Talk:Sex differences in medicine

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Change of Wikilink to men and women

@Maneesh: I've just reverted your two edits to the Wikilinks for men and women [1], [2]. Not all men are male humans, and not all women are female humans. Trans and non-binary people exist, and still have the same rate for some illnesses and disorders as a cisgender. For example a trans woman can still get prostate cancer, and a trans man can still get cervical cancer. Sideswipe9th (talk) 21:04, 13 December 2021 (UTC)

Transwomen are obviously also men, adult males. The edit summary was crystal clear: almost each and every line (and each and every RS that supports each line) uses man/men and woman/women. The fact that some males identify as trans (or "non-binary") has no relevance here. Maneesh (talk) 22:48, 13 December 2021 (UTC)

No, trans women are not men. Trans women are women. Likewise trans men are not women. Trans men are men. Trans is an adjective applied to man/woman. Sideswipe9th (talk) 22:52, 13 December 2021 (UTC)

This is religious thinking, you are entitled to it, but you can't use a title in section here the way you have. Look at all the points, the section titles reflect those points accurately and must use man/woman. Maneesh (talk) 22:54, 13 December 2021 (UTC)

No. It is not religious thinking, and I am going to ask you to self-revert per WP:BRD, as there is not a consensus for this change from the previously stable version. Sideswipe9th (talk) 22:56, 13 December 2021 (UTC)

Please count the number of occurrences of "men" and "women" below each respective title out of the total number of points. Maneesh (talk) 22:57, 13 December 2021 (UTC)

Also please note, the article is titled Sex differences in medicine. Using male/female would be more appropriate here than man/woman. Sideswipe9th (talk) 22:58, 13 December 2021 (UTC)

Men are adult human males, women are adult human females - is it surprising to you that the underlying RS generally use those words that way?Maneesh (talk)

I will not be baited into an edit war with you. I will ask one last time, please self-revert per WP:BRD as there is not a consensus for this change you have made. Sideswipe9th (talk) 23:08, 13 December 2021 (UTC)

I see nothing in BRD that compels me to revert my own (not bold at all) edit. "Men" and "women" is what is being used on almost each and every line in the sections you are trying to revert . Please do put up an RfC if you need to. Maneesh (talk) 23:12, 13 December 2021 (UTC)

Bold, Revert, Discuss. You Boldly made two edits 1, 2. They were reverted 3. Now it is time to Discuss why those changes are WP:DUE and to establish a consensus for them. Right now, there is no consensus for this edit. Sideswipe9th (talk) 23:16, 13 December 2021 (UTC)

Ain't a bold edit, you don't acknowledge that the title is merely reflecting the the content below it. Looking at BRD, all of these seem to apply:

BRD is not a justification for imposing one's own view or for tendentious editing.

BRD is not a valid excuse for reverting good-faith efforts to improve a page simply because you don't like the changes.

Maneesh (talk) 23:19, 13 December 2021 (UTC)

Maneesh, if you insist in your editing that transwomen are ... men and trans men are women you will be blocked from editing: I have never seen any other result come from that POV impulse, when an editor insists on following it to its logical conclusion. This will happen even faster if you remove sources to do so, as you have today. So you will have to decide which is more important to: your POV or continuing to edit Wikipedia. You can't have both, as your recent edit history makes clear. Newimpartial (talk) 23:34, 13 December 2021 (UTC)

I have no problem saying "transwomen are male", particularly in the talk section of an article on sex differences in medicine. Not POV, just a simple facts. I'm terribly uninterested in a wikpedia that censors such simple truths. Please do go out there and do your best to ban me if you think your efforts will be successful. Maneesh (talk) 23:38, 13 December 2021 (UTC)

You best route, is to open an RFC on the matter-in-question. GoodDay (talk) 19:19, 15 December 2021 (UTC)

Wouldn’t including transgender people in this article mostly be wp:UNDUE? Also trans women are less likely than cisgender men to develop prostate cancer, according to this source: https://academic.oup.com/jcem/article/105/9/e3293/5864158 So treating them as though they are cisgender men is wrong. Their bodies do not behave the same way. Feralcateater000 (talk)

A perfect example of why WP:STICKTOSOURCE is important. Crossroads ^-talk- 06:47, 21 December 2021 (UTC)

More strange reverts

Most of the illnesses in the lists are not "sex-related". Almost each and every line uses "men" and "women", associated changes to reflect that simple fact have been reverted. Trans identification has nothing to do with sex-related differences, vague ideas around gender have no place in this article. Maneesh (talk) 23:30, 13 December 2021 (UTC)

Perhaps in your mind "men" means AMAB people and "women" means AFAB people, but that isn't what the recent, reliable sources say, which is what matters on Wikipedia. Also, stop edit-warring and please obtain consensus for your edits before reinstating them. Newimpartial (talk) 23:36, 13 December 2021 (UTC)

What is in my mind doesn't really matter. What matters is that this article uses "men" and "women", so do the underlying MEDRS, and the titles that summarize that information need to as well. Maneesh (talk) 23:40, 13 December 2021 (UTC)

Actually as I said above, the underlying MEDRS use male/female. Sideswipe9th (talk) 23:41, 13 December 2021 (UTC)

Each one I've spot checked uses man/men/male(s) and woman/women/female(s) synonymously. Which ones did you find that only used "male" and "female"? Maneesh (talk) 23:43, 13 December 2021 (UTC)

In the current "Women" section, the following sources use male/female 10, 28-31, 35, 42, 43, 45. In the current "Men" section, the following sources use male/female 25, 26, 30, 35, 47, 48, 49, 50, 52, 54, 58, 59, 60, 61. I was unable to access the texts to sources 33, 34, 38, 40, 55, 56, 57 due to a mixture of dead URLs, or being unable to quickly find a copy of the relevant paper/chapter. Sideswipe9th (talk) 00:01, 14 December 2021 (UTC)

Spot checking it seems that, as I've already said, at least some (I suspect most) of those RS use "men" synonymously with "male" and "woman" synonymously with "female". E.g.: 28: "Estimated new cases and deaths from breast cancer (men only) in the United States in 2021:[1] New cases: 2,650. Deaths: 530. Male breast cancer is rare.[2] Fewer than 1% of all breast carcinomas occur in men.[3,4]". This current WP article uses "men" and "women" overwhelmingly. Maneesh (talk) 00:08, 14 December 2021 (UTC)

Just to be clear, as silly as I feel doing this, this is a standard usage of those terms in English.Maneesh (talk) 00:10, 14 December 2021 (UTC)

It is not standard usage of those terms in English. At least not for about the last decade. Also you've cherry picked a single example. Sideswipe9th (talk) 00:11, 14 December 2021 (UTC)

I don't know if English is your first language? Go out and throw a rock and read the news, google news query for woman AND female. Denying that "woman" and "female" are used synonymously every day is absurd. I read a lot of research, I know these words are used synonymously all the time the way they are outside of research. Why you are trying to suggest that isn't true is more than a little puzzling. Maneesh (talk) 00:16, 14 December 2021 (UTC)

Yes, English is my first language. And like any living language, it evolves over time. Woman or man has not be synonymous with female or male for the better part of the last decade. Woman and man are gender related terms. Male and female are sex related terms. On an article titled "Sex differences in medicine" it is more accurate to use sex related terms than gender related terms. Sideswipe9th (talk) 00:23, 14 December 2021 (UTC)

I would say that while I agree with you that quibbling over using Male vs Men or Female vs Women in this article is dumb, and we should use the most inclusive language which makes clear these studies were almost exclusively conducted on AMAB/AFAB cis individuals. But also that your statement here "like any living language, it evolves over time: perhaps glosses over the fact that science (and especially scientific language) is slow to change. It lags behind the rest of society, for the sake of precision and convention. We should do our best in this article to portray the most modern language which does not remove that precision. — Shibbolethink ^{(♔ ♕)} 00:50, 21 December 2021 (UTC)

I'm just throwing rocks 45: "POTS is more frequent in women (female:male ratio, 4.5:1), and most cases occur between the ages...". You do realize it's an easy bet that almost all the cites you make use of the synonymous terms. How long do you think you can call this "cherry picking"?Maneesh (talk) 00:43, 14 December 2021 (UTC)

I don't even need to bother opening the articles, 21 "Sex differences in pharmacokinetics predict adverse drug reactions in women", perhaps we should notify Biology of Sex Differences, since they are using decade old language in the titles of their 2020 articles. Maneesh (talk) 03:42, 14 December 2021 (UTC)

Woman or man has not be synonymous with female or male for the better part of the last decade....you do realize that the google query is live and returns mainstream stories that are mere hours old, don't you? Maneesh (talk) 01:01, 14 December 2021 (UTC)

I am very unimpressed with the constant goal post shifting. It makes it very hard to assume good faith. The discussion is on language MEDRS use, not what NEWSORG use. Likewise this shift from Please count the number of occurrences of "men" and "women" below each respective title out of the total number of points to Each one I've spot checked uses man/men/male(s) and woman/women/female(s) synonymously. is dishonest. Sideswipe9th (talk) 01:32, 14 December 2021 (UTC)

Ah so now that you can see that I'm not cherry picking and have falsified your claim about English you claim goalpost shifting and dishonesty. You really need to take a hard look at the RS in this article and read virtually any mainstream writing today to know that your original claim,Woman or man has not be synonymous with female or male for the better part of the last decade., is not just false but ridiculous. Likewise, your reverts don't make much sense. Maneesh (talk) 02:18, 14 December 2021 (UTC)

What exactly is being argued here? GoodDay (talk) 01:36, 14 December 2021 (UTC)

Maneesh is playing a fairly elaborate shell game, as far as I can tell. Sideswipe9th is the gull, in this scenario. Newimpartial (talk) 01:43, 14 December 2021 (UTC)

You believe it is a shell game to show the plainly visible examples of man/male and woman/female being used synonymously? In line with the strange claims I've sen you make in these related discussions. Maneesh (talk) 01:47, 14 December 2021 (UTC)

Please see my more elaborate explanation below. Newimpartial (talk) 02:35, 14 December 2021 (UTC)

This article (virtually each and every line), the underlying MEDRS and everyday English use man/male, woman/female synonymously. Newimpartial is in denial of these facts and has prevented the section titles (EDIT: I should say introductory sentences...as the titles already say "Man" and "Woman" before my edits) from reflecting the content of the article. Maneesh (talk) 01:46, 14 December 2021 (UTC)

I've been on this planet for quite a few decades. An adult human male, is called a man & an adult human female, is called a woman. So, what's the dispute? GoodDay (talk) 01:51, 14 December 2021 (UTC)

And these terms have contextually-specific meanings. Anyone who thinks any of these terms always means the same thing has not made very good use of their time on the planet, IMO. As far as my reverts, I am not preventing anything except POV editing without Talk page consensus. ONUS and BRD both back my reverts. Newimpartial (talk) 01:55, 14 December 2021 (UTC)

GoodDay yep, you can see the denial of that plain language and obvious truth here. The article uses "Man" and "Woman" everywhere, the revert is happening on sentences in the intros and being justified by claims that deny the plain knowledge you've just recited. Maneesh (talk) 02:11, 14 December 2021 (UTC)

Ya'll can figure it out for yourselves. This already has become (looking at the edit-spats) one of the lamest disputes, in this projects 20+ year history. GoodDay (talk) 01:59, 14 December 2021 (UTC)

Thank you for that provocative insight GoodDay... Sideswipe9th (talk) 02:00, 14 December 2021 (UTC)

Whatever. GoodDay (talk) 02:01, 14 December 2021 (UTC)

FWIW: the articles Man & Woman open with "adult male human" & "adult female human". Hope that helps. GoodDay (talk) 02:20, 14 December 2021 (UTC)

The thing is, GoodDay: recent, reliable sources use "man" and "male human" in the sense of sex assignment, or gender identity, or without specifying (or even distinguishing) which one is meant. Context is key (and the same is true of "woman" and "female human"). Maneesh's POV approach, to shoehorn in edits as though "man" always meant "assigned male at birth" (and in turn, in his unsubstantiated opinion, meaning in all instances XY or YY chromosomes as well) is, as I stated earlier essentially a shell game. Don't be a mug. Newimpartial (talk) 02:35, 14 December 2021 (UTC)

I'm not a cup full of beer. GoodDay (talk) 12:59, 14 December 2021 (UTC)

I saw this comment at WP:AE first, and responded (somewhat mirthlessly) here. AE does not bring out my gaiest humour. Newimpartial (talk) 13:47, 14 December 2021 (UTC)

Contrary to some claims above, it is still the norm in WP:MEDRS to simply use "women" to refer to adult humans of the female sex. Anyone is free to confirm this by opening Google Scholar, searching for "only in women" or "pregnant women", in quotes, and selecting "since 2021". We do not and should not engage in alienesque writing and random shout-outs to gender identity, as the medical sources themselves do not do this. Crossroads ^-talk- 07:48, 14 December 2021 (UTC)

Crossroads, what you are doing here (not entirely well, but with seemingly good intentions) is appealing to context to decide the usage of "men" and "women", etc. This is the correct procedure, although the way you are doing it leaves out important nuances in "women's health" communication over the last few years.

However, my point is that your approach here is the diametrical opposite to the rationale behind Maneesh's edits as expressed in this discussion: he is denying the relevance of context and playing a shell game with denotation, as I noted above. Newimpartial (talk) 10:15, 14 December 2021 (UTC)

Your best route is to open up an RFC on the matter-in-question. GoodDay (talk) 19:20, 15 December 2021 (UTC)

That would be a waste of time because there is already an explicit community-wide consensus on that from the WP:Village Pump: "the terminology in articles, especially medical articles, is dependent upon the support of reliable sources and it is expected that editors would use the same terminology presented in said sources." And even if there wasn't, WP:STICKTOSOURCE and WP:NOR are clear. We simply use the terminology that the experts writing the MEDRS do. Plus, Wikipedia is not for advocacy about how sex-differences writing is done. Crossroads ^-talk- 19:40, 15 December 2021 (UTC)

And that means that the question needs to be decided based on actual sources. Where sources support, for example, specific language related to transgender hetb, then that would be the relevant STICKTOSOURCE, NOR language in those cases. Newimpartial (talk) 19:46, 15 December 2021 (UTC)

Sure, but that is not nearly as common as you seem to think. Crossroads ^-talk- 19:54, 15 December 2021 (UTC)

I don't think you know what I'm thinking - after all, I'm wearing my chic tinfoil beret. Newimpartial (talk) 20:16, 15 December 2021 (UTC)

• Just to be clear, that discussion was closed as no consensus (This proposal is clearly lacking consensus for implementing a bright-line rule.) and therefore does not impose any restrictions one way or the other - if you want to impose a bright-line rule in the other direction, you need an affirmative consensus doing so and not just a closure rejecting a bright-line rule in the other direction. As the closer noted, there are multiple competing policies and values that have to be balanced and considered on a case-by-case basis. It is specifically not a community-wide consensus - a no-consensus outcome it the opposite of that. --Aquillion (talk) 02:36, 21 December 2021 (UTC)

• Lacking a consensus for the new rule being proposed is not the same as "no consensus", especially when it specifically says that the consensus is that it is expected that editors would use the same terminology presented in said sources - which of course is just standard WP:STICKTOSOURCE, WP:V, and WP:NPOV policies. There is no policy grounds for purging wording that is routinely used in WP:MEDRS, and doing so is against the aforementioned policies as well as WP:NOTADVOCACY. Crossroads ^-talk- 06:45, 21 December 2021 (UTC)

Sure, but you were presenting it as if this was some sort of settled issue; obviously that RFC didn't settle or change anything, it just (as you said) established that standard policies apply. That leaves us in the normal situation of deciding, on a case by case basis, what the best sources are, how to reconcile disagreements between them, what to do with (and how to weigh) sources that place differing degrees of focus on different aspects, and so on. That's obviously not the simple straightforward conclusion you think it is if it's consumed this much text from veteran editors for this long, so the right approach (rather than waste even more time going in circles and risk rising even more bad blood) is to hammer it out with at least a local RFC. If you actually believe, before or after that, that a sweeping global consensus exists or could be formed to override that, you could seek that as well, but I'm not seeing it yet and I'm fairly skeptical myself. --Aquillion (talk) 08:37, 21 December 2021 (UTC)

It showed how those policies apply. 'Resolving disagreements between sources' does not mean 'pick whatever sources I want and fight to use the wording from those', it means following WP:DUE in how sources discuss sex differences. That doesn't change just because a small clique of gender-identity-focused editors followed each other over from WP:AE and are engaging in WP:LOCALCONSENSUS behavior. Crossroads ^-talk- 13:01, 21 December 2021 (UTC)

I love how you are apparently including Nableezy, who expressed sympathy for Maneesh's "scientism" at AE, among your small clique of gender-identity-focused editors - and the main recent contributor to this section was only notified of the AE after contributing here. Maybe, check your privilege ungrounded assertions, in terms of their veracity, before posting angry. Newimpartial (talk) 13:17, 21 December 2021 (UTC)

Can we all at least agree that "gender" has very little, if any, relevance to this article about biological sex? And stop talking about "gender-identity" controversies?

This is not an article about gender. — Shibbolethink ^{(♔ ♕)} 14:07, 21 December 2021 (UTC)

DUE doesn't really apply to terminology, it applies to content. We regularly use reductionist and simple terms in articles which reduce the complexity present in the literature. That's SUMMARY, not SYNTH. — Shibbolethink ^{(♔ ♕)} 14:08, 21 December 2021 (UTC)

"the terminology in articles, especially medical articles, is dependent upon the support of reliable sources and it is expected that editors would use the same terminology presented in said sources" If this were taken to its logical extent, then we would have a wiki full of extremely dense medical articles using obscure and ridiculously complex terms, making it unreadable for the lay public. The point of an encyclopedia is to SUMMARIZE content and make it understandable, while losing as little complexity as possible in the process. We are not creating facsimiles. We are creating summaries. That requires a reduction in the complexity of language, and sometimes, using simpler collapsed terminology which, generally speaking captures the same concepts. — Shibbolethink ^{(♔ ♕)} 14:11, 21 December 2021 (UTC)

• I would agree that an RFC is the best route; there is no community consensus on this topic and it therefore must be decided on a per-article basis. This discussion is likely to go in circles otherwise. --Aquillion (talk) 02:40, 21 December 2021 (UTC)

  Yes I would support a brief and succinctly worded RfC as well. — Shibbolethink ^{(♔ ♕)} 02:41, 21 December 2021 (UTC)

You might have a point on MEDRS using "man" or "woman" except for the fact that those words do depend on context, and sources generally dont say in which way they are using it. Pretending that "man" or "woman" can only mean genetic sex is silly, they very obviously can refer to gender identities. If you are saying that the terms "man" and "woman" on this page refer to genetic sex and include any "assigned male at birth" or "assigned female at birth" respectively then that needs to be clear. I dont have an opinion on which way to do this is best, but I think it silly to pretend that the phrasing in men or in women is not ambiguous as to who exactly is covered. nableezy - 17:08, 20 December 2021 (UTC)

Consider familiarizing yourself with this important research area. How do you think articles in the "Journal of Sex Differences" are using the terms men and women? I happened to read this highly cited (2k+) review, Sex differences in immune responses recently where "men" and "women" are used throughout (along with "male" and "female"). Look at the NIH. Contrived phrases like AMAB would not make sense here, virilized 46,XX CAH can be "assigned male at birth" (though consensus is that they should not be). Would all the sex differences in, say, that review I just showed you make sense if you WP:SYNTH replaced the use of "man"/"male" with "assigned male at birth"? This here is a very highly cited review on the critically important topic of sex differences COVID-19 disease outcomes. Do you see the synonymous use man/male woman/female throughout? Do you see any uses of "AFAB" or "AMAB"? Do you see any sort of suggestion that "man" and "women" are ambiguous in these sources? Do you see any use of the refined term "genetic sex" in these sources? Do you think that all these examples might just be representative of all of MEDRS? Maneesh (talk) 18:14, 20 December 2021 (UTC)

Re Do you think that all these examples might just be representative of all of MEDRS? Why on earth would someone look at your hand-picked examples and reach that conclusion? On the face of it, that seems wildly improbable. Newimpartial (talk) 18:25, 20 December 2021 (UTC)

If anyone is so unfamiliar with MEDRS that they might think that the above observations are a result of sampling: pick your favorite disease and look for highly cited reviews on sex differences: cancer, Alzheimer’s, heart disease. Check all the same things I asked to be check above, I didn't in picking these reviews but I am read enough to know that I don't need to. Go ahead and pick some yourself. Maneesh (talk) 18:37, 20 December 2021 (UTC)

The idea that you think AFAB or AMAB are contrived terms indicates you are not familiar with transgender medical literature. The reason men and women are unambiguous in your sources is (e.g. second nature article) that some of them exclude intersex and transgender individuals from the study, others (first nature article) explicitly disclose they are not studying gender and only sex, making the terms less ambiguous. Santacruz ⁂ Please ping me! 18:59, 20 December 2021 (UTC)

they are not studying gender and only sex, making the terms less ambiguous What is the title of the article this talk page is associated with? Maneesh (talk) 19:07, 20 December 2021 (UTC)

Why exactly are you opposed to clarifying the usage here is specific to sex? nableezy - 22:34, 20 December 2021 (UTC)

There is no problem in clarifying in his article that there are two sex categories (male/female) and that (man/woman) is generally used by MEDRS synonymously throughout. Why are you trying to misrepresent what the studies say and alter the clearly consensus conventions they write in? Most sex difference studies in humans talk about men and women, that's just the way it is. I've already shown you the problem with contrived AMAB style language above, it shouldn't be a surprise to you that serious studies avoid this language. Why do you think you know better than the obvious conventions of MEDRS? Maneesh (talk) 23:05, 20 December 2021 (UTC)

It's not that I know better, it is that Wikipedia is not a medical journal, it's an encyclopedia. And that means that our language usage is going to reflect more than just what medical sources use, and when the wording found in those kind of sources are ambiguous when applied to the type of source we are then we should clarify that. nableezy - 02:01, 21 December 2021 (UTC)

What is wrong with MEDRS sources like this methodological paper, this pharmacology review article or this 2016 piece? Colour me confused. Newimpartial (talk) 00:34, 21 December 2021 (UTC)

Look at your Nature article. Look where it says Intersex and transgender individuals were not represented in this study. See how that clarifies what it is including in "men" and "women". We need to have that type of clarity. And not ignore the fairly obvious fact that it is indeed ambiguous to say "men" or "women". nableezy - 18:58, 20 December 2021 (UTC)

What proportion of RS do you believe provide this disclaimer? What impact does that have on the conclusions on sex differences? EDIT: Also "not represented" does not imply "not included" (they've used that phrase carefully here, and understandably so). Maneesh (talk) 19:10, 20 December 2021 (UTC)

For context, here's the sentence and the one prior to it. This patient group, cohort A, consisted of 39 patients (17 male and 22 female). Intersex and transgender individuals were not represented in this study. In this context, it is absolutely clear that "not represented" is synonymous with "not included". In a study titled "Sex differences in immune responses that underlie COVID-19 disease outcomes" not including trans and intersex individuals makes sense, as it could potentially skew the results. Why? Some intersex conditions, like Klinefelter and Turner syndromes have a increased rates of autoimmune conditions and immunodeficiencies. Sideswipe9th (talk) 19:49, 20 December 2021 (UTC)

I dont think it really matters the proportion, I dont think this is a due weight issue. This is a clarity issue. Do you actually believe that man and woman cannot refer to genders and not strictly sex? If you do not think that, why oppose clarifying what the usage refers to here? nableezy - 19:51, 20 December 2021 (UTC)

It is a due weight issue; why would it make sense to write in the convention of a small area when all of sex differences (and beyond) in MEDRS writes differently? If anyone believes that "not represented" == "not included", You should have no trouble quoting exclusion procedure/criteria in the study. The claims about Klinefelter are embarrassingly uninformed, many subsets of men and women have heightened rates of autoimmunity. Klinefelter *males* are *males*. Many words have contextually different meanings that doesn't mean that they aren't used in specific meanings. It's quite clear that male/men/man and female/women/woman are used synonymously (not a surprise if you look at man and woman). I can link to highly cited studies across any disease area all day that all do the same thing because that is how essentially all of MEDRS is written; you don't seem to be familiar with this fact. Maneesh (talk) 22:50, 20 December 2021 (UTC)

Aside from your misreading of Man and Woman as if they use the terms "male" and "female" always in the sense you attribute to the MEDRS (they clearly don't): Maneesh, do you actually believe that all of sex differences (and beyond) in MEDRS writes differently? If so, what is the evidence for your belief? Are you under the misapprehension, for example, that studies across any disease area stands in adequately for the domain of MEDRS? Because that ain't so, and your claim seems pretty ridiculous, given the topics (including topics related to gender) on which MEDRS sources exist. Newimpartial (talk) 22:58, 20 December 2021 (UTC)

Re Klinefelter, no. They are intersex. Their gender identity is a separate discussion and a distraction.

As for the Nature paper's exclusion criteria, there were multiple exclusionary criteria of which transgender and intersex were explicitly one. I would happily quote the others here, but they aren't at all relevant to this discussion. So no Gish gallop for you. Sideswipe9th (talk) 00:33, 21 December 2021 (UTC)

Just to make it clear I sent a communication to the authors of the Nature paper on Pubpeer where they clarified that no determination of intersex or transgender status was done on their samples/participants. Editors with merely a little experience in clinical science would understand how it would be obscenely impractical to define exclusion criteria and meaningfully verify. There is no evidence of any attempt to do that in the paper as was evident from the beginning. All this being a ridiculous side quest to the basic point that men/males and women/females are used synonymously throughout MEDRS as a rule. Be very wary of editors who display confidence in their interpretations without any demonstration of expertise. Maneesh (talk) 00:48, 23 December 2021 (UTC)

You clearly do not have the ability to interpret such scientific work correctly. People like Klinefelter males are not excluded from that study, you can't pull any evidence that they were and mere familiarity with clinical science would let you know why. It's clear you have no intent on learning any basics. "Not represented" means something very different than "not included"; what a shame if editors with such embarrassing interpretation skills are not corrected here. Maneesh (talk) 00:44, 21 December 2021 (UTC)

The insistence that Kleinfelter males are not males is a form of scientific illiteracy. Maneesh (talk) 00:49, 21 December 2021 (UTC)

Hi, I'm a guy who has studied sex differences and, in particular, Klinefelters in an academic medical setting. In the setting of genetic differences of infectious disease response.

Klinefelter "males" are not strictly "males" for the sake of academic study. For our purposes, they are indeed on the "intersex" spectrum. They are excluded from most clinical trials for that very reason, because the variations in hormone expression they have affect their physiology. [3] [4]

However, it is also true that members of the Klinefelter/XXY community do not usually consider themselves "intersex" in the modern meaning of that term. [5] This contradiction is evident here. To square this, on Wikipedia, we go with academic definitions when discussing studies and science etc. And then we go with societal RS-supported definitions when discussing anthropology and culture and so on. In this article, it would be appropriate to include Klinefelter individuals as "intersex" for that reason. — Shibbolethink ^{(♔ ♕)} 00:58, 21 December 2021 (UTC)

I don't think you did very deep "academic study". I've already linked to 100s of papers that use "Klinefleter male". You'll notice "intersex' is generally absent in clinical work on Klinefelter males. You'll find 1000s with "XXY males". You don't have much expertise here, it is obvious. None of your reasoning makes much sense. Maneesh (talk) 01:03, 21 December 2021 (UTC)

On wikipedia, we operate via consensus. Not via personal attacks. Linking to older studies which were written and published before more recent academic consensus statements is not very useful in this discussion. We also use terms like "internally male" and "externally male" with some intersex patient cases, but that does not make those patients "male," strictly speaking. — Shibbolethink ^{(♔ ♕)} 01:08, 21 December 2021 (UTC)

You have fictitious notions of intersex and Klinefleter. Your claim about clinical trials is ficticous, we don't usually karyotype for clinical trials; many men who are Klinefleter's don't know that they are since presentation is "often subclinical". You have no expertise here. Maneesh (talk) 01:12, 21 December 2021 (UTC)

You've also misrepresented the links, that's a plain google scholar queries for those terms, how many do you count are form 2021? Maneesh (talk) 04:42, 21 December 2021 (UTC)

See, that is an indiscriminate smattering of publications, not at all useful for assessing how a field uses these terms. In comparison, I used the professional/paid versions of UpToDate and Trip, which will give us professional body guidelines, which MEDRS values highest: UpToDate - Society guideline links: Differences of sex development and Trip - Guidelines on "Intersex" terminology. — Shibbolethink ^{(♔ ♕)} 04:50, 21 December 2021 (UTC)

Stunning. You think that showing you *thousands* of scholarly publications with who knows how many cites all the way up to 2021 is "indiscriminate"? Have you read WP:MEDRS: Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies.....do you believe that those sources somehow outweigh an arbitrary review I could find (2018, 138 cites) that states that Kleinfelter males are males? First sentence in the body: "Klinefelter syndrome (KS), 47,XXY, occurs in 150 per 100,000 live born males (1). No universal agreement exists in the scientific community on the exact definition of KS, but in addition to possessing one or more extra X chromosomes, KS males typically exhibit phenotypical traits that include hypergonadotropic hypogonadism, testosterone deficiency, and infertility (2)." Has something happened since 2018 that has made KS males not males? EDIT: Also count how many instances of "intersex" you find in the body of this review. Maneesh (talk) 05:32, 21 December 2021 (UTC)

Whatever changed must've been past 2020 since this 2020 review titled Testosterone treatment in male patients with Klinefelter syndrome: a systematic review and meta-analysis, with 20 cites already. Again, count the number of instances of "intersex". Maneesh (talk) 06:00, 21 December 2021 (UTC)

Some users have taken offense to my assessment of Shibbolethink's claims about Kleinfelters ("males" are not strictly "males"), I cannot stress how factious and easily falsified they are. It is remarkable that saying "transwomen are males" is being considered banworthy, yet users can claim easily falsifiable fictions like Kleinfelters "males" are not strictly "males" without consequence. Maneesh (talk) 16:43, 21 December 2021 (UTC)

I actually don't think anyone is saying that saying "transwomen are males" is banworthy. I said it below as well. Biologically speaking, Transwomen are assigned male at birth. — Shibbolethink ^{(♔ ♕)} 17:08, 21 December 2021 (UTC)

Well it's being treated as banworthy at AE, with "transwomen" being called a transphobic dog whistle, so you may want to clarify your comments there. Crossroads ^-talk- 19:43, 21 December 2021 (UTC)

I made only comments regarding Maneesh's tone and battlegrounding. I did not describe anything about use of the term "transwomen." And very intentionally did NOT go into depth about the rest of that extremely long complaint. Which is frankly too long for anyone to read. There's a reason for word limits. — Shibbolethink ^{(♔ ♕)} 19:47, 21 December 2021 (UTC)

We don't actually need a karyotype to diagnose Klinefelter's (adult males are usually presumptively diagnosed, and only karyotyped if they wish to get a truly "definitive" answer or if they want to seek fertility treatments which would be harmful to their health). I'm not sure where you got the idea that I was suggesting anyone was doing karyotypes in clinical trials (although such studies have been done). — Shibbolethink ^{(♔ ♕)} 01:16, 21 December 2021 (UTC)

Are you for real? "Chromosome analysis. Also called karyotype analysis, this test is used to confirm a diagnosis of Klinefelter syndrome" — Preceding unsigned comment added by Maneesh (talk • contribs) 01:33, 21 December 2021 (UTC)

Yep. [6] Clinical diagnosis has a pretty good true positive rate, but unfortunately, since many KS individuals are phenotypically varied and subtle, there is a high chance of false negative. Karyotype is sufficient, but not necessary. It often "confirms" a clinical diagnosis. — Shibbolethink ^{(♔ ♕)} 01:48, 21 December 2021 (UTC)

Even in your own source "The diagnosis of a male with KS rests on clinical appearance coupled with a karyotype of 47,XXY or mosaics thereof." There is no diagnosis without a karyotype. I am floored that you posses a medical degree and that you would diagnose Klinefelters without a karyotype. Maneesh (talk) 02:01, 21 December 2021 (UTC)

Yes, the only actual standard that could ever be used for any clinical or research purpose. Unconfirmed diagnoses aren't generally the ones that are part of an encyclopedia. Maneesh (talk) 01:56, 21 December 2021 (UTC)

Uncomfirmed (so-called "clinical", as opposed to "pathological") diagnoses are the rule, not the exception, in clinical medicine. A common misconception. [7] To be fair, most DSD/intersex condition diagnoses are pathological/laboratory-confirmed. Most Klinefelter diagnoses are laboratory-confirmed (via karyotype). But many made in adults outside of fertility clinics are made clinically. Karyotypes are quite expensive, on the order of $11,000 in the US. [8] So if it won't change management, the recommendation is to not karyotype. — Shibbolethink ^{(♔ ♕)} 02:05, 21 December 2021 (UTC)

Ha! I can see the naive google query you used to get that number. Never ordered one and look at the cost for a patient, huh? You are really something. Maneesh (talk) 02:21, 21 December 2021 (UTC)

Patient-cost is not the only thing we consider when ordering tests. Cost to the healthcare system and to the public (often medicare/medicaid) is also very important. I usually reference the unadjusted not-yet-negotiated cost billed to insurance, even though it is often substantially reduced in the end. Because it puts in perspective how much hospitals believe they should charge for such tests. Karyotyping can probably range between $2k and $10k, with 11k being the absolute upper end for an undiagnosed anomaly that requires lots of further examination. (sometimes involving so-called "spectral karyotyping") — Shibbolethink ^{(♔ ♕)} 02:24, 21 December 2021 (UTC)

Likewise, you have often referenced WP:MEDRS in this discussion. "Academic consensus statements" from "professional organizations" are held in very high regard by that guideline. So we should respect statements by organizations like the APA and AMA. — Shibbolethink ^{(♔ ♕)} 01:13, 21 December 2021 (UTC)

This is again descending into madness. Please quote in your link where it says Klinefelter males are not males. Any prevalence estimate of Klinefelters is an estimate out of the set of males: "Klinefelter Syndrome (47, XXY) is a chromosomal variation in males...47, XXY (KS) is the most common human sex chromosome disorder and occurs in approximately 1 in 500-1,000 males.". I do not believe you did any serious work anywhere near this condition. Maneesh (talk) 01:19, 21 December 2021 (UTC)

Any prevalence estimate of Klinefelters is an estimate out of the set of males. Yes, because most Klinefelter individuals are raised as "men" culturally-speaking, and are presumed male until they are diagnosed. And many of these individuals continue to identify as "men" thereafter. It does not mean the condition is not on the "intersex" spectrum. It is. — Shibbolethink ^{(♔ ♕)} 01:21, 21 December 2021 (UTC)

Nothing you say is supported by clinical science, you seem determined to be ignorant of it despite having links put in front of you that explain it clearly. "Intersex" does not preclude one from being a male or a female, almost all "intersex" conditions are sex specific and the overwhelming numer of people with intersex conditions are just male or female and the conditions have prevalence estimates out of males and females. How people are raised has nothing, absolutely nothing, do with these estimates which are done via objective tests like karyotypes. Maneesh (talk) 01:26, 21 December 2021 (UTC)

almost all "intersex" conditions are sex specific and the overwhelming numer of people with intersex conditions are just male or female and the conditions have prevalence estimates out of males and females The American Medical Association [9], The Global Disorders of Sexual Development (DSD) working group [10], the European COST expert consensus of Pediatric Endocrinologists, [11], the European Society for Pediatric Endocrinology [12], and the Intersex Society of North America [13] appear to disagree with you there.

There is also, importantly, a distinction between "chromosomal sex" and "sex," two terms which you may be collapsing here. — Shibbolethink ^{(♔ ♕)} 01:39, 21 December 2021 (UTC)

You are very confused. Those organizations don't say what you think they say. Please improve your scientific literacy. Maneesh (talk) 01:43, 21 December 2021 (UTC)

Maneesh you might want to check the user page of the editor you're arguing with, you might find it illuminating. Their academic publishing record is impressive. Sideswipe9th (talk) 01:46, 21 December 2021 (UTC)

I'm not impressed that someone apparently some training could make such absurd claims here. Maneesh (talk) 01:54, 21 December 2021 (UTC)

I just wanted to add here, I think when you say the overwhelming numer of people with intersex conditions are just male or female and the conditions have prevalence estimates out of males and females, you may just be misusing the academic terminology. Typically, the most accurate and up-to-date term for these persons, which is embraced by professional organizations is "chromosomally male" or "XY intersex", or conversely, at the other end of the spectrum, "chromosomally female" or "XX intersex." Example: [14] — Shibbolethink ^{(♔ ♕)} 02:01, 21 December 2021 (UTC)

You can't be for real. Medline as RS here? That is not consensus language *at all*. Go look up clinical papers, recent ones, that focus on these conditions and their prevalences. You own source that you provided makes it clear Klinefelter males are male. Here is some help to start looking at papers: [15] Maneesh (talk) 02:09, 21 December 2021 (UTC)

Never said I was linking consensus (or RS) when I linked Medline, although Medline is an RS, albeit a tertiary not-preferred one. You'll see I'm very precise when I say I'm talking about a consensus versus when I am not. In this case, I said "example:" — Shibbolethink ^{(♔ ♕)} 02:10, 21 December 2021 (UTC)

I suggested in the section prior that, as this is an article titled "Sex differences in medicine", we should consistently use male/female language throughout as that is unambiguously a sex related descriptor. Man/woman have contextually different meanings, and it isn't immediately clear whether or not it is being used as a sex descriptor or a gender descriptor in this article. The lead and causes sections for example use "male" and "female" throughout. The first instance of the words "men" or "women" is in the women subsection. Sideswipe9th (talk) 19:00, 20 December 2021 (UTC)

as this is an article titled "Sex differences in medicine", we should consistently use male/female language throughout as that is unambiguously a sex related descriptor.

Yes, I agree with this and I think it is a relatively uncontroversial opinion. There is nothing gained by using "men" instead of "male" in an article about medical topics. Such terms are less precise. The fact that some authors use them interchangeably does not change their vague quality, and does not make them permissible for this article. — Shibbolethink ^{(♔ ♕)} 00:59, 21 December 2021 (UTC)

Based on your comment above, I was about to ask for clarification on that as I suck at reading between the lines. But you've already addressed the question here. Thanks. Sideswipe9th (talk) 01:07, 21 December 2021 (UTC)

Just as a courtesy note encase anyone was unaware, Maneesh has put out a notice over on WikiProject Medicine. Although it is decidedly non-neutral and a misrepresentation of this discussion.Sideswipe9th (talk) 00:33, 21 December 2021 (UTC)

digression.— Shibbolethink (♔ ♕) 01:25, 21 December 2021 (UTC)

I would encourage you to remove this part of this comment: Although it is decidedly non-neutral and a misrepresentation of this discussion. That may be true, but it does not do anyone any better to continue that trend of non-neutrality here. Notices of other postings placed in the original discussion should also be neutrally worded, per WP:CANVAS. — Shibbolethink (♔ ♕) 01:00, 21 December 2021 (UTC) Just to confirm, do you want me to strike that just here or over at WikiProject Medicine as well? How do you address a non-neutral notification potentially colouring the perspective of incoming editors in this sort of situation? Sideswipe9th (talk) 01:07, 21 December 2021 (UTC) I would encourage you to strike it here, and just place a matter-of-fact neutral description of this discussion over at WT:MED instead of any indictments, etc. — Shibbolethink (♔ ♕) 01:18, 21 December 2021 (UTC) Done here. And I've removed my reply over there and replaced it with the template. Sideswipe9th (talk) 01:23, 21 December 2021 (UTC) Thanks, I'll go ahead and collapse this digression — Shibbolethink (♔ ♕) 01:24, 21 December 2021 (UTC)

I'll open an RFC on whatever's being disputed. What's being disputed? GoodDay (talk) 03:17, 21 December 2021 (UTC)

Please do not open any RfCs without reading the discussion above first. The last two/three times an RfC has been opened like this have been a disaster. RfCs need to be carefully thought out, they aren't something to just start on a whim.

Also I could be mistaken, but I suspect the RfC comments were for a wider consensus than something at this article level. @Aquillion: made the most recent contribution on this. Sideswipe9th (talk) 03:20, 21 December 2021 (UTC)

Where would be a good place to open an RFC to settle whatever's being disputed, if it's also disputed on other articles. GoodDay (talk) 03:23, 21 December 2021 (UTC)

I'm going to wait for Aquillion to reply here before I even make that suggestion, just encase I've completely misinterpreted what they've said. Sideswipe9th (talk) 03:28, 21 December 2021 (UTC)

If, and it's still an if, I've interpreted what the other editor has said correctly, there might be a topic wide language issue that needs to be resolved. There was a prior RfC on this question that, despite one editor stating otherwise here, was closed as inconclusive back in 2019. Or I may have misread their comment, and the RfC suggestion might have been to break a single editor deadlock at a local article level. I'm not entirely sure which. Either way, I'd suggest waiting for clarification before starting anything. Sideswipe9th (talk) 03:37, 21 December 2021 (UTC)

See [16]. Crossroads ^-talk- 06:47, 21 December 2021 (UTC)

• My thoughts, in no particular order:

• I don't think a sweeping Wikipedia bright line on language use is likely to come from an RFC of this nature, at least not of the sort proposed below. (That was one of the specific conclusions of the previous RFC.) That's always going to vary in specific contexts depending on sourcing within that context. If people want a sweeping RFC, I would suggest something closer to the Race and Intelligence RFC, where we try and nail down the broad outlines of what views are generally notable, which are fringe, and so on, but even that is likely to be a hard ask.
• This disputed removal struck me as more concerning than the dispute over terminology, and seems like something that can more productively be pursued as a way forwards - that is, rather than worry about the subtle implications of terminology on trans issues, note them specifically in gensex medical articles in places where substantial MEDRS coverage of them exists (and it usually, in my experience, does - you can see how easy it was for me to find sources for that, and it would be trivial to find hundreds more, if not thousands. Ovarian cancer in transgender men has a lot written about it, much of it in medical journals.) This seems like a decent compromise in the sense that we can stick to the sources and cover things neutrally by simply expanding into what sources say about trans aspects specifically - when they say it, with weight appropriate to the sourcing. It does not have to be at massive length - that depends on the sourcing and context - but a sentence or two in the correct places isn't much when the sourcing tends to be fairly heavy. We can say "women" and then include properly-cited language with impeccable sourcing further down the article that makes the trans context clear with appropriate weight. This isn't likely to be a magical solution to everything (the lead is more difficult because weight requirements for that are harder, and it won't answer people who feel that the language is misleading in any context) but it is a good start with a firm foundation, and usually at least a single-sentence summary of what sources say about trans aspects of sex and gender related medical topics will be leadworthy anyway - again, this aspect really does have significant coverage. The edit summary of that removal implies it would be ridiculous for us to generally mention trans issues in such cases; it does not seem particularly ridiculous to devote a single sentence to that aspect, when literally thousands of sources mention it.
• So for an RFC like below, I would suggest an option along those lines - talk about men and women and males and females using the terminology in the best available sources, but (when appropriate, ie. when adequate sourcing exists) mention trans aspects related to those topics as well, in their own sentence(s) with their own sources.

The precise weight and structure is inevitably going to have to be determined on a case-by-case basis, but this is basically how we handle most comparable topics - trans aspects of these medical issues are, yes, a smaller subset of the larger medical science; but that is only smaller in a relative sense, they still have such overwhelming coverage that it seems difficult to argue for omitting them entirely. --Aquillion (talk) 08:25, 21 December 2021 (UTC)

that is, rather than worry about the subtle implications of terminology on trans issues, note them specifically in gensex medical articles in places where substantial MEDRS coverage of them exists Yes, I would agree. At least where such issues are WP:DUE. I would further state, though, that we can refer in general to Male and Female, and then note exceptions. Not that we should just not have conventions at all. These are articles about biological sex, after all. One would think that material strictly about gender, and not relating to biological sex, would be WP:UNDUE here. — Shibbolethink ^{(♔ ♕)} 14:04, 21 December 2021 (UTC)

Ya'll would be better off concentrating on developing the proposed RFC. GoodDay (talk) 17:49, 21 December 2021 (UTC)

The female reproductive system and "other genders"

This isn't an article about ovarian cancer. It is about the differences between the sexes. None of the sources you are citing are about sex differences. Gender identity is not relevant here. It would be incredibly impractical and yes, UNDUE to add disclaimers about trans people to every bit of sexual dimorphism text on this site. This one is likewise completely unnecessary. Yet you and another editor were edit warring to add it, in violation of WP:ONUS (which requires consensus to include text) and in the latter's case, misusing WP:BRD (it is the two of you who should be discussing rather than reverting, since that text had been gone for over a week, and the previous version was shorter too). We can simply mention the female reproductive system there without extra stuff about gender identity or how ovarian cancer presents in X subset of patients, etc. Crossroads ^-talk- 08:38, 21 December 2021 (UTC)

Just to be clear, before you removed it, the disputed text had been in the article since February. Obviously compared to that a single week (with almost no intervening edits, and therefore no indication that it had any substantial scrutiny) is not enough to make something the WP:STATUSQUO. You boldly removed something, someone objected in a reasonably timely manner, and so on. But either way, the underlying dispute is more important. As far as that goes - and as several of those sources discuss - medical issues for trangender men are specifically affected by issues related to the intersection of their biological sex and their process in transition; this, clearly, is an important topic for sex differences in medicine, in that it is a relevant medical difference that concerns both their (biological) sex and the effect that their transition has on aspects of their body related to it. And, again, it is a single sentence, in the body, saying something unexceptional and as far as I can tell largely uncontroverisal, for which numerous high-quality sources exist; we are not talking about devoting an entire paragraph or section to it. (Well, not to it specifically, anyway - a section on how sex differences in medicine affect trans people specifically, especially as it relates to transitioning, might be reasonable, but that would require a lot more time and thought.) --Aquillion (talk) 08:49, 21 December 2021 (UTC)

That there are "high-quality sources" about trans men and ovarian cancer is totally irrelevant here. I'm sure there are similar sources about black women and female reproductive system cancer, about old vs. young women, poor women, etc. None of it has anything to do with sex differences, which is the topic of this article. Crossroads ^-talk- 08:59, 21 December 2021 (UTC)

Crossroads, this is a classic example of circular reasoning, of assuming the thing that needs to be decided. You are assuming that trans men are a subset of women, for medical purposes, and then arguing because that other subsets of women exist, that therefore none of these categories has any impact on the overall scope (and meaning) of "women" in the context of medicine. This strikes me as nonsensical but even if your conclusion were in agreement with the community, it does need some mechanism of community "ratification" since there are quite clearly multiple editors who disagree with you and only one, nearly topic-banned, editor who is promoting something like your position here (and that, very badly). Let actual sources and policies decide this one, not your opinions. Newimpartial (talk) 12:31, 21 December 2021 (UTC)

No, this an article about the sexes, not genders, and the material is under a heading named "Female". You are claiming that trans men are not, medically speaking, a subset of the female sex - despite somehow having a female reproductive system - such that they need to be mentioned as an exception in terms of sex differences. No MEDRS support that.

You are also ignoring the already existing community consensus that we do not need to avoid straightforward terminology like this, that the terminology in articles, especially medical articles, is dependent upon the support of reliable sources and it is expected that editors would use the same terminology presented in said sources. And the vast majority of those WP:MEDRS sources on sex differences do not mention trans men and "other genders". There is no getting around that simple fact. Crossroads ^-talk- 13:17, 21 December 2021 (UTC)

Would you please stop mis-stating my position as something it is not. You are claiming that trans men are not, medically speaking, a subset of the female sex - no, I am not. I am saying that it may be necessary to specify when the category "female" includes trans men, when (as I have shown with MEDRS sources elsewhere) it includes trans women, and when (as with the discussion of "intersex" people on this page) it may be unclear who is included.

Mis-stating the positions of others (to put it politely) is a violation of WP:TPG and WP:CIVIL, but you do it again, and again, and again. Can you stop, or is this something that needs to go to a dramaboard? I, for one, am sick of your supposedly "civil" POV-pushing. Newimpartial (talk) 13:25, 21 December 2021 (UTC)

Then your entire justification for this evaporates. That bullet point is an article about sex differences, under a heading using a word that is overwhelmingly used in MEDRS to be the name of a sex, and specifically names the female reproductive system, yet treats trans men as some sort of exception to all that. Again, the vast majority of WP:MEDRS sources on sex differences do not mention trans men and "other genders". There is no getting around that simple fact. What you are arguing for is therefore UNDUE, pure and simple. Crossroads ^-talk- 13:38, 21 December 2021 (UTC)

Do you think I am the editor who made that diff? If you're making a socking accusation, it is an extremely oblique one, as well as being quite wrongheaded. Newimpartial (talk) 13:46, 21 December 2021 (UTC)

It's what this subsection is about and you're defending it. Crossroads ^-talk- 14:34, 21 December 2021 (UTC)

I'm the editor who originally added in the stuff about transgender men and ovarian cancer, and I agree with User:Crossroads's decision to remove it as it added undue weight to the gender when this article is supposed to be about sex. I'm sorry for causing all this discourse. Feralcateater000 (talk) 20:29, 21 December 2021 (UTC)

This "us" vs "them" mentality is part of why this discussion is so toxic. Stop it, both of you. No one is "defending" anything or "accusing" anyone of being a sock here. We are discussing how to make a wikipedia article. Any and all discussions of editor conduct are off topic here. I'm gonna start collapsing them. — Shibbolethink ^{(♔ ♕)} 14:35, 21 December 2021 (UTC)

Crossroads, I most recently replied to your comment where you insisted that trans men are a subset of women in the same sense and with the same relevance to this article that black women are a subset of women. This assertion is, ahem, unproven and circular. My pointing that out is not a defense of the specific way the content about trans men and ovarian cancer has been included in the article; claiming that trans men are not, medically speaking, a subset of the female sex is not at all equivalent to my actual position. In this discussion, my position is that insisting on wikivoice assertions that "trans men are (medically) women" does not align with the mainstream position taken by MEDRS sources on trans health and represents, in fact, dogged POV investment on your part (and that of Maneesh, who really got this particular ball rolling). Newimpartial (talk) 15:12, 21 December 2021 (UTC)

Yes I would agree with this comment by Newimpartial. It is more accurate (and supported by sources) to say trans men are, medically speaking, a subset of the female sex and trans men are a subset of the male gender — Shibbolethink ^{(♔ ♕)} 15:21, 21 December 2021 (UTC)

Ya'll would be better off concentrating on developing the proposed RFC. The content discussions on this article have reached a stalemate. GoodDay (talk) 17:51, 21 December 2021 (UTC)

I'm not sure that your efforts at chess criticism are among the most productive recent contributions on this Talk page. #chesscriticismcriticism Newimpartial (talk) 17:54, 21 December 2021 (UTC)

I think restructuring the article should probably take place first. To differentiate Sex vs gender differences — Shibbolethink ^{(♔ ♕)} 18:14, 21 December 2021 (UTC)

Draft RfC on Sexual Dimorphism Terminology

For medical and scientific sex-related articles on Wikipedia (or "For this article"), which terms should be used for the sexual dimorphism of humans?
(Note: "sex-related articles" refers to any article primarily about the sex of humans (chromosomal, gonadal, phenotypic, e.g.: Sex differences in medicine, Sexual differentiation in humans, or Sex differences in human physiology)

(A) Males, Females, and Intersex (e.g. [17])

(B) Men, Women, and Intersex

(C) A or B interchangeably (e.g. [18])

(D) A or B (whichever a source appears to be referring to at any point in the text)

(E) These conventions should be article-specific (status quo)

(Edit at will, discuss draft below) — Shibbolethink ^{(♔ ♕)} 03:34, 21 December 2021 (UTC)

Comment - at a minimum, I think an option is needed that would very the terms by article, rather than for whichever a source appears to be referencing.

Also, I think the RfC needs some additional specification or discussion of what is meant by sex-related articles - I think participants in this Talk page discussion have a pretty good idea what is meant (whether we want to or not), but the RfC, if successfully launched, will attract participants who lack this context. Newimpartial (talk) 03:45, 21 December 2021 (UTC)

Suggestion: The less options, the better the chance of a consensus. Perhaps this proposed RFC should be held at WP:MED, as this appears to be more a medical topic, rather then a gender/sex topic. GoodDay (talk) 03:48, 21 December 2021 (UTC)

@GoodDay @Newimpartial Feelings about latest draft? — Shibbolethink ^{(♔ ♕)} 03:56, 21 December 2021 (UTC)

Many options can lower the chances of a consensus. But, I'm ok with the draft. Will it be held at WP:MED? GoodDay (talk) 04:01, 21 December 2021 (UTC)

I don't think WP:MED is the place to hold this, though they should be notified when it starts. I'm not even sure you can hold an RfC on a WikiProject project page? Though if it is the right place, more editors should get eyes on it before launching. Sideswipe9th (talk) 04:05, 21 December 2021 (UTC)

It can be held at a WikiProject's talkpage. I've done several. GoodDay (talk) 04:52, 21 December 2021 (UTC)

Does it need to be stated/clarified that option E is the current status quo per the previous no-consensus RfC on this? Or would that count as poisoning the well? Sideswipe9th (talk) 04:07, 21 December 2021 (UTC)

Whatever the status-quo is, it should be an option. GoodDay (talk) 04:52, 21 December 2021 (UTC)

added — Shibbolethink ^{(♔ ♕)} 04:55, 21 December 2021 (UTC)

C is the status quo, not E. [19] Crossroads ^-talk- 13:26, 21 December 2021 (UTC)

I really don't believe that to be an accurate statement of the status quo. I suppose it depends on the intended scope of the RfC, though: it might be true for a small enough subset of articles (it doesn't clearly apply to the status quo version of this one, for example). Newimpartial (talk) 13:28, 21 December 2021 (UTC)

This may be a misunderstanding of the point of this RfC. We are currently drafting it for a multi-wiki-article usage, not for just this article. So it wouldn't make sense to call C the status quo, when other wiki articles do it differently. If we later decide to make it just about this article, then yes, C would be the status quo. — Shibbolethink ^{(♔ ♕)} 14:03, 21 December 2021 (UTC)

• Bad proposal. I can't believe what I'm seeing here. First off, no RfC done at one article can be made to apply to thousands. Secondly, does any editor deny that the vast majority of WP:MEDRS to this day, and in almost every case without mentioning exceptions like transgender or intersex conditions, injuries, or what have you, refers simply to "men" and "women"? For example, search Google Scholar for "only in women" or "pregnant women", in quotes, and selecting "since 2021": [20][21] Am I going to have to waste time plopping down dozens of specific sources to establish WP:DUE weight? Are editors really okay with making women invisible in medicine, in a sense? None of the sources vaguely gestured at above support this POV, WP:RGW crusade. Crossroads ^-talk- 06:16, 21 December 2021 (UTC)

  AFAIK, the plan is to have it at the talkpage at WP:MEDS. GoodDay (talk) 06:26, 21 December 2021 (UTC)

• If you think it's bad that people are suggesting this, and that the outcome is obvious, then you should welcome an RFC to settle it properly rather than the interminable sorts of discussions we had above. But I don't think that it's sufficient to just point to the results of searches like those; for one thing, usage can be context-sensitive (option D) which isn't going to be obvious from a broad search. It's particularly inappropriate to use a large number of sources that don't discuss a dispute at all to dismiss a significant (but smaller) number of sources that discuss it directly - the "your honor, look at all the people I didn't stab" defense, so to speak. There may also be solutions that don't rely on sweeping dictates about gender language, which I suspect are unlikely to reach consensus in either direction. We have to stick to the sources, but which sources are appropriate to introduce is important, and especially, to cut at the heart of the issue, whether trans aspects of gensex medical issues ought to be brought up in those contexts and, if so, how and using which sources, to what degree of weight, etc. --Aquillion (talk) 08:10, 21 December 2021 (UTC)

That stabbing analogy is way off. As I said above, it is not relevant just that sources on trans topics exist (though naturally there are many, many times more not about trans topics at all since they are a small minority). There are sources about poor, ethnic minority, older, etc. men and women, but none of that is necessarily relevant to the topic of sex differences. To take the existence of sources on trans people and say that all our material on sex differences has to be framed around how those few sources handle it is POV and WP:UNDUE. It would violate WP:NOTADVOCACY. Crossroads ^-talk- 09:05, 21 December 2021 (UTC)

I'm confused as to how talking about trans health in this context would be advocacy, and I'd appreciate some clarification on that, Crossroads. Santacruz ⁂ Please ping me! 09:38, 21 December 2021 (UTC)

Yes, I would further say that talking about the existence of trans people is not advocacy. It is encyclopedic. — Shibbolethink ^{(♔ ♕)} 14:06, 21 December 2021 (UTC)

• Point by point:

• no RfC done at one article can be made to apply to thousands - wasn't planning on it.
• does any editor deny that the vast majority of WP:MEDRS to this day, and in almost every case without mentioning exceptions like transgender or intersex conditions, injuries, or what have you, refers simply to "men" and "women"? Yes, I would deny this. The vast majority of primary research articles use these terms interchangeably, not caring much for which is used at any given time. A great many professional guidelines use these terms specifically, and with great care. MEDRS treats these two types of sources differently, and prefers guidelines.
• Are editors really okay with making women invisible in medicine, in a sense? This is a straw-man argument. Medicine is concerned with reconcilable differences, and their effects on the health of human beings. It is far easier to delineate studies based on phenotypic sex than it is to worry about gender. And until recently, it was common parlance to not really care about the distinction between the two. But that doesn't mean our articles should lose precision and readability.

— Shibbolethink ^{(♔ ♕)} 13:59, 21 December 2021 (UTC)

MEDRS articles rely heavily on review articles, and their usage is the same as I described. What you are advocating for goes far beyond how academics write about these topics. Writing our articles to pretend as though being a woman has nothing to do with being female is privileging a tiny minority over the experience of the vast majority. Crossroads ^-talk- 14:43, 21 December 2021 (UTC)

Writing our articles to pretend as though being a woman has nothing to do with being female is privileging a tiny minority over the experience of the vast majority

Hi, yeah, that's not what I'm suggesting. I'm saying we must describe them in the most accurate way possible, per the standards set out in MEDRS-privileged guidelines from professional organizations such as the academy of medicine (see page 176 [22])

Example: when discussing a review/study which did not exclude trans persons or non-binary persons, and collapsed them into their phenotypic gender, then we should either A) not include that in an article about sex differences, or B) put it in a section about gender differences. When such a study included these individuals in groups according to their chromosomal sex (or, more likely, did not include them at all), then we should put that in a section about sex differences, and discuss it as regarding biological sex. — Shibbolethink ^{(♔ ♕)} 14:47, 21 December 2021 (UTC)

That page you linked is about use of the specific words "sex" and "gender". That same book's description starts by saying, It's obvious why only men develop prostate cancer and why only women get ovarian cancer. Interesting.

You seem to be saying that - regardless of how a source describes itself - we need to comb through it to examine how it accounted for trans people, and then classify it as sex or gender related accordingly. And that we need to throw out sources on sex differences from the topic if they didn't specifically say anything about this (despite the fact that a review likely leaves that to the articles it is reviewing, and a primary study likely would have rejected such a person without comment if they showed up, and why would a trans person participate in a medical study that clearly does not apply to them anyway?). That is WP:Original research, as well as completely impractical. It means throwing out most sources from being about sex. Crossroads ^-talk- 15:10, 21 December 2021 (UTC)

I never said we should throw out such sources. We shouldn't be citing primary studies in the first place. If they aren't about sex, we should put them in a section about gender differences. many reviews are only studying cis-gendered non-intersex individuals. Those would be appropriate for a section on sex differences.

However, other reviews don't really care and are about men vs women, regardless of sex and regardless of any intersex conditions. Those would be more appropriate for a section on gender differences.

And combing through our sources and making sure they are talking about what we are using them to talk about isn't WP:OR, it's good wikipedia-ing. Interpreting them in a way that was not intended or described by secondary sources is WP:OR. — Shibbolethink ^{(♔ ♕)} 15:13, 21 December 2021 (UTC)

And what if a review specifically about sex differences doesn't specify anything about "cis-gendered non-intersex individuals"? Where are you proposing to classify this? Crossroads ^-talk- 15:19, 21 December 2021 (UTC)

Depends on what sorts of factors the review is discussing. Biological differences, per our high quality MEDRS guidelines, should be placed in a section about sex differences. Cultural influences in outcome would be placed in a section about gender. — Shibbolethink ^{(♔ ♕)} 15:23, 21 December 2021 (UTC)

Shibbolethink, I don't think you've understood that for Crossroads, whether a source is MEDRS and whether it is PRIMARY or SECONDARY depends on whether or not it supports the argument he is making at the tkme; Wikipedia policies like WP:IMPLICITCONSENSUS are the same way. That's just how WP works. Newimpartial (talk) 15:18, 21 December 2021 (UTC)

I would encourage you to not use confrontational battleground language like this, as much as it may feel good, and whether or not it is accurate. — Shibbolethink ^{(♔ ♕)} 15:22, 21 December 2021 (UTC)

In my view it is not a matter of "feeling good" but more a matter that all interlocutors ought to share the same consensus reality, to the extent possible. I don't think it is BATTLEGROUND to describe what is actually happening in the present discussion or to link it to other discussions on the same Talk page. Newimpartial (talk) 15:27, 21 December 2021 (UTC)

It just isn't necessarily helpful towards building a consensus. Just makes people angrier. — Shibbolethink ^{(♔ ♕)} 15:28, 21 December 2021 (UTC)

Nobody here is proposing to pretend as though being a woman has nothing to do with being female. Watch out; straw goats are highly inflammable. Newimpartial (talk) 15:01, 21 December 2021 (UTC)

Can we change "Men, Women" to "Man, Woman" (or Male, Female to Males, Females) please? Tewdar (talk) 10:00, 21 December 2021 (UTC)

Numerous WP:MEDRS, including that cited in this article, do not restrict themselves to "male"/"female". I see no reason to talk so oddly in articles when MEDRS do not. It's like saying that we can't say that humans are bipedal because some people have one or zero legs, and some can't walk because of this condition and that condition, etc. Crossroads ^-talk- 13:22, 21 December 2021 (UTC)

Wow, @Crossroads it appears you may have completely misunderstood @Tewdar's point. They were asking for a better concordance of singular vs plural. — Shibbolethink ^{(♔ ♕)} 13:57, 21 December 2021 (UTC)

Indeed I was, and thank you to whoever fixed it. Tewdar (talk) 14:14, 21 December 2021 (UTC)

Sorry about that, I was tired and didn't look closely. Crossroads ^-talk- 14:32, 21 December 2021 (UTC)

Are we in agreement that the proposed RFC should take place at WP:MED's talkpage? GoodDay (talk) 15:51, 21 December 2021 (UTC)

I would say yes, but hold off on it. Because I think the ensuing discussion on this page has made me change what I think the options should be. I imagine the same may be true for others — Shibbolethink ^{(♔ ♕)} 15:54, 21 December 2021 (UTC)

I'll let ya'll work out what the options for the proposed RFC will be. There's no hurry. GoodDay (talk) 16:16, 21 December 2021 (UTC)

Should this article also be about gender?

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

Wherever possible, researchers often attempt to examine the smallest scope of a question, to get the most accurate answer. Usually, that means excluding trans people and other gender-nonconforming individuals from studies, and stratifying individuals by age and income and race, to avoid the effects these have on health conditions. Unfortunate, and a systemic barrier to improving the health of these atypical individuals, but it is an undeniable fact. It doesn't mean we need to ignore studies which include these individuals, it just means we need to talk about them separately, and in a WP:DUE manner. — Shibbolethink ^{(♔ ♕)} 14:29, 21 December 2021 (UTC)

Some sex differences in outcome are a result of societal factors (i.e. "gender"). Just because they are not the exact same thing does not mean they are separable like that. There is a greater than 99% overlap in the population between sex and gender. Crossroads ^-talk- 14:38, 21 December 2021 (UTC)

"Some sex differences in outcome are a result of societal factors (i.e. "gender")." This statement confuses me. Just because we cannot precisely measure the contribution of societal factors to separate them completely from chromosomal, anatomical, genetic differences, does not mean that we do not discuss them as distinct entities. "sex differences" in outcome are intended to be entirely separate from gender differences. Not measuring them precisely does not mean that the definitions and terms are interchangeable, and it does not mean that we should pretend they are the same.

E.g. We still study "ethnicity" as separate from "race." And these have different articles on wikipedia. — Shibbolethink ^{(♔ ♕)} 14:41, 21 December 2021 (UTC)

While I agree with Crossroads' statement above that some (measured) sex differences result from (causal) gender factors, I also agree that pretending they are the same is not the way to go. Which is why I believe that careful, contextual reading of sources is required, rather than dogmatic assertions of the form "this is what MEDRS always mean by" male/sex/women/gender. Newimpartial (talk) 14:47, 21 December 2021 (UTC)

Yes, I would say we should not include studies of gender and pretend they are about sex, and vice versa. That would be an unfortunate and ill-advised consequence of choices A and B in my RfC above, if we did not remove many citations/sentences from this article. So I would say probably not a good plan.

A better plan would be to separate these things into different sections in ONE article, such that we are discussing sex and gender differences separately, with their appropriate sources. — Shibbolethink ^{(♔ ♕)} 14:50, 21 December 2021 (UTC)

Well, this comment confuses me. I doubt you'd dispute that there are numerous sources about differences in outcomes between males and females, and that many such sources investigate and express uncertainty whether those differences arise from physiological differences, social effects, or both interacting in a complex manner. Something like that can't be split into sex and gender. Crossroads ^-talk- 14:52, 21 December 2021 (UTC)

Something like that can't be split into sex and gender. This is a misunderstanding of what those statements are saying. That we cannot easily separate such effects, does not mean that we do not study them with the intention of isolating physiological effects. We do. All the time. We isolate wherever possible, but cannot remove entirely the possibility that societal effects are present. Such a statement would be analogous to saying to that mouse research and cell culture studies are meaningless and have contributed nothing to the field of medicine... — Shibbolethink ^{(♔ ♕)} 14:55, 21 December 2021 (UTC)

I agree with Crossroads here (except for the "greater than 99% overlap" statement, which seems to me to be a red herring, or perhaps a dead cat). Newimpartial (talk) 14:47, 21 December 2021 (UTC)

Crossroads, you say here "Just because they are not the exact same thing does not mean they are separable like that". But we spend a great deal of time attempting to figure out which is which in medicine, because it changes the way we try to fix it. It is not so easy to use genetic modification or pharmaceuticals to fix problems introduced by society (psychiatry be damned). But it is quite easy to use such interventions to fix problems of physiology. Such as recognizing the impact of breast feeding post-partum on breast cancer risk (it prevents it), and using pharmaceuticals to reproduce this effect in individuals who cannot breast feed.

Is there likely an impact of being able to breast feed on cancer risk, psychologically? culturally? sociopolitically? Yeah, sure. It probably makes you happy and feel better. Reduces stress, etc. But when we examine such effects in cell culture "organoid" models or in breastfeeding mice that do not live in groups, we are attempting to insulate the study from such effects and ignore whatever "leaks through" temporarily.

The same is true of human studies which stratify by economic class, race, geographic region, age. And which exclude trans men (and any intersex individuals, as much as possible) from the study population. It isn't maleficent, and it isn't a political statement. It's good science. And it deserves to be discussed separately from studies which are studying the overall effect of gender on health. — Shibbolethink ^{(♔ ♕)} 14:58, 21 December 2021 (UTC)

Suppose we have a review article about "Sex Differences in Schizophrenia". It examines both biological and cultural factors. It says not one word about trans people. Where are you proposing to classify such an article? Crossroads ^-talk- 15:17, 21 December 2021 (UTC)

I would propose that citations to this article discussing biological differences be placed in a section about sex differences, and citations to this article discussing cultural factors be placed in a section about gender. As we are told to do by professional body statements, which are some of the highest quality MEDRSes. — Shibbolethink ^{(♔ ♕)} 15:19, 21 December 2021 (UTC)

Please answer the question. Where are you proposing to classify material sourced to that article? Crossroads ^-talk- 15:21, 21 December 2021 (UTC)

I think you misunderstood entirely my statement. I answered your question. Where we place such statements depends on what is said and sourced to the article, not on the source itself. As such a review clearly covers both aspects. — Shibbolethink ^{(♔ ♕)} 15:27, 21 December 2021 (UTC)

So even though the source article itself says it is about sex differences, we as editors can just decide they're wrong, and to split their article into separate subjects because that part is not sex differences but gender differences. Never mind that they treat "gender" as directly relevant to sex differences. Crossroads ^-talk- 15:32, 21 December 2021 (UTC)

nope, we are not "deciding they are wrong." Titles are not everything. see WP:HEADLINE for example. Often titles are imprecise. We have plenty of high quality MEDRS sources which are telling us to separate discussions of biology from discussions of society. That the entire field is not actually doing that yet is a sad consequence of the way science progresses. But as an encyclopedia, we are beholden to figure out lots of contradictory things. I'm not proposing original research, I'm proposing we use the highest quality sources to determine how we talk about all other sources. — Shibbolethink ^{(♔ ♕)} 15:36, 21 December 2021 (UTC)

I never said it was just the title framing it that way. Sources about how to write other academic articles - of which there are many which contradict each other - do not apply on Wikipedia. This is because we are not writing research here, we are summarizing secondary research by the experts in the field. They decide how to define what counts as sex differences. Crossroads ^-talk- 15:44, 21 December 2021 (UTC)

The AMA style guide and National Academy of Medicine report are not just about how to write academic articles. They are about how these terms should be discussed in all scientific/medical contexts. See below:

• This explainer discusses how the AMA style guide has grown from originally just for editors/authors, to now for many different contexts, all about how to discuss/write about science: Each chapter has been extensively revised and updated to reflect best practices and developments in scientific research, writing, and publishing, with numerous new examples, updated references, and for the first time, full-color graphics.

• The preface to that National Academies of Science and Medicine report says this: This committee was charged with evaluating the current scientific understanding of the answers to these questions with respect to their influence on human health Specifically, the committee was charged with considering biology at the cellular, developmental, organ, organismal, and behavioral levels. The goal, as in all studies of biology, is to understand the organism in terms of all of the interactions that occur between levels within the organism as well as the mutual interactions between the organism and its environment. This was a broad charge, which required a committee made up of individuals drawn from a wide range of subfields of biology and medicine.

It is a large group of experts who write these professional guidelines and vote on their acceptance, versus individual experts who write these reviews. That's why MEDASSESS places these guidelines so highly in its "hierarchy of evidence." — Shibbolethink ^{(♔ ♕)} 15:55, 21 December 2021 (UTC)

Again, Wikipedia is not bound by these style guides because we do not produce WP:Original research. We follow what other sources say. And it is WP:SYNTH to take general guides and use them to overrule sources by specialists on specific topics like, say, schizophrenia. There are numerous sources about sex differences that express uncertainty about and explore whether "gender" (social factors) are driving those sex differences. Because gender is highly linked with one's sex for the vast majority of people, it is not the case that one can write as though it is some completely separate thing which has nothing to do with sex. Crossroads ^-talk- 19:31, 21 December 2021 (UTC)

No one is saying we should write as though it is some completely separate thing which has nothing to do with sex. I am advocating for this page to be less confusing by not putting hyper-focused biological sex based research about "males" directly next to not controlled, not stratified, not strictly criteria-bound research studies about "men."

We can describe the exact discrepancy, there are reviews about how difficult it is to control this research. We can go into detail about the distinction and when it matters and when it likely doesn't. But ignoring the difference isn't just bad science. It's bad wiki-ing.

Are you advocating for this page to make no distinction between "men" and "males" ?

Only the AMA is a style guide. The NAM statement is a policy statement for professionals, researchers, physicians, for how to understand and describe these issues. Look at the author list. It's essentially all experts in this field. — Shibbolethink ^{(♔ ♕)} 19:44, 21 December 2021 (UTC)

Shibboleth, you are literally asking Crossroads to evaluate a source based on the authority of its authors/authorizing body, rather than the position it takes in a dispute. That would violate the first rule of WP:BATTLEGROUND. Newimpartial (talk) 19:49, 21 December 2021 (UTC)

Shibboleth, you are literally asking Crossroads to evaluate a source based on the authority of its authors/authorizing body, rather than the position it takes in a dispute What you've just described is fundamentally how WP:MEDRS works. Trust the scientific consensus, as gleaned from professional body statements, govt bodies, etc. See WP:MEDSCI. Judging a source by whether or not it agrees with your view rather than how reliable it is, is exactly not what is encouraged per WP:NPOV. — Shibbolethink ^{(♔ ♕)} 19:53, 21 December 2021 (UTC)

Ignoring that. Shibbolethink, the very National Academies source you keep pointing to - which I agree is an excellent source - uses "men" and "males" interchangably. Regardless of intention, if you completely detach content about differences derived from social perception/life as a particular sex ("gender") from that which derives directly from sex-related biology, the effect is to make it seem like there is no link there. Crossroads ^-talk- 19:56, 21 December 2021 (UTC)

do as I say, not as I do. I would tell you that trying to calculate out how often a source uses "men" vs "males" and structure our articles the same way is, in essence, WP:OR. Rather than doing what the source says is the consensus of how these things should be framed. besides, different parts of this statement were likely written by different people. Nowhere does it say "these things should be used interchangeably." Instead it says, past studies used this interchangeably, and it was really confusing. Stop doing that."— Shibbolethink ^{(♔ ♕)} 19:59, 21 December 2021 (UTC)

Where exactly does it say not to use "men" for adult male humans? Where does it say differences in the sexes derived from social factors are not sex differences but gender differences? Quotes please. Crossroads ^-talk- 20:03, 21 December 2021 (UTC)

Page 176 of that report:

RECOMMENDATION 7: Clarify use of the terms sex and gender.

Researchers should specify in publications their use of the terms sex and gender. To clarify usage and bring some consistency to the literature, the committee recommends the following:

• In the study of human subjects, the term sex should be used as a classification, generally as male or female, according to the reproductive organs and functions that derive from the chromosomal complement.

• In the study of human subjects, the term gender should be used to refer to a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation.

• In most studies of nonhuman animals the term sex should be used.

Page 1: 'The committee defines sex as the classification of living things, generally as male or female according to their reproductive organs and functions assigned by the chromosomal complement, and sender as a person's self-representation as male or female, or how that person is responded to by social institutions on the basis of the individual's gender presentation. Gender is shaped by environment and experience.

Also, you said above that this report uses "male/female" and "men/women" interchangeably. Where? I can't find that... In most places, it uses almost exclusively "male/female." I'm not saying it's not there, I just can't find it.

Just to add to this, no one is saying "don't use "men" for adult male humans." I am saying don't use "men" when you are referring exclusively and entirely to people born male. Just say "males." — Shibbolethink ^{(♔ ♕)} 20:08, 21 December 2021 (UTC)

That does not support what I asked about. What you are advocating for goes far beyond that. Stuff about use of the specific terms "sex" and "gender" in no way implies that social influence does not affect sexes (only "genders"). The source itself treats social environmental factors as highly relevant to sex differences (see page 3: [23] and 14: [24]) There is zero justifcation in the source for splitting off "gender" differences from sex differences. Nor does it say we can't use e.g. "women" in reference to sex. They themselves do so sometimes (see pages 120-121: [25]) as do numerous review articles to this day. The sources do not justify but contradict the sweeping changes you are asking for. Crossroads ^-talk- 21:25, 21 December 2021 (UTC)

Crossroads, we have MEDRS articles pointing out that MEDRS sources do not always use the terms "sex" and "gender" consistently (viz. the fad a few years ago for reporting what were actually sex variables as gender). It isn't WP:OR to read the sources carefully. Newimpartial (talk) 15:50, 21 December 2021 (UTC)

@Shibbolethink:I have no intention of editing this article, because my knowledge of medicine is slight, and is skewed towards my own medical history. But I am astonished to hear that breast-feeding prevents cancer (rather than reducing the risk) and that pharmaceuticals are used to ‘reproduce this effect in individuals who cannot breast feed’. I am deliberately childless; no-one has ever offered me such pharmaceuticals. This might have prevented the small case of breast cancer I had some years ago (I’m fine now, thank you). My question is – are you sure you know enough about medicine to edit this article? Sweet6970 (talk) 15:23, 21 December 2021 (UTC)

Yes it reduces risk. I apologize if my quick and dirty use of the language was misleading. The mechanism is believed to be via certain hormones which are released during the process of remodeling the breast to mature lactation ducts. The extracellular matrix which organizes cells into a 3D structure in the breast is a barrier to cancer cells moving around, and the process of having a baby reorganizes this tissue. Breastfeeding releases factors which control this maturation process and organize this extracellular matrix. That being said, it's also even worse risk-wise to have a baby, and then not breast feed, than it is to never have a child at all. Most of these studies are about women who have had children in the first place. It's complicated and there's still a lot to figure out about this. I'm sorry to hear you had a breast cancer diagnosis, and I'm glad to hear you're doing okay. The pharmaceuticals I mentioned are still investigational, and are not FDA approved. They are a part of small scale clinical trials, most are phase I. — Shibbolethink ^{(♔ ♕)} 15:24, 21 December 2021 (UTC)

Hi, I would encourage you to visit my user profile page and ask yourself again, "does this user know enough about medicine to edit this article." Thanks. Besides, prior medical knowledge is not a prerequisite to editing around here. — Shibbolethink ^{(♔ ♕)} 15:25, 21 December 2021 (UTC)

Apologies to all for oversharing my medical history – I thought I had deleted that sentence before I pressed ‘Publish’. Sweet6970 (talk) 16:08, 21 December 2021 (UTC)

Perhaps the article needs to be split into two articles. Gender differences in medicine & the other Sex differences in medicine. GoodDay (talk) 15:54, 21 December 2021 (UTC)

Yes I would agree with this. either split into two articles (the more onerous choice) or just split into multiple sections (my preferred solution, as it requires less work). Plus, these are very related things, as already described above. Extremely related things often belong in the same article. — Shibbolethink ^{(♔ ♕)} 15:57, 21 December 2021 (UTC)

My view is that restructuring the article could simplify the terminological issues; it might even be worth working on that aspect of the article before a future terminology RfC, since the pain points may appear in different places after doing this work. Newimpartial (talk) 16:01, 21 December 2021 (UTC)

Honestly I’m not sure making a separate articles would be ideal to be honest. Mean isn’t gender a sociological thing and varies from culture?

Like I’m aware that there are medical sources out there on medical differences for age or body type. But, I don’t see medical sources for things like religion, political, or nationality differences in medicine.CycoMa1 (talk) 20:37, 21 December 2021 (UTC)

Well, there are MEDRS sources about cultural determinants like smoking, but I think the main point raised here is gender in relation to trans and nonbinary health. Newimpartial (talk) 20:42, 21 December 2021 (UTC)

I actually agree that two separate articles is a bad idea. But I would also tell you we have the articles: Jehovah's Witnesses and blood transfusions and Traditional Chinese medicine and Medicine in China. But your point overall is well taken. I think separating them into two articles would indeed be a bad idea. — Shibbolethink ^{(♔ ♕)} 20:42, 21 December 2021 (UTC)

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

Medial differences in things like age are a result of a person’s body. Like elderly people have a higher chance of dying from diseases like the flu because when you get older your immune system becomes weaker.

That’s the same case for sex differences in medicine. There are many medical sources out there that say the reason women live longer than men is due to things like hormones or genetics.(There is some culture to it as well. But, a lot do mention genetics and hormones are involved.)CycoMa1 (talk) 21:01, 21 December 2021 (UTC)

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

Or medical differences in LGBTQ+ individuals or medical differences in trans people could be a good idea. I just realized there are already articles on health for Lgbt people.CycoMa1 (talk) 21:07, 21 December 2021 (UTC)

Short answer to original question: no. We need stop muddying the water with off-topic gender stuff, and put that in some other article where it belongs.  — SMcCandlish ☏ ¢ 😼  22:30, 21 December 2021 (UTC)

So would you support removing any content pertaining to gender differences in medicine? — Shibbolethink ^{(♔ ♕)} 23:43, 21 December 2021 (UTC)

Stuff about separate gender identities within a sex is off-topic here. Material about differences between those genders which correlate strongly with the sexes is on-topic, because sources on sex differences treat those "gender differences" as part of this topic. Crossroads ^-talk- 05:22, 22 December 2021 (UTC)

Right.  — SMcCandlish ☏ ¢ 😼  17:25, 22 December 2021 (UTC)

Stuff about separate gender identities within a sex is off-topic here - surely the validity of this statement depends on what the RS on this topic actually say, rather than one editor's opinion? Newimpartial (talk) 17:35, 22 December 2021 (UTC)

• If the question is should the article "Sex differences in medicine" be retitled "Sex and gender differences in medicine" -- my response is No. It's unfortunate that sex and gender have been conflated and that gender is more often than not used when referring to sex, but the two are not the same, and confusion has been the result. Adhere to science and let the article continue to be known by its established title. Pyxis Solitary (yak). L not Q. 08:45, 22 December 2021 (UTC)

  Would you support removing gender-based terminology from this article? — Shibbolethink ^{(♔ ♕)} 15:16, 22 December 2021 (UTC)

  All these years, I had always thought 'sex' (not the act) & 'gender' were the exact same thing. Now (in 2021), I've been informed otherwise. GoodDay (talk) 17:03, 22 December 2021 (UTC)

  I think you're a bit behind the curve on that. Anyway, the situation is complex, and "gender" has multiple meanings, which include "sex", and "socially constructed gender identity" (most of what this continual disputation is about), and "gendered noun or verb class" (in linguistics), among several other definitions. See Gender (disambiguation).  — SMcCandlish ☏ ¢ 😼  17:24, 22 December 2021 (UTC)

  Rather than have me do the explaining (because it will be cut-and-dry), the following might provide a better result: Newman, Tim (May 11, 2021). "Sex and gender: What is the difference?". Medical News Today.. Pyxis Solitary (yak). L not Q. 10:06, 23 December 2021 (UTC)

  Behind the curve indeed. Gotta be a generational thing. Or as the Monkees sang "That was then, this is now". GoodDay (talk) 17:45, 22 December 2021 (UTC)

Straw poll on removing side point about transgender identity from bullet point about female reproductive system

I propose to remove the underlined text from the following bullet point under "Females":

Ovarian cancer, endometriosis and other diseases of the female reproductive system occur mostly in women (except in the rare instances where other genders have said organs, such as trans men.)

References

None of the sources are about the topic of sex differences. It is just an off-topic tangent of the sort that could be appended to any discussion of sex differences. There is no reason to shout-out different small subgroups like that here. We're obviously not going to add asides about gender identity to every point about sex differences, but keeping this makes it look like some do want that. Removing it in no way implies anything regarding any other text in the article present or future. There are much more weighty discussions going on above, and this text distracts from and confuses all of that. Crossroads ^-talk- 22:57, 21 December 2021 (UTC)

• Support as proposer. Feralcateater000 also said above that they originally added it and that they now agree it should be removed. Crossroads ^-talk- 22:59, 21 December 2021 (UTC)
• Why not just say women (and trans men) as a much shorter compromise. And perhaps most importantly, what is the citation for the claim about women? I also know it to be true, but right now there are no citations for that fact aside from the transgender citations... — Shibbolethink ^{(♔ ♕)} 23:42, 21 December 2021 (UTC)

I would say the compromise is to not mention gender at all. In fact, isn't that basically your position for other text - to separate sex and gender? Why not just say "female reproductive system" under the Females heading and be done with it? Crossroads ^-talk- 00:59, 22 December 2021 (UTC)

If we are talking about sex, then we shouldn't use the term "woman." That's my position. — Shibbolethink ^{(♔ ♕)} 15:06, 22 December 2021 (UTC)

Noting here that Shibbolethink already elsewhere answered "no" to including this. [26] Crossroads ^-talk- 05:01, 22 December 2021 (UTC)

Please don't put words in my mouth. I reassess each situation as it comes, and offer compromises to try and achieve consensus, regardless of what I may personally feel about the answer. I would appreciate it if you struck this comment and allowed me to answer on my own. Thanks. — Shibbolethink ^{(♔ ♕)} 15:03, 22 December 2021 (UTC)

Let’s just say female and not mention woman. Saying female just makes things easier.CycoMa1 (talk) 01:54, 22 December 2021 (UTC)

I suggested this previously except on a wider basis, that this article should only use male/female and avoid usage of man/woman altogether. Needless to say the discussion on that has been long. Sideswipe9th (talk) 02:29, 22 December 2021 (UTC)

It would adhere to the AMA's guidelines... The sex-gender language is outdated in social sciences (we use sex assignment at birth more often) but it's still normal in medical research. I think I argued for something like this on Wikipedia a long time ago... EvergreenFir (talk) 02:34, 22 December 2021 (UTC)

As a side point, just noting for the record that while that link does talk about "sex assigned..." in a transgender context, it does also simply state, Which term means the classification of people as male or female? Sex. Crossroads ^-talk- 05:01, 22 December 2021 (UTC)

• Support per Crossroads. Maneesh (talk) 04:57, 22 December 2021 (UTC)
• Support per Crossroads.CycoMa1 (talk) 05:21, 22 December 2021 (UTC)
• Support. Ditto. Pyxis Solitary (yak). L not Q. 08:48, 22 December 2021 (UTC)

I'm confused. If it already says the diseases occur in the female reproductive system, is any further description necessary? Isn't it understood that only people with female reproductive systems can have those diseases? Female, women, or any other term would be redundant if so. Santacruz ⁂ Please ping me! 10:42, 22 December 2021 (UTC)

@A. C. Santacruz I think, likely, the issue to some users around here is the use of "female reproductive system" and then immediately after, "women" to refer to the same set of people.— Shibbolethink ^{(♔ ♕)} 15:19, 22 December 2021 (UTC)

• Support per Crossroads. Masterhatch (talk) 13:53, 22 December 2021 (UTC)
• Support removal. Such wording doesn't make much sense in a medical article as opposed to a social-sciences one, and in this context is more confusing than helpful. I have no objection to shifting more toward using "male" and "female" over "men" and "women", especially given that many M or F conditions also affect boys and girls, respectively. But it is clear that the medical literature routinely uses, respectively, "women" or "men" to mean humans with female genetics and biology, or those with male. WP follows the sources and does not engage in language-change advocacy.  — SMcCandlish ☏ ¢ 😼  14:17, 22 December 2021 (UTC)
• Support removal, but also do not include the word "woman" in the sentence. it's confusing, unnecessary, and not supported by the sources currently provided — Shibbolethink ^{(♔ ♕)} 15:40, 22 December 2021 (UTC)
• Support according to Shibbolethink's objections Santacruz ⁂ Please ping me! 16:23, 22 December 2021 (UTC)
• Support - if this is the language that gets everyone in agreement, hell yes I support it. It also is what's being used by professional organizations. Like Shibbolethink, this support include the removal of "woman". EvergreenFir (talk) 17:34, 22 December 2021 (UTC)
• Support - How'd I miss this? Anyways, adding to the consensus. GoodDay (talk) 19:45, 22 December 2021 (UTC)

It's been removed now per clear agreement above. As I said at the beginning of this discussion, "removing it in no way implies anything regarding any other text in the article present or future". Crossroads ^-talk- 19:32, 22 December 2021 (UTC)

Current claims about 'sex-related' in article are incorrect

Straightforward changes to correct the article from being plainly incorrect were reverted. Maneesh (talk) 11:40, 22 December 2021 (UTC)

Well, for one, that edit is full of incorrect grammar. — Shibbolethink ^{(♔ ♕)} 11:43, 22 December 2021 (UTC)

Please do provide alternate text that corrects the currently incorrect claim about sex relatedness. Maneesh (talk) 11:51, 22 December 2021 (UTC)

Also in the addition of Klinefelter syndrome was removed under males. This is a canonical sex specific (and sex related) disease, appropriate highly cited ref was provided with explicit quote, count results and cites for scholar queries Klinefelter syndrome "sex specific", Klinefelter males, XXY males. Maneesh (talk) 11:51, 22 December 2021 (UTC)

Just to be clear: after all the disruption they have already caused on the topic, Maneesh should not be opining about who are or who are not males, whether in article or Talk space. This comes as a variant of the WP:DENY principle applied to disruptive editors. Newimpartial (talk)

DENY does not apply to editors who are still in good standing. Unless and until sanctions are applied, he is within his rights. Crossroads ^-talk- 18:53, 22 December 2021 (UTC)

DENY is just an essay. I would guess that this, overall, is just an admonishment/recommendation, but I would agree with it. Some people don't realize that continuing to WP:BLUDGEON their point when lots of people disagree is actually counterproductive. It makes people less likely to support your position.... — Shibbolethink ^{(♔ ♕)} 19:46, 22 December 2021 (UTC)

Who are the list of users that disagree with "Klinefelters is a sex-specific disease" and "sex-related" is not used correctly in this article? Determining that is the very point of this section. Maneesh (talk) 19:49, 22 December 2021 (UTC)

Reverted per this discussion, which did not produce a clear consensus in favor of your POV on this issue. Newimpartial (talk) 20:17, 22 December 2021 (UTC)

That is a deep and simply uninformed thread that does not represent any sort of explicit consensus or lack of. I will make it explicit then in the way the last two straw polls have. Describing those views as a POV isn't accurate. Maneesh (talk) 20:29, 22 December 2021 (UTC)

Actually, Maneesh, I think you may misunderstand my position on this. I agree that "Klinefelters is a sex-specific disease." I think it's on the intersex/DSD spectrum, but decidedly to one end of that spectrum. It's prevalent only in XX(+)Y individuals, many of whom identify as men. However, not all do. There is also a range of phenotypes within Klinefelter's, with some much more pronounced than others, and many identifying as "intersex" in addition to other identities. There appears to be a generational divide on the attitude some members of the community have, with many younger Klinefelter individuals not identifying so strictly. [27] [28] [29] [30] [31] — Shibbolethink ^{(♔ ♕)} 22:12, 22 December 2021 (UTC)

"Intersex" is not a clinical term, you don't find the word occurring in many high quality focused MEDRS on the topic. Your links are not high quality, first one is from a social science journal, not sure what the second one shows other than talks about GD in KS, next one is not MEDRS and says "Only the individual knows whether they feel male, female, neither or both regardless of how they appear to others. This applies to XXY people too. Most are male, a few are female and others are neither – or both.". The next one is some sort of PR on a letter-to-the-editor that begins the sentence "A common condition affecting males", the next link is just that letter. These links have absolutely no weight against highly cited MEDRS on KS. Many of your claims about "identification" may or may not be true (the same way it is for the rest of us). I'm glad you believe it is sex specific, which sex do you think it is specific to? Maneesh (talk) 22:34, 22 December 2021 (UTC)

I find this comment combative and unnecessarily so, especially with regards to distrusting a source simply because it comes from the social sciences. I am not intending to put any of these citations in this article, to support any medical claims. So it does not matter whether or not they are MEDRS. A MEDRS source is only more valuable when discussing medical or health claims, of which this is neither. At this point, I find discourse with you to be unfruitful and unproductive. Feel free to respond, I will not. I hope you find what you're looking for on Wikipedia, and that it does not need to involve me in any way. Good luck, have a nice day. — Shibbolethink ^{(♔ ♕)} 23:19, 22 December 2021 (UTC)

I will also make it my last reply with that there is precisely nothing "combative" about my critical assessment of the links you presented. Maneesh (talk) 00:08, 23 December 2021 (UTC)

Why is how they "identify" relevant here? Why can we not state what sex it is specific to? Crossroads ^-talk- 22:43, 22 December 2021 (UTC)

I wouldn't bring up identity, except that Maneesh has, several times, said "men" in reference to people with Klinefelter's. That is the original reason to bring it up at all. — Shibbolethink ^{(♔ ♕)} 23:16, 22 December 2021 (UTC)

"Men" doesn't necessarily refer to an identity, it is generally used synonymously with "male". Lots of MEDRS uses "Klinefelter men". Maneesh (talk) 23:20, 22 December 2021 (UTC)

What was the stable version, before all the commotion? GoodDay (talk) 17:54, 22 December 2021 (UTC)

[32] Newimpartial (talk) 17:58, 22 December 2021 (UTC)

Lede also uses "sex related" in "sex-related diseases, which are diseases that are more common to one sex" yet cite has no occurrence of "sex-related" because that isn't the way "sex-related disease" is used. It is generally suffixed with factors/burden/differences etc. Maneesh (talk) 18:47, 22 December 2021 (UTC)

Examples of "sex-related disease" used in the other sense. Maneesh (talk) 18:53, 22 December 2021 (UTC)

see WP:SYNTHNOTSUMMARY and WP:NOTOR. — Shibbolethink ^{(♔ ♕)} 22:13, 22 December 2021 (UTC)

No idea how those are relevant. "Sex-related disease" is just not the correct term here. Again, the citation doesn't use it. I can find one case where it seems to be used that way, Most sources suffix with something reasonable (factors/differences/bias/burden etc.). The phrase "sex-related disease" is not used once in this top tier source. It is used with suffixes several times Maneesh (talk) 23:11, 22 December 2021 (UTC)

Straw poll: Should "female human" link to woman and "male human" link to man ?

This is with regards to the first sentences in the sections "Females" and "Males"
Options:

(1) - Keep it as it is. (female humans · male humans)

(2) - Link to the sex-based article (subsection on mammals) (1 link). (female humans · male humans)

(3) - Link to the female and human articles (2 links) (female humans · male humans)

(4) - Have no link. (female humans · male humans)

(5) - change the plug to the gender-based term (women · men)

(6) - Use 'females' and 'males' and link to 'Woman#Health' and 'no link'. (females · males)

Feel free to add your own options (directly below these), and please restrict your responses/discussion to this question whenever possible. Thanks — Shibbolethink ^{(♔ ♕)} 15:35, 22 December 2021 (UTC)

• Options 2, 3, or 4 - When describing sex-differences, we should not link to articles about gender. It's confusing and gives the impression that these are one and the same. — Shibbolethink ^{(♔ ♕)} 15:36, 22 December 2021 (UTC)
• Option 2 or 3 - As Shibbolethink said, sex is not gender. With these wikilinks on this article we should be linking to sex related pages, not gender related pages. Sideswipe9th (talk) 15:47, 22 December 2021 (UTC)
• 2 , 3 is an unnecessary chain link. nableezy - 16:22, 22 December 2021 (UTC)
• 2 Santacruz ⁂ Please ping me! 16:24, 22 December 2021 (UTC)
• 1 - Human adult males are men & Human adult females are women. GoodDay (talk) 17:09, 22 December 2021 (UTC)
• 4 or 2. Per WP:OVERLINK. we're not supposed to be linking everyday words used in their normal manner, so links are not necessary for this. If we do it anyway, then don't link to a social-gender-related article but to a biological one (and just one, not two).  — SMcCandlish ☏ ¢ 😼  17:29, 22 December 2021 (UTC)
• 2, 3, or 4 EvergreenFir (talk) 17:35, 22 December 2021 (UTC)
• 6 - "humans' is rather implicit here. Very simple and straight forward since, as has been demonstrated in the threads on this page, MEDRS uses man/woman synonymously with male/female. Woman#Health is important opens with discussion on sex differences (and should link back here). The disparities between women's health and men's health is why prominent agencies that have led work in sex differences (which the article does not reflect) in medicine are tied to women, see Sex as a Biological Variable: A 5-Year Progress Report and Call to Action, in Journal of Women's Health with authors from the NIH's Office of Research on Women’s Health. The prominence of Women's Health organizations in sex differences is reflected in the content of the cite in Woman#Health. There is, naturally, no symmetrical cite for men's health organizations. SMcCandlish's comment on overlink is important. EDIT: To be sure woman is not a "gender" article, it unambiguously focuses on female biology and defines "woman" in terms of "female". Maneesh (talk) 17:39, 22 December 2021 (UTC)
• 1 Linking to man and woman is the least ambiguous. Definately don't link to a subsection. Masterhatch (talk) 00:17, 23 December 2021 (UTC)
• 4 - "No link". Tewdar (talk) 14:57, 23 December 2021 (UTC)

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

• Support as proposer. Klinefelters is the most common sex chromosome aneuploidy, associated with infertility and high quality MEDRS describes it in explicit words as "Klinefelter syndrome and the subsequent infertility phenotype caused by it are specific to males." A female *cannot* suffer from Klinefelters. There is a mountain of MEDRS that uses "XXY males", "Kleinfelter males" and "Klinefelter men". High quality sources always describe prevalence out of the male population. Despite what is claimed outside of MEDRS, you don't often find the term "intersex" inside MEDRS on KS. This is, in my mind, an entirely uncontroversial addition under the male list. Maneesh (talk) 23:53, 22 December 2021 (UTC)
• Support - Go for it. GoodDay (talk) 01:28, 23 December 2021 (UTC)

Background section

I have introduced a background section that should eventually be used to replace the severe deficiencies in the lead. All of the high quality, broadest sources on sex differences in medicine use "women" and "men" to communicate clearly and most accessibly, the first para should do the same. An explicit sentence about mapping women and men to females and males can be made at the end to keep language consistent. Maneesh (talk) 23:09, 23 December 2021 (UTC)

This edit [33] is explicitly bad grammar and bends over backwards to use the title in its opening sentence, which is explicitly opposed by WP:BOLDTITLE.

This sentence makes no sense: Sex the differences in medicine describes the differences between women and men in terms of their disease risk, diagnosis and response to treatment.

Compare to my version: Females and males exhibit many differences in terms of risk of developing disease, receiving an accurate diagnosis, and responding to treatments.

MOS tells us to A) avoid redundancy, B) don't bend over backwards to restate titles, and C) use consistent grammatical tense. — Shibbolethink ^{(♔ ♕)} 23:38, 23 December 2021 (UTC)

There is a clear typo in there that is an easy fix (which I've applied). Where do you get "explicitly opposed" from? WP:BOLDTITLE says "If an article's title is a formal or widely accepted name for the subject, display it in bold as early as possible in the first sentence...". You must mean MOS:BOLDAVOID, which is conditional on "If the article's title does not lend itself to being used easily...", the title is easy to use even if it takes a few typo corrections etc. Maneesh (talk) 23:46, 23 December 2021 (UTC)