Talk:Conversion therapy

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)

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[2]: 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[3]

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.[4] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:31, 5 June 2024 (UTC)

Just to note, Cretella is also executive director for ACPeds, so there's direct overlap between the leadership for ATCSI-formerly-NARTH and ACPeds. VintageVernacular (talk) 19:12, 11 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 was writing about "What's the essentials for this page" (as as far as trans conversion therapy is concerned). You were arguing on the internet with someone about whether trauma leads to gender distress. Not sure why you feel able to fling NOTFORUM at anyone. And we still have that "The same month..." sentence citing "Mother Jones" and putting internet gossip in wikivoice. -- Colin°^Talk 13:22, 12 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.[5][6] 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)

I was hoping for a reply that addressed the question. And any answer suggesting research from 2013 has much to say about the cohort presenting to childhood gender clinics in 2024 is missing reality. If only we could, you know, write an article about a medical therapy and what is and is not acceptable professional practice without having to argue that perhaps some nonsense claims in Mother Jones are wrong. Letting any old fool on the internet write about serious medical stuff is how we got all that MMR autism nonsense. It is frustrating to see Void above have to point out very basic errors like claims Cass "excluded topic experts" which is the sort of misunderstanding that comes when one's feed of information is activist bloggers. -- Colin°^Talk 13:39, 12 June 2024 (UTC)

I was hoping for a reply that addressed the question. Your question was based on a flawed premise, you said "gender questioning kids", while we are talking about "trans kids sure of their gender seeking medical transition".

So when do we reach "conversion therapy" vs what clinical psychologists actually do for a living. - when you presume that being transgender and wanting to transition is (or, likely is) a mental disorder due to trauma, and argue that trans kids medical care should be indefinitely placed on hold (possibly forever) while you "explore" the reasons you think the kid isn't "really" trans. If a "gender questioning kid" comes in and says "I don't know if I'm trans, I might be, I want to explore that" - nobody is just giving them hormones ffs. Nobody is against them being free to explore and supported in that. The conflation of "kids questioning their gender" and "kids sure of their gender" is precisely the kind of imprecise nonsense we are supposed to avoid.

The TLDR: the line is when you make indefinite "exploration" a nebulously defined requirement for people sure they're trans instead of a choice for those who actually want to explore whether they are.

Here are 6 MEDORGS stating that Cass endorsed "exploratory therapy" which they consider a form of conversion therapy.[7][8] There continues to be no evidence whatsoever that GET is beneficial or effective.[9][10]

Arguments here that "yes, there is a kind of conversion therapy called GET, pushed by organizations X, Y, and Z, AND Cass was criticized by MEDORGS for endorsing it BUT Cass endorsed a different GET that just happens to cite the definitions provided by X, Y, and Z. are silly.

• For the record, they are even sillier when you argue a MEDRS source is needed to say "members of X, Y, and Z were advisors to the review"[11] even thought WP:MEDPOP obviously applies: Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, financial, and historical information in a medical article.

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 14:56, 12 June 2024 (UTC)

guys, is this relevant? --Licks-rocks (talk) 15:15, 12 June 2024 (UTC)

Perhaps? I'm trying to stick to sources say. Can we all agree on these basic facts?

1. The Cass review says GET shouldn't be conflated with conversion therapy because it's not directed. Cass based this definition of Spiliadis 2019, a SEGM member who coined the term GET.
2. There is no evidence GET is effective or necessary or studies of it in action.[12][13]
3. Florence Ashley's piece directly notes it's comparison to "reparative therapy" and interrogates Spiliadis's definition: The attempt to distance and distinguish gender-exploration therapy from conversion practices is also familiar. After California banned conversion practices, Joseph Nicolosi wrote an essay claiming that his reparative therapy did not directly aim at altering same-sex attraction but, rather, encouraged inquiry and exploration into its underlying cause. The positive-sounding language of inquiry and exploration sanitizes his approach despite him viewing “most same-sex attractions as reparations for childhood trauma”[14]

   • VIR removed this and probably shouldn't have - the key point was the similarity of the "undirected exploration" narrative because that's exactly what NARTH peddled [15].

4. We have a bunch of reliable sources saying GET is conversion therapy pushed by SEGM/Genspect/GETA/NARTH, largely citing Ashley
5. We have sources saying exploration is already encouraged and allowed under the affirmation, just not mandatory sessions trying to find pathological roots for wanting to transition.
6. We have 6 medical organizations saying that Cass is endorsing GET, which is conversion therapy, also citing ashley.[16][17]

There seem to be 3 main ideas in the thread for how to handle this.

1. Some think the section should be rewritten on the grounds if Cass says GET isn't conversion therapy we can't say it is
2. Some think the section should note the Cass Review endorsed GET / said it shouldn't be called conversion therapy
3. Some think there is conversion therapy GET, and there is Cass Review GET, but agree there's no sources specifying they're different

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:23, 12 June 2024 (UTC)

Well it at least seems that Cass is in agreement about how GET is defined, and agrees about its definition, as laid out by a member of SEGM. So it's an idea about GET that comes from a group that is deeply involved in anti-trans advocacy, and has been classified by the SPLC as an anti-LGBTQ+ hate group.

Notably, SEGM seems to hold the view that the term "conversion therapy" is only applicable to sexual orientation, so by definition, they would reject the label of conversion therapy. This, of course, is not a mainstream view. Hist9600 (talk) 21:33, 12 June 2024 (UTC)

So what we have is:

• A four-year multidisciplinary review that came to conclusions which proponents of gender-affirming care don't like, favouring an exploratory approach and criticising the over-affirmative approach employed by GIDS, while also cautioning that equating exploratory therapy with conversion therapy is harmful to vulnerable youth and scaring ethical clinicians.
• The opinions of Florence Ashley - a strong proponent of zero-gatekeeping - which were only ever an expression that there are "similarities" between exploration and conversion, based on the (deliberately) obfuscatory language used by "reparative" therapists, being cited repeatedly by other sources as concrete equivalence, and thus presented here in wikivoice as definitively true.
• An independent statement from WPATH criticising Cass for endorsing gatekeeping and exploration.

VIR removed this and probably shouldn't have

The removed part was a definitive, wikivoice statement that A "psychotherapeutic” approach viewing gender incongruence as a mental health disorder or a state of confusion was used for decades, has not been shown to be effective, and was superseded by an evidence-based gender-affirming approach which is way, way overstating things, and the very conflict the Cass Review weighs in on, on the side of evidence and caution. This was making broad medical claims where the strongest MEDRS do not agree at all, and it was based on WPATH's response to Cass, exemplifying this dispute.

Cass is interrogating the whole basis for offering medical treatments to young people, ie what condition is being treated, how is it diagnosed, on what basis and are these even the best treatments, what is the safest and most effective holistic pathway for this group of youth.

But Florence Ashley argues that medical transition should be no more gatekept than contraception because there is no medical condition being treated.

These are irreconcilable viewpoints, and those with Ashley's perspective will always view any gatekeeping of medical transition as an attempt at "conversion". It simply arises logically from this different perspective.

I think we have a lot of reliable sources for stating the beliefs and strong opinions of people, but not reliable sources for factual, wikivoice statements that exploratory therapy is conversion therapy.

The existence of the Cass Review, as a MEDRS, weighing in on this topic to the contrary, means we should not be taking one "side" of this as definitive as the section currently does. At best, there is a clear difference of medical opinion over how exploratory/affirmative approaches are framed, given that all parties seem to be talking about the exact same things. Void if removed (talk) 11:17, 13 June 2024 (UTC)

The Cass Review is out of step with existing medical sources, and it is referencing members of SEGM, so we should be very careful there. Florence Ashley is a bioethicist who studies conversion therapy, and their research on the matter is important in the field, which is why other medical reliable sources may reference Ashley. Ultimately, Cass doesn't have a lot to contribute on this topic, as it just appears to parrot some views trying to say that GET is not conversion therapy, while using SEGM definitions of GET. The stance is the same as what SEGM also says. It just shows how closely Cass is aligned with the views of GET that come from SEGM / Genspect / GETA / Therapy First. Hist9600 (talk) 12:57, 13 June 2024 (UTC)

Florence Ashley is a bioethicist who studies conversion therapy

From the standpoint that gatekeeping is dehumanising, desistence is irrelevant, and puberty blockers are necessary.

Ashley's opinion is diametrically opposed to a neutral assessment of the evidence.

Cass is aligned with the views of GET that come from SEGM / Genspect / GETA / Therapy First.

So you now agree with my original point which is that the exploratory approach advocated by all those organisations are one and the same as what is put forward by the Cass Review, and which the Cass Review says is not conversion therapy.

So we have a MEDRS source saying it isn't conversion therapy and equating the two is harmful, a WPATH statement attacking that source saying it is "tantamount" to conversion, an opinionated essay saying it has "similarities", and a load of sources based off them.

Which means we should not be saying it definitively is conversion therapy, in wikivoice, but should make an effort to reflect what these different sources actually say. Void if removed (talk) 13:20, 13 June 2024 (UTC)

No, I see one source (Cass) that is closely aligned with fringe anti-LGBTQ+ groups on this issue, against the medical consensus. It says more about Cass than it does about other sources, not that Cass actually evaluated the effectiveness of GET, or bothered to do any actual analysis of it. Hist9600 (talk) 19:32, 13 June 2024 (UTC)

The removed part was not the thing I am talking about...

You changed Bioethicist Florence Ashley found that GET had strong conceptual and narrative similarities with previous conversion practices such as "reparative" and "reintegrative" therapy, noting they portrayed themselves as exploring the underlying psychological causes of same-sex attraction rather than directly aiming at altering it. to Commenting on gender exploratory therapy in 2022, bioethicist Florence Ashley argued it had similarities to conversion therapy.[18]

You took out 1) what specific historical form of conversion therapy she compared it to and 2) why. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 13:26, 13 June 2024 (UTC)

Ah I see, I misunderstood - I'll try and reword it. Void if removed (talk) 13:51, 13 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)

I agree with Void that Wikipedia cannot simply assume the idea that exploratory approaches are definitely conversion therapy is an undisputed truth. British doctors have come to a jarringly different conclusion to their American counterparts, as seen in the Cass Review and the statement from the UK Council for Psychotherapy last November. Two more sources defending an exploratory approach: D'Angelo 2018 and Spiliadis 2019. Even Florence Ashley, who opposes this approach, acknowledges that exploratory therapy is being presented as having a different goal to conversion therapy. Anywikiuser (talk) 16:39, 20 June 2024 (UTC)

Robert D'Angelo[19] is the president and a founding member of SEGM[20] He argues in that piece that Statements and bans on conversion therapy usually problematically merge gender identity with sexual orientation, which is misleading as these are very different constructs - a WP:FRINGE view as every medical org and human rights org agrees bans should cover both types of conversion therapy. He also says A priori assumptions, either that trans identification is always a healthy development or that trans identification is always pathological, violate this foundational principle - but there is an overwhelming consensus that trans identities aren't pathological. He's a political activist who has never worked in trans healthcare and has done thinks like argue in court that a 16 year old should be denied gender affirming care.[21]

Anastassis Spiliadis[22] is a member of the IATDD (a group founded by Lisa Littman, known for methodologically flawed research, to promote the ROGD hypothesis) alongside other founding members of SEGM/Genspect.

D'Angelo and Spiliadis are WP:FRINGE activists linked to pro-GET lobbying groups. Those sources you linked are from years ago, and all the medical orgs and human rights orgs which have said "GET is conversion therapy" have done so based on the definitions put forth by them.

Even Florence Ashley, who opposes this approach, acknowledges that exploratory therapy is being presented as having a different goal to conversion therapy. - I agree this should be better included since we have the sources to note that GET's proponents argue that GET isn't conversion therapy since it's undirected. As Ashley notes though, that is exactly what NARTH said about reparative therapy based on the same reasons.

• Descriptions of reintegrative therapy by people who offer it are reminiscent of how gender-exploratory therapy is described by its proponents. Clinicians promoting gender-exploratory therapy have notably insisted that the approach is “not the same as ‘conversion,’ as the latter implies a therapist agenda and an aim for a fixed outcome” (D’Angelo et al., 2021, p. 10) and emphasized that they “do not aim to change someone’s gender or sexuality related feelings but rather engage in a dialogue exploring the meaning-making around identity development” (Spiliadis, n.d.)[23]
• Proponents of gender-exploratory therapy acknowledge that some consider it a form of conversion practice, paradoxically resenting the suggestion while opposing bans on conversion practices on account that it would prohibit their approach. As for critiques of gender-exploratory therapy, they are presented as evidence of trans health care’s ideological capture. Yet a close comparison of gender-exploratory therapy and conversion practices reveals many conceptual and narrative similarities. How proponents talk about gender-exploratory therapy is nearly identical to how individuals offering conversion practices targeting sexual orientation frame their own work.

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 17:14, 20 June 2024 (UTC)

I agree with YFNS. The president of an anti-trans lobbying group, and a member of a lobbying group founded by the author of the most infamously sloppy research in the topic area, are not reliable sources here. Loki (talk) 18:25, 20 June 2024 (UTC)

This is circular.

They are described as "anti-trans lobbying group" by people who describe what they espouse as "conversion therapy" - and what they espouse must be "conversion therapy" because they are an "anti-trans lobbying group".

They insist it is not, and WP:RS agree. Calling Spiliadis WP:FRINGE when he is cited by Cass in the definition of what exploratory therapy is, is absurd.

There is a difference of perspective in MEDRS and absolutely none of the definitive claims should be in wiikivoice. Void if removed (talk) 08:31, 21 June 2024 (UTC)

I agree it is circular. Also, it is ad hominem, something that is all too common in debates on this fraught, polarised topic. If one must resort to ad hominem arguments, they at least ought to be factually correct. I pointed to two papers whose authors are not merely "activists"; they are both psychotherapists who have worked in gender medicine. Ironically, Spiliadis used to work at the Gender Identity Development Service, a clinic that was accused of being too cavalier in using the affirmative approach. Anywikiuser (talk) 09:38, 21 June 2024 (UTC)

You cite Cass for Spiladis being a RS, while Cass cites Spiladis for their one-sentence comment on exploratory approaches, which I remind you again doesn't even mention GET by name. In every discussion about this subject so far, I've never seen you deviate from your single-minded focus on what the Cass-report says. The Cass report is not god, and I would suggest you should take it deviating from every other RS as a sign that it might be wrong, instead of everything else. --Licks-rocks (talk) 10:51, 21 June 2024 (UTC)

You cite Cass for Spiladis being a RS

No, I cite this to demonstrate it is clearly not FRINGE, and using FRINGE in this hyperbolic way to exclude entirely legitimate sources is inappropriate and question-begging.

single-minded focus on what the Cass-report says

That is the subject of this current topic.

it might be wrong

It is not for us to say which is wrong - it is for us to give a neutral rendition of what reliable sources say. Void if removed (talk) 11:10, 21 June 2024 (UTC)

If you think a scientific article or other high-quality source can't support a fringe perspective I have a couple asteroid craters in Spain to sell you. The subject under discussion is GET, about which the cass report only barely even says one sentence, which we seem to have concluded is due for inclusion here but is way too short to do anything else with, and that brings me to my final point here, which is that my problem with you isn't that you refuse to rebut the Cass report, the problem is that you consistently, throughout multiple discussions now, refuse to seriously consider any other source, regardless of relevance, quality (WPATH guidelines come to mind), or DUE-ness. In short, I don't think responding beyond this point is a productive use of my time. --Licks-rocks (talk) 11:15, 21 June 2024 (UTC)

Ashley cites Spiliadis as a proponent of "gender exploratory therapy", whereas Cass cites him in defining "exploratory approaches", and Spiliadis proposes a "gender exploratory model" and several times in the paper uses the phrase "exploratory work". That's an example of how different exact wordings may be used for the same concept, though the use of "exploratory" is consistent. I don't think anyone disputes that "GET" and other phrases containing "exploratory" could be used as a cover for conversion therapy, but there's also clear evidence that it's being used for a concept of conducting a therapy with a different goal in mind. Anywikiuser (talk) 11:35, 21 June 2024 (UTC)

SEGM argues that conversion therapy has never been practiced on trans people (a FRINGE statement), lobbies against bans on conversion therapy (more fringe advocacy), lobbies against public funding for transition for adults (so spare the "think of the children" shtick, that's pure bigotry), and works with the American College of Pediatricians.

Even if SEGM didn't advocate it's own new form of conversion therapy, it would be FRINGE, so no, it's not circular to point out they're WP:QUACKS. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 12:31, 21 June 2024 (UTC)

There are two key NPOV problems here: 1) The wikivoice states that "Gender Exploratory Therapy (GET) is a form of conversion therapy". This is too strong a claim for the wikivoice given that other sources have, even when not using the exact same three words, have argued that "exploratory" approaches are distinct from conversion therapy (see UK Council of Psychotherapy in November 2023 and the Cass Review). As Cass notes, even proponents of the affirmation model argue that it can still include "exploring the meaning of that experience in a non-directive therapeutic relationship." 2) It barely says what proponents of exploratory therapy actually claim, even for the purposes of refuting them. Anywikiuser (talk) 20:09, 21 June 2024 (UTC)

1) The UKCP withdrew from the memorandum of understanding on conversion therapy signed by every other professional body in the UK. Their views are an outlier even in the UK. A sentence in the Cass Review does not outweigh the many sources saying it's conversion therapy, especially when many are specifically calling out the review on that basis

1.5) As Cass notes, even proponents of the affirmation model argue that it can still include "exploring the meaning of that experience in a non-directive therapeutic relationship." - we already note that the affirmative model already encourages exploration without making it a prerequisite for care

2) Yes we do. We note GET proponents claim it's not conversion therapy because it's an undirected exploration of why kids think they're trans. We note they believe that kids are identifying as trans due to trauma, autism, social contagion, and homophobia. We note who supports it. We note the proponents argue that bans on conversion therapy make it more difficult to practice GET. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:27, 21 June 2024 (UTC)

Therefore, it is incorrect to say that it is the unanimous, undisputed view of the medical community. Anywikiuser (talk) 10:25, 22 June 2024 (UTC)

We don't care about unanimity here, only consensus. A sufficiently strong consensus is equivalent to unanimity. Loki (talk) 15:07, 22 June 2024 (UTC)

Strongly condemning those who disagree is not the same as "strong consensus". It is pretty clear this is disputed, but sources which dispute it are continually (exhaustingly) accused of being WP:FRINGE, which is circular. Void if removed (talk) 15:15, 22 June 2024 (UTC)

Sourcing from an author so closely associated with SEGM / Genspect would be inappropriate. These are classified as anti-LGBTQ+ hate groups by the SPLC, and they generally oppose trans rights, and trans healthcare, and also oppose conversion therapy bans. Hist9600 (talk) 05:05, 23 June 2024 (UTC)

SPLCs designations have to be attributed, precisely because they are somewhat unreliable, hyperbolic and highly partisan. We don't have to afford this any weight when considering sources, especially when the claims are circular and non-independent like this, and wander into an area where MEDRS apples. Void if removed (talk) 07:39, 23 June 2024 (UTC)

The SPLC is very much green at WP:RSP. Attribution is for bias, not unreliability. Loki (talk) 12:07, 23 June 2024 (UTC)

And SPLC's biased opinion carries no weight when evaluating MEDRS. Void if removed (talk) 12:23, 23 June 2024 (UTC)

Ok but we don't go to SEGM and genspect because they're fringe and promote bad science like rogd (there's no evidence for it). Them being a hate group clearly shows they're biased and as Wikipedia editors we should be careful with what they say, but from a Medrs pov, they just don't care about science and only use it as a tool LunaHasArrived (talk) 12:25, 23 June 2024 (UTC)

Can you explain how citing Spiliadis (2019) is "going to SEGM and genspect"? Void if removed (talk) 17:22, 23 June 2024 (UTC)

I'd wager a guess and say it's because Spiliadis is an advisor of SEGM[24]...

Also, wrt And SPLC's biased opinion carries no weight when evaluating MEDRS.

• 1) MEDRS are pretty unequivocal that there is no evidence GET works or is necessary
• 2) MEDRS are overwhelmingly clear it's conversion therapy pretending not to be
• 3) We don't use the SPLCs designations in this article (though we should). We don't even use them to say GET is conversion therapy. We use them for relevant facts like the obviously anti-LGBT group the American College of Pediatricians supports GET and cites SEGM to do so.

• Friendly reminder that ACPeds directly recommends GET/GETA[25][26]

• 4) WP:PARITY says: The prominence of fringe views needs to be put in perspective relative to the views of the entire encompassing field; limiting that relative perspective to a restricted subset of specialists or only among the proponents of that view is, necessarily, biased and unrepresentative.

SEGM, Genspect, GETA, and the ACPeds continue to be fringe anti-trans groups and the fact they're the biggest proponents of GET matters Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:26, 23 June 2024 (UTC)

I'd wager a guess and say it's because Spiliadis is an advisor of SEGM

So Spiliadis' 2019 paper about the term he coined in 2017, written when he was a clinician at the Tavistock GIDS, is uncitable because Spiliadis went on to advise SEGM after it was founded in 2020. That's your answer? Void if removed (talk) 21:43, 23 June 2024 (UTC)

You asked Can you explain how citing Spiliadis (2019) is "going to SEGM and genspect"? I answered. As RS have noted for years, SEGM is a small group of quacks who make ridiculous claims (which he has also made, ie that trans people don't experience conversion therapy) and lobby against trans rights - his position there does make him less reliable.

More importantly: Spiliadis 2017 and 2019 are primary sources where he lays out a new approach: in 2019 he said I attempted to move away from current theoretical polarities around psychosocial support for gender questioning young people and invite the reader to a different approach, the Gender Exploratory Model.

His papers and model proposed therein have been extensively criticized by RS and medical orgs. Neither paper has any weight as neither are secondary or independent - GET is only notable because other sources discuss it. We weigh and discuss those, not the primary source. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 23:02, 23 June 2024 (UTC)

In fact this paper Says spiliadalis developed GET and cites this paper so it would be the most primary source. LunaHasArrived (talk) 23:16, 23 June 2024 (UTC)

As I noted at the start, Spiliadis 2019 is the originator of the term and the formalisation of the model.

That paper you cite is notable for its description:

Responding to the increased visibility of detransition journeys, another model has emerged: the exploratory approach. Developed by Anastassis Spiliadis in England, this approach acknowledges the uncertainty inherent in trans journeys and underscores the clinician’s responsibility in facilitating exploration before undertaking a transition (Spiliadis, 2019). While recognizing the importance of contextual understanding and the dynamic nature of gender for appropriate support (Ashley, 2019; Coleman et al., 2022; Wren, 2019), some critique the exploratory approach’s suggestion that exploration should precede transition (Ashley, 2019).

All this says is it is a proposed model that has been critiqued. It doesn't say it is illegitimate or "conversion".

I also think that's a strange final citation. It is Ashley 2022 that was the first direct critique of exploratory therapy.

Ashley 2019 however does contain lines such as:

From the premise that facilitating exploration should be our starting point in caring for trans and gender creative youth, puberty blockers must be seen as the default position, to be readily prescribed since they leave the largest space for future identity development and negotiation.

Which is of course completely at odds with the eventual findings of the Cass Review, and why Ashley is so opposed.

We're simply talking about fundamentally different models of what "best practice" looks like, and those in favour of affirmative-medical-transition-on-demand consider any psychotherapeutic gatekeeping to be "conversion therapy", while those who view it as essential in determining who would benefit from medical interventions, do not. Void if removed (talk) 08:49, 24 June 2024 (UTC)

"and why Ashley is so opposed" prove it. --Licks-rocks (talk) 10:50, 24 June 2024 (UTC)

Secondary/tertiary sources are things like systematic reviews, meta-analyses, textbooks and standards of care. A source that discusses something mentioned in another primary source doesn't make it a secondary source. Most of the sources here are either primary medical sources or popular press articles, which can be acceptable for a topic like this that probably hasn't been discussed directly in any secondary sources, but it is not true that we are excluding primary sources. Anywikiuser (talk) 23:18, 23 June 2024 (UTC)

And so I invite you to read once again my comment at the top of this section which states that the Cass Review notes this dispute, and warns against considering exploratory therapy to be conversion therapy.

Everyone has gone round the houses in this discussion and wound up right back at the start, which is to concede my original assertion which is that when all these sources are talking about exploratory therapy/exploratory psychotherapy/gender exploratory therapy/exploratory approaches they are all talking about the exact same thing.

Florence Ashley and WPATH have both likened this to conversion therapy (similarities/tantamount to), and other sources have subsequently cited them for these positions.

The Cass Review has said comparing it to conversion therapy is "harmful".

So this entire section should be rendered as a disagreement between MEDRS, with contested terminology.

What you keep trying to do is use ad hominem to exclude sources - directly or indirectly - and force one "side" of a real dispute between MEDRS into wikivoice. It is entirely inappropriate. Void if removed (talk) 08:33, 24 June 2024 (UTC)

Why not WP:DROPTHESTICK for a while. This thread is enormous now. Zenomonoz (talk) 08:47, 24 June 2024 (UTC)

This would not be a resolution. One possible way around is to replace the initial phrase by saying that "The denial of gender-affirming treatment under the guise of Gender Exploratory Therapy (GET)" is a form of conversion therapy. Anywikiuser (talk) 13:03, 24 June 2024 (UTC)

Do we have RS that use the term GET and doesn't refer to it as conversion therapy. We certainly have RS that use Gender Exploratory model but that's not one to one the same (as WPATH SOC 8 says that's a term with many different meanings). If not we have to say that GET is conversion therapy (although I'd be happy to suggest that the part saying that GET is not gender exploration by itself should become more prominent in the section). LunaHasArrived (talk) 13:44, 24 June 2024 (UTC)

That's the heart of the issue, that intentional GI conversion therapy disguised as "exploration" should not be confused with the concept of gender exploration that (as Cass notes) even some proponents of the affirmative model consider an acceptable practice as part of a care pathway. Anywikiuser (talk) 15:18, 24 June 2024 (UTC)

Your problem there is that you'd have to remove the citation to WPATH's criticism of the interim Cass Review, because that says "exploratory therapy" is tantamount to conversion therapy.

And this also means you're disagreeing with other editors (and the currently cited sources) that these are all the same thing.

You then have to reconcile that these sources all reference Spiladis 2019, but so does the Cass Review, in defining "exploratory approaches".

You then have to reconcile any source (like the Mother Jones article) which states Cass endorses "gender exploratory therapy".

And if you take out WPATH-attributed claims, none of this carries any MEDORG weight at all, making the highest MEDRS source on this subject the Cass Review.

The limitation you're trying to achieve won't work, and IMO the only feasible way through is to present this as the clear difference of opinion about ill-defined and contentious terms that it is, by stating what the Cass Review says about the use of these terms.

Because the heart of the dispute is that proponents of the affirmative model do not think that access to medical transition should be behind psychotherapeutic gatekeeping, and proponents of an ethical exploratory model think it should, and proponents of conversion therapy will call whatever barbarism they practice by whatever euphemism sounds palatable. Void if removed (talk) 08:18, 25 June 2024 (UTC)

The RS's say that GET is a term used by (seemingly almost exclusively) conversion therapists as a euphemism for denying any care indefinitely. Some go further and criticise individual documents (or people) for promoting this whilst not actually using the term GET (see WPATH on interim Cass). Cass (full) seems to be worried that people are thinking you can't have both a medical pathway and psychological interventions (as a side effect of this, affirmative Vs exploratory approach) but wants kids to have time to explore their gender and not feel 'pushed' down any pathway. WPATH SOC 8 says affirmative model and exploratory model are undefined terms. Is any of the above incorrect?

Based on this Wikipedia should say GET is a form of conversion therapy and is characterised by a denial of care. That gender exploration shouldn't be confused with GET. Then there's any details about organisations or documents Wikipedia should or shouldn't include.

Our current section does the above pretty well (I might argue the not confused with bit could be placed better, but it's alright) I fail to see where the npov problem with the entire section comes from. LunaHasArrived (talk) 11:17, 25 June 2024 (UTC)

Based on this Wikipedia should say GET is a form of conversion therapy and is characterised by a denial of care.

But "gender exploratory therapy" as described by Spiliadis (2019) and reflected in Cass' citation of it and others as an "exploratory approach" is not that at all.

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).

What you put forward is overly simplistic and if that were all there was to it, there wouldn't be this disparity between Cass and WPATH. You're trying to draw a distinction that does not exist and that the cited sources do not themselves draw.

What Cass advocates is considered by WPATH tantamount to conversion therapy, which makes Cass' insistence that it is not a direct conflict between MEDRS, and one that absolutely should be reflected. And Cass' interpretation of Spiliadis (2019) carries more weight than Ashley (2022), which is foundational to this entire section.

Nothing here should be in wikivoice, it has to be a difference of attributed opinion only. Void if removed (talk) 12:13, 25 June 2024 (UTC)

Sorry Cass (full) doesn't mention Gender Exploratory therapy or Exploratory therapy anywhere so it's impossible to say that Cass supports that definition of GET. Cass uses Spiliadas once in a glossary for a definition they use (being generous and just searching the word exploratory) 4 times in the actual text. It seems like your and anywikiuser's arguments aren't convincing anyone. I'm going to drop the stick here and I'd recommend you do the same. LunaHasArrived (talk) 13:19, 25 June 2024 (UTC)

Adding this new paper which is an explicit response to Ashley (2022), which - again - rejects the idea that exploratory therapy is conversion therapy.

According to Ashley, conversion practices include not only direct attempts to change a person’s gender identity or gender expression, but any form of psychotherapy that examines possible causes of a person’s gender related distress or leads to any delay in medical transition

To resolve the POV issues, I propose:

• Open with a statement like The role and nature of psychotherapeutic approaches to treating gender dysphoria is controversial.
• Describe Spiliadis (2019) as proposing "gender exploratory therapy" as a name for undirected therapy for gender dysphoria with no fixed outcome in mind.
• Describe Ashley (2022) as critiquing this as reminiscent of conversion or reparative therapy
• Describe the evolving conflict between the affirmative/exploratory model as exemplified by the disagreement between WPATH and the Cass Review, with WPATH claiming Cass' endorsement of exploratory approaches are tantamount to conversion, and the Cass Review stating that comparing exploratory therapy to conversion is harmful.
• Add attributed claims from eg. Caballero saying it is conversion therapy, and attributed claims from this new paper directly responding to Ashley saying it is not
• Note eg. Mother Jones' reporting of usage of term "exploratory therapy" euphemistically by some gay conversion practitioners
• Stop using the abbreviation "GET" as if it is a singular coherent defined practice that everyone agrees is the same, when various sources use gender exploratory therapy, exploratory therapy, exploratory approaches, exploratory psychotherapy, ethical exploratory approaches, and now (in this new paper) psychodynamic psychotherapy for gender dysphoria, and it is clear they are all discussing the same thing and responding to/accusing/criticising each other of various degrees of bias and misrepresentation
• Retitle the section "Gender exploratory therapy controversy"

Void if removed (talk) 08:52, 28 June 2024 (UTC)

That's a perspective piece (opinion), so let's look at the credentials of the author:

• 1) her total published contributions to transgender healthcare are 3 letters (including this one) to the editor citing SEGM/GENSPECT/GETA to argue that trans healthcare is bad and ROGD is real.
• 2) She signed a letter by the Foundation Against Intolerance and Racism (a culture war advocacy group) arguing the American Academy of Pediatrics gender-affirming care textbook should be recalled because it's biased and activistic. If you want to play the fun game of how many board members of indisputable conversion therapy advocacy orgs like ACPeds, NARTH, and the IFTCC signed it - I counted 4 at a glance (upwards of a dozen if you include SEGM/GENSPECT/GETA members known for publicly campaigning against gender-identity conversion therapy bans or arguing trans people have never experienced conversion therapy).
• 3) We do have an actually strong source, Decoding the Misinformation-Legislation Pipeline: an analysis of Florida Medicaid and the current state of transgender healthcare, which states: According to Florida Medicaid, Littman (2018) is one of multiple studies to introduce “additional subtypes of gender dysphoria” (in this case, ROGD) [23]. It is not clear which studies outside of Littman’s 2018 article do propose additional subtypes, as--at this time--no such studies exist in the peer reviewed literature outside letters to the editor, specifically by Sinai et al (2022), Littman (2022), and Hutchinson et al (2020) [26 - 28]. Rather, the only published original research that follows up on Littman’s 2018 study on ROGD “...did not find support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence” [29]. In other words, the existence of ROGD is unsupported in current research.[27]
• 4) Our duty, an org whose explicit goals banning transition for those under 25, banning public healthcare for trans healthcare, and making desistance ("no longer identifying as trans") the "stated goal of treatment" for young people believes that she's a reliable source and cites her in anti-trans legislation[28]
• 5) I've exhausted anything close to relevant expertise of hers

In short, this is an incredibly weak and biased source and doesn't justify any of the changes you present here.

P.S., as an aside, Cretella straight up uses "gender exploratory therapy", not the shortened version, and NARTH always practiced conversion therapy on trans people too.[29] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 10:04, 28 June 2024 (UTC)

Generally in agreement. We should not bring WP:FRINGE views into the article and misrepresent them as viable and important mainstream views, or present the matter as "controversial" on that basis. Especially when those weak sources are known to be closely aligned with known anti-trans advocacy groups. Wikipedia should not lend prominence to fringe views and pseudoscience on the topic of conversion therapy. Hist9600 (talk) 03:14, 29 June 2024 (UTC)

NPOV tag

Void if removed added a NPOV tag to the GET section a while ago[30] and discussion here died down, do the other editors agree it's needed? There seems to be a clear consensus there is a form of conversion therapy labelled GET pushed by practioners of conversion therapy. RS are clear it exists, and specifically call out it relies on the reparative therapy trick of it's not conversion therapy if it's undirected exploration of what trauma made this person gay trans. And international medical consensus is that being transgender is not a mental health issue. We really only have one source saying it's not, the Cass Review, and per the article the fact they endorse GET has been a subject of major criticism. There are very weak sources, commentaries and primary sources, from WP:FRINGE lobbying groups that argue GET isn't conversion therapy. GET is supported by many conversion therapy orgs like NARTH and the IFTCC. Some thought they are talking about different things both labelled GET, but per all the sources they are talking about the same GET.

@Void if removed, @LokiTheLiar, @Hist9600, @Colin, @VintageVernacular, @Licks-rocks, @Snokalok, @Zenomonoz, @Anywikiuser, @LunaHasArrived - do you believe a NPOV tag is necessary? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 18:22, 23 July 2024 (UTC)

I disagree that even the Cass Review endorses GET, as opposed to therapy that encourages exploration of gender, no euphemisms. Which is to say, no I don't think the tag is appropriate. Loki (talk) 18:26, 23 July 2024 (UTC)

I do not believe an NPOV tag is necessary Snokalok (talk) 18:26, 23 July 2024 (UTC)

My earlier posts are still on this page. This is political game playing. Your comments about medical consensus is not representing how youth gender clinics actually work, in Europe at least. There is no medical consensus that 100% of youth referrals to gender clinics, which are all psychiatric clinics in Europe, must immediately write out a referral to endocrinology and surgery, and anything short of doing that is GET/conversion therapy. This is some new invented nonsense by activists who can't accept a middle ground as that is giving an inch to US politicians. Actual reality is complex and nuanced and this silly Mother Jones piece is just trash activist journalism. -- Colin°^Talk 20:32, 23 July 2024 (UTC)

That is a strawman, please stop accusing everyone who disagrees with you of playing politics.

There is no medical consensus that 100% of youth referrals to gender clinics, which are all psychiatric clinics in Europe, must immediately write out a referral to endocrinology and surgery - nobody has said there is. WPATH doesn't even endorse this. This is a boogeyman.

GET - what we're taking about, is characterized by indefinite mandated "exploration" of "what trauma made you want to transition" while delaying all medical options. It is pushed by a few small conversion therapy groups. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:59, 24 July 2024 (UTC)

I don't think the NPOV tag is needed. We shouldn't allow tags to linger if there is no consensus that there is an issue that needs to be addressed. And we definitely should not allow tags to linger if the objections are based on fringe views and pseudoscience from anti-trans advocacy groups. Hist9600 (talk) 23:10, 23 July 2024 (UTC)

I think Void described the problem well elsewhere. That essentially you have one side who thinks every single child referred to a gender clinic is trans, and is trans in a way that requires cross-sex hormones and put on the waiting list for surgery when 18, and anyone who delays that should be in prison. And the other side who thinks no child is trans, that they are all deluded by the cult of gender ideology, and anyone forcing hormones and surgery on mentally ill children should be in prison. Neither side, it seems, think nonbinary people exist or forget they exist. Both side say "Don't listen to the other side, they are a fringe advocacy group, expounding a dangerous ideology". Meanwhile actual scientists and actual medical professionals are doing their job in a way that bears no resemblance to what either side claim is going on or should be going on. We have a problem that both sides are writing terrible terrible sources that are no better than rants in the Daily Mail for their level of fact checking and accuracy. How we got into a situation where some activist blogging in their bedroom is considered more reliable than systematic reviews in medical journals is deeply troubling to me from a MEDRS point of view.

I do not think for a moment Cass endorses conversion therapy. They have said so themselves and there's no indication they are a dishonest person or ignorant of what that means. They fully agree a trans life is not an inferior life or a second best choice, that hormones and surgery have a place. Wiser people than the Mother Jones authors, people who do actually know their stuff because its their job, are working out how best the psychiatrists should handle this group (and despite what YFNS keeps saying, it is psychiatrists) when they are referred gender questioning children. There will be a law banning trans conversion therapy in England and Wales, the Labour government committed to it in the King's speech the other day. Scotland has been consulting on the wording of such a law for they have their own legal system. Clearly this will also be compatible with the Cass recommendations, though there is anxiety that if badly worded it is so vague in scope no psychiatrist would want to work in that field. I have no doubt the concerns of both sides will be addressed in a way that makes both sides not entirely happy but could we leave the details and nuance of that all to professionals rather than trash magazine writers.

What we currently have in the article is hyperbolic claims by one activist side. It doesn't need tagged. It needs removed. -- Colin°^Talk 07:45, 24 July 2024 (UTC)

I would agree that some of the stuff Currently in the article is hyperbole. I heavily disagree that the entire section is activist hyperbole. There are groups of people out there performing conversion therapy under the name of GET (no evidence of recommending anyone go to endocrinology and their measure of success is people being happy with not transitioning), this phenomenon has a place in this article. I honestly think the only problem with the section is the statement "recommended by the Cass review". LunaHasArrived (talk) 09:06, 24 July 2024 (UTC)

Frankly I don't see how you can square yours and Loki's this has nothing to do with Cass perspective with YFNS comment at the top of this section which is adamant about the relevance. If you think that, you need to remove all the sources which direct their criticism at the Cass Review, which in particular means WPATH.

And you need to deal with the fact that Cass references Spiliadis, and so does Ashley - and virtually all the sources cite Ashley - so either they're talking about the same thing or they aren't.

And as for hyperbole you need to deal with the fact that the currently cited MEDRS are far more equivocal than currently implied by this section ("likened to", "tantamount to", "it seems doubtful" etc).

I see no substantive effort to deal with that so far or any of the issues I've raised, and conflicting opinions in this section already. Void if removed (talk) 09:26, 24 July 2024 (UTC)

From memory Cass barely mentions GET by name. WPATH criticised interim Cass, Final Cass used Spiliadas as a reference for a glossary (for a term barely used in the full report). It seems likely that Cass may have taken this criticism on board for the final report. LunaHasArrived (talk) 09:42, 24 July 2024 (UTC)

It seems likely that Cass may have taken this criticism on board for the final report.

This is pure speculation when quite the opposite seems to be the case, since Cass specifically criticised the conflation of exploratory approaches with conversion, as WPATH did.

And both the interim and final Cass cited Spilliadis in the same way.

And note that current citations like this reference both Spilliadis and Ashley, and talk about a "gender exploratory model of care" and "exploratory model". None of this terminology is as neat or as definite or separable as editors would like it to be. Void if removed (talk) 10:22, 24 July 2024 (UTC)

Cass is not a significant source for this page, as we've already seen. It contains no more than passing reference to this topic. People end up speculating about what it means by exploratory therapy, but it's not really relevant, because the review contains practically nothing about this topic. Hist9600 (talk) 14:58, 24 July 2024 (UTC)

I repeat:

I don't see how you can square yours and Loki's this has nothing to do with Cass perspective with YFNS comment at the top of this section which is adamant about the relevance. If you think that, you need to remove all the sources which direct their criticism at the Cass Review, which in particular means WPATH.

I don't see how sources explicitly criticising Cass are relevant, but Cass isn't. Please explain. Void if removed (talk) 15:23, 24 July 2024 (UTC)

Cass has so little on this topic, and what it does have requires interpretation. If someone has sources that provide meaningful interpretation / analysis, then that source may be due. But using Cass directly require novel interpretation / analysis from editors, which should be avoided. Hist9600 (talk) 19:22, 24 July 2024 (UTC)

For the record, here's

• PATHA saying Cass endorsed GET[31], covered in RNZ[32] and the Gay Times[33]
• WPATH/ASIAPATH/EPATH/USPATH/PATHA saying Cass endorsed GET[34]
• Here's a peer-reviewed paper on the Cass Review heavily criticizing its endorsement of GET[35]
• Here's a piece in the Guardian noting a Tavistock staff member said Cass's recommendations are pushing GET.[36]

Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:29, 24 July 2024 (UTC)

• PATHA says that a number of people involved in the review ... have promoted non-affirming ‘gender exploratory therapy’, which is not saying that the review itself does.
• WPATH et al say that the interim report endorsed GET, which is not saying that the final report does.
• The Horton paper is concerned about the Cass Review's support for "non-affirmative" therapy in general, and does not at any point say it endorsed GET per se. In fact, it comes the closest to saying what I'm saying, in that it distinguishes between gender exploration within an affirmative approach and so-called “exploratory therapy” offered by non-affirmative practitioners who do not regard trans identities as valid
• The Guardian article is about the interim report, which is again not the final report.

Loki (talk) 23:09, 24 July 2024 (UTC)

How does everyone feel about just removing the fact the Cass Review supported it to remove the NPOV tag? I'll note that Cass Review links here and one of it's heaviest criticisms has been it's endorsement of GET, but we can leave that for the Cass Review article. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 21:16, 24 July 2024 (UTC)

Presenting sources in such a way as to leave out the relevant fact that they are directed at the Cass Review in order to avoid dealing with what the Cass Review says on this subject isn't NPOV. Void if removed (talk) 21:40, 24 July 2024 (UTC)

Believe me, I think the Cass Review should be mentioned here, but so far we have:

• a clear consensus there are conversion therapists practicing under the cover of GET and the section is due in the article
• no consensus that Cass/everybody else are talking about the same thing (though they are)
• absolutely no consensus to rewrite the section to say "sources disagree on if GET is conversion therapy" considering how many conversion therapists support it

If you want to propose a rewrite of the sentence mentioning Cass that leaves everyone happy, I'm all ears. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:03, 24 July 2024 (UTC)

I'm fine with this. Loki (talk) 23:20, 24 July 2024 (UTC)

I would be fine with that as well. But if there are reliable sources saying that the Cass Review does support it, then those may be relevant. Depending on the sources, attribution may be appropriate. Hist9600 (talk) 03:39, 25 July 2024 (UTC)

I have collated 20 sources in a table here

These are sources either currently cited or that have been discussed on talk. I may have missed some, but it should be the major ones.

It is useful to sort by date to see the evolution of this from Spiliadis' original case study, to Ashley's opinion on it, to increasing polarisation and hyperbolic/definitive claims in a variety of sources.

I've tried to tag each source whether I think it is MEDORG, MEDRS, RSOPINION etc, I've probably got these wrong so input here is welcome.

I have indicated whether a source is currently cited in this article, and also whether I believe the text of the source supports a wider interpretation of this section, either because it uses language other than strictly "gender exploratory therapy" (eg. exploratory approaches, exploratory psychotherapy) or because it directly references Cass or Spiliadis.

By my count, of those 20, 14 support an interpretation that goes beyond simply "gender exploratory therapy" and encompasses other terms and the Cass Review, of which 6 are already cited on this article (ie, fully half the relevant citations).

Notable excluded sources are The Cass Review, UKCP, Spiliadis, D'Angelo and Sinai. The rationale for their exclusion has varied from:

• They are not relevant (which I dispute, by a reading of even just the currently cited sources)
• They are WP:FRINGE (which I dispute, as the basis for that is a circular argument and largely relies on hyperbole from PARTISAN sources like SPLC).

I also note that much of the language is opinion, and caveated ("critics consider", "tantamount to", "said", "my view" etc) and does not support the bold wikivoice claims being made.

I think at this stage if you seriously want to argue this only and strictly about "gender exploratory therapy" and claim the Cass Review is not relevant, you need to remove the following citations:

• Ashley 2022 (Interrogating gender exploratory therapy)
• WPATH statement on Cass
• Erin Reed (Xtra Magazine)
• MacKinnon et al 2023
• SPLC's CAPTAIN report
• Pauly and Carnell (Mother Jones)

At which point you a) lose the strongest MEDORG source and b) call into question all the MEDRS that cite Ashley 2022.

And in any case I don't think deliberately selecting sources in that way would result in NPOV. Void if removed (talk) 10:09, 25 July 2024 (UTC)

1) most of what you labelled RSOPINION is just RS (the SPLC continues to be an RS and not a SPS)

2) Spiliadis, D'Angelo and Sinai are indeed FRINGE, we've extensively discussed on this page how they're tied to FRINGE lobbying groups that would still be FRINGE if not mentioning GET.

3) Rewriting this to say GET isn't conversion therapy is a non-starter, you've been crusading to change it for months and consensus disagrees with you.

4) I just removed the pov tag per the consensus it's not needed, I also removed the sentence on the UKCP and Cass since it's obviously contentious. If you want the Cass review and UKCP to be included, please propose a version you'd be ok with. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:32, 25 July 2024 (UTC)

Thanks, this is an improvement. Generally in agreement about some of those sources being fringe, and we shouldn't waste time and space revisiting them. Hist9600 (talk) 18:08, 25 July 2024 (UTC)

SPLC continues to be an RS and not a SPS)

It is an SPS. They wrote it and published it themselves. That's the definition of an SPS. And given the note on WP:SPLC your continued use of them as an authoritative source on subjects well out of their wheelhouse is inappropriate. The biased opinion of a highly partisan US-based lobbying group does not override MEDRS, least of all internationally.

To demonstrate the problems with this section and the continued refusal to cite Spiliadis, here's what Mackinnon et al says:

The gender exploratory therapy model is characterized by required, in-depth talk therapy over an extended period of time in an attempt to foster an understanding of underlying factors that may be contributing to gender-related distress [41]. Proponents argue that this approach is developmentally-informed while also enabling clinical discrimination between gender dysphoria and mental illness prior to facilitating medical/surgical interventions [41,42]. Practitioners of gender exploratory therapy also often view medical transition as a last resort availed to patients only after judicious therapy and evaluation [42]. To date, known practitioners of this model primarily work clinically with children and adolescents [43], however Spiliadis [42] states that gender dysphoric children, adolescents, and adults alike could benefit from gender explorative therapy. [...] To date, there are no known empirical studies that examine psychosocial or medical/surgical outcomes following the gender exploratory model of care and some authors have raised questions regarding its clinical practices. For instance, this model has been likened to gender identity conversion therapy given that some practitioners avoid using clients’ affirmed name and pronouns, while aiming to question trans identification in children and adolescents [44]. However, Spiliadis’ differentiates the exploratory model from identity conversion therapy, stating that practitioners of the former are advised to acknowledge patients’ gender identities, and to collaborate with them without any active guidance toward a specific identity or outcome [42].

This citation presents all of the problems you, Loki, and Hist6900 refuse to grapple with, namely:

• It cites Spiliadis, whose terminology is "gender exploratory model", so we know that's what we're talking about (which therefore brings in Cass, which also cites Spiliadis and is talking about the exact same thing)
• It does not treat Spiliadis as FRINGE (and nor does Cass)
• It couches language in a far more balanced way ("has been likened to" is VERY different to "is", and Spiliadis' explanation of the distinction is included)
• It uses multiple overlapping terms, including "exploratory model", as juxtaposed with the "affirmative model" (which again brings in Cass, because this is not just about the specific phrase "gender exploratory therapy", but is exactly the exploratory/affirmation contrast Cass addressed)

MacKinnon et al is one of the stronger citations on the page, as it is an actual study and not just an opinionated essay published in a journal, and - IMO - this passage above gives a very clear indication of how we should be presenting this subject, and the language that should be used.

Rewriting this to say GET isn't conversion therapy is a non-starter, you've been crusading to change it for months and consensus disagrees with you.

Please see upthread for what I've been reasonably proposing, which is balance and a description of the various perspectives, ie that some say it is and others say it depends what you mean but you shouldn't conflate ethical psychotherapy with conversion. All perspectives need to be fairly represented, as in MacKinnon et al, which you cite, especially when different sources mean different things with overlapping terms.

Editors keep insisting that sources that aren't about "gender-exploratory therapy" aren't relevant, but of the sources on this page, only seven talk only about "gender-exploratory therapy", with the rest using broader terminology. McKinnon brings in multiple terms. Note that the direct quote from the actual conversion therapy advocate in the Mother Jones piece uses the terms "change therapy" and "exploratory therapy".

“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.’”

The highest authority source in this section WPATH's direct response to the interim Cass Review, which also doesn't even say "gender exploratory therapy". How do you justify neither the Interim Cass Review nor the Cass Review being relevant given that citation? How do you justify selectively including some sources which use broader terminology, while excluding others as "not relevant" when they use the same terminology?

Snipping Mother Jones' reference to UKCP and the Cass Review is not a suitable solution to the clear POV issues. All the Mother Jones piece does is confirm what I have said for months, which is that the Cass Review is relevant. I know you accept it is relevant, you've said so. I agree. The solution is not to exclude the most relevant sources to preserve a particular POV, but to neutrally render what RS say. The selective interpretation of sources that actually use multiple terms or snipping the parts of the Mother Jones article that bring in Cass is very clear WP:CHERRYPICKING, which violates NPOV by selectively presenting one point of view from available reliable sources that actually support two or more points of view that may conflict with each other. Void if removed (talk) 12:30, 27 July 2024 (UTC)

I support the statements made here - Cass, and the UKCP statement, seems very relevant. To remind ourselves on UKCP: after validating the exploratory approach they are very explicit:

• "exploratory therapy must not be conflated with conversion therapy which seeks to change or deny a person’s sexual orientation and/or gender identity. Conversion therapy as so defined is harmful and must not be practised".

Peckedagain (talk) 22:32, 19 August 2024 (UTC)

Because it fails the Duck test - if something looks like conversion theory, sounds like conversion theory and smells like conversion theory, then it's probably conversion theory. A different name doesn't change that (which is why this discussion had ended several weeks ago with no consensus for inclusion). Many worldwide experts have called it what it is, as has been explained above in the thread. Repeating the same argument over and over is why we have behavioral guidelines. Raladic (talk) 22:39, 19 August 2024 (UTC)

It is not for you to apply the duck test yourself, it is for you to stick to what reliable sources say. And accusing an editor of IDHT for their first contribution on this talk is inappropriate. Void if removed (talk) 07:48, 20 August 2024 (UTC)

I'll add that your comment here is at odds with your argument here. If you think that simple mentions of "exploratory therapy" and comments from the Cass Review about conversion therapy are relevant to establish an in-quote link in an other article to this section on "gender exploratory therapy", then you should be consistent in arguing that relevance here, where the majority have argued against it, even removing material about Cass to that effect. I think that your argument that this article justifies a link to this section means the whole perspective that the Cass Review and sources about "exploratory therapy" are relevant. I don't think you can have it both ways. Void if removed (talk) 08:56, 27 August 2024 (UTC)

Pending or proposed (yellow) category on the map

It's obvious that yellow "pending or proposed" category on the map is pure WP:CRYSTAL and must be removed. Cyanmax (talk) 18:41, 25 July 2024 (UTC)

not to be confused with "Transgender hormone therapy"

@LunaHasArrived Since both are "therapy" related to transgender topic and the names do not contain information about their differences, doesn't it merit a template:distinguish there? --by Huhu9001 (talk) at 15:10, 28 July 2024 (UTC)

I'm not seeing much evidence of this confusion, outside of TERFs intentionally misusing the term to paint trans people as being misguided or groomed into transitioning. However, the OED [37] defines one sense of the term as GAC, attributing this to a 1967 journal misusing it in the same way; "Apparently an isolated use". I think we may as well have a hatnote to get ahead of that. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 15:18, 28 July 2024 (UTC)

I largely agree with this, I think a full disambiguation is unnecessary. I'm honestly not sure how someone looking for THT would end up here rather than at THT. LunaHasArrived (talk) 15:40, 28 July 2024 (UTC)

New Source (Metanoia apology coverage)

Over on this talk, in the past few weeks this source has been argued several times as referring to to this subject by @Raladic, @Snokalok, @RoxySaunders, @DanielRigal, @Your Friendly Neighborhood Sociologist and @LokiTheLiar, eg this from YFNS:

By my count, me, Raladic, DanielRigal, RoxySaunders, Snokalok, and Loki think we should link exploratory therapy to gender exploratory therapy,

I note this source does not say "gender exploratory therapy" anywhere, so it raises again the question: are sources that simply say "explorative therapy" or some variant - in the obvious context of relating to gender - relevant? If so, this undermines some of the prior argument for excluding several notable WP:RS.

I also note that the point of this source is that:

• A student was expelled for a petition saying that "explorative therapy" might end up caught in a gender identity conversion practices ban
• Metanoia fully apologised, and both that apology and this Guardian source supports as a matter of general principle the validity of the professional belief that children with gender dysphoria should be treated with explorative therapy, rather than being affirmed towards medical intervention
• The Cass Review: She noted that medical professionals were nervous about being accused of “conducting conversion therapy if … they take a cautious or exploratory approach”

I think the treatment of this source calls into question the consistency of what YFNS described as no consensus that Cass/everybody else are talking about the same thing (though they are)

I think if you're going to make strong arguments this source is relevant, you really have to accept the Cass Review is too, and I think this is something better decided here rather than another page. Arguing that this source justifies a link to this section (because it is allegedly about this subject) while excluding the substance of this source (that Metanoia thinks exploratory therapy is entirely valid, and Cass' warnings about clinicians fearing being accused of conversion therapy for exploratory therapy) makes no sense.

And in that light, I question how sound this action was:

How does everyone feel about just removing the fact the Cass Review supported it to remove the NPOV tag?

When this story provides yet more secondary coverage that it is actually relevant.

The best and highest quality definition of what is referred to as "explorative therapy" and "exploratory approach" in this article - which many editors now insist is relevant - is that in the Cass Review:

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).

Void if removed (talk) 18:29, 9 September 2024 (UTC)

I think that there might be a distinction between what we all know that they are talking about and what we can actually demonstrate with Reliable Sources. We can't say things in articles that are not covered in reliable sources, even if anybody with two brain cells knows exactly what they mean, but we also can't be breaking our backs bending over to find tortured excuses to split hairs that have not been explicitly split by Reliable Sources. It is not our job to invent excuses or deflections on their behalf. "Gender exploratory therapy" is uncontroversially recognised as a form of conversion therapy. The term was coined to try to hide, or delay recognition of, that fact. We are already in the realm of deliberate bad faith terminology so we have to be careful. Could there be something completely different called "exploratory therapy"? I guess so? That would be terrible bad luck though. If there are Reliable Sources to prove that there really is a completely different thing which, purely coincidentally, has a similar name then the Reliable Sources have it. If not, I think Occam's Razor applies. "gender exploratory therapy" is a bit of a mouthful and is extremely likely that people might shorten the name, even when not seeking to be deceptive. As yet, nobody has proposed a specific alternative meaning for "exploratory therapy" and I think that they would have if there was one.

Please indulge me in an analogy. If you see an article about "Trump" then your first thought is that it is about the former President of the USA. You might read a little further and discover that it is actually about Mary Trump but not until you see the name "Mary". If you are reading material about Presidents of the USA and it says "Trump" then it would be perverse to assume it meant anybody other than the former President. Similarly, if you are reading material about gender and the phrase "exploratory therapy" comes up then it can safely be assumed to mean "gender exploratory therapy", with all the implications that carries, unless it explicitly provides some other meaning. DanielRigal (talk) 19:11, 9 September 2024 (UTC)

As yet, nobody has proposed a specific alternative meaning for "exploratory therapy" and I think that they would have if there was one.

I quoted the Cass Review definition in the comment you're replying to, which is derived from and cites Spiliadis (2019).

Similarly, if you are reading material about gender and the phrase "exploratory therapy" comes up then it can safely be assumed to mean "gender exploratory therapy"

So you agree that the Cass Review is talking about the same thing? Because the entire point is that this is controversial, but all the sources that point out this is controversial are excluded from this page.

In her review, Cass said professionals supporting young people with gender incongruence or distress were “overshadowed by an unhelpfully polarised debate around conversion practices”. She noted that some medics were afraid of being accused of conducting “conversion therapy if, again, they take a cautious or exploratory approach” and some clinicians expressed “fearfulness about what colleagues might say if they speak up and express an opinion that is not consistent with theirs”.

A good thought experiment is how would this section look if it was produced only from MEDRS.

I wrote a suggestion here for how this would look, using only MEDRS/MEDORG sources, in date order, including the ones that have been wrongly excluded from this page, and directly quoting the equivocal language from the ones that are used (ie, "similarities" and "tantamount") instead of the current strong wikivoice claim.

We should be basing this from the ground up on the best sources, and there is no good reason not to cite Cass. Void if removed (talk) 08:50, 11 September 2024 (UTC)

@Void if removed his website links to Genspect and GETA, which RS identify as the pushers of this nonsense. Some of the things linked there, such as Our Duty, have stated desistance should be the explicit goal of therapy for trans kids, called to end public healthcare for all trans people, and banning trans healthcare for those under 25. [38]

This man is painfully obviously a fringe conversion therapy pusher.

My position is consistent. Even if we assumed Cass is talking about something else, Esses would still obviously be a conversion therapy advocate.

I continue to maintain this article should mention the Cass Review and the fact it's been criticized for pushing conversion therapy. I disagree with your assessment we have to rewrite the section to say "it isn't/might not be conversion therapy because Cass said so". Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 19:15, 9 September 2024 (UTC)

I mostly agree with DanielRigal here. "Gender exploratory therapy" and similar is often used as a euphemism for conversion therapy. But it's also possible to go to a therapist to explore your gender identity in a not-conversion-therapy way. The main difference is whether the therapist in question is supportive of trans identities or whether they try to discourage the patient by means of constant questioning whereby being trans can never be the correct answer.

Obviously there is no way to fully disentangle this terminology, so some parsing of the terms in context is necessary, the same way it's often necessary for a bunch of other terms. If I came across an LBJ speech where he was talking about "the war" I would usually assume he meant the Vietnam War, even though he was also responsible for a policy agenda called "the war on poverty". Some contexts might make me change my mind but other contexts would make me even more sure he meant Vietnam.

In this particular case, I'd normally assume that the words "gender exploratory therapy" in that order mean conversion therapy, because people who mean the other thing usually don't make a clear distinction between it and other reasons one might go to therapy. James Esses is strongly associated with anti-trans groups, so when he says it he almost certainly means the euphemism for conversion therapy. The authors of the Cass Review are sort of an ambiguous case, but just based on the way they talk about it I'm inclined to give them the benefit of the doubt. Loki (talk) 20:52, 9 September 2024 (UTC)

I agree with what others are saying. These statements are not in a vacuum, taken in the context of the subject matter, “exploratory therapy” obviously refers to gender exploratory therapy.

If so and so in Eugene Oregon said he underwent what he called “exploratory therapy” for his depression, that’s different, but in the context of gender dysphoria, trans rights, and psychosocial approaches, “exploratory therapy” is an obvious reference to “gender exploratory therapy”

Also, Metanoia fully apologized not because it’s not conversion therapy, but because support for such is a legally protected belief under British law.

I also fully disagree with rewriting this section because a highly criticized report by the British government said it was okay to practice. I’m perfectly okay with including the nervousness quote somewhere though. Snokalok (talk) 01:35, 10 September 2024 (UTC)

How often do we use settlement apologies as Medrs? LunaHasArrived (talk) 08:08, 10 September 2024 (UTC)

How often do we use reports from the Southern Poverty Law Centre to decide MEDRS are FRINGE? Void if removed (talk) 08:16, 10 September 2024 (UTC)

We don't, void. Not ever. This comes across to me as a mean-spirited jab at hist900 above, but even then that's not what they said at all. --Licks-rocks (talk) 08:59, 10 September 2024 (UTC)

Studies

• some individuals do become skilled at ignoring same-sex attractions and go on to lead ‘outwardly heterosexual lives’, however this appears to be less common among those who were not to some degree attracted to members of the opposite sex (for example, bisexual in orientation) prior to change efforts.[39]

I need help deciding how to incorporate this APA quote in the article.

Unwanted same-sex attraction has reportedly been diminished with talk therapy (but only for adult volunteers). Uncle Ed (talk) 19:08, 5 October 2024 (UTC)

ABA in lead

@Laurier: I just undid your expansion to the introduction, for a couple of reasons.

1. It created an ungainly mess of a sentence, ending a list with subclause and parenthetical. Particularly up front, we want s more straightforward read ing.
2. It interwove ABA and aversion therapy in a way that may or may not be accurate (I'm no expert), but that we do not do within the body of the article. The introduction is supposed to be a summary, and in the article, we have a section on aversion therapy but the only mention of ABA is not in that, but in the GICE section with no further explanation. The introduction is not the place to be synthesizing those two things.

What you want to say may well have a place in the article, but if so, it should appear in relevant portions of the main body, not the introduction. -- Nat Gertler (talk) 17:44, 20 November 2024 (UTC)