and Cohen-Kettenis (2011) write: “It is conceivable that the drawbacks of having to wait until early 8 J. T. NEWHOOK ET AL. adolescence (but with support in coping with the gender variance until that phase) may be less serious than having to make a social transition twice” (p. 649). Yet again, this statement itself acknowledges that future distress is merely “conceivable” and again, not certain. As Ehrensaft, Giammattei, Storck, Tishelman, and Keo-Meier (2018) note, the evidence that a second transition would be traumatic is very thin, drawn from a case study of two children who found a reversion back to their original gender challenging in Steensma and Cohen-Kettenis’s (2011) clinic. Yet in another clinic (Edwards-Leeper & Spack, 2012), a de-transitioning girl and her mother expressed gratitude for her opportunity to live as a boy for a time, and they felt that if she had been forced to live as a girl for her entire childhood, that her mental health would have suffered. Thus, with many possible outcomes for the future, young people’s needs in the present must be prioritized"
 * "Lastly, while many clinicians would not propose attempting to alter gender expression, many still interpret desistance research as support for delaying transition, lest a trans identity becomes more likely. Steensma et al. (2013) write: “...with a link between social transitioning and the cognitive representation of the self [social transition may] influence the future rates of persistence” (pp.588–589). Yet we would ask why an increase in the number of transgender people (“persistence”) would be interpreted in a negative light, and how this sentiment could be consistent with the WPATH position that transgender identity is a matter of diversity not pathology (Coleman et al., 2012). Drescher and Pula (2014) as well as Ehrensaft et al. (2018) note that at times there appears to be a willingness to expose transgender children to the stress of living in a gender they do not identify with, in order to protect cisgender children from the possibility of “mistakenly” transitioning. Yet we would contend that the quality of life of transgender children is no less important and no less valuable than that of cisgender children"
 * TheTranarchist (talk) 03:03, 28 January 2022 (UTC)theTranarchist

"Some studies state that most prepubertal children with gender dysphoria identify as cisgender after reaching puberty." Are there studies that point away from this conclusion? If not, why say "some studies"? TheTranarchist, do you believe none of the children in the earlier studies who desisted had gender dysphoria? What percentage of children in the earlier studies do you believe were trans? Your conclusion is we don't know because the previous criteria was different? What about the studies done later? Pipenswick (talk) 03:20, 10 February 2022 (UTC)


 * Hello @Pipenswick! Welcome to Wikipedia and glad to have you on board! Onboarding can be difficult so reach out if you need any help! In regards to the original question, not per se. The problem is more so the framework the high desistance studies/review used, the conclusions drawn from them, and their impacts on trans healthcare. This isn't WP:OR on my part, but the results of many reviews done on that review criticizing how it's been used and misinterpreted, and the statement of the original reviewers themselves. About 10 studies (including those by Richard Green) were considered for the review, and of those it chose 4 as relevant to the modern day. Some of the children indeed had dysphoria (in the modern definition and percentage varying by study), they largely went on to identify as trans/seek hormone treatment as a high correlation was noted by the reviewers between intensity of dysphoria ("I am a girl" vs "I want to be a girl" and bodily/anatomical dysphoria) and "persistence". In more modern research, studies have noted the stability of stated trans identity over time (Florence Ashley 2021: "At the Royal Children’s Hospital Gender Service in Australia, 96% of youths continued to identify as transgender, whether binary or nonbinary, into late adolescence. The study was not published in a peer-reviewed journal and did not only include participants who were first assessed before puberty (In re: Kelvin, 2017), making it impossible for us to infer the rate specific to prepubertal children. Nevertheless, the sheer disparity between persistence rates in desistance research (which focuses on medical transition) and percentages more narrowly tied to gender identity is striking. At the very least, it offers reasons to doubt that desistance research can be used to approximate the constancy of gender identity." and "Recent studies on gender development have shown that social transition is associated with prior gender identification, that gender identification does not meaningfully differ before and after social transition, and that trans children are similar to cis children of the same gender identity (Gülgöz et al., 2019; Rae et al., 2019)."). However, the original studies did not track stability of gender identity or desire for future medical intervention, which was acknowledged by the original reviewers. The definition of dysphoria at the time relied heavily on stereotypes and lumped together trans kids with kids exhibiting gender noncomforming behavior/presentation (for example, boys who weren't "rough and tumble" enough or preferred the company of girls, and girls who were too "rough and tumble" or preferred the company of boys). The children weren't necessarily those interested in being referred, but were referred by parents who weren't sure what to make of their children's behavior. In some of the studies used around 40% didn't meet the threshold for dysphoria even then. Thus, what "desistance" referred to whether children exhibiting non-normative gender behavior at any degree in childhood stated they were transgender at a follow up (and of course being gender-nonconforming is very common especially among LGB youth and does not necessarily imply being trans), but was then commonly used as evidence of whether children who said they were trans/wanted medical transition would continue to and therefore whether social/medical transition should be allowed. TheTranarchist (talk) 19:18, 10 February 2022 (UTC)TheTranarchist
 * Hi, TheTranarchist, thanks for the welcome! I hope you don't mind, but I copied your format for my user page.
 * Personally, I know how the professionals word things today, but "I am a girl" vs. "I want to be a girl" never impacted on me and many other trans girls to identify the difference. I'm sure I never said "I am a girl" when I was a kid. It was always "I want to be a girl." And I always knew I was trans. Maybe it's a product of the time because being trans has been stigmatizing for so long? So we're conditioned to think "I want to be" rather than "I am"? While the distinction between "I am a girl" vs. "I want to be a girl" might help identify who's truly trans, it seems to be a "hit or miss" measure.
 * When I saw "some studies", I wondered if there's studies that say differently. I think choosing "A review of studies titled 'Gender dysphoria in childhood' stated that most prepubertal children with gender dysphoria identify as cisgender and lesbian, gay, or bisexual after reaching puberty." is an improvement over "some studies". And it appears to have satisfied Mathglot and Crossroads's concerns, but I think they also made important points about what we know and can't know so far, and being bound by the studies we have presently. Pipenswick (talk) 22:47, 10 February 2022 (UTC)


 * No problem, I'm honored! And thanks for that clarifying edit suggestion/Crossroad's implementation! I think the original reason for choosing some was because there were studies before 2000 with similar conclusions, but their methods were often too explicitly conversion therapy, so they're not commonly referred to in modern sources. Since most publications refer to the findings of that review, that's much better!
 * I feel that completely, for me, part of what helped me realize I was trans was realizing that constantly wanting to be a girl, but suppressing and and hiding that, was a pretty good hint I am a girl. Growing up, I never worded it out loud and most of the time didn't think the words themselves, just daydreamed of being a girl, felt different when looking in the mirror with long hair swept a certain way, or stuff like in middle school dressing up as a girl on the schoolbus "as a joke". I knew I had to hide it and feel shame about it, and puberty nearly killed me and left me thinking it was too late. Back then, I had no real exposure to trans people. Just jokes and gags on TV growing up on TV, and as I got older porn where I saw bodies like mine/how it could be and felt I had to hide it more because it was some sort of fetish. While I didn't know I was "trans", I knew I was trans and wouldn't be accepted. Learning I wasn't alone or a freak was incredible. These days, I see more young trans kids who get to exist as themselves and know they're not alone and have the language to define themselves, and it's heartwearming, but I also still see so many who don't have supportive families, especially since our very existence is used as a political football. The total dependence on parental consent to puberty blockers or hormones is outrageous. Circling back, with the resources and information trans people have spread across the internet, more and more are realizing who they are younger. But, I don't think there's any real research on how to detect a closeted trans kid, since I was still in elementary when I was calculating which particular aspect of myself I would hide if my parents sent me to a shrink. Once a person knows and verbalizes it to the world, it's not likely they'll stop. Before they decide to is another matter. So tests of this nature will return a lot more false negatives compared to false positives and don't tell us much. So as more accurate information is spread about trans people, more kids will know they're trans, the overall accuracy will increase.
 * The constant dialectic between trans people and the medical system and larger systems of oppression fascinates me though, no small part of why I joined Wikipedia. In one very early case of a trans kid before trans medicine in general took off, a young trans girl named Angie stole her mother's birth control and took the estrogen for a while, after breast growth/pubertal effects she went to a doctor(name escapes me at moment) and pretended to be an intersex girl to gain access to further treatment/bottom surgery. As the medical field starting issuing guidelines (often based in gender stereotypes: homophobic flattening categories like "true transsexual" for those who wanted to live life completely passing as a straight cis woman and get bottom surgery or "transvestite" for those attracted to women who were assumed to not benefit from it), trans people started changing their narratives to match doctors and thus gain access to treatment. As time's gone on, trans people have had a constant push and pull between defining their own lives and stories and fitting them into dominant ones. However, the current standard of saying who you are and knowing it is much better than it's been in the past (despite the fact it still relies on stereotypes for non-essential diagnostic criteria). TheTranarchist (talk) 18:26, 11 February 2022 (UTC)TheTranarchist

Persistence/desistance in the lead, and the medical interventions subsection
With the small change made last night, I was wondering if it might be more helpful to copy content from Gender dysphoria in children for the lead, and medical interventions subsection as that has been updated more recently.

Semi-related, I think we should also adjust the Gender dysphoria subsection within Vulnerability to be a summary style subsection deriving content from and directing readers to the main Gender dysphoria in children article. Sideswipe9th (talk) 20:13, 19 June 2022 (UTC)

Recent sources
Recent investigative reports by Reuters, The BMJ and others may be useful for article improvement, especially the societal aspects. --Animalparty! (talk) 21:22, 25 February 2023 (UTC)

'Vulnerability' section needs help!
The Vulnerability section is full of stylistic problems, issues with neutrality and verifiability, and a total dearth of recent sources. I've edited a lot—please, if you feel inclined, edit further! Isthistwisted (talk) 06:31, 29 June 2023 (UTC)