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The following references may be useful when improving this article in the future: "Gender Identity Service Series". 2024-04-10.

Section sizes Section size for Cass Review (38 sections) Section name Byte count Section total (Top) 8,235 8,235 Background 16,715 16,715 Methodology 14,671 14,671 Interim report 8,345 8,345 Final report 492 26,974 Findings 16 13,656 Lack of research 1,361 1,361 Increase in referrals 1,482 1,482 Social transition 2,307 2,307 Puberty blockers 1,743 1,743 Hormone therapy 1,507 1,507 Psychosocial intervention 721 721 Clinical pathways 1,575 1,575 International guidelines 908 908 Conflicting clinical views 2,036 2,036 Recommendations 5,625 5,625 Implementation 7,201 7,201 Reception 16 63,354 Response from UK political parties and public bodies 6,321 6,321 Response from devolved governments 7,661 7,661 Response from health bodies in the United Kingdom 10,996 10,996 Response from other health bodies globally 7,433 7,433 Response from transgender specialist medical bodies 4,889 4,889 Other academic responses 10,562 10,562 Reception by charities, unions and human rights organisations 5,430 5,430 Reception by gender-critical organisations 1,242 1,242 Hilary Cass's response 8,804 8,804 Subsequent government actions in the UK 45 16,706 Ban on private prescription of puberty blockers 5,834 5,834 Adult clinics 6,830 6,830 NHS Scotland 1,733 1,733 Department for Education 1,279 1,279 Rejection of independent review 985 985 See also 335 335 References 30 942 Works cited 912 912 Endnotes 29 29 External links 557 557 Total 156,863 156,863

sources for consideration

• Vinter, Robyn (11 April 2024). "Trans children in England worse off now than four years ago, says psychologist". The Guardian.
• "The Guardian view on the Cass report: rising numbers of gender distressed young people need help". The Guardian. 11 April 2024.
• Barnes, Hannah (10 April 2024). "The Cass review into children's gender care should shame us all". New Statesman.
• "The Observer view on the Cass review: children were catastrophically failed by the medical profession". The Observer. 14 April 2024.
• "RCPCH responds to publication of the final report from the Cass Review". RCPCH.
• "Cass Review 'should mark a watershed moment' – charity chief". The Shropshire Star. 9 April 2024.
• Hansford, Amelia (10 April 2024). "Cass report urges 'caution' in prescribing puberty blockers to trans youth". PinkNews | Latest lesbian, gay, bi and trans news | LGBTQ+ news.
• Dyer, Clare (9 April 2024). "Guidelines on gender related treatment flouted standards and overlooked poor evidence, finds Cass review". BMJ: q820. doi:10.1136/bmj.q820.
• Abbasi, Kamran (11 April 2024). "The Cass review: an opportunity to unite behind evidence informed care in gender medicine". BMJ: q837. doi:10.1136/bmj.q837.
• Abbasi, Kamran (9 April 2024). ""Medication is binary, but gender expressions are often not"—the Hilary Cass interview". BMJ: q794. doi:10.1136/bmj.q794.
• Cass, Hilary (9 April 2024). "Gender medicine for children and young people is built on shaky foundations. Here is how we strengthen services". BMJ. 385: q814. doi:10.1136/bmj.q814. ISSN 1756-1833.
• "Evidence for puberty blockers and hormone treatment for gender transition wholly inadequate | BMJ". BMJ.
• Penna, Dominic (16 April 2024). "Chris Whitty: Debate around transgender issues 'too vitriolic'". The Telegraph.
• Reed, Erin. "Why Hilary Cass' NHS report is wrong about trans health care". The Advocate.
• "Gender care review: Children 'let down' by research amid 'exceptionally toxic' debate". ITV News.
• "Hilary Cass: Ideology on all sides directed gender care of children". ITV News.
• Horton, Cal (14 March 2024). "The Cass Review: Cis-supremacy in the UK's approach to healthcare for trans children". International Journal of Transgender Health: 1–25. doi:10.1080/26895269.2024.2328249.
• "Gender Identity Service Series". Archives of Disease in Childhood.
• Thornton, Jacqui (April 2024). "Cass Review calls for reformed gender identity services". The Lancet. 403 (10436): 1529. doi:10.1016/s0140-6736(24)00808-0.
• Ghorayshi, Azeen (2024-05-13). "Hilary Cass Says U.S. Doctors Are 'Out of Date' on Youth Gender Medicine". The New York Times. ISSN 0362-4331. Retrieved 2024-05-14.
• Grijseels, D. M. (8 June 2024). "Biological and psychosocial evidence in the Cass Review: a critical commentary". International Journal of Transgender Health. doi:10.1080/26895269.2024.2362304.
• Horton, Cal; Pearce, Ruth (7 August 2024). "The U.K.'s Cass Review Badly Fails Trans Children". Scientific American. Retrieved 13 August 2024.
• Polgreen, Lydia (13 August 2024). "The Strange Report Fueling the War on Trans Kids". New York Times. Retrieved 13 August 2024.
• Davie, Max; Hobbs, Lorna (8 August 2024). "Cass: the good, the bad, the critical". Retrieved 18 August 2024.
• Budge, Stephanie L.; Abreu, Roberto L.; Flinn, Ryan E.; Donahue, Kelly L.; Estevez, Rebekah; Olezeski, Christy L.; Bernacki, Jessica M.; Barr, Sebastian; Bettergarcia, Jay; Sprott, Richard A.; Allen, Brittany J. (28 September 2024). "Gender Affirming Care Is Evidence Based for Transgender and Gender-Diverse Youth". Journal of Adolescent Health. doi:10.1016/j.jadohealth.2024.09.009. ISSN 1054-139X.

Enforced BRD

Just so nobody misses this: There's a thing called 'enforced BRD', and it now applies to this page. That means that the rules used to be:

• Make your edit
• Get reverted
• Maybe restore your edit (but never to the point of edit warring)

and they are now:

• Make your edit
• Get reverted
• Start a discussion on the talk page (or just decide to never restore your edit)
• At least 24 hours after starting that discussion, you can maybe restore your edit (but never to the point of edit warring, nor if the discussion on the talk page has active opposition. Silence is not active opposition).

See User:Awilley/Enforced BRD FAQ and User:Awilley/Consensus Required vs Enforced BRD for more information.

WhatamIdoing (talk) 04:04, 11 December 2024 (UTC)

Glad to see this - is it wrong that I think this should be mandatory on GENSEX? Void if removed (talk) 18:06, 11 December 2024 (UTC)

I think you would be surprised how cumbersome it can be, especially for problems like subtle vandalism. WhatamIdoing (talk) 18:29, 11 December 2024 (UTC)

ILGA, Transgender Europe, and IGLYO Joint Statement

The largest and oldest international LGBT watchdog ILGA, one of the largest and oldest international trans watchdogs Transgender Europe, and the largest LGBT student group IGLYO released a joint statement criticizing UK government policy and said The “Keeping Children Safe in Education 2024” guidance uses the Cass Review as an evidentiary basis for this policy change, despite its poor and inconsistent use of evidence, pathologising approaches, and exclusion of service users and trans healthcare experts. As stated by healthcare activist and feminist researcher Dr Ruth Pearce in an article titled “What’s wrong with the Cass Review? A round-up of commentary and evidence” (2024), the Cass Review “has been extensively criticised by trans community organisations, medical practitioners, plus scholars working in fields including transgender medicine, epidemiology, neuroscience, psychology, women’s studies, feminist theory, and gender studies”.

@Void if removed removed it saying this is about a government action, and it happens to mention the Cass Review in passing. This is not due, and also citing a blog?

1. This is about a government action explicitly justified by the Cass Review, which the statement spends a paragraph critiquing
2. They explicitly reference the blog in their statement. We aren't citing it directly, we're providing a courtesy link to who ILGA et al cited.

Today alone, you removed the fact the UK's LGBT doctors org explicitly criticized it, that the labour party's LGBT chapter criticized it , and are now removing criticism from Europe's largest LGBT rights watchdog and trans rights watchdog by claiming, somehow, a paragraph criticizing the Cass review is not relevant to the section "Reception by charities and human rights organisations". That's today alone, there are dozens of diffs of you trying to remove criticism from LGBT rights orgs, hell you even tried to remove that PATHA criticized them for whitewashing a form of conversion therapy.

Please self-revert. This is painfully obviously due, and your continued removal of criticisms from LGBT orgs is getting tendentious to the extreme. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:54, 2 January 2025 (UTC)

ILGA are huge and influential. If ILGA release a statement about the Cass Review, and it gets coverage in a RS, it is arguably more due than the Stonewall and Mermaids statements.

This, OTOH, is a self-published statement about a completely different matter, 9 months after the release of the final report. that happens to mention the Cass Review. It isn't a response and doesn't belong in "reception".

Now, if we had a section for wider impacts, or further coverage about related sociopolitical events, there's a case for it there, but even so, I'd hope for a secondary source that directly links this statement to the Cass Review. For example, perhaps if we had coverage of the "Keeping Children Safe in Education 2024" guidance that RS explicitly linked to the Cass Review, and a section in "wider impacts" or something that mentioned it and explained what it was, then this response to that guidance would go there.

And citing a blog is terrible sourcing.

So I would say: if this statement gets reliable secondary coverage relating it to the guidance, and there's coverage of the guidance relating it to the cass review, and we build enough to make a section relating all three things together in some sort of "wider impacts" or "subsequent events" section of this article, then it would be due. Void if removed (talk) 21:56, 2 January 2025 (UTC)

I dont understand why we cannot use advocacy group statements in attributed voice on Misplaced Pages in a reception section, and you just admitted that they are a giant watchdog. I also do not understand, this is clearly a large portion of info about the Cass Review and its effect on government policy. It is like arguing that a report about lung cancer criticizing cigarettes as a cause for cancer in a single paragraph is not about cigarettes and cannot be used as evidence.

The statement isn't a blog either and is part of the IGLYO website. this seems like tendetious editing. Bluethricecreamman (talk) 22:13, 2 January 2025 (UTC)

I dont understand why we cannot use advocacy group statements in attributed voice on Misplaced Pages in a reception section

If it were ILGA's statement upon the release of the Cass Review you'd have a point. That's not what this is, it is a statement about a different thing, months down the line.

The problem here is the longstanding resistance to expanding this article and instead turning "reception" into a coatrack, because it seems everyone wants their favourite response to be in "reception".

I would like to expand this article. I think you could make a better case for this statement as part of an expansion in a different section. It isn't "reception" because this is months down the line and a response to a completely unrelated political matter.

I think a better approach rather than continuing to bloat "reception" with ever more tenuous things is: make the case that the political matter itself is due, explain what it is and why, and then include ILGA's response to that.

The Cass Review is significant. It has had a significant impact. Now lots of subsequent matters rely on it. I think it is well past time to try to move past "reception" and into broader matters, and I would like to see the subsequent critical to and fro in that light, where they can be properly presented.

The guidance in question is here and the sole reference to Cass is:

However, the Cass review identified that caution is necessary for children questioning their gender as there remain many unknowns about the impact of social transition and children may well have wider vulnerabilities, including having complex mental health and psychosocial needs, and in some cases additional diagnoses of autism spectrum disorder and/or attention deficit hyperactivity disorder

That's literally it, and it is hardly contentious. Now if there's secondary coverage of this guidance, that makes the point it is directly the result of the Cass Review, then there's a case to be made for creating a section in "subsequent government actions" for this, and then arguably ILGA's response would be due as a response to that. I couldn't find any but I didn't look hard so be my guest. The only ones I found on a cursory search making a big deal out of it is Sex Matters, but that's nowhere near enough, it needs secondary coverage to make it notable, not just advocacy orgs taking predictably polarised positions.

The statement isn't a blog either

The edit included a citation to a blog. Void if removed (talk) 22:31, 2 January 2025 (UTC)

To be clear: this is a blog, by someone very invested in collecting every bad thing anyone said about the Cass Review all in one place. This is not a reliable source for anything, and there's no reason to cite it. Trying to justify citing it by calling it a "courtesy link" is no policy I've ever come across. As it stood, the edit inappropriately inflated the opinion of this individual blog.

We have a longstanding consensus to avoid individual responses in the "reception" section because there are so very many of them, and if we start adding them, there are a dozen higher quality ones in the queue before this one. Trying to add one like this, attached to the ILGA statement, is reopening an old argument.

So aside from the fact ILGA aren't even responding to the Cass Review I also strongly object to trying to get this extensive opinionated quote in:

They also quoted healthcare activist and feminist Dr Ruth Pearce, who collated criticisms of the review and said it "has been extensively criticised by trans community organisations, medical practitioners, plus scholars working in fields including transgender medicine, epidemiology, neuroscience, psychology, women’s studies, feminist theory, and gender studies"

Attempting this simply because ILGA cite this blog is ridiculous when we've excluded far, far more weighty and significant contemporaneous individual responses from, say, the editor-in-chief of the BMJ and surely nobody wants to have the "individual response" argument all over again. Void if removed (talk) 22:57, 2 January 2025 (UTC)

Bruh, ILGA cited them and quoted them. It was not cited for the statement, ILGA was cited quoting them. It would be silly to not provide a courtesy link. It is common practice on Misplaced Pages, when a source quotes and references another, to link the original.

We have a longstanding consensus to avoid individual responses in the "reception" section - Once again, it was ILGA et als response being quoted. The fact you don't like what they quoted doesn't mean they didn't quote it. If we have a source that says "BMJ editor-in-cheif said so and so", that would be different, but we don't. Apples and oranges. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:09, 2 January 2025 (UTC)

that would be different

It is not - we have dozens of sources of individuals being quoted, and we took the decision not to include any of them because it was so contentious, and it was more important to focus on what, say, WPATH thought, than what, say, David Bell thought. Once we got past the immediate and significant political and medical figures directly responsible for policy and implementation, just adding endless quotes from Doctor X saying "I think its great" and Doctor Y saying "I think its terrible" wasn't adding a lot. Void if removed (talk) 23:16, 2 January 2025 (UTC)

And here we have ILGA saying according to this collection of criticism and commentary of the Cass Review, it is xyz. Those are individual responses, this is a collation of responses that ILGA thought important enough to name, quote, and reference. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:22, 2 January 2025 (UTC)

Well, let's get some outside opinions. Would you like me to ask at WT:CITE, since this seems to be a question closer to formatting than to whether her blog contains the quote? Or do you have a different policy/guideline/noticeboard that you think would be more relevant? WhatamIdoing (talk) 23:34, 2 January 2025 (UTC)

That might help actually! Though, I did just find MOS:QUOTE saying Per the verifiability policy, direct quotations must be accompanied an inline citation which seems straightforward. Formatting and policy wise, when have source A saying X and and as B said Y, it makes sense to cite it as A said X. It cited B saying Y.Somebody should make WP:RECURSIVEQUOTES for this lol Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:55, 2 January 2025 (UTC)

WP:V only requires a single source.

I've posted it at Misplaced Pages talk:Citing sources#Convenience links. It took a while to figure out how to explain the situation for people who know nothing about the subject matter, but I think it will be clear enough. We'll probably get at least one response in the next 24 hours. WhatamIdoing (talk) 04:37, 3 January 2025 (UTC)

Interested to see what other people say. WP:CONVENIENCE is about alternative hosting for the same source. So, eg, a formal citation to a book, and a convenience link to an archived public domain copy. I can't see how that justifies adding a direct citation to a blog mentioned in a source. Void if removed (talk) 09:36, 3 January 2025 (UTC)

First response: It's permitted but not required.

Years ago, we did something similar for mass media explanations of medical sources, with the |lay-source parameter in {{cite journal}}, but it wasn't used much, and eventually the community voted to remove the parameters, with the idea that any such secondary source should be presented with its own little blue clicky number (or a WP:REFBUNDLE). WhatamIdoing (talk) 23:29, 4 January 2025 (UTC)

a response to a completely unrelated political matter. - How exactly is UK government policy explicitly justified by the Cass Review "Completely unrelated"?

We should expand on the anti-trans schools guidance, and note ILGA's criticisms, in the section on "Subsequent government actions in the UK". But also cover what they explicitly said about the Cass Review itself in the section on human rights orgs.

WRT That's literally it, and it is hardly contentious. - That is ridiculously contentious...

• Almost every criticism of the Cass Review highlights the fearmongering about supposed dangers of social transition. It's a human right, not requiring any kind of "caution".
• Almost every criticism of the Cass Review highlights referring to kids who explicitly identity as trans "gender questioning".
• Right after the Cass quote, they recommend multiple things Cass called for, which were also heavily criticized such as 1) outing trans kids to their parents 2) telling parents to take their pre-pubertal (ie, in no need of any medical treatment) trans kids to a clinic
• As ILGA noted, the guidance previously said trans kids should be affirmed. That was replaced with "LGB kids should be affirmed", followed immediately with However, the Cass review, which is then followed by saying Cass's recommendations about trans kids

The edit included a citation to a blog. which ILGA et al explicitly referenced and linked. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:00, 2 January 2025 (UTC)

How exactly is UK government policy explicitly justified by the Cass Review

Do you have some good secondary sourcing for that? If so, please, expand on this in "subsequent government actions", ideally under a heading like "Keeping children safe in education 2024 guidance" and add the ILGA response there.

which ILGA et al explicitly referenced and linked

So? Void if removed (talk) 23:06, 2 January 2025 (UTC)

I said How exactly is UK government policy explicitly justified by the Cass Review "Completely unrelated"?. You have no compelling arguments for why it isn't, we have a statement from multiple reliable watchdogs that it is. Also, the fact it's blindingly obvious and verifiable. The guidance changed from "affirm LGBT youth" to "affirm LGB youth, however the Cass Review said XYZ about trans kids, so do the things Cass said for trans kids",

Like I said, ILGA's response to the guidance can go into a section on education, but the response to the Cass Review should be in the normal place.

So? If we mention what ILGA said, we mention the quote they gave, and there's no good reason not to provide a link and plenty of reasons too. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:20, 2 January 2025 (UTC)

You keep saying How exactly is UK government policy explicitly justified by the Cass Review.

I'm asking you to provide secondary coverage that would justify this statement.

If it is indeed explicitly justified by the Cass Review, I would very much like to see a dedicated section explaining how, and then the ILGA statement in response, because that is what ILGA are responding to and it demonstrates, for better or worse, the wide impact of Cass on policy, and the ongoing criticism of Cass by orgs like ILGA every time that policy comes up. This would benefit the article as a whole. Void if removed (talk) 23:29, 2 January 2025 (UTC)

Page 55 of the DfE guidance says to consult the Cass Review in this area. The guidance is here. Lewisguile (talk) 13:06, 5 January 2025 (UTC)

very clearly due and should be included. Bluethricecreamman (talk) 22:07, 2 January 2025 (UTC)

Clearly due. The source is appropriate as per WP:USESPS and WP:ABOUTSELF, since ILGA is a well-recognized expert group and because the statement concerns the source itself.

The revert was unwarranted and the content should be reintroduced. HenrikHolen (talk) 23:12, 2 January 2025 (UTC)

@Void if removed I don't have the energy for this. Consensus is against you, you aren't convincing anybody, please self-revert so this can be dropped. Best, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:26, 2 January 2025 (UTC)

I've started wondering (not just due to this, but this is a fine example) if Misplaced Pages's whole notion of sourcing is rapidly becoming outdated.

Fifteen years ago, when our Official™ Rules started calcifying, we would have said that if ILGA/this joint statement was actually important, you would know that because someone other than the self-publishers would have picked up on it. There'd be a newspaper article, or a magazine story, or some independent source we could cite. If we were lucky (and we frequently were) that source would combine several, so that we had a single source telling us which of several press releases we needed to pay attention to.

But here we are, four months later, and it sounds like nobody's picked this up. Traditionally, we'd have said that was evidence that the joint statement was not important to get mentioned on Misplaced Pages, as it's too easy for editors to accidentally end up with NPOV failures if we get to cherry pick which sources we personally deem important.

That said, in this case (and some others), I wonder if the problem is that our old assumptions about journalism are now unrealistic. Why would the news media write a story about this statement, when the people who want to read about it have already heard all about it on social media? WhatamIdoing (talk) 04:52, 3 January 2025 (UTC)

Here's how I'd expect something like this to be covered:

In September 2024, the UK Government released new statutory guidance for schools and colleges, titled "Keeping children safe in education 2024". This provided guidance for safeguarding in education, covering a variety of topics from physical abuse to mental health, along with escalation pathways and statutory duties for educators. The guidance contained new measures explicitly justified by the Cass Review, regarding social transition within the education environment, cautioning that schools and college should be aware of the Review's findings and guidance in this area. IGLYO, ILGA-Europe and TGEU released a statement strongly condemning the new guidance, expressly criticising its reliance on the Cass Review as an evidentiary basis.

Or something similar, expand ILGA's effusive condemnation as appropriate etc. If that could be sourced I would support that at a minimum for starters, and as I suggested, it would fit nicely under "further government actions".

The problem is that everything up until the mention of the ILGA statement has absolutely zero coverage that I can find. This guidance has been roundly ignored by the press since it came out 4 months ago, nobody has made any connection to the Cass Review outside of activist groups, and the mention of Cass in the actual document boils down to a single paragraph in a 180-page document, making the "explicitly justified" overstating things somewhat. Without the underlying guidance being notable, and without it having some relation to the Cass Review as established in a RS, there's no real grounds for incorporating ILGA's statement on this page, as if it were a direct response to the Cass Review when it is - very explicitly, from the title on down - a response to new statutory guidance and a criticism of that guidance's reliance on the Cass Review.

So I would say you could make a case that ILGA etc are big and notable enough that their self-published statement doesn't need a secondary source to establish notability, but I think you need a secondary source to establish the notability of what they're actually responding to, and that connects that government guidance to the Cass Review, so you can hang the ILGA statement off it. Otherwise we're going to be mining every activist statement that responds to every policy downstream of the Cass Review, and chucking it in "reception" pretending they're responses to Cass, when they aren't - they're responses to further events the Cass Review precipitated, which individually should be included if they're notable. Void if removed (talk) 09:18, 3 January 2025 (UTC)

I thought the source itself was fine (subject matter experts talking about themselves and not about a BLP), and it is notable. But it's probably too long where it was. I would support it going under "further govt action" as per @Void if removed. I'd suggest the following:

In September 2024, the UK Government released new statutory safeguarding guidance for schools and colleges, titled "Keeping children safe in education 2024". Among the topics covered by the guidance, it contained new measures regarding social transition within the education environment, saying that schools and colleges should follow the Cass Review in this area. International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), international LGBTQ student organization IGLYO, and Transgender Europe released a joint statement condemning the new guidance, and criticising its reliance on the Cass Review for its "poor and inconsistent use of evidence, pathologising approaches, and exclusion of service users and trans healthcare experts". Lewisguile (talk) 11:19, 3 January 2025 (UTC)

Ok, now find a good secondary source for the first two sentences to establish notability and relevance of the topic to Cass so we're not just cobbling it together from WP:OR and primary sources and I'll agree.

The best I found was:

https://www.tes.com/magazine/analysis/general/keeping-children-safe-in-education-kcsie-safeguarding-guidance

Which describes it as "only minor changes in language", stressing how inconsequential the update is, and no reference at all to Cass or social transition. Absent a better source, this seems to not be WP:DUE. Void if removed (talk) 15:41, 3 January 2025 (UTC)

A primary source is adequate for the first two sentences, since the interpretation is provided by the second source itself (the ILGA statement). The DfE report mentions the Cass Review directly on p. 55. As the DfE is an expert source on this area, there's no problem using it. Your source also helps. Secondary sources are needed for interpretation – but the IGLA statement is a secondary source for the purposes of discussing the DfE report. Lewisguile (talk) 12:53, 5 January 2025 (UTC)

I'm not entirely sure that your primary/secondary analysis holds up. I'd have to spend more time looking at what, exactly, the joint statement says. Something like "This report uses the Cass Review" could be a simple WP:LINKSINACHAIN situation and therefore still primary. Also, the DfE document is not the Cass Review or either of the Cass Reports, so what the joint statement says about the DfE document is irrelevant.

Even if we stipulate that the joint statement is secondary, it is also self-published, which is a reason to not use it at all.

To look at our third usual point, although I don't think Misplaced Pages:Independent sources addresses advocacy groups specifically (at least, it didn't when I re-wrote it years ago), it is possible that the community would not judge them to be an independent source, either. It would depend on whether editors saw the organizations more as political rivals. Two candidates for the same political office, or two businesses producing rival products, would not usually be considered independent. If editors saw advocacy groups vs government agencies in a similar light, they'd consider it non-independent, which would be another reason not to use it at all. But they might see such orgs as completely independent. I really don't know what they would say if we asked, e.g., whether People for the Ethical Treatment of Animals is independent of veganism, or of a law promoting meat-eating that they oppose. That would be something interesting (to me, anyway) to discuss elsewhere, unrelated to this joint statement. WhatamIdoing (talk) 05:45, 6 January 2025 (UTC)

The DfE guidance is relevant because it says "because of the Cass Review, we should do x", and then ILGA and others commented on that. Regardless of how one feels about the IGLA statement, the DfE guidance is a potentially relevant topic for the "other government responses" section. The DfE is generally considered notable and reliable, and few people would argue against its inclusion. A literal reading of policy does mean it's also "self-published", but that's the tension inherent to the policy and guidance we have in this area.

If we do include the DfE guidance, the second question is whether the ILGA/IGLYO statement should also be mentioned with it, whether it should be mentioned separately in charity responses, or whether it shouldn't be mentioned at all. That's where consensus is needed.

The DfE report is certainly notable. ILGA is generally considered notable and an expert in its area, as is IGLYO. They are writing within their areas of expertise, in this case. From this past discussion at WP:V, I see that many people did

Given differences in how policy is interpreted, I think we can resolve this with consensus among ourselves. VIR suggested some wording upthread, which I have tweaked and offered some sources for, and I think that could be used (potentially with more sources if needed).. Lewisguile (talk) 12:08, 6 January 2025 (UTC)

I agree that the Department for Education is WP:Notable, but I disagree that "The DfE report is certainly notable". Do you mean that the report is subjectively important to you?

The story here appears to be:

• A government agency issued a 185-page-long document. It mentions the subject of this article by name in exactly one (1) sentence. 99% of the document is not about trans students, gender-questioning students, or anything else related to the subject of this article.
• That one sentence is under the bold-faced subheading that says "N.B. This section remains under review, pending the outcome of the gender questioning children guidance consultation, and final gender questioning guidance documents being published."
• Three advocacy organizations have self-published a joint statement objecting to the Cass Review's POV being mentioned.
• No independent media has mentioned the Cass Review in connection with the DfE's document.
• No independent media has mentioned the joint statement objecting to the DfE's document mentioning the Cass Review.

Are we agreed on these facts? WhatamIdoing (talk) 20:42, 6 January 2025 (UTC)

I think the statement should be mentioned in the article (as it is significant), but no more than a single sentence should be needed. Also, I agree with Void that the blog should not be cited, nor is it necessary to discuss the blog post specifically. Nosferattus (talk) 07:00, 4 January 2025 (UTC)

Are you saying that it's "significant" that this trio of organizations issued a press release? How do we know that this is significant, since other reliable sources have apparently completely ignored it?

I think that both Void's suggested text above and Lewisguile's might be vulnerable to a WP:SYNTH challenge precisely because all the sources have ignored it. WhatamIdoing (talk) 23:38, 4 January 2025 (UTC)

@Nosferattus' suggestion works for me. The ILGA statement is a primary source on itself but a secondary source on the DfE report. The DfE report is a primary source on itself and a secondary source on the Cass Review (p. 55). The DfE is also an expert in this area (education policy). So, the ILGA statement comments on the DfE report which comments on the Cass Review. The ILGA statement and the DfE report can both therefore be cited for this statement.Lewisguile (talk) 13:02, 5 January 2025 (UTC)

Well quite, my example was how it could be written if sources existed to justify doing so.

I looked and they do not. There's no notable secondary coverage of this guidance, which has been ignored for four months, and what little there is makes no mention of Cass and describes it as a fairly trivial update.

I think we need a higher standard for statements to be added to the "reception" of the Cass Review, in that they are principally about the Cass Review, and not about tertiary events. I have no objection to including these in response to tertiary events elsewhere (and as I've made clear would actively encourage that approach), but unless that tertiary event becomes notable, this statement - no matter how notable the organisation issuing it - is also not notable.

Trying to assemble the wording I posited as a hypothetical from primary sources is SYNTH. Void if removed (talk) 14:48, 5 January 2025 (UTC)

The guidance has been discussed by several legal organisations, who also note the impact of the Cass Review

• Here: https://www.hcrlaw.com/news-and-insights/kcsie-2024-what-to-expect/
• And another: https://www.stoneking.co.uk/literature/e-bulletins/have-you-implemented-changes-keeping-children-safe-education-kcsie-2024
• And here: https://www.irwinmitchell.com/news-and-insights/expert-comment/post/102jhbf/keeping-children-safe-in-education-guidance-whats-changed
• And here: https://wslaw.co.uk/insight/keeping-children-safe-in-education-2024-the-main-changes-and-action-required/
• And here: https://www.brownejacobson.com/insights/keeping-children-safe-in-education-kcsie-2024-the-main-changes-and-what-to-do-next
• The draft DfE guidance was also mentioned here: https://www.irwinmitchell.com/news-and-insights/expert-comment/post/102j6jj/cass-review-implications-for-schools-and-colleges

LifeLessons, an education website, published an article about it here: https://lifelessons.co.uk/resource/kcsie-updates-2024/ The Key, originally a government start-up, also wrote about the guidance here: https://schoolleaders.thekeysupport.com/pupils-and-parents/safeguarding/managing-safeguarding/keeping-children-in-safe-education-kcsie-changes-september-2024/?marker=content-body (both mention the Cass Review). Lewisguile (talk) 12:43, 6 January 2025 (UTC)

Thank you, I did find most of these when I was looking before but since they're all WP:SPS I didn't think this was notable coverage. I was hoping for a news report that the guidance had even been updated.

Of them, the ones that I think make the most of the Cass Review are:

https://www.hcrlaw.com/news-and-insights/kcsie-2024-what-to-expect/

Another change made is in the ‘Children who are lesbian, gay, bisexual or gender questioning’ section. This has been adapted to comply with the gender questioning children guidance terminology. The guidance notes that schools should take a cautious approach as there remain many unknowns about the impact of social transition, and children may have wider vulnerabilities. When families and carers are making decision about support for gender questioning children, KCSIE 2024 notes the recommendation of the Cass review that they should be encouraged to seek clinical help and advice. Schools should consider the broad range of their individual needs, in partnership with the child’s parents when supporting a gender questioning child.

https://www.stoneking.co.uk/literature/e-bulletins/have-you-implemented-changes-keeping-children-safe-education-kcsie-2024

New wording has been inserted at paragraphs 205 – 209 following the publication of the Cass Review, which, in summary, urges school to “take a cautious approach” and consider the “broad range of individual needs” when supporting a child who is gender questioning.

https://wslaw.co.uk/insight/keeping-children-safe-in-education-2024-the-main-changes-and-action-required/

this update found in paragraphs 205 – 209 was to be expected following the release of the Cass review report. The main thrust of these paragraphs is that schools exercise caution due to the many unknowns about the impact of social transitioning and need to consider the broad range of needs that the child may have, to include complex mental health and psychosocial needs, and in some cases additional diagnoses of autism spectrum disorder and/or attention deficit hyperactivity disorder.

Several point out this section is still a work in progress and as the document itself states:

This section remains under review, pending the outcome of the gender questioning children guidance consultation, and final gender questioning guidance documents being published.

Based on these, if it were to be used I'd phrase it something like:

In September 2024, the UK Government released new statutory safeguarding guidance for schools and colleges, titled "Keeping children safe in education 2024". Following the Cass Review, the guidance contained new draft measures recommending a cautious approach to social transition within the education environment due to the many unknowns, and to consider that gender-questioning children may have wider vulnerabilities. International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), international LGBTQ student organization IGLYO, and Transgender Europe released a joint statement condemning the new guidance, and criticising its reliance on the Cass Review for its "poor and inconsistent use of evidence, pathologising approaches, and exclusion of service users and trans healthcare experts".

I still don't think that, without some sort of notable coverage of the first event, this is due. Looking at the other events in the section on "subsequent government actions" they are based on widespread coverage on the BBC, CNN, the Times, The Independent, The Telegraph and The Guardian. If we're having to scrabble round with WP:SPS, this isn't comparably notable. But if others disagree, this is how I'd suggest inclusion. I just get the impression this is work in progress guidance that hasn't become a significant event yet, but might once it is finalised. The outcome of the consultation is due to be published in 2025.

(On notability - the glaring exception is the section on the charity commission/mermaids which IMO is UNDUE and should be removed.) Void if removed (talk) 13:40, 6 January 2025 (UTC)

Fair enough. I'd be fine with your wording (probably removing "due to the many unknowns" as redundant given that's already clear from the rest of the article), but on reflection, I don't think it's necessary to go in just now, either. As you say, the final guidance will probably be more notable and will get more coverage. At that point, the ILGA/IGLYO statement might be superceded anyway.

I've also just realised my browser scrambled my earlier post (sometimes happens when I hit publish). I've edited it to be legible. Sorry about that! Lewisguile (talk) 14:44, 6 January 2025 (UTC)

I'm doubtful that this is WP:DUE, since we only have self-published sources.

Law firm websites, in particular, use this kind of post for advertising purposes. It's not considered sufficiently dignified to do hard-sell advertisements, so they subscribe to content services such as these to get blog posts. (AI must be a boon for these services; you can write it once, and then generate a dozen "unique" variations.) Accountants do the same. WhatamIdoing (talk) 20:51, 6 January 2025 (UTC)

Methodology V3.0

Hi @13tez,

I've taken a stab at a new consensus version of Methodology, using your comments and some feedback from others. This is a new topic to avoid getting lost in a wall of text. Changes and reasons as follows:

• Restored assessment tools but removed the Times source for why these were used per WP:MEDPOP, as it was conflating two different things (it's standard practice to assess studies in meta-analyses; that's how you know how to weight stuff).
• Per the discussion with @WhatamIdoing, I reworded the sentence about limitations/scope so it hopefully doesn't read as criticism (we all seemed agreed that it wasn't). Now it is more focused on what the review did do, not on what it didn't. E.g., it says it "examined English-language studies of minors" rather than "it excluded non-English studies", etc. I have added an endnote after "minors" to clarify that the systematic reviews looked at ages <=18, while the qualitative review included people up to 30 to speak about their prior experiences. This is important, I think, because there has been some confusion about whether the report covers people aged 19–25 and whether the evidence reviews can be extended to this age range or older. But as an endnote, it's out of sight. Another possibility would be to replace "minors" with "participants up to 18 years old" to be absolutely clear in the body text, but that felt too long.
• I have merged the MMAT and NOS info into the bit about confidence ratings, so that we haven't removed @Your Friendly Neighborhood Socialist's additions but now they're more explicitly relevant. (An alternative would be to use some of the Yale comments about use of these tools instead, but that feels like a whole other can of worms.
• For the evidence base, I used Cass and the BMJ as sources for "assist" and "supplemented", rearranging the order a bit as per those sources. Because the "engagement programme" is explicitly supplementary, I've put that at the end, as it was in my prior edit and yours. Because the qualitative/quantitative research is described as supplementary and part of the research programme in the BMJ overview, I have put that with the York stuff, but have marked it as supplementary in the text. As I understand it, York wasn't involved in the focus groups, etc, so this also clearly delineates the research programme from the engagement programme. (I can see the latter were performed by market research types.)
• I have updated the BSN note to better reflect where that conversation left off, although I still think there was generally consensus that the source itself is high quality (regardless of whether one thinks it's exactly equal to Cass or not) and that the approach taken by Cass for her own conclusions and recommendations is a narrative one (a narrative review can use systematic reviews as well). Personally, I would remove that tag, but didn't want to without confirming you were satisfied first.
• The agreed upon endnotes should all still be intact as well. @Snokalok, did I get yours in here too?

I think that should cover most of our concerns. I'm sure there are still bits we both think should/shouldn't be there, but I feel happy with this level of compromise. Is it okay with you?Lewisguile (talk) 10:52, 3 January 2025 (UTC)

I don't think this though certainty-of-evidence ratings were not provided for individual outcomes makes sense in isolation. What's happening here is that the RAND report took one approach, and the York reviews took another. The RAND report simply lists the differences in approach, so saying what the York reviews did not do in this way is misleading. It is like York cycled to work, Rand drove to work, and so we say in wikivoice "York did not drive to work". I think far too much is being made of this fleeting comparison. Also, again, that opening sentence - the Cass Review was a process, that ended up producing two reports, only the first of which this document describes as a "narrative review". Describing the process as a "narrative review" doesn't make sense, and in any event the only thing this source can plausibly be used to describe as a "narrative review" is the interim report, so this claim as presented is unsupported by the source. Void if removed (talk) 11:35, 3 January 2025 (UTC)

Re: process versus review: The problem is that we can cite a review but we can't cite an intangible "process". Even if that process is outlined in a document, it's the document we're referencing. However, we could change the wording to clarify that we're talking about the reports/conclusions and recommendations themselves, such as: The Cass Review's final conclusions and recommendations were published in a non-peer-reviewed narrative review, which synthesised evidence from multiple sources to make policy recommendations for services offered to transgender and gender-expansive youth in the NHS...? But that seems more complicated.

Re: certainty of outcomes: it's relevant to know that confidence ratings weren't published for individual outcomes. Confidence ratings aren't necessarily interchangeable with quality ratings, but also, if you want to know specific confidence ratings for particular/individual outcomes in different studies, rather than the quality rating of studies as a whole, these SRs won't provide that information. That is a significant difference from most systematic reviews conducted by NICE, the WHO, and others, and is a notable limitation (though that doesn't mean it's necessarily a criticism either). GRADE, which is the international standard for systematic reviews (rather than the MATT and NOS), does provide this data because confidence ratings can vary between different outcomes in a single study, as well as between studies. This then allows you to pool outcomes across different studies, while properly weighting it. The Cass Review doesn't do that, even though it's an international standard, so that should be noted. Lewisguile (talk) 12:30, 3 January 2025 (UTC)

Even if that process is outlined in a document, it's the document we're referencing.

No, the "methodology" section refers to the review as a whole. This is the process by which a series of systematic reviews were commissioned, stakeholder involvement took place, and two reports were produced.

This page is about The Cass Review, and the final report of The Cass Review has its own dedicated section within it. This is the wrong place for this information, even if were correct or due.

When you cite "The Cass Review", what you're citing is the final report of the Cass Review. See all the citations on the page to "Cass review final report 2024". Describing the process by which that final report was produced as a "narrative review" makes no sense whatsoever.

The Cass Review's final conclusions and recommendations were published in a non-peer-reviewed

We can't say that because it isn't true and it isn't sourced.

Put it another way - WPATH's SOC8 is not a "narrative review" - it is a set of guidelines and best practices. However, within it, Chapter 6 (Adolescents) contains a narrative review.

a systematic review regarding outcomes of treatment in adolescents is not possible. A short narrative review is provided instead.

If someone were to refer to the evidence on adolescent treatment in SOC8, they might accurately describe it as a narrative review but it would be an inaccurate description of SOC8 as a whole.

In the RAND document, they describe the interim report of the Cass Review on the topic of "Gender dysphoria treatments" as a "narrative review". That might be true. Therefore, with this source, you could say that the Interim report of the Cass Review contains a narrative review of gender dysphoria treatments.

But that is not everything contained in the interim report, and to describe the whole document as a "narrative review" is as wrong as calling the WPATH SOC8 a "narrative review", and neither of which are as wrong as calling a 4-year independent service review a "narrative review".

This is all a very unnecessary series of hoops to jump through to justify an inappropriate label. I simply don't understand why so much energy is spent on trying to wrongly describe an independent service review as a narrative review. Void if removed (talk) 15:16, 3 January 2025 (UTC)

I disagree that the scope of the article is about a process rather than the product of that process. In 10 years, people may still be referring to the final report, but they won't be talking about the process (except inasmuch as it informed the final report). The process itself isn't notable but the report and its conclusions/recommendations are. Consider the Scarman Report and MacPherson Report – they're relevant for their recommendations and not for the process of writing them. The process is only relevant to explain how the final report came about.

I also think "narrative review" is a WP:SKYBLUE statement for the final report, since it describes the existing literature base and uses that to make conclusions and recommendations of its own. For those who weren't satisfied with that, RAND also suffices to source this statement (the protocol didn't change between the interim and final reports, only before that point, so it didn't change from one type of review to another). It also seems the clearest and most precise language we can use which explains to the lay person what the review is (e.g., I can't find a page on here that satisfactorily explains what an "independent review" is, in this context, because the term is so broad).

All that said, I think the article is looking good and I appreciate we've all done some compromising here, including you. I don't want to be unreasonable – and, as I've said before, I'm not particularly attached to using the "narrative review" language even if it seems accurate to me. I'd be happy with "non-peer-reviewed, independent service review" if we can get consensus on it. I think it was @Your Friendly Neighborhood Sociologist who originally added the "narrative review" wording. So, if they're happy with it, we could use that wording instead? Lewisguile (talk) 12:33, 5 January 2025 (UTC)

I also think "narrative review" is a WP:SKYBLUE statement

I think it is WP:SKYBLUE that this is just incoherent language - it is comparing apples to bicycles, and doing so on the basis of one field in one table in one report by a US think tank that references only one subject area within the interim report. Neither the independent review itself, nor either of its reports, nor any of the other independent inquiries and reviews you brought up are "narrative reviews".

You seem to be under the impression that everything called a "review" must fall into a binary of either "narrative" or "systematic", when that's just terminology that applies to a specific form of literature review in academia. When a public body commissions an independent service review, that is neither of those things.

The Cass Review is an authoritative source on itself. It is an "independent review", or if you prefer an "independent service review". Not only that, it is referred to in those terms consistently across a wide range of secondary sources, just as other independent service reviews are. I don't think this is even remotely debatable. The current wording is both factually incorrect and not even supported by this one source. Void if removed (talk) 15:40, 5 January 2025 (UTC)

I've tried changing the opening line of methodology to ditch all language about what sort of "review" it was, and simply state what its remit was, which fits with the questions the methodology was supposed to answer. I also changed it to actually cite the review itself and use the language of the review for what its subject matter was instead of this US report, because the "gender expansive" language is incongruous and inconsistent with all other usage.

The Cass Review was commissioned to make recommendations about the services provided by the NHS to children and young people questioning their gender identity or experiencing gender incongruence. cited to: https://cass.independent-review.uk/about-the-review/terms-of-reference/ and https://cass.independent-review.uk/home/publications/final-report/

This is simpler and cleaner and doesn't require outside third-party sourcing. Void if removed (talk) 10:32, 6 January 2025 (UTC)

Our posts crossed. I've reverted your new wording as this also undoes a lot of other consensus wording from the past few weeks. I've just implemented "service review" instead, since you seemed to accept that as a compromise. Lewisguile (talk) 10:38, 6 January 2025 (UTC)

Please WP:AGF. I did offer a compromise, and I'm not under any binary assumptions – narrative reviews can include a variety of methods and can be used for a variety of purposes. Cass describes the literature, draws conclusions from it, and then makes recommendations based on those conclusions. That fits the definition of a narrative review. In the same sentence, we also state that it looked at NHS services and made recommendations for improvements in that area. And then we detail the research and engagement programmes. So nothing is left out by this description either – we're not saying it's A over B, we're saying it's A + B + a bit of C and D as well. RAND also describes the final report as a "summary of research evidence" on p. 31, which fits its description of the Cass Review as a narrative review in the table on p. 10. Describing it as "independent" or anything else doesn't contradict the "narrative review" part, and those other elements (reviewing a service) are already mentioned too. The nature of other reports and reviews is immaterial, but I didn't actually say they were narrative reviews either – I was comparing the scope of their articles.

If you feel that this isn't up for debate, then I'm more than happy to stick to the current wording ("non-peer-reviewed, independent narrative review"), since we've already discussed this and you're the only person continuing to challenge this wording at present. But I don't think you want that, which is why I'm trying to engage in discussion so we can reach a compromise. So, to clarify, would you be happy with "non-peer-reviewed, independent service review" as a compromise? I'm still hoping @Your Friendly Neighborhood Sociologist will support this as well, but I think we can have consensus between us if not. Lewisguile (talk) 10:35, 6 January 2025 (UTC)

I'd support that. I think it's more important to note the lack of peer review than the fact it was a narrative review. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 13:06, 6 January 2025 (UTC)

Perfect. That's 3/3. We can leave it as is. Lewisguile (talk) 13:39, 7 January 2025 (UTC)

International Guidelines

@Snokalok You've reverted my change here https://en.wikipedia.org/search/?title=Cass_Review&diff=prev&oldid=1267315347

There's no consensus for the Italian response being where you've placed it, because I added it where it was - this was a new addition. The point was this was additional and wider impact of the Cass Review on guidelines internationally, as it was with the Japanese ones - new context justifies new presentation of old information.

I simply don't understand your insistence on stuffing "reception" with this. Can you please explain why it is so important to you to have it there, rather than where I placed it, especially now we had new guidelines from Italy to justify this move? Neither are a "response" and both are examples of international guidelines taking account of the Cass Review.

Also, calling this "shot down 100 times" is very WP:BATTLEGROUND and hyperbole. I may be misremembering, but the only discussion on this specific move was here I think.

Your objection at the time was it makes them read the reception section and think those are the only responses. which again I don't understand - people will read as much of the article as they read, and they'll use the section headings to navigate or skip over information as appropriate. An ever-expanding dumping ground of "reception" is only making it more likely readers will give up rather than read nicely organised, summarised and well-presented information. Void if removed (talk) 17:43, 6 January 2025 (UTC)

Also I've removed the bit you added about Meloni which was WP:SYNTH - the source actually says:

This month, a separate National Bioethics Committee issued a nonbinding recommendation that puberty blockers be limited to controlled trials, with children allowed to enter only if they have been involved in psychiatric therapy, as well.

The Meloni appointees is a completely different committee. Void if removed (talk) 17:49, 6 January 2025 (UTC)

It's a different committee to the other one the article was talking about, but based on the context in the article they both must have been appointed by the Meloni government. Here's their website; you'll notice that they were created in December 2022 and Meloni took power in October 2022. Loki (talk) 18:54, 6 January 2025 (UTC)

That is SYNTH. Void if removed (talk) 19:22, 6 January 2025 (UTC)

Okay first off, calling “shot down 100 times” battleground is a stretch. The use of a military-based metaphor does not mean battleground, it just means that early 21st century English takes most of its idioms from military and wartime sources due to the fact that the English speaking world is always invading *somewhere*. If I say someone is “calling the shots”, I don’t mean they’re ordering a sniper to shoot someone, I mean they wield substantial directive influence.

With that aside, you’ve more or less answered your own question - people will read as much of the article as they read, and they'll use the section headings to navigate or skip over information as appropriate exactly, if people are looking for how it was received, they’ll look at reception, but if they don’t see Japan and Italy, they’ll think those countries aren’t part of the reception when they absolutely are, and there is no practical reason to separate them. Originally this was proposed I recall as further reception, and now as guidelines, but the fact is that, there’s no reason to separate guidelines anymore than further reception. It’s simply how the relevant org responded, how it received the Review. If you’d like to create a subsection of the “other global health bodies” for guidelines, I wouldn’t oppose that, but there is certainly no reason to remove Italy and Japan from the reception section entirely in favor of a completely separate section when guideline responses are objectively part of the Cass Review’s reception. Snokalok (talk) 17:58, 6 January 2025 (UTC)

The use of a military-based metaphor

That's not what WP:BATTLEGROUND means. Not everything has to be a fight.

there’s no reason to separate guidelines anymore than further reception

Other than that reception is turning into an unreadable dumping ground. It was discussed back in October when it was really only Japan at issue, with a fairly even split of interest, and even yourself saying you didn't mind the idea of initial/further reception, and IMO the emergence of new Italian guidelines changes that a bit.

to remove Italy and Japan from the reception

Italy was never in the reception. I added it where you removed it from. You've moved it to a new location. Void if removed (talk) 22:43, 6 January 2025 (UTC)

Not everything has to be a fight.

That’s what I’m saying. Using a military-related metaphor doesn’t mean I see us as opposing forces, it just is the way the English language has formed. If I say that an admin is “calling the shots” somewhere (an idiom derived from spotters giving orders or ‘calls’ for snipers to take a specific shot) I’m not saying the admin is ordering adverse surgical action against an enemy force, just that they wield some level of influence.

Other than that reception is turning into an unreadable dumping ground.

Mild disagree on the grounds that the blue/red text helps the reader see which countries said what very easily, and also, it’s much less bad on desktop.

Italy was never in the reception. I added it where you removed it from. You've moved it to a new location.

I reverted your creation of a new section to put certain receptions in, but I didn’t oppose the inclusion of the Italian guidelines, so when moving Japan back to reception per the revert, I put Italy there as well. If you want to delete Italy entirely until we sort this out since that would be a much more full revert, I wouldn’t contest that. Snokalok (talk) 01:16, 7 January 2025 (UTC)

If you want to delete Italy entirely until we sort this out since that would be a much more full revert

I'd appreciate it if you did that, with the other edits in the interim its simpler if you just take the whole paragraph out yourself (ie we treat that as you fully reverting it back to what it was before, and we BRD from there).

Returning to this concern:

if people are looking for how it was received, they’ll look at reception

So how about we stick a hatnote at the start of "reception" that says something like "This section covers the initial response to the publication of the final report of the Cass Review. For further in depth response and analysis see §x, for the impact on international guidelines see §y".

And then section link to the later sections (assuming we can agree to create them/name them)? That way any reader is under no illusion that the initial reception is all there is, and it gets away from this constant expansion of the reception with a blow by blow of increasingly disconnected events from several months down the line. Void if removed (talk) 10:33, 7 January 2025 (UTC)

I'd appreciate it if you did that

It’s done.

So how about we stick a hatnote at the start of "reception"

So, I’ll say that I vastly prefer “further reception” to a guidelines section, but consider also the idea that we simply divide up the current reception section by country the way we do on the puberty blockers article. Otherwise I’d want to perhaps discuss dividing reception up by specific time. That is, 2024, 2025, first year after, second year after, etc. But at the same time, I don’t expect us to have new material in future to rival that which we have now, so I’d perhaps suggest reception (first year after) and then reception (beyond April 2025) Snokalok (talk) 13:24, 7 January 2025 (UTC)

I could see it in going in either location, TBH. Happy to go with consensus on this one, or to be convinced either way. Lewisguile (talk) 13:38, 7 January 2025 (UTC)

UCU

@HenrikHolen you have reinstated the following text:

In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion saying that the review "falls short of the standard of rigorous and ethical research expected of research professionals" and "provides no evidence for the ‘new approach’ it recommends". The motion described the Cass Review as having "serious methodological flaws" and defined by "selective use of evidence and promotion of unevidenced claims". They resolved to "commit to working with trans-led organisations to resist the Cass Report recommendations".

Claiming this was "more neutral" than what was previously there which was:

In June 2024, the University and College Union's (UCU) national executive committee was condemned as "anti-scientific" by some academics after it unanimously passed a motion criticising the review and committing to "working with trans-led organisations to resist the Cass Report recommendations".

I remind you that WP:NPOV is about representation of sources, not about your own personal opinion. WP:CHERRYPICKING from sources to convey a particular POV that is not reflective of the balance of coverage in those sources is not NPOV.

With that in mind, the opening paragraph of the source in question - and thus the aspect that this source emphasises most strongly - is:

Academics have condemned the University and College Union’s decision to campaign against a widely praised independent review into NHS treatment for gender-questioning children, claiming its position is “anti-scientific” and could expose researchers to harassment.

By my count, that article is roughly half about the condemnation of the motion and praise for the Cass Review, and half coverage of the motion itself, which is why I specifically devoted about half the length to each in my revised wording. As it is, given the opening POV of the article, and its balance of coverage, I would say my text is a fairer representation of the source.

I ask you to self revert, or explain why you think your representation is an accurate and neutral representation of this source. Void if removed (talk) 22:57, 6 January 2025 (UTC)

Just so that we are on the same page, I reinstated the language from before your edit, this is not something I have written. The language of the current version succinctly describes the motion passed without making judgements as to whether this was the correct decision. Your edit editorialized the paragraph and created the impression that the author believes the UCU acted in error when passing the motion.

I am not opposed to including responses from third parties. However, when doing so, we cannot solely present the opinions of third parties who opposed the move. Moreover, the "academic criticism" in question refers to tweets by one professor and an interview with one other, not published academic literature. I have to question whether this is even due. HenrikHolen (talk) 00:26, 7 January 2025 (UTC)

I am frankly suspicious of using the Times as our sole source here. They're known to be biased on trans issues, and in my experience especially in this specific way, where they portray anything trans-supportive as controversial but anything trans-hostile as obvious.

I also second Henrik's skepticism that the criticisms they mention in this article constitute "academics have condemned", the very NPOV old framing. (Even if we rely on the Times for facts, there's no reason we need to copy their biased language.) I don't think that they even reach "academics were critical". Maybe "a small handful of particular academics were critical"; certainly it seems likely from the totality of the sources that WPATH would be fine with it, and they're academics. Loki (talk) 01:00, 7 January 2025 (UTC)

This is not about the motion, this is about the source. You are editorializing by selective representation of the source, excluding aspects that are reported with at least equal prominence. WP:CHERRYPICKING says A source must be fairly represented for the purpose of the article and that includes contradictory and qualifying information, see WP:BALASP for policy.

Again, from WP:CHERRYPICKING

As to contradictory information that needs to be reported in Misplaced Pages, if, for example, a source says "Charlie loves all blue coats and hates all red coats", to report in Misplaced Pages that according to that source "Charlie loves all ... coats" is cherrypicking from the source. It is cherrypicking words with the effect of changing the meaning of what the source is saying. It is cherrypicking even if the source is precisely cited. It is still cherrypicking even if the editor meant well in changing the meaning; the issue is not the editor's intention, but how the Misplaced Pages article represents the source's meaning.

This is exactly the case of this paragraph.

Your edit editorialized the paragraph and created the impression that the author believes the UCU acted in error when passing the motion

I did no such editorializing and created no such impression. I accurately represented the balance of treatment in the source, which gave no indication of the author's opinion, but merely the conveyed the reaction to UCU's actions, which was given equal weight in the originating source.

If you want to remove the paragraph because it isn't DUE, do so. Void if removed (talk) 10:50, 7 January 2025 (UTC)

I think you're misreading the cherry-picking guidelines. Cherry-picking would be to include only criticism of the UCU motion but not support, or vice versa. The current state includes no responses from third parties, neither supportive nor critical, and so I am struggling to see how that can be construed as cherry-picking.

When it comes to the language, the phrasing "was condemned for" in the topic sentence, in my view, creates a clear impression of wrongdoing by the UCU, and does not give equal prominence to the fact that the move was lauded by many.

I suggest we let other editors weigh in and possibly post this in WP:NPOVN

HenrikHolen (talk) 13:53, 7 January 2025 (UTC)

WP:BALANCE states Neutrality assigns weight to viewpoints in proportion to their prominence in reliable sources.

Meanwhile WP:WEIGHT states Neutrality requires that mainspace articles and pages fairly represent all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in those sources.

This is policy. It is not our job to give or avoid giving the impression of wrongdoing, it is our job to represent what RS say in proportion to the views presented in those sources. You could have argued for different wording to reflect this balance, but that's not what you did - you reverted back to a POV that is an inaccurate representation of the balance of views in the source, claiming it was "more neutral".

the move was lauded by many.

Can you quote the part from that source which says that? I don't see any. The only defence is from a UCU spokesperson defending their own actions.

You can argue none of this is DUE and take out the paragraph completely and I'd support that, but if you want to use this source, you should represent it accurately. Void if removed (talk) 10:14, 8 January 2025 (UTC)

I think the original text did editorialise with its framing, but the revised text does the same (albeit in the opposite way). Following that adage that "we describe debates; we don't engage in them", something like this might be better:

In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion committing to "working with trans-led organisations to resist the Cass Report recommendations". Political economy professor Thomas Prosser said the motion "risks making the union appear anti-scientific". Other union members said it suggested the union and its members were "against research", and that a union motion was an insufficient avenue to critique the review.

This way, we are describing the debate (group a said x, group b said y), without engaging in the debate ourselves. This details more of the critique of the motion than the motion itself without having to use the source's non-neutral tone. This is hopefully NPOV without omitting anything major. Anyone reading it can then make up their own minds or read the sources directly. Lewisguile (talk) 12:30, 8 January 2025 (UTC)

I think that's too much text for such minor coverage IMO, and much of the article itself is social media drama (ie the "against research" stuff is just posts on Twitter). All I'm after is a way of presenting the info in broadly the same proportion as it is in the source, not a blow by blow of everyone saying why they love/hate the motion.

I think "some academics" was a fair compromise, and its not necessary to name individuals.

I disagree with "insufficient", that's not anywhere in the source and I'm not sure what its a paraphrase of.

How about:

In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion criticising the review and committing to "working with trans-led organisations to resist the Cass Report recommendations". This was met with criticism from some academics and union members, who described the move as "anti-scientific". Void if removed (talk) 13:40, 8 January 2025 (UTC)

This seems like a fair middle ground. Barring any objections from other editors I would support amending the paragraph to VIR's proposed phrasing. HenrikHolen (talk) 15:25, 8 January 2025 (UTC)

Sounds good to me, too. I probably added too much in to try to balance it out. (E.g., "insufficient avenue" was my attempt to summarise the "Using a union motion to argue against a lengthy and detailed report was also unwise, suggested Alice Sullivan, professor of sociology at UCL"). Since we all seem to like VIR's version, I'll add that text in now. Lewisguile (talk) 17:07, 8 January 2025 (UTC)

I think if we have the “anti-scientific”, we should say what the criticisms were, lest we give readers the impression that criticism of the review itself is inherently anti-science; and thus we should have the quotes from the THE article. I’m going to boldly add them, if you take exception feel free to invoke the BRD. Snokalok (talk) 21:30, 8 January 2025 (UTC)

I was on the verge of suggesting this myself. I think it makes sense to include the UCU's stated motivations for opposing the Cass review. Thanks HenrikHolen (talk) 00:03, 9 January 2025 (UTC)

I've taken these out again, I just think 3 quotes from the same source assembled like this is overkill, and not balanced compared to the other coverage in the source - and once you start trying to balance it with more quotes from the critical POV, it gets bloated for something with so little coverage. "Anti-scientific" is just an attempt to find an NPOV way of describing the criticism (ie by quoting it directly, given the prominence in the source). If this quote can be instead summarised in different language that doesn't require more quotes back and forth trying to balance it, I'd favour that? Void if removed (talk) 10:48, 9 January 2025 (UTC)

On the one hand, I think VIR is right about length and WP:DUE here. On the other, I sympathise with the clarity issue re: the current wording. With that in mind, perhaps we could just change the text to: In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion criticising the review's methodology, sourcing and claims. (Deleting the rest after and committing to working with..., etc.) This keeps it brief, but focuses on the actual objections. Lewisguile (talk) 12:50, 9 January 2025 (UTC)

Sounds good to me. HenrikHolen (talk) 14:04, 9 January 2025 (UTC)

I’m fine with this as long as we take out the “anti-science”. That’s not something that I feel we can have without giving the UCU’s quotes as well Snokalok (talk) 16:16, 9 January 2025 (UTC)

I think the UCU's position is well covered with that. If we removed "anti-scientific", it starts to become unbalanced again. What wording would you suggest instead? Lewisguile (talk) 17:47, 9 January 2025 (UTC)

unanimously passed a motion criticising the review's methodology, sourcing and claims. What are they saying about such things? Are they saying that the review derived its conclusions from reading animal entrails? Are they saying it was bought off by the Catholic Church? We don’t know. All we know was that the review was criticized in these areas - and when you balance that with a direct quote of “anti-scientific”, you lend said rebuttal an air of greater credence, and make it seem as though the very act of criticising the review in such a capacity is reasonable to call anti-science Snokalok (talk) 19:11, 9 January 2025 (UTC)

I do prefer your proposed text over the current text though. Snokalok (talk) 19:11, 9 January 2025 (UTC)

I take your point, but I disagree there. I think we don't need to list the details (people can find those for themselves), as it takes up a lot of space and starts becoming WP:UNDUE. If anything, both the claim and counter claim are vague enough that it shouldn't sway a person either way (which is as intended). Saying something is "anti-scientific" without rationale is equally as unpersuasive as saying there are issues with methodology, sources and claims. The detached reader would probably (and should) think, "I'd need to read more about these claims to make my mind up" before deciding either way.

A better way to handle the entire Response section might be to summarise the key objections and the areas of key support/praise, and then cite those broadly ("Politicians generally supported x, while academics said y. Trade unions and LGBTQ charities said a, and human rights organisations said b..."), maybe with a couple of representative quotes as illustration. Or to separate it into media coverage, medical responses, and then general support/disagreement in civil/wider society. But that's probably a long way off.

To find a way forward, one way to compromise might be to add a short clarification as an endnote? That can go at the end of the UCU sentence. We probably need to do the same for the objectors' response, too, though. As much as I agree the Times is biased and highly emotive in this area, there's very little coverage elsewhere to rely on. Lewisguile (talk) 07:42, 10 January 2025 (UTC)

What’s your proposed wording? Also is it okay if we put your compromise wording above in for now? Snokalok (talk) 15:46, 10 January 2025 (UTC)

Another option is to swap to the later quote from the article, which is more caveated, ie "risks making the union appear anti-scientific" Void if removed (talk) 16:28, 10 January 2025 (UTC)

That's a good shout. So I think we have the following at the moment:

In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion criticising the review's methodology, sourcing and claims. This was met with criticism from some academics and union members, who said the move "risks making the union appear anti-scientific".

Does that seem acceptable for now? If so, we can always add the above while we iron out any other changes.

@Snokalok, for the endnote, I was thinking something like this: The motion said the review has "serious methodological flaws", "provides no evidence for the 'new approach' it recommends", and is based on "selective use of evidence and promotion of unevidenced claims".

If we put all that together, we end up with:

In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion criticising the review's methodology, sourcing and claims. This was met with criticism from some academics and union members, who said the move "risks making the union appear anti-scientific". Lewisguile (talk) 17:45, 10 January 2025 (UTC)

This is acceptable. I still think we can make it even better, but this proposal is acceptable. Snokalok (talk) 18:20, 10 January 2025 (UTC)

I'm sure we can make it better, too. If you want to add the interim wording while we sort that out, I think that will be okay now? Lewisguile (talk) 19:00, 10 January 2025 (UTC)

Done. Personally, I have a mixed relationship with endnotes - because I feel that, while they are a useful tool, the only people who really know to click them are[REDACTED] editors. The average reader will see them oftentimes as just a weird citation, and they rarely check those Snokalok (talk) 21:14, 10 January 2025 (UTC)

True. But someone who wants more info will presumably look for more info, and that's a good a place as any to start. If they don't click on the endnote, they may not care to find out more. Lewisguile (talk) 08:40, 11 January 2025 (UTC)

Bit late to this but I don't think the responses to the response are due. The UCU represents over 100,000 people. It would be more noteworthy if not a single one disagreed, we have 4 referred to in the source, a shockingly low number.

Of the two named ones, one, Sullivan, is a WP:FRINGE academic discussed at RSN. The other one petitioned his university to disassociate with Stonewall, , says "I advocate traditional definitions of gender and sex and am very concerned about the transitioning of children", and signed an open letter by Sex Matters. So, yeah, 4 criticisms, 2 from GC figures and 2 from anonymous tweets.

The UCU's motion was notable. The handwringing by 2 people on twitter and 2 GC activists isn't. I'm also not a fan of the endnote and support putting the actual quoted criticisms accessibly. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 02:11, 14 January 2025 (UTC)

If you're going to use a source, you should reflect it accurately, not select the bits you like from a source and dismiss the bits you don't. Void if removed (talk) 11:19, 14 January 2025 (UTC)

The section is "Reception by charities, unions and human rights organisations". It is not "Reception by charities, unions and human rights organisations and some people on twitter who disagreed with them". UCU's motion was and due, the response to it aren't. From WP:DUE Giving due weight and avoiding giving undue weight means articles should not give minority views or aspects as much of or as detailed a description as more widely held views or widely supported aspects

• "In June 2024, the University and College Union's (UCU) national executive committee unanimously passed a motion criticising the review's methodology, sourcing and claims."
• "This was met with criticism from some academics and union members, who said the move "risks making the union appear anti-scientific"

We are giving two GC academics and two people on twitter equal weight to a unanimous motion from a >100,000 member organization. WP:UNDUE.

Would you be ok with me appending a sourced note "a few people in the org disagreed" to every positive statement about the Cass Review or does this only apply to critical ones? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 15:39, 14 January 2025 (UTC)

We are not determining weight - the source is. Your citation of WP:DUE is arguing against your own original wording, which focused exclusively on one aspect of this source, while ignoring another. The source itself gives both aspects at least equal weight, and arguably prioritises the negative response. In that context, the compromise arrived at is more than fair. Void if removed (talk) 16:18, 14 January 2025 (UTC)

Retitled to "Response from charities, unions and human rights organisations"

I renamed the section "Response from charities, unions and human rights organisations" just now, since unions don't quite fit the other two brackets. Is there a better umbrella term? "Civil society"? "Third sector"? Other NGOs could potentially go here, too, such as the EHRC (meaning the top subsection could just become "Response from political parties"), but I'll leave it as is for now. Lewisguile (talk) 17:16, 8 January 2025 (UTC)

This section is a bit of a mish-mash of different types of organisations and needs either a unified title, splitting up or moving some responses elsewhere. These are the organisations mentioned and I've attempted to categorise them:

*Amnesty International: HR organisation

*Mermaids: trans charity

*Stonewall: LGBTQ+ charity

*University and College Union: Trades Union

*Trades Union Congress (TUC) LGBT+ conference: (part of a) Trades Union

*100 LGBTQ+ organisations and activists: unknown

*The International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA): LGBTI organisation

*international LGBTQ student organization IGLYO: LGBTQI organisation

*Transgender Europe: trans organisation

As far as I can tell, none of the one I've categorised as organisations are charities. Zeno27 (talk) 19:04, 10 January 2025 (UTC)

I'm happy for things to be moved around, as needed. What do you suggest? Lewisguile (talk) 11:41, 14 January 2025 (UTC)

This section was originally "Response from advocacy organisations" IIRC. I think that's a fair description. Void if removed (talk) 12:16, 14 January 2025 (UTC)

I'm not sure that fits unions. "Responses from civil society" seems broader? Lewisguile (talk) 13:32, 14 January 2025 (UTC)

Unions are worker advocacy organisations. Void if removed (talk) 15:24, 14 January 2025 (UTC)

Sort of. But it's probably a stretch to call them advocacy orgs in the way most people would understand that term. Trade unions aren't the same sort of thing as Amnesty International, for example.

Another option would be "Responses from other civil society organisations", given that other NGO academic groups and other charities are elsewhere. But I think "Responses from LGBTQ rights groups, human rights groups, and trade unions" might be okay, even if it's long? That was Henrik's suggestion downthread.

A final option would just be to call it "Other responses", but I worry that opens the door to everything and everyone being added. Lewisguile (talk) 08:42, 15 January 2025 (UTC)

"Responses from LGBTQ rights groups, human rights groups, and trade unions" is the least bad option, but personally I think this makes clear that this responses section is a coatrack and we're trying to fashion enough pegs to hang everything off.

I think a section dedicated to the ongoing and developing criticism from LGBTQ orgs later in the article would make more sense. Void if removed (talk) 10:58, 15 January 2025 (UTC)

Wouldn't civil society strictly speaking include NGO academic groups which at present are discussed in another section. I think the current headline is fine. HenrikHolen (talk) 18:00, 14 January 2025 (UTC)

"Responses from LGBTQ rights groups, human rights groups, and unions"? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 15:42, 14 January 2025 (UTC)

I'd suggest 'Trades Unions' to differentiate it from any other kind of union. Zeno27 (talk) 18:05, 14 January 2025 (UTC)

That works. Lewisguile (talk) 08:38, 15 January 2025 (UTC)

References

1. "Joint statement: Trans children and young people in schools deserve safety and understanding". ILGA Europe. September 2, 2024. Retrieved 2025-01-02.
2. Grove, Jack (2024-07-03). "Anger over UCU's 'anti-scientific' fight against Cass Review". Times Higher Education. Retrieved 2025-01-06.

1. The motion said the review has "serious methodological flaws", "provides no evidence for the 'new approach' it recommends", and is based on "selective use of evidence and promotion of unevidenced claims".

Contradiction between articles

Our article Transgender health care misinformation says of the Cass Review:The Cass Review, a non-peer-reviewed narrative review of trans healthcare in the United Kingdom's National Health Service (NHS), claimed that there was a lack of evidence to support trans healthcare for children. It has been criticized by a number of medical organizations and academic groups for its methodology and findings. Refuted aspects of the report include claiming that a majority of transgender youth desist, endorsing gender exploratory therapy, and implying poor mental health causes children to be transgender. It has been criticized for bias by international and UK-based transgender healthcare organizations as well as transgender activists such as youth-led organization Trans Kids Deserve Better. In May 2024 the UK government enacted a ban on puberty blockers based on the report. This does not seem to tally with what this article says about it. Sweet6970 (talk) 16:00, 18 January 2025 (UTC)

Specifically what do you think is mismatching here?

While this article does into significantly more detail (as we would obviously expect), we do include international criticism of the review here. We go into significantly more detail about domestic endorsement of Cass here than I think is necessary, but I'm not sure I can see which aspects of this misinformation article you are considering inaccurate and contradictory.

That article is a well-referenced Good Article; which parts of this C-class article do you think need amendment? — OwenBlacker (he/him; Talk) 19:57, 18 January 2025 (UTC)

I imagine you are mostly concerned with the sentence: "Refuted aspects of the report include claiming that a majority of transgender youth desist, endorsing gender exploratory therapy, and implying poor mental health causes children to be transgender", since this article does discuss the opposition from some medical groups.

I don't think this qualifies as a contradiction. The Cass review article might not make the same claim, but it also does not make any statements which conflict with this claim. I will say though, that "refute" is perhaps too strong a word, and "dispute" might be better. HenrikHolen (talk) 20:12, 18 January 2025 (UTC)

I have no particular interest in improving that article. If its wrong, it is wrong - and it clearly is factually wrong, uses sources that reference the interim report, and strangely promotes an almost inconsequential activist group above all the other, better documented, higher profile critics and supporters. If it is another WP:POVFORK of material here, it probably needs taking to the NPOV board. Void if removed (talk) 21:05, 18 January 2025 (UTC)

This article should have a criticism section that actually outlines why people have criticized the review. As it stands, we offer bits and pieces of why, but no centralized collation of the issues raised.

it clearly is factually wrong Care to explain? Does the report not endorse exploratory therapy or say most kids desist? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:09, 18 January 2025 (UTC)

I'm not a big fan of criticism sections in general, but I do agree we should be clearer about why and not just list off a bunch of organizations that have criticized it without any attempt to connect the fact of the criticism to the actual critiques of the report. Loki (talk) 21:39, 18 January 2025 (UTC)

I think - again - if we could just move past the need to shove everything in the "responses" format and accept having another section, there's definitely scope for some sort of collected discussion of the criticism. Void if removed (talk) 22:28, 18 January 2025 (UTC)

Care to explain?

It isn't a narrative review, it wasn't about "trans healthcare" but a review of gender identity services for children and young people, it didn't say there was a lack of evidence to support trans healthcare, it found that the existing services were based on weak evidence, and the ban by the UK government was related to private provision. As for other issues, why did you deviate from the lede of this article in describing it, ie leaving off the praise and acceptance of all the UK medical bodies and focusing only on criticism? Why did you rely heavily on material that you know - from the many discussions here - is critique of the interim report? Why the focus on a tiny and inconsequential activist group and not criticism from someone actually notable like, say, the BMA or Stonewall?

As for the "exploratory therapy", as you know it was kept off the page on Gender exploratory therapy as a source - and the NPOV tag there removed, by you - because editors said it didn't endorse it. Void if removed (talk) 22:08, 18 January 2025 (UTC)

I think this is a good point, and I think it makes sense to have more in depth description of the criticism instead of just a list of orgs that criticize it without much explanation as to why. HenrikHolen (talk) 22:31, 18 January 2025 (UTC)

Changes to lede

I have reverted this change.

The lede should summarise the body, not itemise it. Over-emphasising specific responses in this way is undue and POV. Highlighting the BMA criticism and none of the criticism of the BMA's resposne is POV. the GLADD response is less notable than the endorsement of medical colleges. Changing "widely" to "some" is editorialising and misrepresents the wide endorsement of the review by the bodies that actually matter (ie the royal colleges, the NHS etc). Emphasising that WPATH "heavily criticised" is POV. Void if removed (talk) 21:31, 19 January 2025 (UTC)

There was criticism of the BMA's response: council unanimously voted to critique and evaluate the review before outcry from some members led the BMA to pledge to undertake it's assessment neutrally.

The GLADD response is highly notable as the overarching body for LGBT medical professionals in the UK

Changing "widely" to "some" is editorialising and misrepresents the wide endorsement of the review by the bodies that actually matter (ie the royal colleges, the NHS etc). Except we have sources that gave mixed support in there (such as the Royal College of Psychiatrists noting criticisms from trans members and patients and calling for their inclusion), and "widely" hides that the BMA and GLADD objected.

Emphasising that WPATH "heavily criticised" is POV - Let me get this right, the world's leading body for trans healthcare, whose guidelines are internationally accepted (Even Cass noted this, she said it was a bad thing but she noted it's the standard), which has repeatedly criticized the Review, is undeserving of space in the lead?

Your reversion also removed the numerous critiques from LGBT rights bodies, notes about the Green Party's rescinded support, and hid the fact that Labour's LGBT branch criticized the report even as the party welcomed it.

Your reversion is highly POV and seems to be part of a continued campaign to make the Cass Review appear more widely accepted than it was and downplay it's criticisms. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:42, 19 January 2025 (UTC)

The existing wording is longstanding NPOV consensus, so reverting to it is not POV. Summary style is much better for the lede than simply re-enumerating items that are in the body, selecting the items you think are most important.

The endorsement of the relevant medical bodies is far more significant than GLADD's response.

Noting the official response of the two largest parties is notable, much more so than factions within Labour dissenting.

The issue with WPATH's response is it is the response to the interim review. Void if removed (talk) 22:04, 19 January 2025 (UTC)

WP:LEDEFOLLOWSBODY

Why is GLADD not a relevant medical body?

A brilliant way to sidestep LGBT orgs within the party criticizing it to make it look more accepted than it is and remove responses from parties who you don't like.

WPATH responded to the final report as well. But anyways, this is an article about the Cass Review, not the Final report, so criticisms of the report at multiple stages are due. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:11, 19 January 2025 (UTC)

Sorry, I meant the inline citation in the lede was still referencing the Interim Review response. It still is actually - I think that should focus on the longer, May 2024 response.

I think that the lede should be a brief WP:SUMMARY, and as things stand the current wording gives that.

Once you start bringing individual responses up, then its about which - and if you're only bringing the critical ones, it becomes POV, which needs offsetting, then it grows, and the whole thing ends up a mess that's harder to balance. Void if removed (talk) 22:57, 19 January 2025 (UTC)

For a brief summary - it was widely welcomed by medical organizations in the UK with the exception of the British Medical Association, who are independently reviewing the Review, and the Association of LGBT doctors and dentists. International medical organizations and those in other countries were ambivalent or critical of the review. The review was heavily criticized by the World Professional Association of Transgender Health and regional affiliates, LGBTQ+ rights bodies within the UK and internationally, and UK-based trade unions. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:23, 19 January 2025 (UTC)

An alternative might be: it was broadly welcomed by UK medical organisations with the exception of the British Medical Association, which said it would independently evaluate the Review, and the Association of LGBTQ+ Doctors and Dentists. International and non-UK medical organisations were ambivalent or critical of the review. The review was criticised by the World Professional Association of Transgender Health and regional affiliates, and LGBTQ+ rights bodies within the UK and internationally. Lewisguile (talk) 09:45, 20 January 2025 (UTC)

I think if you mention the BMA in the lede, you have to mention that it was the subject of significant controversy as that's what the balance of coverage reflects, so I'd shy away from it because it is hard to summarise in the lede in a neutral way.

I'd say:

International and non-UK medical organisations were ambivalent or critical of the review. Is taking it too far, and veers into WP:OR, especially since some positive receptions have been excluded or never raised. Really we should be basing that sort of assessment on secondary sources rather than our own.

I'd leave:

The review's recommendations have been widely welcomed by UK medical organisations.

And maybe add the following sources if we need to substantiate "widely":

https://www.bbc.co.uk/news/articles/cqe6npgyr5ro

https://www.abc.net.au/news/2024-04-12/gender-dysphoria-cass-review-medical-treatment-children/103700476

WPATH is probably due a specific mention as the most notable critic, so how about just sticking with that by adding it to the existing wording like:

However, it has been criticised by a number of medical organisations and academic groups outside of the UK and internationally for its methodology and findings, most notably the World Professional Association of Transgender Health and regional affiliates. Void if removed (talk) 11:35, 20 January 2025 (UTC)

I like Lewisguile's wording of the first sentence and last sentence, and am not a big fan of Void's changes to either: the lead is supposed to be a summary and I think that the British Medical Association ... said it would independently evaluate the review is a perfectly fine summary of that situation. I agree with Void that the middle sentence should ideally have a source saying that directly. Loki (talk) 19:26, 20 January 2025 (UTC)

The lede is supposed to cover major controversies and the fact is the majority of coverage of the BMA council's action has been to note it was controversial - so much so they actually rowed back on it somewhat. Conveying that in the lede is hard and probably would be overlong, but leaving out the controversy is not neutral, hence my preference for simply letting the body explain that particular saga.

As for GLADD, they aren't notable enough for an article and aren't in our list of Medical associations based in the United Kingdom. The endorsement of the royal colleges etc is of far greater consequence. Giving such WP:UNDUE prominence in the lede to two outliers - one controversial - is WP:FALSEBALANCE. Void if removed (talk) 11:00, 21 January 2025 (UTC)

I'm generally opposed to sweeping changes to the lede, and I think this could be approached more incrementally. One change I feel would be warranted is to briefly summarize the response from WPATH in the lede, since this is by far the weightiest source on the topic. HenrikHolen (talk) 01:36, 20 January 2025 (UTC)

I agree. I also think a middle ground between "widely" and "some" is "many", because I think that's true: many UK medical organizations were positive but certainly not all of them. Loki (talk) 19:20, 20 January 2025 (UTC)

Criticism section

I have removed the criticism section, which was a laundry list of new points. I suggest working to agree neutral summary wording on these, and what the points should be, rather than simply (as this section did) enumerating the criticisms from (mostly) the Yale report as if factual. The Yale white paper is a non-independent, non-peer-reviewed source. I suggest trying to summarise all perspectives on each claim from a broader range of sources.

The suggested subjects in the addition are:

• Transparency and exclusion of transgender expertise
• Pathologization
• Social Transition
• Desistance
• Exponential growth
• Social contagion
• Puberty blockers
• Evidentiary standards
• Recommendations

Taking them one at a time, are there any sources, for example, both making and responding to the accusation of lack of transparency? Void if removed (talk) 21:50, 19 January 2025 (UTC)

We also need to decide how this affects the responses section, ie when what is in the responses is expanded into the criticism section, how do we deal with those, which do we prioritise etc. Void if removed (talk) 21:55, 19 January 2025 (UTC)

both making and responding to the accusation of lack of transparency - what? Why would a source accusing the review of lacking transparency respond to it's own accusation? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:13, 19 January 2025 (UTC)

Meanwhile the WPATH/USPATH statement focuses on the following:

• Cass' credentials
• Lack of subject matter experts
• International consensus
• Ethical concerns for PB restriction

As a WP:MEDORG statement, this is weightier than other criticism and could be a good starting point. Perhaps to add to that it is a good idea to collate overlapping criticism that can be multiply sourced (but that aren't just WP:LINKSINACHAIN). Void if removed (talk) 23:05, 19 January 2025 (UTC)

Are there any good secondary or tertiary sources summarising the criticism, rather than building this from primary sources. Void if removed (talk) 07:50, 20 January 2025 (UTC)

Here's one secondary source:

Despite its comprehensive analysis and well-reasoned arguments, the Cass Review has faced criticism from various quarters. Advocates for transgender rights and medical professionals specializing in gender-affirming care have raised concerns about the review's methodology, perceived biases, and potential to undermine access to essential healthcare services for transgender youth. They argue that the review's emphasis on caution and skepticism may perpetuate stigmatization and discrimination against gender-diverse individuals, exacerbating their vulnerability to mental health disparities and social marginalisation. The critics also argue that for many individuals, puberty suppression can be a life-saving intervention, alleviating distress associated with incongruent physical development and facilitating a smoother transition process. Moreover, they emphasize the importance of patient autonomy and informed consent in healthcare decision-making, asserting that adolescents have the right to access gender-affirming treatments under appropriate medical supervision.

I think that this sort of thing could serve as a basis for a summary introduction to criticism? Then expand on the topics? Void if removed (talk) 09:51, 20 January 2025 (UTC)

Perhaps? It's not a great source - it cites none of the criticisms directly and is a recurring column ,"Alcimedes", for stuff that's been going on relevant to the profession. It often isn't even attributed to a specific author and habitually refers to itself in the third person. It's basically a bulletin in the journal. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:56, 20 January 2025 (UTC)

Which subjects do you think shouldn't be included? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:25, 19 January 2025 (UTC)

I think the criticism section worked fine as a standalone section, but there is definitely room for expanding upon it. I also agree statements from WPATH/EPATH/USPATH… and the endocrine society are the most weighty and should be given more prominence. If the criticism section repeats info from the reception section, then we should consider rewriting.

I propose we reintroduce YFNS' edit and discuss sources which could be used to expand it. HenrikHolen (talk) 01:24, 20 January 2025 (UTC)

Here's one source we might consider adding

https://www.nejm.org/doi/full/10.1056/NEJMp2413747 HenrikHolen (talk) 18:03, 20 January 2025 (UTC)

This is "perspective" so it is WP:RSOPINION and should be attributed but it is decent source for a criticism section (though I think by NEJM editorial policy might not be peer-reviewed? I am not sure on this point). The principal citations are, again, the Yale White paper and Horton's critique of the interim review.

I think a look at what this considers to be the primary criticisms would be a good start.

From a first read I find the focus is:

• A reliance on a higher standard than other medicines (to whit RCTs)
• Bias/lack of transparency

I think these two represent two of the strongest common themes across all criticism, and would make a good initial focus.

As a critique of this piece, I note it says:

The Review calls for evidentiary standards for GAC that are not applied elsewhere in pediatric medicine. Embracing RCTs as the standard, it finds only 2 of 51 puberty-blocker and 1 of 53 hormone studies to be high-quality.

Which is nonsense, none of the high quality sources picked up by the Yale team were RCTs.

The substantive methodological criticism is largely limited to a single paragraph, which just cites and quotes the Yale white paper:

Commentators also point out that the Review (and associated studies) misrepresented the data behind its conclusions,1 had both a high risk of bias according to the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS) and a “substandard level of scientific rigor,”1 and improperly excluded non-English articles, “gray literature” (non–peer reviewed articles and documents), and other articles not identified by its simplistic search strategy.1

Is this part just WP:LINKSINACHAIN?

And the last four paragraphs are a strange diversion that seems to tie the Cass Review to medical sexism.

Its certainly usable, and fits better in a criticism section than "responses". Void if removed (talk) 12:44, 21 January 2025 (UTC)

Perhaps we should restructure the Responses section to cover these points instead? That can completely replace the existing structure, and removes the need to have a lengthy discussion of who liked/didn't like the review. Instead, we'd be framing it in terms of responses to key areas of the review. That seems more encyclopaedic than what we currently have. Lewisguile (talk) 09:43, 20 January 2025 (UTC)

I don't have a problem with a "critical response" section that amalgamates / summarises and recounts these, rather than going chronologically, but the issue is the attempt to simply recount every single point made in primary sources, because that's really not what we should be doing - we need secondary sources to summarize some of this criticism so we know what's notable and what's not.

I think that also it has to acknowledge first and foremost there is a significant split in the response, ie every domestic institution that actually matters endorsed it - with the controversial exception of the BMA - while WPATH, US-based medical institutions, and transgender rights orgs condemned it, and haven't stopped condemning it over and over ever since. There's a few other international responses but we've been nowhere near comprehensive there (eg. Ireland's endorsement has never made it onto the page, and the Italian ethics board endorsement was removed after an argument over implication of attribution it to the far-right government of the day).

Aside from the MEDORG statements, in truth, what we have are:

• Cal Horton's paper on the interim review (primary)
• The Yale white paper (primary, not peer-reviewed, and with conflicts of interest)
• The Grijseels paper (primary, and the typo in one review that was pointed out has been corrected).
• The Noone preprint (primary, not peer-reviewed)

These sources are not independent of each other and all cite each other or have overlapping contributors.

And then rather than much secondary analysis, we just have orgs like the BMA levelling criticism at the Cass Review by citing these, or commentary pieces noting these that are little more than WP:LINKSINACHAIN.

What we should have is a secondary source that actually sifts through this criticism and establishes what is or is not relevant, what has weight, and so on. That's how this sort of thing should be guided. As WP:CRITS suggests:

In some situations the term "criticism" may be appropriate in an article or section title, for example, if there is a large body of critical material, and if independent secondary sources comment, analyze or discuss the critical material.

Personally, I'd much rather a criticism section that summarises and lays out the criticism and who is making it, but I'm surprised at the lack of secondary sources now I've gone looking. Its been months, yet what's mostly there is primary, or very superficial news coverage of this or that statement in protest. I'd like to see what the BMA comes up with, frankly, its overdue. Void if removed (talk) 10:16, 20 January 2025 (UTC)

The BMA said their Task & Finish Group will present their critique of the Cass Review to their UK Council at its January meeting and that is to be held this Wednesday, 22nd, so not quite overdue yet! Hopefully, it will be published soon after. Zeno27 (talk) 11:03, 20 January 2025 (UTC)

That's interesting, especially as the BMA cited the above sources in their original justification for the critique. Void if removed (talk) 17:06, 20 January 2025 (UTC)

I just want to note, all of those are secondary sources on the Cass Review. Just because they are critical doesn't make them primary. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:25, 20 January 2025 (UTC)

Endocrine statement

I have removed a lengthy quote that was from the end of the source where it started talking generally about healthcare bans in the US and was not referring specifically to the Cass Review. https://en.wikipedia.org/search/?title=Cass_Review&diff=prev&oldid=1270527688

As presented it appeared the endocrine society was accusing the review of misinformation, which is not the case from reading the full statement.

Also this source is terrible - a PDF embedded in a WBUR page. Is there no better source for their statement? Void if removed (talk) 23:56, 19 January 2025 (UTC)

Here's a better link.

The statement said what it said: Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment. Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions. This was after being asked for comment on the Cass Review. The Cass Review seems to oppose the idea that Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment so this is obviously relevant. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 00:13, 20 January 2025 (UTC)

It looks like you forgot the link, but i'm guessing this is the link you meant to post.

https://www.endocrine.org/news-and-advocacy/news-room/2024/statement-in-support-of-gender-affirming-care

After reading the statement it seems to me that the endocrine society is suggesting that the Cass review contains misinformation. I support reintroducing the quote in full. HenrikHolen (talk) 01:49, 20 January 2025 (UTC)

Here's the full quote in context:

Although the scientific landscape has not changed significantly, misinformation about gender-affirming care is being politicized. In the United States, 24 states have enacted laws or policies barring adolescents’ access to gender-affirming care, according to the Kaiser Family Foundation. In seven states, the policies also include provisions that would prevent at least some adults over age 18 from accessing gender-affirming care. Cisgender teenagers, together with their parents or guardians, are deemed competent to give consent to various medical treatments. Teenagers who have gender incongruence and their parents and guardians should not be discriminated against. Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment. Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions. Medical evidence, not politics, should inform treatment decisions.

You are misrepresenting this source, which only mentions Cass in the second line, and is in every other way a defence of their guidelines and a criticism of politicised bans in the US. Void if removed (talk) 09:09, 20 January 2025 (UTC)

It doesn't say "misinformation about gender-affirming care is being politicized in the US". It says it's being politicized, gives examples in the US, and then continues with the general principle that trans kids, their parents, and their doctors should be the ones making these decisions.

Considering Cass criticized the guidelines, and generally seems to oppose that principle, and the statement was a response to the Cass Review, your argument that it being a defense of their guidelines means it wasn't about the Cass Review seems lacking. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:01, 20 January 2025 (UTC)

I said: a criticism of politicised bans in the US which my quote bears out. That's what it says. It talks about bans in the States and then straight on to the claim about misinformation, in a paragraph 8 paragraphs after the one solitary mention of Cass, in a statement titled "Endocrine Society Statement in Support of Gender-Affirming Care".

WP:SYNTH says do not combine different parts of one source to state or imply a conclusion not explicitly stated by the source.

You are improperly over-interpreting this source. Void if removed (talk) 20:13, 20 January 2025 (UTC)

So you're saying a response by the organization specifically to the Cass Review that goes on to say Although the scientific landscape has not changed significantly, misinformation about gender-affirming care is being politicized and then concludes Cisgender teenagers, together with their parents or guardians, are deemed competent to give consent to various medical treatments. Teenagers who have gender incongruence and their parents and guardians should not be discriminated against. Transgender and gender-diverse teenagers, their parents, and physicians should be able to determine the appropriate course of treatment. Banning evidence-based medical care based on misinformation takes away the ability of parents and patients to make informed decisions is not referring to claims from the Cass Review, in this response to the Cass Review? Silverseren 00:18, 20 January 2025 (UTC)

To add onto this, the Endocrine Society is an international org, not a US one, and the quote seemingly refers not just to the US but the situation in general. That said, it was a bit lengthy of a quote. I’ve partially reverted the removal to address this but feel free anyone to let me know if you prefer a different course of action.Snokalok (talk) 03:39, 20 January 2025 (UTC)

FWIW, I'm not a big fan of long quotes categorically, and so I'd really like to see if there's some way we can summarize this. Loki (talk) 19:30, 20 January 2025 (UTC)

Yes I'm saying that, because it is a statement in support of gender affirming care, per the title. It responds to Cass at the start, and then moves to general defence of the subject at the end. Void if removed (talk) 07:48, 20 January 2025 (UTC)

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