Talk:Conversion therapy

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Hans Eysenck

Hey DisciplinadoLector, your addition to the lead has been reverted twice now. Please note that both times we noted this is not included in the body. While it is true that behaviourism was the underpinning to some conversion therapy treatments, that is partially covered by masturbatory reconditioning. There is no need to refer to Hans specifically, who had nothing to do with conversion therapy. We don’t say “freud’s psychoanalysis”, we say “psychoanalysis”. The missing area from the lead was behaviourist therapy for gender nonconforming children, which I will add in when I have the time. Thanks for trying to improve the article but please try to read WP:LEAD to understand the reverts. Zenomonoz (talk) 04:12, 26 May 2023 (UTC)

Hans Eysenck had everything to do with conversion therapy, he was a main advocate of that typeof "therapy". In 1972 gay activist Peter Tatchell protested against Eysenck in the London Medical Group (LMG) – a forum for doctors and medical students. Also Eysenck produced false science, see https://journals.sagepub.com/doi/10.1177/1359105318820931 DisciplinadoLector (talk) 16:20, 26 May 2023 (UTC)

You can read about gay activist Peter Tatchell's protest against Hans Eysenck's conversion therapy for example here https://www.petertatchell.net/lgbt_rights/psychiatry/dentist/ DisciplinadoLector (talk) 16:23, 26 May 2023 (UTC)

The problem is that if you mention "psychoanalysis" and "hypnosis" then "behaviourism" should also be mentioned, because not all forms of psychoanalysis and not all forms of hypnosis are to be blamed for the bad practices of some. I mentioned Hans Eysenck to clarify that it was his type of behavioral therapy that was most implicated in conversion therapy, which is why gay activist Peter Tanchell protested against Eysenck in 1972. DisciplinadoLector (talk) 16:28, 26 May 2023 (UTC)

@DisciplinadoLector: The WP:LEAD is supposed to be a summary of the article's body. "Psychoanalysis" and "hypnosis" are mentioned because there are subsections covering those topics in the article's body. You are adding content to the lead that is not mentioned or sourced anywhere in the article's body. This goes against Wikipedia's verifiability policy, and it is not helpful to readers who would expect anything mentioned in the lead to be explained in greater detail in the body. Bennv123 (talk) 17:10, 26 May 2023 (UTC)

I just added that info in the article body, with references. I can expand on that subject in the body alsoif it is necessary. DisciplinadoLector (talk) 17:21, 26 May 2023 (UTC)

!! DisciplinadoLector, please gain WP:CONSENSUS first here on the talk page. I just reverted you because you incorrectly included content about Hans Eysenck/behavior therapy under 'gender identity change efforts' for transgender people, despite the source stating it was for homosexuals. In addition, as Bennv123 stated, referring to Hans Eysenck in the opening paragraph is WP:UNDUE. You are welcome to include content about behaviourism and behavior therapy under 'methods', then refer to that in the opening, but 'Hans Eysenck' doesn't need be mentioned (he can be mentioned in the body). There are/were dozens of high profile conversion therapists, many of them psychoanalysts, and we do not need to mention them in the opening paragraph. In addition, please do not use scare quotes around the word "therapy", even if it is quackery. See MOS:SCAREQUOTES. Zenomonoz (talk) 09:15, 27 May 2023 (UTC)

I understand that the inclusion of Hans Eysenck in the opening paragraph and his mention in the section on efforts to change gender identity have been removed. However, I don't understand why he was removed from the section on efforts to change sexual orientation. Hans Eysenck was a campaigner for changing sexual orientation and a leading spokesman for behaviorism. In the article there are headings for psychoanalysis and hypnosis. Specific authors are also mentioned, such as where he says: "Sigmund Freud, the founder of psychoanalysis, viewed homosexuality as a form of arrested development. Later psychoanalysts followed Sandor Rado, who argued that homosexuality was a "phobic avoidance of heterosexuality caused by inadequate early parenting"." Therefore, I think it is not neutral to include psychoanalysis and hypnosis but not include a section on behaviorism (Hans Eysenck was not the only behaviorist to practice aversion therapy, but he was one of the most important). There should be a section on behaviorism that includes the work of Hans Eysenck and the protests that gay activist Peter Tatchell made against Eysenck in the 1970s Naming "aversion therapy" and not naming behaviorism is not neutral, because that is only one technique, while in the case of psychoanalysis the name of the entire theoretical movement is mentioned. In addition, Freud was not always consistent in his opinions on this issue, he also once said that homosexuality is not something to regret. On the other hand, I do not know of any psychoanalyst who has used aversive methods with electric shocks to change sexual orientation, as Eysenck and other behaviorists did. DisciplinadoLector (talk) 22:11, 28 May 2023 (UTC)

DisciplinadoLector when I mentioned psychoanalysts, I wasn’t insinuating that Hans was one. I mentioned them because they have been the primary purveyors of therapy. Yes I agree behaviourism is separate. The claims about Freud and arrested development are questionable, as you noted, he stated homosexuality was a part of natural variation. You asked why I reverted the edit: I did so because of the mistakes in the edit which need discussed first. The content is easily copied from the edit history for you to reinsert it. From experience, it’s best to make use of the talk page when there are disagreements. I am glad we could reach some agreement. Zenomonoz (talk) 22:50, 28 May 2023 (UTC)

Sorry I am coming in late to the discussion. And this point im about to make might deserve its own subtitle.

But and I will come back to cite this later when I'm less busy. Isn't there only limited research on "who the purveryor" is? I know there is definitely only limited research on this outside of North America/Australlia, but even there I am pretty sure that is one of the things lacking in the literature. Isn't that the entire point of Higbee's studies on SOGICE that is administered by parents? EpsteinJ1994 (talk) 08:57, 30 August 2023 (UTC)

Correction:

Higbee did the study on the prevalence of exposure to SOCE. https://doi.org/10.1080/00918369.2020.1840213

Ryan Et Al. 2020 https://doi.org/10.1080/00918369.2018.1538407, is the study on Parent initiated SOGICE that I was reffering to. EpsteinJ1994 (talk) 09:04, 30 August 2023 (UTC)

Just remember to use secondary sources (e.g. academic literature reviews, meta-analyses, books, textbooks etc.) rather than primary sources (single studies, etc) because it's best to run on the reputable scientific consensus established in secondary sources. This means poorer quality research is evaluated and avoided. See WP:PRIMARY for further details. One way to do this is to look at the texts citing the study you are interested in using on Wikipedia. E.g. by going into Google scholar and searching the first study, I can see that a review by Judith Glassgold cites the study. The Glasgold APA review can be cited on Wikipedia, whereas the original study probably shouldn't be cited. Zenomonoz (talk) 09:30, 30 August 2023 (UTC)

Hey you make a really good point so I just want to point out that the review by Judith Glassgold is a chapter in a book "The case against conversion “therapy”: Evidence, ethics, and alternatives." Edited by D.C. Hadelman.

Authors on this page in general should refer to this book for the best overview of Conversion Therapy and where research currently stands on it. EpsteinJ1994 (talk) 13:57, 3 September 2023 (UTC)

Corrective rape

In Belgium and Germany conversion therapy includes corrective rape. Who dares to whitewash these most criminal government? The truth is they commit most sexual violence in the world. 2A02:1811:2C09:F100:C10C:80E2:82D0:59C7 (talk) 17:29, 4 August 2023 (UTC)

If it is true that corrective rape is used, as you put in your edit, we would need a reliable source saying so to include it in the article. --Nat Gertler (talk) 23:07, 4 August 2023 (UTC)

A far less accusatory way of asserting that would be appreciated. Acroterion (talk) 23:12, 4 August 2023 (UTC)

GET sourcing problems

The recent undoing of an attempt to claim that GET is not a form of conversion therapy and sourcing it to an instigator of GET who is trying to distance it from methods under attack was appropriate. However, it does leave us with a section which is sourced to Science-Based Medicine, Xtra, and Slate, none of which are WP:MEDRS. I don't know if Perspectives on Psychological Science qualifies as an RS here, but they have this, or perhaps this from The Journal of Law, Medicine, and Ethics. -- Nat Gertler (talk) 20:01, 8 August 2023 (UTC)

The journal articles are appropriate if attributed to Florence Ashley. Zenomonoz (talk) 23:21, 8 August 2023 (UTC)

If, as NatGertler says, none of the sources for the Gender exploratory therapy section are WP:MEDRS, surely this section should be deleted in its entirety? Zenomonoz why do you say that the articles are appropriate if attributed to Florence Ashley? Sweet6970 (talk) 14:46, 29 October 2023 (UTC)

It seems likely to be an appropriate topic, and I would hope that someone better than I at surfing through journals should be able to source some of it. (I am avoiding creating material for articles at this time.) I suspect that the requirement that the material be attributed to the author is rooted in the analysis of the ethics of GET in those articles having an opinion aspect. -- Nat Gertler (talk) 14:55, 29 October 2023 (UTC)

I might have been wrong. An editor can either remove it per WP:MEDRS or they can update it with appropriate sources (if they exist). Obviously, magazine articles are inappropriate. WP:THEREISNORUSH to cover a topic that isn't mentioned in MED RS. Zenomonoz (talk) 19:26, 29 October 2023 (UTC)

I am not able to provide any sources – this is not my usual reading matter. The current sources look to me to be unsuitable even without considering MEDRS. Per Science-Based Medicine this source is a blog. Xtra* appears also to be a blog, written by Erin Reed, "she/her) is a queer legislative researcher, content creator and activist based in Washington, D.C." Slate (magazine) is not a medical magazine According to its former editor-in-chief Julia Turner, the magazine is "not fundamentally a breaking news source", but rather aimed at helping readers to "analyze and understand and interpret the world" with witty and entertaining writing. And presumably if there were better sources, the person who originally added this material would have added those sources. So I am intending to delete this section unless someone can come up with proper sources. Sweet6970 (talk) 22:02, 29 October 2023 (UTC)

Being a "blog" does not inherently rule anything in or out of reliability; it's a publishing format, not an editorial structure. Science-Based Medicine is generally considered a reliable source (see WP:SBM), although not MEDRS. Xtra Magazine is not a blog, it's an online magazine with an editorial team I'm a bit surprised that Slate does not yet have an entry at the Reliable Sources Perennial list. -- Nat Gertler (talk) 22:35, 29 October 2023 (UTC)

Thank you for your comments. However, I think we are agreed that the sources are not adequate for the material they are required to support in this article. Sweet6970 (talk) 12:43, 30 October 2023 (UTC)

I have now deleted the material. Sweet6970 (talk) 12:10, 2 November 2023 (UTC)

@Sweet6970 You just reverted my addition of 2 paragraphs on GET/GETA stating this is massively UNDUE - there is already a discussion about GET on the Talk page – take it to the Talk page

1. The discussion of whether the UKCP statement is DUE/UNDUE is completely unrelated to the text I added. There is no wikipedia policy whatsoever saying "if people are discussing whether a source is due, you must check with them about every other source".
2. How are 9 sources, 6 from peer-reviewed journals, and 3 from generally reliable sources, UNDUE? Additionally, the 3 non-journal articles are not used for medical claims, they describe the propagation of GET.
3. Per WP:PARITY, In an article on a fringe topic, if a notable fringe theory is primarily described by amateurs and self-published texts, verifiable and reliable criticism of the fringe theory need not be published in a peer-reviewed journal. - we do not need a full systematic review to come out every time some WP:QUACKS rebrand conversion therapy.

In short, GET is recognized by the majority of sources as a fringe and unevidenced rebrand of conversion therapy, and that should be included in the article. Please self-revert and raise actual concerns with the sources here. Pinging @NatGertler and @Zenomonoz as they were part of this discussion above touching on some of the same sources. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:22, 1 January 2024 (UTC)

Firmly agree that additional context on the fringe nature of GET and GETA (particularly its connections to anti-trans and Fundamentalist Christian organizations), is necessary and warranted by the multiple available sources, particularly the WP:SPLC, attributed and truncated if we must. Our current text, describing it solely as an alternative practiced by some clinicians creates a false balance wrt its acceptance in the medical mainstream. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 21:52, 1 January 2024 (UTC)

I was referring to the current discussion below. This article is about conversion therapy. You added a considerable amount about GET, which according to the sources in the discussion below, is not a form of conversion therapy. There does not seem to be any general agreement as to what ‘gender exploratory therapy’ actually is, yet you have added a large amount of text in wikivoice, as if there is no disagreement about this. So I think you should engage in that discussion, instead of adding a large amount of text during the course of the discussion. Sweet6970 (talk) 21:55, 1 January 2024 (UTC)

I know, the discussion below is irrelevant per my point 1. I responded there anyways. GET, which according to the sources in the discussion below, is not a form of conversion therapy is referencing one primary statement from a random organization saying it's not, and one article saying some people advocate it but it isn't practiced. That source does not say "it isn't conversion therapy" and was written before the majority of scholarly research of GET. Those are ridiculously poor sources, especially compared to the multitude I added which are explicit that it's conversion therapy. What makes the UKCP statement saying it's not conversion therapy and one outdated definition of GET (that still acknowledges it's fringe) outweigh 9 (10, including Ashley) RS saying it is? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:07, 1 January 2024 (UTC)

The discussion below is relevant to my point. I don’t know what you mean by ‘a random organization’ , and why you have not commented on the view of Dr Hilary Cass. Please make your comments in the discussion below. Sweet6970 (talk) 22:18, 1 January 2024 (UTC)

I mean there is no evidence it is DUE and consensus seems to lean toward it not being DUE. I have repeatedly referenced the Cass review, I reference it in the comment you're replying to and the comment in the UKCP section: The CASS Review defines exploratory therapy (citing papers from 2009, 2018, and 2019, ie before the majority of scholarship on GET), but doesn't mention it anywhere else apart from to say it isn't used at GIDS and its advocates left GIDS. and one article saying some people advocate it but it isn't practiced. That source does not say "it isn't conversion therapy" and was written before the majority of scholarly research of GET.

Please, answer my question: What makes the UKCP statement saying it's not conversion therapy and one outdated definition of GET (that still acknowledges it's fringe) outweigh 9 (10, including Ashley) RS saying it is? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:27, 1 January 2024 (UTC)

I did not say that the UKCP statement ‘outweighs’ anything. I said your addition was UNDUE. My view is that (a) there is far too much of it (b) it should not be in wikivoice (c) the text should acknowledge the difference in views on this matter. I request that you propose an alternative wording which addresses these points. Sweet6970 (talk) 13:00, 2 January 2024 (UTC)

You stated You added a considerable amount about GET, which according to the sources in the discussion below, is not a form of conversion therapy. You're explicitly saying a myriad of sources saying it is conversion therapy are, if not outweighed by, the same weight as, the UKCP and Cass review.

WRT (a), we have one paragraph on the definition and particularities of GET, and one on how it's spread and been amplified. I'm not sure how much further it can be trimmed. I did ask when I added it that somebody integrate Ashley's paper into it so it isn't a standalone paragraph.

WRT (b) and (c), these are the same point as we put medical consensus in wikivoice. The "differing views" so far presented are a statement by a non-expert body (with regards to transgender health) and one review, which is outdated compared to all the research on GET, gives a definition of it, still acknowledges it's not used, and doesn't once weigh in on the question "is it conversion therapy". The support of GET by FRINGE groups like GETA, SEGM, Genspect, and ACpeds is already mentioned. We are not here to provide a WP:FALSEBALANCE as the majority of sources (especially WPATH, the world's leading organization in transgender healthcare) are clear it's conversion therapy. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:15, 2 January 2024 (UTC)

Sweet6970, per Hist9600's comment below, WPATH considers GET to be conversion "conversion" or "reparative" therapy under another name. Per WP:MEDASSESS/WP:MEDORG, it is the most high-quality source we have discussed on GET, and settles the question of whether it's conversion therapy or not. I ask you again to self-revert. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 00:59, 2 January 2024 (UTC)

That WPATH apparently accuses Dr Cass of advocating conversion therapy does not ‘settle the question’ – on the contrary, it shows how vast is the difference of views on this matter. Sweet6970 (talk) 13:05, 2 January 2024 (UTC)

Too late, I've already reverted him her. Loki (talk) 02:03, 2 January 2024 (UTC)

Loki, my edit was not ‘against consensus’ – there was not, and could not be, consensus about the addition of this material when it had been added without discussion. And by the way, I am female, as I have declared on my user page. That you have made an innocent mistake about my sex is unimportant, but I would welcome an apology for your accusation of misconduct on my part in your edit summary. Sweet6970 (talk) 13:08, 2 January 2024 (UTC)

Apologies about the misgendering, I genuinely missed that. I won't apologize about the revert or edit summary though. The consensus in this discussion is quite clear. Loki (talk) 00:05, 3 January 2024 (UTC)

Loki: Thank you for the apology for the unintentional misgendering. But the point which concerns me is your edit summary: you accused me of editing against consensus, which would be misconduct, but I did not, and could not have done so, since there was no consensus at the time, because the material had been added to the article without any prior discussion. You have accused me of misconduct which I did not commit, and in fact, could not have committed. Sweet6970 (talk) 13:07, 3 January 2024 (UTC)

The Cass Review does not draw this conclusion and is the highest quality independent review of the evidence base presently available. What you have is a number of WP:PARTISAN sources advocating the "affirmation" model claiming that anything else is conversion therapy. "Reparative" therapy is widely understood to be conversion therapy. "Exploratory" therapy OTOH is now politically contested, and while there are many opinionated sources happy to insist it is conversion therapy, others are pretty clear it is just therapy.

The Cass Review is a top-tier independent review of all of the available evidence instigated by a national health service. Its conclusion on this matter is that there is no consensus on the best approach. It does not call "exploratory therapy" conversion therapy, but treats it as a wholly legitimate alternative to "affirmation". It describes it in entirely neutral terms, and stresses that there are disagreements about the best approach - not that one is definitively to be favoured and the other inappropriate. The statement from UKCP - citing Cass - makes it abundantly clear that comparing exploratory therapy to conversion therapy is wrong.

Cass draws repeated attention to issues of "diagnostic overshadowing" and notes:

Primary and secondary care staff have told us that they feel under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters

Cass states:

Clinicians and associated professionals we have spoken to have highlighted the lack of an agreed consensus on the different possible implications of gender-related distress – whether it may be an indication that the child or young person is likely to grow up to be a transgender adult and would benefit from physical intervention, or whether it may be a manifestation of other causes of distress. Following directly from this is a spectrum of opinion about the correct clinical approach, ranging broadly between those who take a more gender-affirmative approach to those who take a more cautious, developmentally informed approach.

This is exactly the sort of thing that Ashley considers to be "conversion therapy". Per Ashley:

approaching trans identities and gender dysphoria from a position of suspicion—suspicion that, regardless of indication, they may be attributable to pathological causes and should be explored as such—is incompatible with therapeutic neutrality.

What Cass considers to be a professional lack of consensus over the role of undirected exploratory therapy - based on evidentiary assessment and large clinician panels - Ashley considers definitively unconscionable.

UKCP in terms of weight is significantly higher than Ashley's WP:RSOPINION, seeing as this is a clear and unequivocal statement of applicable standards by a professional body with 11,000 members, interpreting a gold-standard review of best practice and evidence, and not the opinion of one researcher who advocates strongly for the affirmative model claiming that other approaches look a bit like conversion therapy.

No definitive claims about this should be made in wikivoice. Cass is clear there is no consensus, and this should be presented as such. Over-reliance on popular sources and lobbying organisations on a matter such as this is inappropriate. Void if removed (talk) 10:13, 2 January 2024 (UTC)

1) The Cass Review was written before research into GET. It says nothing about it's efficacy, safety, or etc, just provides a definition.

2) The sections you quoted don't mean it isn't conversion therapy, just that some clinicians support it and felt they couldn't do it. Do not mistake "some clinicians at one clinic feel XYZ is true" with "XYZ is true"

3) the opinion of one researcher I don't know why you're quoting Ashley, when WPATH is the strongest source saying it's conversion therapy.

4) WPATH in terms of weight is significantly higher than UKCP with regards to trans healthcare

5) WPATH is more reliable than 1 person's review, which, again, still makes clear GET is FRINGE and not practiced. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:00, 2 January 2024 (UTC)

was written before research into GET

No, it was written before advocates of the affirmation model openly started calling exploratory therapy - which everyone had previously agreed was uncontroversial - "conversion".

In April 2022, the British Psychoanalytic Council released a statement supporting a then-proposed conversion therapy ban, stating:

we believe that including gender alongside sexuality in a ban will carry no real risk of ethical exploratory therapy being misconstrued as an alleged form of “conversion therapy”

Given that a scant five months later, Florence Ashley's paper doing exactly that was published, followed two months later by this WPATH statement, perhaps BCP were naive in that risk assessment.

more reliable than 1 person's review

I'm sorry, but are you under the impression that the Cass Review is "one person's review"?

Hilary Cass is the chair. A huge amount of manpower is involved, not least a seven-person governance panel. The clinician panel on the "spectrum of approaches" portion alone involved over a hundred participants.

This is a high-quality, independent, systematic review of the international evidence base and per WP:MEDASSESS sits at the top of the pyramid. You can't just handwave it away because WPATH don't like it.

I don't know why you're quoting Ashley

Because that is (or was, prior to a huge revision adding a bunch of other new questionable claims) the sole citation on this matter in the article, and also the one cited by virtually every other subsequent source. Void if removed (talk) 17:16, 2 January 2024 (UTC)

which everyone had previously agreed was uncontroversial

No, it was written before advocates of the affirmation model openly started calling exploratory therapy ... "conversion". - If by "advocates of the affirmation model" you mean "RS/MEDRS", yes, that was my point. Just because you don't like the newer research doesn't mean the Cass review isn't outdated.

Given the biggest proponents of GET routinely advocate against conversion therapy bans, the BPC is a minority view. I'll also note, as the text I added does, gender-affirming care routinely includes exploration anyways. It was only recently a few small advocacy groups started advocating "exploratory therapy" as an alternative to gender-affirming care while opposing transgender rights and legislating against conversion therapy bans.

I'm sorry, but are you under the impression that the Cass Review is "one person's review"?

I apologize, let me rephrase: WPATH, especially with the other cited sources, is more reliable than 1 outdated review of 1 clinic in 1 country, which, again, still makes clear GET is FRINGE and not practiced.

and also the one cited by virtually every other subsequent source.

So Ashley's paper, the first to explore GET, was considered reliable and correct by multiple other sources. Good to know.

The activism of a few FRINGE anti-trans groups and an outdated review that comments on GET less than you do is not about to outweigh WPATH and the rest of the RS. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:51, 2 January 2024 (UTC)

1 outdated review of 1 clinic in 1 country

The terms of reference are here.

still makes clear GET is FRINGE and not practiced.

This is the third time you've said this in this thread. This is completely incorrect. Please stop making this false claim, it does absolutely nothing of the sort. Void if removed (talk) 19:30, 2 January 2024 (UTC)

The interim report mentions GET 3 times. Once to define it, once to say From the point of entry to GIDS there appears to be predominantly an affirmative, non-exploratory approach, and once to say many individuals who are more cautious and advocate the need for an exploratory approach have left the service. Not once does it advocate for it or even say anything about it's effectiveness. The only place where GET is state sponsored is places like Florida, where minors banned from trans healthcare are recommended "GET" instead. This is getting silly and I have better things to do than argue over conversion therapy's latest rebranding, so I've notified WP:FTN. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:43, 2 January 2024 (UTC)

You refer to the Cass review as being ‘outdated’. Actually, it has not yet been completed – what has been published so far is the Interim Report. [1] And in any event, it does not make sense to refer to something so recent as the Interim Report as being ‘outdated’. According to that logic, as soon as the final report is published, all the sources you have used would become ‘outdated’. Sweet6970 (talk) 18:28, 2 January 2024 (UTC)

WPATH has stated that the recommendations in the interim report are outdated because they recommend outdated methods that have been shown to be ineffective over decades. They are not saying that the interim report itself is outdated (i.e., publication date). They are saying that the methodology and approach are outdated, and not following current standards for evidence-based treatments for transgender people. Hist9600 (talk) 18:39, 2 January 2024 (UTC)

So really, what they are saying is they disagree. Not that it is actually outdated, but that the independent assessment of evidence came up with a result that does not support the exclusively affirmative model they now recommend.

Hence: what needs to be represented is that there is a controversy, and not render into wikivoice highly contested claims from partisan sources. Void if removed (talk) 19:34, 2 January 2024 (UTC)

Additionally, wrt: Actually, it has not yet been completed – what has been published so far is the Interim Report

That means it weighs even less and is less due. Not only was it published before all scholarly analysis of GET and therefore unable to take them into account (the main sense in which I used "outdated"), it's not even a completed report. And that still leaves the issue, it provides a definition of GET, briefly mentions it's not used, and that's it. It says absolutely nothing whatsoever about GET's safety or efficacy or whether it's conversion therapy. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:50, 2 January 2024 (UTC)

Including GET (or similar) into the "conversion therapy" label, or excluding it, is a political and legal decision as much as a medical one. Recent political proposals about laws in the UK were very much considering whether to include transgender into those laws or not. Activists, politicians, legal experts and medical professionals of various flavours are all involved in this. I don't think what amounts to an "is this ethical" question is entirely a matter of MEDRS. For example, did conversion therapy for "sexual deviancy" really fall out of favour because someone published a systematic review showing it ineffective? Or perhaps society changed its mind on whether being gay was morally wrong, legally forbidden and a psychological illness. We do lots of things that are ineffective, such as throwing people in jail or building more roads, but are desirable for social or political beliefs in punishment or progress. A systematic review will not inform us whether therapy X is ethical.

We ran into problems with people demanding MEDRS over the Covid 19 lab leak theory. That was also a political, legal and possibly criminal matter as much as it was a biomedical or scientific matter. One big clue that this is a multifaceted issue is that we have Medical views of conversion therapy and Legality of conversion therapy daughter articles. I think this is an ongoing debate and so we should describe these viewpoints appropriately per NPOV. The word "FRINGE" is being thrown about on this page as a weapon. I don't think that is helpful to constructive discussion. Both sides need to recognise when their sources are partisan. I mean, Florence Ashley is an activist who wrote a book called Banning Transgender Conversion Practices: A Legal and Policy Analysis so they aren't neutral but likely worth quoting more than just some random journalist. Their article we cite is more of a personal exploratory essay than anything MEDRS would consider authoritative (for example, consider the closing sentence: "As a scholar of conversion practices, the uncanny resemblance cannot but give me pause." would never close any systematic review or NICE guideline) What the Cass review is attempting is closer to what MEDRS would value, but I think way too much is being read into what is a rather skeletal interim report. -- Colin°^Talk 14:35, 3 January 2024 (UTC)

I am fine with keeping attributed opinion - I am only suggesting that attributed opinion reflecting the actual nature of this disagreement be included. Presuming that "everything that disagrees with WPATH is fringe" is not the way. I don't particularly want to get into a debate about Cass when the UKCP statement is clear, concise and to the point.

Until I raised the issue the other day, the 2022 Ashley paper was the sole citation on this matter in the article, and presented as attributed opinion, noting only "similarity" with "conversion practices". Since I suggested it be balanced with the UKCP statement, substantial unattributed additions have been made from popular and WP:PARTISAN sources, making much stronger claims, obscuring the issue even further. Void if removed (talk) 16:45, 3 January 2024 (UTC)

In response to User:NatGertler's original post, the source "Interrogating Gender-Exploratory Therapy" by Florence Ashley is not a MEDRS source and if all we are drawing from it is an attributed opinion on what is or isn't conversion therapy in their personal view then that's ok, but it isn't ok to discredit other opinions as not MEDRS. Reading Asheley's document and the UKCP guidelines, the former explicitly states that the exact parameters of the thing they are criticising are vague and possibly mean different things to different therapists, and poses a series of questions. Drawing from it the prose "In a September 2022 review of gender exploratory therapy, bioethicist Florence Ashley found strong similarities to "conversion practices"." is not IMO justified. This is not a "review of gender exploratory therapy". What they say is "Few detailed descriptions of the approach’s parameters have been offered. In this article, I invite clinicians to reflect on gender-exploratory therapy through a series of questions." they then "discuss" whether the approach is "unethical". That's not a review. That's an exploratory document, an essay and some personal opinions. To claim they have actually reviewed gender exploratory therapy in that document, would imply quite something else, especially in the medical domain. Further "strong similarities" contains an adjective unsupported by the text. Just say "similarities" which is all they say. The word "strong" is some editor's personal opinion. So let's just say "Commenting on gender exploratory therapy in 2022, bioethicist Florence Ashley argued it had similarities to conversion therapy". And no need to quote those latter two words. -- Colin°^Talk 18:12, 3 January 2024 (UTC)

@Colin asks: did conversion therapy for "sexual deviancy" really fall out of favour because someone published a systematic review showing it ineffective? Or perhaps society changed its mind on whether being gay was morally wrong, legally forbidden and a psychological illness – the most peruasive evidence comes from Bailey et al. 2016 (page 86): proponents of conversion therapy have failed to provide any evidence of change in arousal patterns before and after therapy. This would be rather easy for prove (for males). Indeed, as Bailey notes the two small studies examining the question found men who claimed to have lost homosexual attraction through therapy, still had homosexual arousal patterns. I find this line of reasoning a bit more persuasive than other arguments. We have plenty of countries in which conversion therapies are acceptable, so we might expect some good evidence to have emerged by now.

As you note, terminology relating to conversion therapy for gender identity is a bit less clear cut.

Edit: whoops lol I thought I was replying to the most recent conversation. Sorry, Colin this is an old one and kind of irrelevant. Zenomonoz (talk) 08:19, 6 June 2024 (UTC)

Yes but we'd have banned it even if it was "effective". That wasn't the reason we decided this kind of conversion is wrong. (clearly not all kinds of "conversion" are wrong, as we don't complain when doctors try to fix anxiety or depression). I should clarify my earlier comment about what is "a political and legal decision as much as a medical one". Deciding it is wrong and thus falling into a ban on "conversion therapy" has aspects of all three worlds giving their opinions. But carefully describing whether therapy X has conversion as its aim or is in fact more nuanced, is as much a medical MEDRS matter as describing the side effects and intended effects of a drug. There's a problem below where editors have been using poor quality activist sources to oversimplify the categorisation of approaches. Reality is nuanced. -- Colin°^Talk 08:28, 6 June 2024 (UTC)

Can we really consider conversion therapy an MEDRS topic though? By and large it’s not a WP:BIOMED practice, it’s a psychological one. Snokalok (talk) 09:07, 6 June 2024 (UTC)

Article Evaluation

The leading paragraph of this article provides an introductory sentence that concisely and clearly describes the article's topic. The lead provides brief information on the various content that will follow in the sections below. However, the intro section contains no explicit description of which major sections the reader should expect in the article's body. The lead is not overly detailed; it provides just enough information to contextualize the article for the reader, and it only covers information which is further elaborated upon in the article's body.

The article's content is relevant to the topic and is up to date. However, the majority of space is given to theories and techniques for conversion therapy, and less focus is given to motivations, public opinion, and media coverage of the practice. Understandably, the majority of research and knowledge about conversion therapy is related to its history and techniques. I believe the article could give more attention towards the personal implications of the practice and the historical motivations behind its legality. However, this article's content does important work in shedding light on this particular issue facing the historically underrepresented LGBT population.

This article is written from a neutral point of view, with attention given towards facts and science. While conversion therapy is a complex, controversial topic, the article does not stray away from reporting on how the practice is not a legitimate form of therapy. The article bases their claims on reliable sources, such as academic peer-reviewed journals and novels. The sources are current, thorough, and written by a diverse spectrum of authors. The writing is clear and professional, and the organization of the content into sections is intuitive and easy to follow. That being said, some of the information on the legal status of conversion therapy is not as detailed as it could be, given the prevalence of the practice around the world and within certain pockets of America. Additionally, more attention could be given towards detailing the consequences and life threatening effects of the practice.

This article could use more images to enhance understanding of the topic. There are only three images, one of which is a helpful map to visualize jurisdictional bans on conversion therapy. The other two images do not do anything to provide additional enhancement of the topic or visual appeal.

There is healthy debate within the article's Talk page on understanding how psychological practices have been manipulated for the purpose of conversion therapy. Discussions center around how not to undermine the importance of some of these psychological practices while also giving attention towards how they have been abused in the service of harmful conversion practices. This article is rated B-class on Wikipedia's content assessment scale and is of interest to multiple WikiProjects.~~~~ Efloden (talk) 03:04, 1 September 2023 (UTC)

I disagree. I think this article is written with a bias. For example, calling it a pseudoscientific practice vs. simply a practice goes to show that the writers of this article don't allow the reader to think for themselves or draw their own conclusions. Encyclopedias are supposed to be written with neutrality. Calling it a "practice" vs. a "pseudoscientific practice" does not limit the reader's understanding of the concept.

Imagine if on the gender reassignment surgery article they called it "pseudoscientific" due to lack of long-term effects, consequences, or outcomes. It wouldn't happen because people would consider it to be a bias statement, even if it may be true.

We speak about the horrors of electroconvulsive therapy (an outdated practice) but we do not speak about the horrors of performing mastectomies on young girls? 216.49.128.107 (talk) 21:40, 9 December 2023 (UTC)

We don't call it pseudoscientific because that's our opinion, we say so because that's what reliable sources say. Please stop bringing up irrelevant tangents - if you are so convinced that gender reassignment surgery is "pseudoscientific", provide sources that say that on that article's talk page. Otherwise, you are comparing apples to oranges, though a more apt anaology would be flat-eartherism to evolution. Best regards, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:45, 9 December 2023 (UTC)

Just goes to show your implicit bias, as does your profile. 216.49.128.107 (talk) 21:50, 9 December 2023 (UTC)

Please see WP:PSEUDOSCIENCE, which discourages the sort of "neutrality" you describe, and WP:FRINGE/PS for what gets to be qualified as pseudoscience. -- Nat Gertler (talk) 22:33, 9 December 2023 (UTC)

Pseudoscience

WP:SOAPBOXING about the supposed efficacy of conversion therapy and violations of WP:CIVIL and WP:NPA. No prejudice against deleting if anyone thinks that's a better way to handle this. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:17, 9 December 2023 (UTC)

Can we remove pseudoscience/scientific references? There's not a lot of long-term, scientific articles that conclusively state that HRT or gender reassignment surgery are effective long-term, but we don't call transgender surgeries or treatments "pseudoscience". Clearly a double standard on an encyclopedia that is supposed to remain neutral. Conversion therapy does work for some just like transgender surgeries work for some. Why can't we practice neutrality? 216.49.128.107 (talk) 21:30, 9 December 2023 (UTC) There are in fact quite a lot of medical sources that say HRT is effective, but that has nothing to do with this. We go by reliable sources (more specifically, medically reliable sources). If you can find such sources that say conversion therapy does work for some, we can include them. At the moment, we have a lot of high quality sources that say it is pseudo-scientific bunk that doesn't, so that's what we'll stick to. Best regards, Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:40, 9 December 2023 (UTC) I think it's one of those cases where the loudest don't necessarily speak for the majority. For example, I thought I was gay when I was younger, but it was actually because of trauma associated from sexual abuse as a child. After some therapy, I found that I was actually trauma bonded and that my homosexual desires were actually a neurotic compulsion akin to epilepsy. I don't see how remaining more neutral on the topic would degrade the article. Calling it simply a practice does a lot more for allowing the user to come to their own conclusions, and encyclopedias should be written with neutrality. 216.49.128.107 (talk) 21:47, 9 December 2023 (UTC) A dubious (considering medical consensus on this) personal anecdote about how conversion therapy worked for you is not a reliable source, much less a medically reliable one. WP:NPOV means we stick to the sources, especially when the medical community overwhelmingly agrees on something (per WP:FRINGE). Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:57, 9 December 2023 (UTC) What I'm saying is calling it "pseudoscientific" is moreso to validate your own life decisions versus remaining neutral on the topic. It also promotes your outcome as the only viable one. It's why you gatekeep the article. It's fine, though. I wish you the best in your sex change. I hope it has cured your mental illness. I hope that others who may read this in the future know that change is possible without having to delve into the extremely noxious transgender ideologies. Thankfully, these people tend to reside only in online spaces and not in the real world. 216.49.128.107 (talk) 22:08, 9 December 2023 (UTC) Ok, I think it's clear you cannot be WP:CIVIL and this entire discussion can be closed or removed. Zenomonoz (talk) 22:11, 9 December 2023 (UTC) "After some therapy, I found that I was actually trauma bonded" or, you know, that could be entirely unrelated. Sounds similar to "after therapy, I found out I had schizophrenia as a result of a refrigerator mother" which was a popular belief in the 20th century. Zenomonoz (talk) 22:10, 9 December 2023 (UTC) Glad to know that Wikipedia is now a licensed therapist? 216.49.128.107 (talk) 22:16, 9 December 2023 (UTC)

GET - UKCP statement

Per this edit, Florence Ashley is cited comparing exploratory therapy with conversion therapy. I suggest it is at the very least worth counterbalancing this with the UK Council for Psychotherapy's Statement on therapy and gender on 02/11/2023. This states in the opening paragraph:

This statement is also being made to highlight the fact that exploratory therapy must not be conflated with conversion therapy.

This cites and builds upon the interim Cass Review, which describes gender affirmation/exploratory therapy thus:

Affirmative model - A model of gender healthcare that originated in the USA which affirms a young person’s subjective gender experience while remaining open to fluidity and changes over time. This approach is used in some key child and adolescent clinics across the Western world.

Exploratory approaches - Therapeutic approaches that acknowledge the young person’s subjective gender experience, whilst also engaging in an open, curious, non-directive exploration of the meaning of a range of experiences that may connect to gender and broader self-identity.

The Cass Review is a high quality independent assessment of international evidence and best practice, and UKCP is the UK's leading professional organisation covering this area. Void if removed (talk) 13:49, 1 January 2024 (UTC)

On the one hand, the addition by Void if removed seems reasonable to balance the inf on ‘exploratory therapy’ in the article. On the other hand, I don’t know that the term ‘exploratory therapy’ has a fixed, agreed, meaning, and so I am inclined to think that the whole paragraph should be removed from this article. Sweet6970 (talk) 16:20, 1 January 2024 (UTC)

The issue is that whether exploratory therapy is conversion therapy is a subject being litigated across multiple highly contentious pages independently at the moment based on a mixed bag of often partisan sources. Also gender exploratory therapy redirects to this page. All of this is highly POV, and not easily unpicked or balanced in separate contexts. I think this is something that has to be settled here, with high quality sources. A statement from UKCP stating that it is not is a significant intervention, and the fact that the statement cites and builds on the Cass Review carries weight. Void if removed (talk) 16:29, 1 January 2024 (UTC)

The fact that this is in a statement explicitly defending therapists who hold gender-critical views should be taken into account when evaluating this source to determine whether the UKCP here represents a reliable medical source or a medical consensus among experts on the matter. Hist9600 (talk) 18:10, 1 January 2024 (UTC)

Are you saying that defending gender-critical views is de-facto disqualifying for being a reliable source? Void if removed (talk) 18:26, 1 January 2024 (UTC)

No, but we should look at the source more carefully and whether it reflects medical consensus, and consider the overall context of the statement. There are many efforts to institutionalize discrimination against transgender people, or block transgender healthcare, and these are regularly undertaken by governments around the world. Hist9600 (talk) 18:40, 1 January 2024 (UTC)

The statement cites and reinforces the interim report from the Cass Review - which I quoted above - which is a top-tier independent review of the international evidence base and therapeutic best practice, commissioned by the NHS. Void if removed (talk) 23:03, 1 January 2024 (UTC)

A defense of the legal protection of gender-critical views of therapists, as published by one group in the UK, hardly qualifies as a medical reliable source for establishing gender exploratory therapy as being substantially different from conversion therapy.

The interim service specs developed as a follow-up from the Cass interim report has also been responded to by the World Professional Association for Transgender Health, and characterized as being tantamount to conversion therapy, or reparative therapy.

The response from WPATH has stated that, "WPATH, ASIAPATH, EPATH, PATHA, and USPATH have major reservations about this interim service specification." The response goes on to make many criticisms including:

The document makes assumptions about transgender children and adolescents which are outdated and untrue, which then form the basis of harmful interventions.

We can also see a response about "gender exploratory therapy" specifically:

WPATH, ASIAPATH, EPATH, PATHA, and USPATH call attention to the fact that this "psychotherapeutic" approach, which was used for decades before being superseded by evidence-based gender-affirming care, has not been shown to be effective (AUSPATH, 2021; Coleman et al., 2022). Indeed, the denial of gender-affirming treatment under the guise of "exploratory therapy" has caused enormous harm to the transgender and gender diverse community and is tantamount to "conversion" or "reparative" therapy under another name.

The WPATH SOC is well-established as the international standard for transgender healthcare, and is followed by healthcare providers in many countries around the world. By contrast, the report you have cited was only prepared for NHS England, on the basis of the admitted failure of NHS England to provide adequate services. Hist9600 (talk) 00:32, 2 January 2024 (UTC)

I'll just note as editors we should not seek to "balance" anything. We follow the sources. We are under no obligation, and in fact discouraged from, propping up minority positions "along with commonly accepted mainstream scholarship as if they were of equal validity." The UKCP statement is one organization's primary statement and there is no evidence it is DUE. It is certainly not a good source compared to the multiple peer-reviewed journal articles contradicting it. The CASS Review defines exploratory therapy (citing papers from 2009, 2018, and 2019, ie before the majority of scholarship on GET), but doesn't mention it anywhere else apart from to say it isn't used at GIDS and its advocates left GIDS. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:40, 1 January 2024 (UTC)

See my comments above. Sweet6970 (talk) 21:55, 1 January 2024 (UTC)

YFNS is correct that this discussion (about whether we should include UKCP's opinion on GET being different from SOGICE) is largely unrelated to our inclusion of other (higher quality and peer-reviewed) sources likening the two, as well as noting the prevalent transphobia among its practitioners and advocates. In no universe does your preference for this particular statement make the text discussed in that thread UNDUE, but if you insist on its supposed validity for that purpose, please bring it up in that thread instead of ping-ponging back and forth. It's very hard to follow. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 22:37, 1 January 2024 (UTC)

I was trying to avoid the ‘ping-ponging’, which I also find inconvenient. But there is a connection between the two discussions – the difference of views is relevant to the final wording to be added to the article. Sweet6970 (talk) 13:02, 2 January 2024 (UTC)

I think Hist9600 provides a very clear summary regarding the (lack of a) need for "counterbalancing" here. Most material published by the British government does not qualify as MEDRES. That a topic is contentious does not mean we should give equal weight to both or all sides. --Licks-rocks (talk) 22:55, 2 January 2024 (UTC)

The Cass Review is not ‘material published by the British government’. Sweet6970 (talk) 13:26, 3 January 2024 (UTC)

Don't set my steel scarecrows on fire, please :p. (thanks for correcting me anyway, though.) --Licks-rocks (talk) 19:25, 8 January 2024 (UTC)

I am, genuinely quite confused as to why we’re taking one review conducted by an institution which shapes its policy on the matter predominantly based off gender critical views; in a country where most of the policy and public opinion on trans rights supports gender critical views, as the end all be all definitively correct opinion.

Should we give the same level of deference to a review commissioned by the Russian or Saudi governments on the matter? Snokalok (talk) 01:38, 3 January 2024 (UTC)

We are not taking one review……as the end all and be all definitively correct opinion. The problem is, on the contrary, that the Cass Review is being completely ignored, thus compromising the neutrality of this article. I do not see the relevance of your references to the Russian and Saudi governments. Sweet6970 (talk) 13:23, 3 January 2024 (UTC)

I just want to further note that it's not actually a review.[2] Regarding your latest edit Snokalok, imo it's important to be explicit that GET is conversion therapy with a bundle of RS supporting it. I support the trimming, but think something like GET is a form of conversion therapy[refs] that presumes that patients... would be an improvement. Relatedly, I'm about to make a new topic on this talk page to address the paragraph on Ashley. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 01:49, 3 January 2024 (UTC)

GET - Ashley

I propose we merge the paragraph on Ashley's paper into the subsequent paragraph on GET. This entails removing the paragraph and just adding the paper as a citation to the 1st, 2nd, and 5th sentences of the 1st GET paragraph:

• GET presumes that patients suffering from gender dysphoria have underlying causes other than being transgender such as homophobia, social contagion, sexual trauma, and autism.
• GET is characterized by requiring in-depth talk therapy over an extended time period; practitioners often view medical transition as a last resort
• Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth.

I'd appreciate hearing people's thoughts on this! Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 01:59, 3 January 2024 (UTC)

I don't think we can. I don't view that paragraph as about Ashley's paper but as an introduction to what GET is, with Ashley's paper as a source. I do think we may want an extra section heading there. Loki (talk) 05:08, 3 January 2024 (UTC)

I’m not sure how we can either, though I believe somewhat the current section misses the primary mechanism of GET as a means of conversion therapy - that is, to find a reason to deny care indefinitely, or else to delay treatment long enough that the patient stops trying, often after puberty has run its course. Snokalok (talk) 06:06, 3 January 2024 (UTC)

Loki, Snokalok, my concern is that it's a relatively weak introduction when we have high quality sources saying explicitly GET is conversion therapy. I just boldy merged content from it into the subsequent paragraphs and noted what similarities she said existed, let me know if you think it captures it well!

Snokalok, I tried to get at to find a reason to deny care indefinitely with my edit as well, but sadly I haven't been able to find any RS that touch on or else to delay treatment long enough that the patient stops trying, often after puberty has run its course (though quite a lot of trans authors have pointed that out independently since it's fairly obvious, official RS have a lag).

I propose we remove the Ashley paragraph now her paper's better integrated and change the first sentence of the following paragraph to GET is a form of conversion therapy [3][4][5] which presumes that patients suffering from.... Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 01:51, 5 January 2024 (UTC)

My issue here is that we can't start with GET presumes that patients suffering from gender dysphoria have underlying causes other than being transgender such as homophobia, social contagion, sexual trauma, and autism without explaining what GET is. I agree with Snokalok that we should be clearer about the mechanism of GET, and I agree with you that we should be clearer that it is conversion therapy, but we really need an introductory paragraph there. Loki (talk) 02:18, 5 January 2024 (UTC)

Gotcha, I see what you mean about the starting with the explanation of it's methods rather than theory behind it. What do you think about this reordering swapping the contents of the first and second sentence? GET is a form of conversion therapy characterized by requiring mandatory extended talk therapy attempting to find pathological roots for gender dysphoria while simultaneously delaying social and medical transition indefinitely. Practitioners often view medical transition as a last resort and propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism. Bioethicist Florence Ashley found...

I think that ordering (mechanism of GET -> proposed reasoning for GET -> how those narratives are just reparative therapy 2.0) flows well introducing it. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 02:48, 5 January 2024 (UTC)

That's a lot better. I think I'd be okay with that. Loki (talk) 02:49, 5 January 2024 (UTC)

@Snokalok, how's this proposal look? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:13, 6 January 2024 (UTC)

Perfect. Snokalok (talk) 20:14, 6 January 2024 (UTC)

Spitzer study

I just undid an addition claiming that this study "found that 200 homosexual men and women reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years following some form of reparative therapy." A quick check of that link shows that that was not a finding of the study, but rather its sample; it's not like it checked a larger base of reparative therapy patients and found X% had lasting change. The mere existence of this set of people is not scientific proof of anything other than "reparative therapy does not 100% prevent sexual fluidity"; one could do a study of people who were in such therapy and later had car accidents, and the mere existence of such a sample does not suggest causation. What findings it does have is that even among this sample, "Reports of complete change were uncommon" -- i.e.,, the therapy was not a complete "cure" even among those who felt change in its wake. And that's all just from looking at the study's own summary. If you go to the portion of the article on Spitzer that covers this study, you'll see Spitzer himself asked that the study be retracted, that the many criticisms of it had merit, and he apologized for it.

So... bad science that didn't even say what the addition claimed. --Nat Gertler (talk) 15:27, 21 January 2024 (UTC)

NatGertler, there used to be a section on the page that evaluated a bunch of studies on conversion therapy, which I had some role in creating. Including the Spitzer study. It was deleted when I was off en-Wiki for a couple of years. I should probably bring that back? Zenomonoz (talk) 00:10, 27 January 2024 (UTC)

I would certainly look back at when it was deleted and what the justification was before doing so; in fact, since it proved controversial on at least some level, best practice would be to raise it on the talk page before adding. (I'm saying this without having checked when it went away.)

Also, of course, if it was years ago that you did it, there are likely superseding studies to consider. --Nat Gertler (talk) 00:29, 27 January 2024 (UTC)

Article is biased and poorly sourced

It is said at one point that their is a consensus that such therapy doesn't work, but only one study of cases in the South is quoted. How is that proof of a consensus? 207.244.205.106 (talk) 20:34, 16 February 2024 (UTC)

The first sentence of that source is Numerous studies have determined that conversion therapy, a practice meant to change one’s sexual orientation to heterosexual or gender identity to cisgender, can be ineffective and severely harmful. I cannot currently access the full source, but I would presume that the numerous studies in question are cited in the article's body, so an interested editor could retrieve and cite them in support of that consensus. The sources which claim otherwise are predominantly either not scientific, or (as described further in the article) subject to methodological issues. As it stands, reference 2 looks to be a reliable source for this claim. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 01:19, 17 February 2024 (UTC)

From "Conversion Therapy in the Southern United States: Prevalence and Experiences of the Survivors" (reference 2 in this article):

There is a scientific consensus that conversion therapy is ineffective and can result in significant, long-term psychological harm (Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth, 2015). Many pro-conversion therapy studies utilize biased samples that only include clients who have recently undergone conversion therapy, thus distorting the purported success rates and failing to analyze whether conversion therapy remains effective in the long term (Shidlo & Schroeder, 2002). Further, even the most scientifically rigorous studies report success rates of no more than 30% (Haldeman, 2002).

–RoxySaunders 🏳️‍⚧️ (💬 • 📝) 06:32, 17 February 2024 (UTC)

I agree the article is overall quite poorly sourced. I will try and improve it when I have more time. Zenomonoz (talk) 23:47, 28 February 2024 (UTC)

Conversion therapy is not illegal in Iceland.

Conversion therapy is not illegal in Iceland per se. It's only illegal to trick or force someone to go to conversion therapy. You can legally perform conversion therapy in Iceland if your clients give their informed consent. Can someone correct the article? Thanks. 85.220.49.247 (talk) 08:29, 21 March 2024 (UTC)

Querying the claims in the 'gender identity change efforts section'

The content in this section concerns a sensitive topic, most of it was added by hist9600.

In particular, there is reference to work by Stoller, Green, and Lovas, working with samples of effeminate young boys. They used behaviourism techniques to 'stamp out' this behavior, and then assessed their gender identity (and sexual orientation) later on.

Although this is listed under a 'gender identity change efforts', many scholars have noted that the boys in their treatment samples would not meet the diagnostic criteria for gender dysphoria today. They were diagnosed with gender identity disorder, which included very effeminate boys who were not uncomfortable with their natal sex.

At adulthood follow up, only one of Green's sample identified as a transgender woman. The rest as men (most of them gay). Green's conclusion is that therapeutic intervention in prepubescent children can resolve gender identity disorder (under the definition then), but does not alter later sexual orientation (in males). Many scholars in favour of the affirmative approach to prepubescent gender dysphoria, argue that Green's experiment does not provide the first assertion, because boys in this sample were not gender dysphoric in the first place.

But the current state of the article plays into accepting Green's premise that feminine boys are all gender dysphoric, and thus, this is conversion therapy for children destined to be transgender adults... if we accept this premise, then we must (incorrectly) conclude that Green's intervention does alleviate dysphoria in prepubescents.

There is also reference to the case of Kirk Murphy, a boy who was enrolled in Green's sample. He didn't want to be a girl according Green's reports. It was only George Rekers, who misrepresented the case, making the claim. Murphys sister denies it. Rekers also falsely claimed that Kirk had grown up to become a heterosexual man, while Green acknowledged he was predominately homosexual. Hist9600 also cited directly to Rekers paper on Kirk (whom he called Kraig), which is a total misrepresentation disputed by Kirk's sister. This is why we often avoid citing primary sources. It gives the false impression that Rekers was really working with a gender dysphoric child. Rekers was embellishing.

The cited CNN article regarding his suicide makes no mention of him as a gender dysphoric child who wanted to be a girl, but plenty of reference to him as a homosexual man who was "treated" for his femininity as a boy. So why is it being used to bolster the idea that a transgender conversion therapy had occurred? Green/Rekers were also looking to see if they could prevent homosexuality, remember. I think His9600 has been a bit flexible with the sources here.

So, what is to be done? It needs some modification, at least. There probably needs to be more accurate coverage on the history and debate about therapeutic intervention for gender dysphoria in prepubescent children. This is extremely controversial and a sensitive area, so I would be interested in other editor thoughts.

Zenomonoz (talk) 11:34, 23 May 2024 (UTC)

As Florence Ashley has pointed out, traditional conversion therapy often targeted gender non-conformity. The aim was to potentially prevent transsexualism and some forms of homosexuality. Similar to what Kenneth Zucker did until it became no longer acceptable to publicly talk about preventing homosexuality.

Early conversion therapy efforts did not always distinguish between transsexualism and homosexuality, and sometimes it targeted both, with the presumption that transsexualism may be a more extreme form of homosexuality. To use terms like "transgender", "gender identity", and "gender dysphoria" in the context of 1970s conversion therapy efforts is anachronistic. The framework of SOCE and GICE also presumes a clear distinction between gender identity and sexual orientation that these early efforts do not fall into neatly.

It is true that Kirk was eventually understood to be a gay man (long after the fact), but those running the project did not know that, or care about that. They were concerned with his gender non-conformity, and warned his family about him potentially becoming a transsexual. I believe his apparent history of "cross-dressing" behavior was cited (which was of course overblown). Rekers referred characterized these things collectively as "childhood cross-gender identity".

They basically produced a traumatized cisgender gay man who eventually died of suicide.

Although this is listed under a 'gender identity change efforts', many scholars have noted that the boys in their treatment samples would not meet the diagnostic criteria for gender dysphoria today.

You realize that these two things don't contradict each other, right? For someone to go through gender identity change efforts, does not mean that they actually have gender dysphoria in any way, or that they would qualify as having gender dysphoria according to the criteria of the DSM-5 in the 21st century. Why would the modern criteria for gender dysphoria be relevant to the conversion therapy efforts of the 1970s?

plays into accepting Green's premise that feminine boys are all gender dysphoric

I'm not sure where you got the idea that the article characterizes all the people who went through these programs as being gender dysphoric by the standards of the 21st century, like the DSM-5 definition of gender dysphoria, but that's not the case. It also isn't even the case now in the 21st century. Someone's personal gender identity, or their personally-felt clinically-significant distress of gender dysphoria, doesn't change the aims of the program, the methods used, and what behaviors were punished. Cisgender people can be put through these programs and can be traumatized until they eventually die of suicide. Hist9600 (talk) 16:23, 23 May 2024 (UTC)

I broadly agree with what Hist9600 said. The distinction between SOCE/GICE is largely modern as many people involved did both, targeting gender noncomformity as the predictor for being trans and being LGB. Their therapy was based on upholding conventions of gender - both trans kids and gender nonconforming cis kids they saw got the same treatment: attempts to make them conform to the gender stereotypes of their sex (thinking if untreated the kids would grow up trans). A few involved were of the camp that it's fine to be a gay man, just not an effeminate one.

Regarding Rekers and Kirk, some choice quotes include[6]: TLDR they thought the kid was likely trans, and treatment was intended to try and "cure" that.

This study suggests a preliminary step toward correcting pathological sex-role development in boys, which may provide a basis for the primary prevention of adult transsexualism or similar adult sex-role deviation. Young boys with feminine sex-typed behaviors have recently become the object of increased psychological interest, perhaps because of growing evidence that childhood cross-gender manifestations are indicative of later adult sexual abnormalities; e.g., transvestism, transsexualism, or some forms of homosexuality since Kraig had these problems before the age of 5 yr, our best prediction (based on the literature) would indicate that he will have even more severe adjustment problems in adulthood. Most adult transsexuals and transvestites and some homosexuals report that their cross-gender behaviors began in early childhood (Green, 1968; Money and Primrose, 1968; Walinder, 1967; Zuger, 1966). It appears to be the case, in boys at least, that substantial deviation from appropriate sex-role behavior at the age of 5 yr leads to substantial gender problems in adulthood in the majority of cases third reason for treating Kraig is that intervention on deviant sex-role development in childhood may be the only effective manner of treating (i.e., preventing) serious forms of sexual deviance in adulthood, since in adulthood such severe deviance appears to be quite resistant to psychological treatment (Baker, 1969; Benjamin, 1969; Pauly, 1969). Apparently, there is only one published report of the successful psychological treatment of an adult transsexual (Barlow, Reynolds, and Agras, 1973). ... it may be preferable to attempt to change the individual's behavior during the formative childhood years than to change the adult's body.

On the flip side, Joseph Nicolosi and NARTH actually framed homosexuality as a gender disorder. They focused mostly on gay men, while also "treating" trans people, but framed either as a failure to properly internalize the correct gender identity (ie, heterosexual man). And Rekers worked with them extensively.

I think the best line of inquiry is how we can restructure the article so SOCE/GICE don't appear more separate than they historically were and we can better acknowledge the constant overlap between providers who did both. I'm partial to rewriting the history section by decade and prefacing it with mention of the overlap (particularly with regard to earlier conceptions of sexuality/gender identity being the same). And it would be useful to tag primary sources in the article. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:21, 23 May 2024 (UTC)

Yeah, maybe a revised structure for the article could in one section provide an overview of what qualifies and conversion therapy, mention that early efforts often targeted gender non-conformity, and then also introduce modern concepts like SOCE and GICE? Then in another section, maybe there could be a history by decade? Hist9600 (talk) 14:14, 24 May 2024 (UTC)

Reply to Hist9600 and Your Friendly Neighborhood Sociologist,

I will comment on the other points later, but this is why I've removed direct reference to the Rekers papers:

• Rekers reports are questionable in their accuracy. He claimed that Kirk showed up in the clinic: “swishing” around the home and clinic, fully dressed as a woman with long dress, wig, nail polish, high screechy voice, slovenly seductive eyes".
• This is refuted by his sister as completely fabricated. They didn't even own a wig, nor any dress that would fit him, nor would this be allowed.
• Per Bailey (p.25) Kirk's father spanked him after he put 'girl' toy clothing on stuffed animals. Are we really to believe Kirk's parents were letting him come to the clinic in a dress, wig and nail polish?
• None of these claims were mirrored in Green's interviews on with "Kyle" (Kirk).

Consider how Wikipedia is frequently used as a source for university students and some academics. How might including citation to a misleading/fraudulent description of a case study impact student writing, academic writing, papers, and books in future?

Sometimes it is fine to cite a primary source alongside a secondary source. However, you're both aware that it is best to cover topics via secondary sources. I especially agree in this case given the circumstance. So I've removed direct citation to them from the article. We can let secondary sources cover it.

Zenomonoz (talk) 00:59, 25 May 2024 (UTC)

Just a brief follow up comment after looking at the sources. The Rivera source is more focused on Kenneth Zucker as an example of gender identity change efforts. The Green/Rekers work is certainly cited as laying the groundwork for this, but Rivera describes their work as intended to extinguish atypical gender behaviors as well as prevent eventual homosexual orientation.

Rivera goes on to clarify: Green’s methods were adopted by Dr. Kenneth Zucker at the Center for Addiction and Mental Health in Toronto (Zucker & Bradley, 1995; Zucker et al., 2012) but modified so that the focus was primarily on preventing a child from developing an eventual transgender identity – i.e. there seems to be a distinction between Green's work and Zucker's work.

Green/Rekers did have a control group of feminine boys who were not subject to "treatment". As I mentioned, only one of their subjects grew up to identify as a transgender woman. I am unsure if the trans woman was a member of the the treated group, or the control group. Regardless, this further strengthens the argument that Green/Rekers weren't working with gender dysphoric children, but rather, feminine boys... it doesn't seem to offer much support for the idea that they would be transwomen had they not been enrolled in the experiment (in the control group, matched feminine boys who had relatively relaxed parents grew up to be satisfied with their natal sex). That's important context (at least for editors) because this section is supposed to be about gender identity change efforts. This is a bit unclear for those with little background knowledge. A potential solution is clarifying that Lovas/Rekers (and Green?) were incorrectly assuming that all feminine boys were potential transgender adults. No doubt there are probably reliable sources somewhere since I've seen scholars (including trans ones) advance similar arguments before.

Zenomonoz (talk) 10:34, 5 June 2024 (UTC)

Gender Exploratory Therapy - Cass Review

The Cass Review has the following to say about exploratory therapy:

Exploratory Approaches - Therapeutic approaches that acknowledge the young person’s subjective gender experience, whilst also engaging in an open, curious, non-directive exploration of the meaning of a range of experiences that may connect to gender and broader self-identity (Bonfatto & Crasnow, 2018; Churcher Clarke & Spiliadis, 2019; Di Ceglie, 2009; Spiliadis, 2019).

Spiliadis 2019 is the original "Gender Exploratory Therapy" paper.

It also says:

Terms such as ‘affirmative’ and ‘exploratory’ approaches have been weaponised to the extent that it is difficult to find any neutral terminology.

And:

The intent of psychological intervention is not to change the person’s perception of who they are but to work with them to explore their concerns and experiences and help alleviate their distress, regardless of whether they pursue a medical pathway or not. It is harmful to equate this approach to conversion therapy as it may prevent young people from getting the emotional support they deserve.

Cass also stated:

She noted that some medics were afraid of being accused of conducting “conversion therapy if, again, they take a cautious or exploratory approach”

Given the weight of this source, how do we square this with the coverage in this section? That is, this whole section does exactly what Cass warns agains, ie conflating conversion therapy with exploratory therapy. The Cass Review has been directly accused of espousing conversion therapy on this basis, by WPATH. The final Review's opinions on this are due here. Void if removed (talk) 20:38, 5 June 2024 (UTC)

The treatment of the Cass Review in the recent addition after I made this comment takes none of this into account, instead adding this and a whole chunk right next to it about NARTH.

The same month, the UK Council for Psychotherapy announced it was fine for counsellors to practice GET and in April 2024 it was endorsed by the Cass Review.

The source doesn't even support this sentence. I'm adding an NPOV tag to this section. Void if removed (talk) 21:57, 5 June 2024 (UTC)

The source doesn't even support this sentence - what?

From the source: In November 2023, the UK Council for Psychotherapy—the nation’s top professional association—declared that it was fine for counselors to take GETA’s “exploratory” approach to gender. This April, a long-awaited review of gender-related care for youth in England’s National Health Service endorsed exploratory therapy, according to Alex Keuroghlian, an associate psychiatry professor at Harvard Medical School[7]

Care to explain the NPOV tag? This section's been extensively discussed on the talk page and got consensus. You've been arguing for months that the UKCP and Cass Review endorsing GET should be mentioned, but now it's been mentioned you have an issue? Make it make sense. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:08, 5 June 2024 (UTC)

Pinging others who've discussed this section: @Zenomonoz, @NatGertler, @RoxySaunders, @LokiTheLiar, @Hist9600, @Licks-rocks, @Snokalok, @Sweet6970, @Colin. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:15, 5 June 2024 (UTC)

My intuition here is actually pretty similar to Void's below, for once. Namely that "gender exploratory therapy" is both a euphemism used by conversion therapists to cover up what they're doing, and a literal self description used by actual credible gender therapists.

What we do about this, I'm not sure. Especially since I would be truly amazed if we could actually source this split. But it does seem to be what's happening with Cass's quote. I really don't think she means to endorse conversion therapy. Loki (talk) 22:27, 5 June 2024 (UTC)

Can you provide sources to substantiate the idea that there are two different interpretations of "gender exploratory therapy", that refer to two significantly different practices? I've read some ideas about "intuitions", and some ideas that are clearly original research on the matter. But I'm not sure if it makes sense to create some new interpretation of "gender exploratory therapy" if there are not significant independent reliable sources actually saying that there are two major interpretations. Hist9600 (talk) 22:50, 5 June 2024 (UTC)

Yes - the Cass Review says it is not, with a definition quoted above that is not about "change", and the recently added Mother Jones article quotes a conversion therapist saying it is.

:::::“It truly is very similar to how the Alliance has always approached unwanted SSA [same-sex attraction],” she told the assembled therapists. “You approach it as ‘change therapy’—or, even less triggering, ‘exploratory therapy.’” Void if removed (talk) 22:57, 5 June 2024 (UTC)

That's not what I asked. I asked if there are reliable sources substantiating the idea that there are two major and differing interpretations of gender exploratory therapy. Saying that the Cass Review says that gender exploratory therapy is not conversion therapy, is not an answer to the question. Hist9600 (talk) 23:53, 5 June 2024 (UTC)

Like I said, I would be truly amazed if we could actually source this split. No I can't, and I would be very surprised if anyone could. Loki (talk) 03:06, 6 June 2024 (UTC)

The source doesn't even support this sentence - what?

Ah my bad, I couldn't see the Cass Review mentioned.

now it's been mentioned you have an issue?

The Cass Review is a high quality source you've been falsely dismissing as FRINGE for months, and it says that conflating exploratory therapy with conversion therapy is harmful. You've made no effort to render this POV, and instead have slapped the cass review "endorsing GET" right after a section with NARTH chuckling about how it really is code for conversion therapy. No effort has been made at all to show that there is a legitimate medical dispute over trans youth healthcare here, and that when some people say "exploratory therapy" they mean ethical psychotherapy, while others do not. Void if removed (talk) 22:28, 5 June 2024 (UTC)

The Cass Review is indeed a high quality source, but it's only a single high quality source, and it contradicts many other high quality sources on this point.

What we do when sources contradict each other like this is not always clear, but certainly it's not to just go with the one new source over the five we currently have for Gender exploratory therapy (GET) is a form of conversion therapy. Loki (talk) 03:16, 6 June 2024 (UTC)

Mother Jones is not a reliable source about the Cass Review. YFNS posted something before sourced to them that was so fully of shit I despaired. Henry Carnell is a young journalist, with training in "communication", according to their linked-in, currently looking for work. Psychological therapies, their description and comparisons, are WP:BIOMEDICAL material and thus fall under WP:MEDRS. While the ethics of "conversion therapy" fall outside MEDRS, a claim that a particular therapy has conversion as a goal falls into MEDRS. Carnell is simply not qualified to assess the Cass review and comments by other activists and put two and two together for us here as the added sentence says. I'm struggling also to find where in the Mother Jones piece it says "the UK Council for Psychotherapy announced it was fine for counsellors to practice GET". This open letter makes clear they do not regard any and all kind of "exploratory" therapy to be "conversion therapy" ("To conflate exploratory psychotherapy and conversion therapy is potentially dangerous and harmful to the public." and "Conversion therapy as described in the statement is harmful and must not be practised").

It is disappointing that this article is indeed falling into the trap recognised by Cass and exploited by activists who want to over simplify a range of approaches into one bucket term they can attack. Cass makes it clear that a trans life is not worse than a cis life. But Cass also does not accept every single child coming to a gender clinic is trans or has a fixed trans identity or that that trans identity must be lived in a body that has been medicalised (can't find the word) to be one of only two genders. I think some of the commentary about therapy is taking the view that any child who goes to a gender clinic and leaves without a prescription for hormones has been converted. Clearly there are a range of opinions among experts and a range of points of view. There are reliable sources saying this matter is in dispute and the everyday word "exploratory" has been weaponised into a bad faith assumption it is always a euphemism for conversion therapy. We have experts who disagree on this and can cite better sources than some rag written by a "communications" graduate. -- Colin°^Talk 07:54, 6 June 2024 (UTC)

IMO, we have sources who say that exploratory therapy is a standard psychotherapeutic approach intended to determine if there are underlying causes of gender distress, with no set endpoint in mind, and not conversion therapy, eg.

• https://www.researchgate.net/publication/334559847_Towards_a_Gender_Exploratory_Model_slowing_things_down_opening_things_up_and_exploring_identity_development
• The Cass Review

Then we have sources who say that the conflation of standard exploratory psychotherapy is conversion therapy is dangerous and harmful, especially in the context of proposed bans on conversion therapy, where practitioners fear being accused of conversion therapy for pursuing standard psychotherapeutic exploration, eg.

• https://jme.bmj.com/content/early/2023/11/21/jme-2023-109282
• https://www.psychotherapy.org.uk/news/ukcp-guidance-regarding-gender-critical-views/
• Cass here and the Cass Review itself, again.

Then we have an opinionated essay from Florence Ashley in 2022 saying that "gender exploratory therapy" (as described in that first link by Spiliadis) has similarities to "conversion".

And then we have a variety of sources of various levels of quality explicitly calling anything short of the affirmative model conversion therapy, and those who advocate it - including the Cass Review - conversion therapists peddling WP:FRINGE WP:PSEUDOSCIENCE:

• https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978
• https://osf.io/preprints/psyarxiv/gz5mk
• https://explore.bps.org.uk/content/bpscpf/1/369/91
• https://www.digest.ugent.be/article/id/85309/
• https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E
• https://www-tandfonline-com.wikipedialibrary.idm.oclc.org/doi/full/10.1080/26895269.2024.2328249
• https://www.splcenter.org/captain

Virtually all these sources make this claim based on that Florence Ashley paper.

And finally we have actual conversion therapists gleefully saying that "exploratory" or "change" therapy is conveniently a less triggering name for processes like trying to get rid of "unwanted" same-sex attraction:

• https://www.motherjones.com/politics/2024/05/conversion-therapy-lgbtq-anti-trans-gay-gender-affirming-care/

And this source also conflates this directed, unethical approach with the undirected, ethical positions taken by the Cass Review and UKCP.

Meanwhile we have the Cass Review explicitly saying the terms have been weaponised to the extent that neutral terminology is hard to find, and we have NHS England, Finland and Sweden moving away from the affirmative model and toward exploratory psychotherapeutic intervention as a first line treatment.

I think we can give a good faith rendition of this disagreement and ongoing controversy over contested terms, but it cannot start from the point of view that the Cass Review and UKCP are espousing WP:FRINGE WP:PSEUDOSCIENCE as was failed to be demonstrated six months ago, and it should not be stating in wikivoice that the kind of therapy being adopted by national health services is conversion therapy, because this is an WP:EXTRAORDINARY claim. Void if removed (talk) 09:27, 6 June 2024 (UTC)

And this source also conflates this directed, unethical approach with the undirected, ethical positions taken by the Cass Review and UKCP. You are again presuming there are two major and differing practices for GET. Whether Cass believes that GET is ethical and effective, is a different matter. The major name associated with GET is the Gender Exploratory Therapy Association (GETA), which is promoted by Genspect, with materials produced by SEGM. Both Genspect and SEGM are gender-critical advocacy groups, deeply entrenched in advocating against trans rights, and are both considered anti-LGBTQ+ hate groups by the Southern Poverty Law Center. Hist9600 (talk) 12:29, 6 June 2024 (UTC)

You are again presuming there are two major and differing practices for GET

No, I'm saying the sourcing for the opening line of this section includes a WPATH statement specifically in response to the Cass interim review and NHS service specification calling the "exploratory therapy" described there (not GET or any other moniker) "tantamount to conversion". Void if removed (talk) 13:13, 6 June 2024 (UTC)

Now the line is between gender "exploratory therapy", and "gender exploratory therapy"? What's next, a new distinction between "affirming care" and "affirmative care"? Is it really appropriate for Wikipedia editors to reify a passing remark about gender exploratory therapy into an entirely new interpretation of what that term might mean, when there are numerous sources here that have already provided discourse on what gender exploratory therapy is? As far as I can tell, the assertion that Cass is referring to anything other than conventional gender exploratory therapy, seems to be WP:OR. Hist9600 (talk) 22:46, 6 June 2024 (UTC)

Nub of the issue:

In November 2023, Michelle Cretella, a board member of the pro conversion therapy group Alliance for Therapeutic Choice and Scientific Integrity (ATCSI, formerly NARTH), gave a speech at an ATCSI conference which endorsed GET and arguing it "truly is very similar to how the Alliance has always approached unwanted same-sex attraction".

See, here's the problem - you have an actual conversion therapist calling actual conversion therapy "gender exploratory therapy" to hide the fact that it is conversion therapy. And then you have the Cass Review saying that exploratory approaches are not conversion therapy, because actual, ethical, exploratory psychotherapy is not conversion.

This section needs to make this distinction, rather than saying these two are the same thing.

So this should not be said like this in wikivoice:

Gender exploratory therapy (GET) is a form of conversion therapy

Saying this in wikivoice when we have a MEDRS that says, specifically, that making this comparison is harmful is a huge concern. We have to distinguish between what the cass review means when it says "exploratory approaches" and what Cretella means when she is talking about "exploratory therapy" as a euphemism for conversion therapy. Void if removed (talk) 22:19, 5 June 2024 (UTC)

Gender exploratory therapy (GET) is a form of conversion therapy That's been there for months and you adding a NPOV tag after extensively discussing this and consensus disagreeing with you is disruptive.

See, here's the problem - you have an actual conversion therapist calling actual conversion therapy "gender exploratory therapy" to hide the fact that it is conversion therapy.... Yeah...

because actual, ethical, exploratory psychotherapy is not conversion. - you do realize this is literally NARTH's whole thing, right? They opposed "gay affirmative" therapy, arguing that it was necessary that a psychiatrist "ethically explore the roots of a persons same sex attraction", but that it wasn't "conversion" because there was "no preset goal in mind". Literally, same exact argument.

And it would be a lot easier to take the Cass Review seriously if SEGM and Genspect weren't involved at almost every step of the process.[8] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:31, 5 June 2024 (UTC)

• hmm, funny one. First, I think we're agreed on the first sentence void quoted, that looks like an endorsement of exploratory therapy to me, even if they're being quite cagey about it, the sources quoted make it abundantly clear what they're referring to.

Terms such as ‘affirmative’ and ‘exploratory’ approaches have been weaponised to the extent that it is difficult to find any neutral terminology. I don't care about neutral terminology, I care what the cass report is saying about it, so this is a distraction to me.

The intent of psychological intervention is not to change the person’s perception of who they are but to work with them to explore their concerns and experiences and help alleviate their distress, regardless of whether they pursue a medical pathway or not. It is harmful to equate this approach to conversion therapy as it may prevent young people from getting the emotional support they deserve.

Another endorsement of exploratory therapy, again, cagey language, which, judging by the 10+ sources we have already quoted for that section, seems to slightly mis-define it. But we are already aware of what exploratory therapy is from a multitude of other MEDRS, so the misdefinition doesn't really matter, we've established from the first sentence that we're still talking about the same thing.

This just leaves the question of how we should treat the cass revieuw here. I would call it a primary source (thus needing attribution) that is, indeed, due for a mention. Which leaves me at the result that the contested insertion was probably reasonable. I don't care about the NARTH bit, if you want that moved elsewhere in the section so it doesn't seem like they're of equal quality, do whatever. Having said all that, Isn't an NPOV tag on the entire section a bit much for two sentences? --Licks-rocks (talk) 23:49, 5 June 2024 (UTC)

I think you’re missing the key underlying point.

Cass is saying that therapy to merely explore the psychological environment present is not conversion therapy, and what is being described there is a firmly different procedure from what is being described in the article subsection.

Conversely, it deliberately refuses to at any point tie what it’s describing to the words “gender exploratory therapy”.

So the most basic interpretation of the text here, is that the report is not describing gender exploratory therapy at all, itms describing a therapy that it does not assign a name, as says it wishes the word “exploratory” was used in a more well defined way. It’s simply making some broadstrokes musings on the current professional environment. I feel that making that connection on our own would become SYNTH or OR. Snokalok (talk) 05:19, 6 June 2024 (UTC)

To simplify my words, there’s nothing in the review but our own preconceptions to suggest it’s talking about GET at all. And thus, we can’t really add anything here except perhaps a line on Cass lamenting a lack of solid definition of “exploratory” maybe but even that’s fairly tangential Snokalok (talk) 05:22, 6 June 2024 (UTC)

I think this is a fair point, and I considered including a similar analysis in my own comment, but at the time I wrote my comment above, both other participants seemed to agree that the cass revieuw was endorsing, so I decided not to rock the boat. For what it's worth, I think the point hinges a little bet on how explicit we need them to be. If you read the text on a very surface level, your interpretation is or seems correct. As I pointed out above, they're being cagey and stopping just short of naming the practice they're referring to, but looking a little deeper, the sentence about exploratory approaches cites material about exploratory therapy, making it clear that this is at least included in their definition of "exploratory approaches". I obviously can't speak on authorial intent, but the end result behaves as a dog-whistle: strongly different implications depending on who is reading it and how. --Licks-rocks (talk) 10:05, 6 June 2024 (UTC)

The problem with this is that the very first citation for this section is WPATH attacking the Cass Review for recommending it and the NHS Service Specification for going along with it.

At several points in the document, there is an emphasis on “careful exploration” of a child or young person’s co-existing mental health, neuro-developmental and/or family or social complexities. There is also a suggestion that a “care plan should be tailored to the specific needs of the individual following careful therapeutic exploration…” WPATH, ASIAPATH, EPATH, PATHA, and USPATH are concerned that this appears to imply that young people who have coexisting autism, other developmental differences, or mental health problems may be disqualified, or have unnecessary delay, in their access to genderaffirming treatment. This would be inequitable, discriminatory, and misguided (Coleman et al., 2022). WPATH, ASIAPATH, EPATH, PATHA, and USPATH recommend that puberty suppression, where urgently indicated, can be commenced promptly, and proceed alongside and at the same time as any necessary diagnostic clarification of other conditions, or treatment of other conditions. Whilst careful assessment is imperative, undue delay inherent within a model of care is not a neutral option and may cause significant harm to those accessing services (Coleman et al., 2022). There is an alarming statement in the summary that “the primary intervention for children and young people… is psychosocial (including psychoeducation) and psychological support and intervention.” In another section, the document goes on to state that one outcome from the screening process would be “discharge with psychoeducation…” Disturbingly, this decision might be made without speaking directly with the young person or family. Taking No 8 and 9 together, this document seems to view gender incongruence largely as a mental health disorder or a state of confusion and withholds gender-affirming treatments on this basis. WPATH, ASIAPATH, EPATH, PATHA, and USPATH call attention to the fact that this “psychotherapeutic” approach, which was used for decades before being superseded by evidence-based gender-affirming care, has not been shown to be effective (AUSPATH, 2021; Coleman et al., 2022). Indeed, the denial of gender affirming treatment under the guise of “exploratory therapy” has caused enormous harm to the transgender and gender diverse community and is tantamount to “conversion” or “reparative” therapy under another name. This document reasserts the outdated “gatekeeping model” of access to gender affirming care.

The first citation I'm afraid widens the scope to exploratory approaches, first-line psychosocial interventions, and directly criticises the Cass Review on that basis.

This brings us to disagreement between MEDRS on a matter of the ethics of exploratory psychotherapeutic interventions - and Cass, as a high quality MEDRS, definitively supercedes many, if not all, of the other sources.

You cannot have your cake and eat it here. You cannot employ sources which attack first-line psychotherapeutic gatekeeping as tantamount to conversion, and then exclude MEDRS that say this is a harmful comparison to make.

And given all these sources it is clear this section should not be titled "gender exploratory therapy" but "exploratory therapy" since that is the only real unifying terminology. Void if removed (talk) 07:25, 6 June 2024 (UTC)

I think we should be careful about putting too much weight on one review here. I've said this before, but I don't believe the cass revieuw is the be-all end-all on this topic. also, it's not just WPATH, it is cosigned by four national organisations, and followed by four more sources. The Cass revieuw can supersede a lot, but we shouldn't tunnel-vision on it either. Especially not when it is being this cagey about a topic. --Licks-rocks (talk) 10:25, 6 June 2024 (UTC)

Citation 2 (which can be found in actual printed form here) says, in a discussion about what constitutes conversion therapy:

In fact, given the increased visibility of different sexual orientations and gender identities and expressions, efforts nowadays include clinicians gatekeeping life-saving hormonal interventions by encouraging clients to not commit to their transgender identity or initiate gender-affirming care until they are absolutely sure (sometimes euphemistically called “gender exploratory therapy”), or even ascribing transgender identity or asexuality to trauma (ashley, 2023).

So they are calling psychotherapeutic exploration that examines possible underlying causes of any kind "conversion therapy" and cite Florence Ashley as a basis.

This is not appropriate for a wikivoice claim that this is definitively true, when a MEDRS like the Cass Review says it is not. Void if removed (talk) 08:22, 6 June 2024 (UTC)

Just to be clear, that quote doesn't say 'examines possible underlying causes', it refers to encouraging clients to not commit to their transgender identity or initiate gender-affirming care until they are absolutely sure as gender exploratory therapy. I think if somebody already has declared a gender identity, then it would be qualified as a conversion attempt under most of the definitions.

If we are talking about therapy for gender dypshoria, that might not qualify as conversion therapy. Many people with dysphoria do not identify with a gender identity that is discordant with their natal sex. But this is a grey area. Zenomonoz (talk) 09:22, 6 June 2024 (UTC)

I was referring there to ascribing transgender identity or asexuality to trauma. This whole line conflates multiple things - but the cite to Ashley means this is referring specifically to the model described in Spiliadis 2019 which is explicitly an undirected model with no fixed outcome in mind.

The Cass Review cautions about the diagnostic overshadowing that results from an uncurious affirmative approach. Some youth presenting with gender distress do have underlying causes that, when properly explored by the individual themselves, resolves that distress, and sometimes this is trauma.

So yes, directed therapy with an intention of changing is unethical. But undirected exploration of the reasons behind someone's desire to transition is not. Dismissing up-front that someone's gender identity is definitively the result of trauma is unethical. Uncovering that it actually is a response to trauma as part of standard exploratory psychotherapy is not.

But, since that exploration can ultimately lead to desistance, it is being classed here as "conversion".

And that brings us back to the Cass Review, and clinicians being afraid to engage in exploratory psychotherapy that may result in desistance - even if it isn't intended or clinician-directed - for fear of accusations of "conversion therapy". Void if removed (talk) 09:57, 6 June 2024 (UTC)

You wrote: Some youth presenting with gender distress do have underlying causes that, when properly explored by the individual themselves, resolves that distress, and sometimes this is trauma – I do not think Cass review states this as fact. This is speculation. Nor do they claim that dealing with trauma alleviates dysphoria. As far as I am aware, Littman and ROGD proponents argue that a subset of young natal female individuals are transitioning due cultural ideas about gender, and that they are misinterpreting their mental anguish as evidence of dysphoria. If 'trauma' were causing gender issues, we would expect to see quite a lot of gender dysphoria in war zones and the rest. Regardless, I'd advise against stating this kind of speculation as fact. Plenty of psychological theories claim that 'trauma' causes 'X thing I don't like', but in large well designed studies, there isn't strong evidence for causality. Zenomonoz (talk) 10:10, 6 June 2024 (UTC)

I think we should watch not to argue back and forth about our own ideas and opinions (e.g. "If 'trauma' were causing gender issues, we would expect to see quite a lot of gender dysphoria in war zones and the rest.") If that's an argument against X then cite a good source saying that about X. We'll just end up filling this page with editors arguing about what they meant by "trauma" in that particular case, and not focusing on the article topic. What's the essentials for this page? There are a spread of opinions about how to treat trans children. Loosely we might characterise this at one end is being credulous about whoever walks through the door being trans and also that being trans means hormones and surgery, and the other end is actively preventing trans identities which are viewed as either inferior or mentally unwell or an abomination in the eyes of god or whatever. And varied opinions about what portion of children walking through the door have a certain and fixed trans identity. And almost zero evidence on the portion identifying as non-binary. It isn't really up to us to work out where the truth lies, and be cautious about offering any side's view as "fact". Reality seems to lie between the extremes (nothing like 100% of children referred to gender clinics go onto hormones as children and I don't think any serious expert thinks that should be the case) Both extremes in this culture war are over careless to describe their opinions as fact and to assert things with little or no evidence. We also need to be aware that political battles in this area mean writers at both extremes are unwilling to give an inch or accept there is nuance. Better sources are required or else say less. Don't just run with whatever low-level rubbish turns up on a google search.

Why is the sentence "The same month... endorsed by Cass" still in this article. The source is not reliable nor does the source mention Cass nor does the UKCP endorse what is being called GET and nor does Cass endorse what is being called GET. Allowing activists to take control of plain English words like "exploratory" is exactly the sort of problem that must be making clinical psychologists despair. Wikipedia isn't a trans activist blog any more than it is a gender critical blog. Both such activists use techniques like this (conflating a whole bunch of things into one thing that can be labelled BAD) which wouldn't be acceptable in either proper grown up journalism or in a medical journal. -- Colin°^Talk 13:39, 6 June 2024 (UTC)

I think we should watch not to argue back and forth about our own ideas and opinions – well you just wrote a giant paragraph of your own opinions. My comment was a brief "correlation is not causation" statement, clarifying that plenty of psychological ideas are "just so" stories that aren't supported by evidence of causality. Can we stick to WP:NOTFORUM. Zenomonoz (talk) 04:02, 7 June 2024 (UTC)

I do not think Cass review states this as fact.

I think if there's one takeaway from the Cass Review it is "we don't know", and that applies to a whole swathe of issues. The Cass Review states very little as "fact" but expresses extreme caution about proceeding with medical pathways given the paucity of evidence. Trauma and its possible contribution are discussed as part of the review, happy to dig out the passages if you like, but a neat summary is the figure on page 57 of the interim report which highlights how unresolved sexual abuse/trauma can be one possible presentation that can possibly end up at "Gender dysphoria resolved without transition" as part of the explanation of how complex presentations may have multiple different pathways.

What the Cass Review says is that the evidence base is not strong enough to rule any of this out. What critics say is that even considering other underlying factors may actually be at root of gender distress is conversion therapy. See one of the current citations:

GET is just conversion therapy by another name [...] Similarly, proponents of GET often point to issues such as unprocessed trauma, childhood abuse, internalized homophobia or misogyny, sexual fetishism, and autism as the “real” explanation behind one’s transgender identity, rather than accepting that a child who identifies as trans is sharing a real, deep, and even joyful truth about themselves.

If 'trauma' were causing gender issues, we would expect to see quite a lot of gender dysphoria in war zones and the rest.

This is overly simplistic. We're talking about complex psychosocial factors, not just "trauma results in gender dysphoria". Void if removed (talk) 14:15, 6 June 2024 (UTC)

one takeaway from the Cass Review it is "we don't know" – this is more moderate. I agree. The Cass review is mostly focused on the effectiveness of puberty blockers, not the cause of dysphoria. It includes a brief overview on speculative causal pathways, but it excluded topic experts, hence it gets rather speculative. Regarding trauma: children with gender dysphoria are atypical in other ways, and we know that children who veer from behavioral norms are more targets for abuse over other children. I.e. correlation is not causation.

What critics say is that even considering other underlying factors may actually be at root of gender distress is conversion therapy – well, the Slate source is not labelling all therapy for gender dysphoric youth as 'conversion therapy'. It's referring to a very specific subset of therapists who are demanding clients find an external cause (how the heck do they prove this?) and who are opposed to transition in nearly all cases. Mainstream psychology remains open minded to potential causes of dysphoria... it's the groups cited in that piece who are claiming they know (and it must be something bad!) and that they hold the solution.

The APA statement cites six studies and reviews, which have found that 'gender identity change efforts' (in this case, psychotherapy) are ineffective in treating dysphoria. Whether or not this will apply to a different cohort of transitioners (i.e. the more recent cohort of young natal females/AFAB) is an open question, and seems to be what the Cass review is concerned about. But for now, I think you'll simply have to wait until a clearer picture emerges.

Zenomonoz (talk) 05:02, 7 June 2024 (UTC)

The Cass review is mostly focused on the effectiveness of puberty blockers, not the cause of dysphoria.

This is simply untrue, the Cass Review looked at the entire epidemioloigcal, diagnostic and care pathway, and went far beyond just "blockers".

it excluded topic experts

No it did not.

The APA statement cites six studies and reviews

And doesn't say the word "exploratory" once, so I don't know why you mention it here. There's no debate that coercive attempts to "change gender identity" are unethical and don't work, that's not the problem.

This is all a total derailing of the point of this section.

The very first citation for the section on "gender exploratory therapy" establishing, in wikivoice, that it is conversion therapy, is one calling the Interim Cass Review and NHS service specifications tantamount to conversion therapy. This is a source editors have kept as a consensus for months. See further up this talk WRT WPATH's response to the interim Cass Review and NHS Service Spec:

WPATH considers GET to be conversion "conversion" or "reparative" therapy under another name. Per WP:MEDASSESS/WP:MEDORG, it is the most high-quality source we have discussed on GET, and settles the question of whether it's conversion therapy or not.

This source only says "exploratory therapy", and with specific reference to what is described by Cass.

Your interpretation of other sources and what they may or may not be referring to isn't relevant. Current editorial consensus here, supported by WP:RS is that what is described by WPATH as only "exploratory therapy" in the Cass Review and NHS Service Spec is "gender exploratory therapy", and also that this is the best quality source establishing it is "conversion therapy".

But the final Cass Review is a high quality MEDRS explicitly saying it is not conversion therapy and that the weaponisation of these terms is scaring clinicians and is harmful to vulnerable youth in need of the best possible care.

So - how to resolve this? None of this can be safely rendered in wikivoice the way it is at present, and the conflict and difference of opinion needs rendering, taking into account that there are no neutral terms and terminology is contested. Void if removed (talk) 09:06, 7 June 2024 (UTC)

Unless you're sitting on some massive chapter that somehow hasn't come up yet (which, fair, it's a long read, I might've missed it), the cass revieuw doesn't actually say that much about gender exploratory therapy.

As already established in your original comment, they don't actually talk about "gender exploratory therapy" at all! they talk about "exploratory approaches" which snokalok above already points out may or may not be the same thing, or a category including that thing. And the WPATH comment comes in the middle of a long series of related points establishing a pattern within multiple parts of the cass revieuw, striking me as more of a sidenote building up to a larger point (and indeed, the main point of that alinea is medical gatekeeping in general, not endorsement of gender exploratory therapy).

I think the cass revieuw being a MEDRS doesn't actually end up factoring into it all that much. All six sources under discussion fit the MEDRS label and we always need to look beyond the cover to establish due weight. I think the weight of the cass revieuw just doesn't weigh all that heavy here, due to the lack of on-topic content. Granted, I think the same goes for the WPATH&co. statement, but again, that's why we don't just cite to them, as you seem to keep implying. --Licks-rocks (talk) 11:23, 7 June 2024 (UTC)

Yeah, again, my intuition here is that Cass's comments aren't about the euphemism for conversion therapy, but about people who take the fact that it's a euphemism for conversion therapy to mean that anyone who does therapy about gender exploration is a conversion therapist. Loki (talk) 15:56, 7 June 2024 (UTC)

Genuine question, how is exploratory therapy supposed to work? You say But undirected exploration of the reasons behind someone's desire to transition is [ethical]. Dismissing up-front that someone's gender identity is definitively the result of trauma is unethical. A trans kid (let's say 16) comes into a clinic, knows they're trans, already socially transitioned, and is seeking medical transition. Just how much "exploration of the reasons behind someone's desire to transition" should be required before they can transition? Who gets to decide? When does the therapist say, "alright, we've explored everything, you're free to go"? What's stopping the therapist preventing their transition indefinitely?

For the record, there is no evidence GET is effective or helpful.[9][10] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:42, 6 June 2024 (UTC)

Void, your most recent comment includes sources which support my point. Cass review and others are arguing therapy for gender dysphoria (rather than gender identity) cannot necessarily be taken as a form of conversion therapy. Zenomonoz (talk) 09:39, 6 June 2024 (UTC)

When a "gender questioning" child is referred, in Europe at least, to a clinical psychologist, what is it that various bodies think that person should do. It clearly isn't "That's nice. Here's a referral to endocrinology for hormones". Only a minority of referred children go down that path as children. So when do we reach "conversion therapy" vs what clinical psychologists actually do for a living. -- Colin°^Talk 10:02, 6 June 2024 (UTC)

So when do we reach "conversion therapy" vs what clinical psychologists actually do for a living? When kids who are sure they're trans, have already socially transitioned, and wish to medically transition are made to go through an indefinite period of a therapist trying to make them explore "what made you trans? trauma? the internet? we have to look at everything before I say you're trans enough in my book to recieve medical care". The population is not, as you called them, "gender questioning" children being met with an immediate Here's a referral to endocrinology for hormones". As the infallible Cass Review said:

• 12.18 Clinicians have said that most children have already socially transitioned before reaching the specialist gender service
• 12.32 Early research cited in Chapter 2 found low rates of persistence of childhood gender incongruence into adulthood, around 15% (for example, Zucker, 1985). Papers from this period were criticised because the children were not formally diagnosed using ICD or DSM. At that time, it was rare for children to have socially transitioned before being seen in clinic.
• 12.33 Later studies, which showed higher rates of persistence at 37% (for example Steensma et al., 2013) did use formal diagnostic criteria, but by that time a greater proportion of the referrals had socially transitioned prior to being seen.

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:24, 6 June 2024 (UTC)

But we also have sources calling what the Cass Review is discussing conversion therapy, and criticising that fixating on a diagnosis of "gender dysphoria" is pathologising. These aren't different things. Void if removed (talk) 10:04, 6 June 2024 (UTC)

Also: the section is in the wrong place, it should be under "techniques". I'll move it down unless anyone has a good reason not to. Void if removed (talk) 12:11, 7 June 2024 (UTC)