Talk:Irreversible Damage

ROGD in the body

Can we add the following to the Background section? Much of this content has been in the lead for a long time without corresponding content in the body.

The contentious concept of rapid-onset gender dysphoria, which Irreversible Damage endorses, was first proposed in a 2018 paper by Lisa Littman. ROGD is not recognized as a medical diagnosis by any major professional institution and is not backed by credible scientific evidence.

References

Firefangledfeathers (talk / contribs) 18:57, 30 July 2023 (UTC)

Seems reasonable to me. Loki (talk) 20:46, 30 July 2023 (UTC)

This analysis and history lesson isnt related to the book --FMSky (talk) 21:22, 30 July 2023 (UTC)

It's mentioned in the book itself and by reliable sources covering the book. Firefangledfeathers (talk / contribs) 21:51, 30 July 2023 (UTC)

It is not neutral or accurate to say that ROGD is "not backed by credible scientific evidence". I documented above on this talk page what the sources actually say. You are cherry-picking a source. Besides that, it's not about the subject of this article. That debate can happen at the linked page. Just say that the book supports the idea. Cuñado ☼ - Talk 22:28, 30 July 2023 (UTC)

You presented some evidence above, and multiple editors tried to point out the errors. We have your disputed primary source analysis clashing with the statements of reliable secondary sources. The very short statement about ROGD, a focus of both the book and coverage of the book, is very due here. Not mentioning the mainstream view would be an NPOV violation. Firefangledfeathers (talk / contribs) 22:34, 30 July 2023 (UTC)

You are misrepresenting sources. Cuñado ☼ - Talk 22:37, 30 July 2023 (UTC)

Please don't accuse editors of misrepresenting sources, especially when they do not appear to be misrepresenting sources. Sideswipe9th (talk) 22:53, 30 July 2023 (UTC)

All the sources and evidence “supporting” the concept of ROGD are incredibly biased, coming from transgendertrend.com and similar sites. She only interviewed the so-called ROGD kids’ parents, who already believed their kids had ROGD. In conclusion it is quite safe to say ROGD is not backed by any real sources. Jacksfilms enthusiast (talk) 18:41, 12 June 2024 (UTC)

I'm still not quite sure why content on ROGD was removed from the lead given how much of the book's premise it is based on, as well as the resulting criticisms of the book, but yes we should at minimum be mentioning this in the article's body if we weren't already. Sideswipe9th (talk) 22:56, 30 July 2023 (UTC)

It wasn't removed from the lead, but the two bits about ROGD were split apart. I'd favor some reassembly. Firefangledfeathers (talk / contribs) 03:10, 31 July 2023 (UTC)

Huh, for some reason I thought the outcome of the Big ol' bundle o' refs discussion was that it was removed from the lead. Otherwise yes, I would suggest that we should keep the two bits of text on ROGD together. When this was discussed back in August 2022, the two bits were kept together in order to comply with WP:FRINGE and WP:MEDSCI. I don't really see any arguments here, or in the discussion from January as to why this wouldn't still be the case. Sideswipe9th (talk) 01:28, 1 August 2023 (UTC)

For the record, I'm agnostic to content, not to standards. GMG^talk 01:37, 1 August 2023 (UTC)

• Considering it's one of the critical topics of the book, it's rather weird it wasn't in the body before this. Your summary and sources, especially since they are sources on the book itself and not separately on ROGD, seem good for that. I have no idea what Cuñado is talking about above. All of the high level sources and scientific commentary on the subject of ROGD, including in that article proper, are very clear on it being an unsubstantiated and refuted hypothesis verging on outright pseudoscience (particularly in its usage in popular culture separate from scientific evidence). Silverseren^C 02:07, 6 August 2023 (UTC)

  Agree entirely with Silverseren. Red Fiona (talk) 10:42, 6 August 2023 (UTC)

• FYI, I posted about this at the NPOV noticeboard about 12 hours ago. The thread is WP:NPOVN#Irreversible Damage. Firefangledfeathers (talk / contribs) 13:18, 6 August 2023 (UTC)

Yes, this passage is reasonable and is clearly what the sources relevant to the book say. Barnards.tar.gz (talk) 15:12, 29 August 2023 (UTC)

Above in #Lead description I described the issue in detail, and I'd be happy to repeat the arguments and sources here if needed. The issue is pretty straightforward and the activists that came here to trash the author are misrepresenting sources and violating NPOV pretty openly, regardless of what the chat sounds like. Cuñado ☼ - Talk 18:54, 6 August 2023 (UTC)

I see you're once again calling people who disagree with you "activists", further showcasing that you shouldn't be editing in this topic area at all. Silverseren^C 19:06, 6 August 2023 (UTC)

I'm not calling people who disagree with me activists, I'm calling people who are openly violating core content policies, "with a specific ideological, religious, political, national or other agenda" who are putting "the goal of promoting their views above that of improving the encyclopedia", activists. Cuñado ☼ - Talk 20:07, 6 August 2023 (UTC)

Cuñado, if you have behavioral issues to discuss, ANI is thataway ––>. I'm sure you will have no trouble convincing the community if there is indeed tendentious editing going on here as you claim. However for the time being there does appear to be a rough consensus for FFF's addition. I'm persuaded as well, especially since WP:FRINGE requires us to identify fringe beliefs wherever we discuss them in article space. That guideline trumps other competing concerns such as e.g. WP:COATRACK, which is after all only an essay. Generalrelative (talk) 21:08, 6 August 2023 (UTC)

Generalrelative I think you're missing the point of the content dispute. The source you inserted is a self-described blog to support a statement that a theory is not backed by any "credible scientific evidence". The actual statements from the original researcher and medical organizations are more along the lines of "there is not enough evidence to endorse it and it needs further study".

Sources on ROGD

Littman's original article: "Emerging hypotheses include the possibility of a potential new subcategory of gender dysphoria (referred to as rapid-onset gender dysphoria) that has not yet been clinically validated and the possibility of social influences and maladaptive coping mechanisms. Parent-child conflict may also explain some of the findings. More research that includes data collection from AYAs, parents, clinicians and third party informants is needed to further explore the roles of social influence, maladaptive coping mechanisms, parental approaches, and family dynamics in the development and duration of gender dysphoria in adolescents and young adults."

When the article was revised, the same conclusion reads: "ROGD appears to represent an entity that is distinct from the gender dysphoria observed in individuals who have previously been described as transgender. The worsening of mental wellbeing and parent-child relationships and behaviors that isolate AYAs from their parents, families, non-transgender friends and mainstream sources of information are particularly concerning. More research is needed to better understand this phenomenon, its implications and scope."

The WPATH statement: "a proposed clinical phenomenon that may or may not warrant further peer-reviewed scientific investigation... WPATH asserts that knowledge of the factors contributing to gender identity development in adolescence is still evolving and not yet fully understood by scientists, clinicians, community members, and other stakeholders in equal measure... WPATH encourages continued scientific exploration within a culture of academic freedom, not censorship."

The AusPATH statement: "“ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings... AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship.

The Bauer article: "We did not find support within a clinical population for a new etiologic phenomenon of rapid onset gender dysphoria during adolescence... Similar analyses should be replicated using additional clinical and community data sources.

The statement you re-inserted into the article is someone's misrepresentation of the status of ROGD, published on a blog. Cuñado ☼ - Talk 01:32, 7 August 2023 (UTC)

published on a blog Nope. Per WP:SBM, Science-Based Medicine is a generally reliable source, with a credible editorial board and a robust set of editorial guidelines.

You've been a bit selective with your eliding in your quotations.

• The WPATH statement also states The term “Rapid Onset Gender Dysphoria (ROGD)” is not a medical entity recognized by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD).
• The AusPATH statement likewise contains The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD).
• And the Bauer article states This putative phenomenon was posited based on survey data from a convenience sample of parents recruited from websites, and may represent the perceptions or experiences of those parents, rather than of adolescents, particularly those who may enter into clinical care.

When we look at what the WPATH and AusPATH statements actually say, it's pretty clear. ROGD is not a recognised diagnosis by any major medical organisation. As for the lack of credible scientific evidence, the CAAPS position statement published in 2021 stated There are no sound empirical studies of ROGD and it has not been subjected to rigorous peer-review processes that are standard for clinical science. In the time since that statement was published, there have been three papers published; the November 2021 paper by Bauer (quoted above), an August 2022 paper by Turban et. al, and a March 2023 paper by Turban et. al. All three have found evidence that runs counter to the ROGD hypothesis. And to my knowledge, to date there have been no researchers independent of Littman who have found any evidence in support of the theory. Sideswipe9th (talk) 04:03, 7 August 2023 (UTC)

And this is all plainly exhibited in our ROGD article. Cuñado seems to very much be promoting a WP:FRINGE position here. Silverseren^C 04:06, 7 August 2023 (UTC)

Thanks for pulling this together Sideswipe9th. I'll add that calling for more research (or "scientific exploration") shouldn't be read as any kind of endorsement. It's some of the most boilerplate language there is in science/medicine. We have an article on the cliché. Firefangledfeathers (talk / contribs) 04:13, 7 August 2023 (UTC)

"ROGD is not a recognised diagnosis by any major medical organisation."

Well obviously. Because it is a social contagion. Not a medical diagnosis.No one said it was. Except people denying its real. 75.143.54.190 (talk) 19:48, 20 June 2025 (UTC)

I think that text was a good and necessary addition. When the main thing the book is about is X (as discussed by RS), and the main thing about X is that it's not credible/credited (as discussed by RS), and RS about the book point that out, it'd frankly be undue (arguably profringe) for the article to leave it out. If anything, the current wording is a bit too wishy-washy and could stand to be even more to the point. -sche (talk) 15:42, 9 August 2023 (UTC)

Thanks -sche. I'm in agreement with you about how we're characterizing ROGD. We had a RfC about the wording a year and a half ago that ended in no consensus. I'm not sure that enough has changed since then to try again, but I'm not opposed. Firefangledfeathers (talk / contribs) 17:06, 9 August 2023 (UTC)

You're pretty much just describing textbook SYNTH. We don't go to Animal Farm and include a bunch of otherwise unrelated sources about husbandry, to make sure readers have the broader context of why Boxer is being carted away to be turned into glue. Context about slaughtering horses to make glue should go on the main article for Adhesive.

If sources about the book cover it, then we use the sources covering it in the context of the book. The only reason we're having this discussion is because it feels politically timely and topical in popular culture in a way that horses and glue don't. But it doesn't matter. It's the same principle. If we're using sources generally and not sources about the subject of the article, then that is our own original research. GMG^talk 10:51, 10 August 2023 (UTC)

And I'm not sure it's worth mentioning, because it's been a staple of this talk page, but I still very much get the impression that I'm the only one here who actually read the daggum book. GMG^talk 10:57, 10 August 2023 (UTC)

Re If sources about the book cover it, then we use the sources covering it in the context of the book. So we're in agreement that the added text about the book, which is cited to references about the book, is good? As I said, we include it if [...] RS about the book do, and the RS cited above do. -sche (talk) 12:58, 10 August 2023 (UTC)

I'm not sure what specific text you are referring to. I've been off working on a bunch of random stuff and arguing with a COI account for a logistics company. But in general yes, as I said above, I'm agnostic to content, not to standards. Using sources not about the subject is original research. If it's relevant, we are not the ones who decide that, the sources are. Ours is to simply follow their lead. GMG^talk 13:49, 10 August 2023 (UTC)

The debate here is not whether ROGD is credible or not, it's whether that statement belongs in the first paragraph of this article, which is about a book. The first sentence already describes ROGD as "controversial" and links to the ROGD article which contains criticisms. The second sentence is unnecessary and is hurting NPOV. Fnordware (talk) 16:49, 6 September 2023 (UTC)

The second sentence is required by WP:NPOV (and the WP:FRINGE guideline which builds on it). Anytime we mention ROGD we need to make clear to the reader that it is not an accepted medical diagnosis. In this case that's the first paragraph. Failing to do so would be WP:FALSEBALANCE. Generalrelative (talk) 17:05, 6 September 2023 (UTC)

No we do not. A simple mention of ROGD is not an endorsement of it, does not require a rebuttal. It is already described as "controversial" which is an accurate and neutral description. Fnordware (talk) 06:10, 29 September 2023 (UTC)

@Firefangledfeathers: would you care to respond to the very reasonable objections expressed here? Zacwill (talk) 15:19, 20 September 2024 (UTC)

I think my position here is pretty clear, as it was in prior discussions here and here (among other prior discussions). I'd rather not just trade assertions without engaging in discussion about actual sources. Are there new ones that might shift the consensus here? Is there a new argument to be made about the existing sources? Firefangledfeathers (talk / contribs) 15:26, 20 September 2024 (UTC)

As Fnordware said above, we're not talking about the reliability of the statement – we're talking about whether it belongs in the first paragraph of the article. The sources are irrelevant. Zacwill (talk) 15:40, 20 September 2024 (UTC)

I may have misinterpreted Fnordware's "A simple mention of ROGD is not an endorsement of it, does not require a rebuttal." I understood that to mean he was in fact questioning the reliability of the statement. Are you concerned primarily with placement in the first paragraph? Your edits removed it from the lead entirely. Firefangledfeathers (talk / contribs) 16:01, 20 September 2024 (UTC)

I don't think it belongs in the lead at all. It's enough to note that the concept of ROGD is "controversial" and then include more detailed commentary in the body of the article. Note that the statement I removed also appears more or less verbatim in the Background section. Zacwill (talk) 16:59, 20 September 2024 (UTC)

Zacwill, you are correct, and I think there is consensus to change it. Cuñado ☼ - Talk 20:31, 20 September 2024 (UTC)

There was never consensus to change it and I can't believe you're still beating this dead horse a year later. Silverseren^C 21:06, 20 September 2024 (UTC)

Maybe I should have said, there is not consensus to keep it. Cuñado ☼ - Talk 15:54, 24 September 2024 (UTC)

The lead line is a shortened version of the relevant body content, which is as it should be. I don't think noting that ROGD is "controversial" is sufficient; I think it's especially important to pair biomedical-adjacent, fringe-adjacent ideas in conjunction with the mainstream view. Also, MOS:CONTROVERSIAL gives some reasons why "controversial" is not preferred as a stand-alone descriptor. Firefangledfeathers (talk / contribs) 02:56, 21 September 2024 (UTC)

revert

How, exactly, are you justifying this revert? Cuñado ☼ - Talk 19:16, 7 August 2023 (UTC)

As I said in the edit summary, per the rough consensus in this section. There is a rough consensus for the version that Firefanglefeathers drafted, which I restored. Sideswipe9th (talk) 19:37, 7 August 2023 (UTC)

Cuñado, don't you have the framing backward? What justification would you put forward for your bold edit? At a glance, it looks like you replaced the content we (roughly) agreed upon above with content that is cited to sources that are not about the book. Firefangledfeathers (talk / contribs) 19:40, 7 August 2023 (UTC)

Hello, I have reverted your change. It seems that there is a loose consensus that the tag is unwarranted. If you disagree, then please work with the other editors to arrive at a new consensus. Thank you. Hist9600 (talk) 00:46, 8 August 2023 (UTC)

Author Link

The author has a Wikipedia page, which should be linked to in this article. — Preceding unsigned comment added by 80.187.120.202 (talk) 06:48, 11 April 2024 (UTC)

 Done, thanks! Firefangledfeathers (talk / contribs) 13:09, 11 April 2024 (UTC)

Book's misgendering of its subjects

I am discussing the following edits: (tagging involved editors Cuñado, Ezra Fox):

Show diff contents

• 21:55, 7 February 2025  Ezra Fox (talk | contribs): (Previously it said people "characterized" this as misgendering. That is misleading, it is misgendering, as in it fits the exact definition of what misgendering is. I think my edit here is mildly sloppy, maybe I'll tighten it up later or others can feel free to.)

  −

  There were several boycotts aimed at the book which characterized it as [[anti-trans]] and its use of "she" to refer to teenagers identifying as [[transmasculine]] and [[non-binary]] as [[misgendering]].

  +

  There were several boycotts aimed at the book which characterized it as [[anti-trans]] and took issue with its use of "she" to refer to teenagers who identified as [[transmasculine]] and [[non-binary]].

• 16:11, 9 February 2025  SreySros (talk | contribs): (ce, tighten prose)

  −

  There were several boycotts aimed at the book which characterized it as [[anti-trans]] and took issue with its use of "she" to refer to teenagers who identified as [[transmasculine]] and [[non-binary]].

  +

  There were several boycotts aimed at the book which criticized Shrier's [[misgendering]] of the book's [[transmasculine]] and [[non-binary]] subjects and which characterized the book as [[anti-trans]].

• 21:32, 10 February 2025  Cuñado (talk | contribs): (Undid revision 1274849274 by SreySros (talk): don't put the criticism in wikivoice)

  −

  There were several boycotts aimed at the book which criticized Shrier's [[misgendering]] of the book's [[transmasculine]] and [[non-binary]] subjects and which characterized the book as [[anti-trans]].

  +

  There were several boycotts aimed at the book which characterized it as [[anti-trans]] and took issue with its use of "she" to refer to teenagers who identified as [[transmasculine]] and [[non-binary]].

I am perplexed by the desire to tiptoe around Shrier's treatment of her subjects as use of "she" to refer to teenagers who identified as transmasculine and non-binary. There is a (simpler, cleaner) term for precisely that: misgendering. Use of this term is not criticism -- there is no dispute among the sources (or by the book itself, for that matter) as to whether Shrier does misgender her subjects. In fact, it's clearer, as the boycotts were not just about Shrier's use of "she", they were also about other forms of misgendering, such as refering to her subjects as "girls".

Use of the term misgendering is a neutral description of the book's treatment of its subjects. Proponents of the book (and the author herself) would simply see this misgendering as a positive thing. To be clear, I favor the following language: There were several boycotts aimed at the book which criticized Shrier's misgendering of the book's transmasculine and non-binary subjects and which characterized the book as anti-trans. Srey Sros^talk 17:44, 24 February 2025 (UTC)

As far as I can tell, the sources in the relevant section don't actually focus on misgendering either way, and in fact don't really describe boycotts per se but rather retailers taking the book down in response to backlash.

So what I would rephrase this as is The book was harshly criticized for repeating anti-trans medical misinformation. Several retailers refused to sell it in response to these criticisms. Loki (talk) 19:00, 24 February 2025 (UTC)

I would be happy with that, I didn't like it before because it said she was "accused" of misgendering, which is nonsensical, so I removed it. She did misgender, before it made it sound like that was up for debate. But I didn't want to be controversial with my edit. However I would be happy with your or Loki's version. Ezra Fox🦊 • (talk) 23:56, 24 February 2025 (UTC)

@LokiTheLiar Ah yeah you're right, that does stick to the sources better -- I made the mistake of trusting the WP coverage and misremembered what the boycotts were about. I support Loki's over mine as well. Srey Sros^talk 18:06, 25 February 2025 (UTC)

The book was harshly criticized for repeating anti-trans medical misinformation: that wording is putting a criticism in wiki-voice, and it doesn't reflect the majority of reputable sources. The hypothesis of the book is that there is a social hysteria causing an unnatural increase in natal females identifying as other-than-women during adolescence. It's very hard to describe that while adhering to the norm among some circles that self-identification of gender at any stage must be backfilled to their birth. It's accurate that she was criticized, so word it in a way that doesn't make the criticism stated as fact. Cuñado ☼ - Talk 19:42, 25 February 2025 (UTC)

The very first paragraph of this article is:

Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, published by Regnery Publishing, which endorses the controversial concept of rapid-onset gender dysphoria (ROGD). ROGD is not recognized as a medical diagnosis by any major professional institution nor is it backed by credible scientific evidence.

I don't think repeating the same (well-sourced) criticism a second time in different words makes it less true. Loki (talk) 07:55, 26 February 2025 (UTC)

Either way, we definitely don't use editorializing language like "harshly". GMG^talk 13:27, 26 February 2025 (UTC)

harshly is an accurate descriptor, but has a negative connotation. A word like forcefully or severely would also be accurate while having a more neutral connotation Ezra Fox🦊 • (talk) 23:37, 26 February 2025 (UTC)

I'm fine with either of those. Loki (talk) 00:18, 27 February 2025 (UTC)

We would generally use none of these modifiers unless that is the language the sources use. We don't take it upon ourselves to come up with colorful descriptions. GMG^talk 18:33, 27 February 2025 (UTC)

Remember WP:Wikipedia is not a reliable source, and this is a good example why. Referencing another page making the same error does not justify bad writing on this page. Cuñado ☼ - Talk 05:10, 3 March 2025 (UTC)

I am referencing the first paragraph of this page. Please read more carefully, both the talk page and the article itself. Loki (talk) 06:15, 3 March 2025 (UTC)

Revise assessment to conform with recent medical developments

The framing of this wikipedia article should be rewritten to conform to recent developments in the treatment of children with gender dysphoria. While support for the ROGD hypothesis is still not very substantial, research is increasingly suggesting that the central message of the book, that children are being «hurt» (for lack of a better term), might in fact be more accurate than the framing of this wiki suggests. Following events like e.g. the Cass review in the UK, there has also been a crackdown on gender-confirming treatment and administering of puberty blockers to children.

The contents and framing of this wiki has thus not aged very well, and the focus should be moved from the current status of whether or not ROGD is true (arguably a nitpick), to whether the central message of the book holds up. DJHellduck (talk) 07:01, 25 June 2026 (UTC)

The Cass Review has been overwhelmingly rejected, debunked, and discredited by every major medical organization outside of the UK. The only orgs outside the UK that have at all sided with the Cass Review are the health departments of far right governments whose people are appointed by said far right governments. Snokalok2 (talk) 07:03, 25 June 2026 (UTC)

To my knowledge, the Cass review has not been rejected, debunked and discredited by every major medical organization outside the UK. DJHellduck (talk) 08:20, 27 June 2026 (UTC)

Then I would suggest reading the supporting sources on the relevant Wikipedia articles that demonstrate this. We had very well-attended RfCs on the topic. Simonm223 (talk) 14:01, 22 July 2026 (UTC)

While there exists a small fringe that supports the ROGD hypothesis, the prevailing scientific consensus continues to be that the ROGD hypothesis is without merit. I would take great care not to conflate changes in public policy or polling with changes to the evidence base. HenrikHolen (talk) 15:31, 25 June 2026 (UTC)

I don't think these comments are accurately reflecting the consensus. For example, the article Gender dysphoria in adolescence: examining the rapid-onset hypothesis concludes:

In summary, it becomes clear that neither prematurely adopting ROGD as a valid explanatory model nor its hasty condemnation as transphobic is an appropriate response. It is hard to deny that Littman’s research has made an important contribution to the discourse. It is now the task of the scientific community to take up this contribution and build on it with further research. We have to face the fact that ROGD may provide a convenient pathogenic explanatory model for those who are fundamentally opposed to medical transitioning of adolescents. In our opinion, however, the correct response to such possible tendencies is not to suppress research in this direction, but to strengthen it, so that evidence-based judgments of its validity are possible.

This article on Irreversible Damage has been a poor example of NPOV for years. Cuñado ☼ - Talk 17:03, 25 June 2026 (UTC)

Sorry, how does one obscure opinion piece that comes out to “more research is needed” on a topic which we have full MEDORG sources weighing against do anything to help your argument? Snokalok2 (talk) 17:59, 25 June 2026 (UTC)

Calling that an "opinion piece" just proved my point. Cuñado ☼ - Talk 15:10, 26 June 2026 (UTC)

Things like the Cass review is not policy, it is a review. It leads to policy. In this case, the policies around treatment of gender dysphoria that happened in the UK (and still happens in the US to my knowledge), diverged from medical science, and thus were corrected. Like this wiki ought to be.

Personally, I don’t give a damn about the ROGD hypothesis. My problem is that this article uses the criticism of that fringe hypothesis to discredit the medically mainstream premise of the book. This is intellectually dishonest.

Put the ROGD criticism where it belongs: under «Criticism». DJHellduck (talk) 08:36, 27 June 2026 (UTC)

It is not accurate to say that the premise of the book is within the medical mainstream. We have multiple sources describing it as fringe, and you have offered no sources disputing this.

You have only mentioned the Cass Review. There is dispute over whether or not the Cass Review is an acceptable source, but regardless of what stance we take on that question, having searched through the 500 or so pages that comprise the Cass review and the subsidiary York reviews, the term Rapid Onset Gender Dysphoria does not appear in the reviews even once. HenrikHolen (talk) 15:43, 27 June 2026 (UTC)

Having reviewed those sources, am I correct when I say they are mostly American blog posts? How are those weighted heavier than insights from large, paradigm-shifting review commissions undertaken by liberal democracies with multipartisan political support? I really expect a proper justification here, for what you describe as «fringe» is really only one part of the picture, something which hardly justifies how the book is presented in the current form of this article. DJHellduck (talk) 17:57, 27 June 2026 (UTC)

Do you have any reliable sources that back up your assertions here, if not this exercise is pointless LunaHasArrived (talk) 18:00, 26 June 2026 (UTC)

From the rest of the discussion, it seems most here are familiar with what we’re talking about. But you can find the Cass review at this link - it is the most comprehensive review currently available I think. If I remember correctly, the medical substance is mostly in the sub reports, while the final report mainly focuses on policy.

https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143933/https://cass.independent-review.uk/home/publications/final-report/ DJHellduck (talk) 08:50, 27 June 2026 (UTC)

Sorry, where does the 400pg document (where there's no consensus as to it's reliability in a medical setting for Wikipedia) does it mention the book irreversible damage. If it doesn't please bring sources that do. LunaHasArrived (talk) 10:59, 27 June 2026 (UTC)

I’m afraid this is the current state of the field when it comes to gender dysphoria. Wikipedians unfortunately don’t get to decide how the world really is - that is for science and philosophy to do, and per my understanding of the guidelines of best practice for Wikipedia, a review is the better source to use, not cherrypicked quotes from individual studies, blog posts or newspaper articles (for that matter nor «consensuses» among whomever participates on the Talk section of the Wikipedia pages).

You will rarely find works of popular science referenced in actual scientific literature and other important documents. DJHellduck (talk) 12:37, 27 June 2026 (UTC)

A quick look at the Cass Review page's Global reception section shows it being rebuked by The Endocrine Society, The Australian medical community at large, The New Zealand medical community (minus the right-wing government), The Canadian medical community, Germany, Austria, Switzerland, Japan, Poland, The Netherlands, and the United States (minus the right-wing government); and a look at the puberty blockers page shows, in the time since the Cass Review has been published, additional support for puberty blockers from the medical communities of Chile, France, and Italy.

And none in support of the Cass Review other than the UK themselves, the Trump admin, and the NZ First admin. So yeah, this isn't the state of gender dysphoria research - what you're saying is thoroughly debunked by the entire global medical community. Snokalok2 (talk) 12:48, 27 June 2026 (UTC)

This is a good opportunity to remind everyone that Wikipedia is not a proper source (and for wikipedians especially, due to contamination effects), and a list from there certainly does not count as evidence, especially in a domain with a lot of strong feelings and activists.

Yes, this particular review tossed a torch into the theatre, and received some loud pushback. But it did indeed move the bar significantly. And it has shifted both scientific discourse as well as policy worldwide, either through tightening regulation, or through cancelled liberalisation. Such significant and subtle effects would not appear among the noise in Wikipedia lists, and honestly, it is hard to see how it could, as there wouldn’t be many blogposts or newspaper articles that would suffice as source in a concrete operational sense.

But this discussion has really digressed. The point is: this particular wiki page should be reworked so it presents a more neutral representation of the book. DJHellduck (talk) 17:27, 27 June 2026 (UTC)

To the last point, why? You have presented no sources that discuss this book and haven't given any reason why the sources already used are unsuitable or being misrepresented. LunaHasArrived (talk) 17:44, 27 June 2026 (UTC)

I see no problem with including those sources in the article, and they absolutely have their place (typically to balance out things like the «Book of the year» award from the Economist). It is not appropriate to present it like it is currently. A few negative blog posts from Americans of minor importance (I am correct that they are blog posts?) do not warrant discrediting the entire book from the very outset of the article. This lack of neutrality goes against the whole essence of the Wikipedia project. DJHellduck (talk) 18:14, 27 June 2026 (UTC)

That's why I linked you to the pages, so you can go there and see the tens of sources for all of that that would be incredibly cumbersome to repost here when I can just link you to the page.

Yes, this particular review tossed a torch into the theatre, and received some loud pushback. But it did indeed move the bar significantly. You keep saying these things with absolutely no assertion of truth. At least I'm referring you to a list of sources, you're just sitting here and saying "No because actually let me tell you a better story" Snokalok2 (talk) 02:17, 28 June 2026 (UTC)

I guess that would have been a nightmare to read, so thanks for not doing that.

I had hoped that arguments would mostly suffice (what you call storytelling), but I guess wikipedians need more concrete materiel. I did not start this discussion thread to prove Irreversible damage «correct», but to make that case that the framing should be changed: in essence that discrediting the book in the introduction and the main sections of the page is inappropriate, as the central message of the book is not fringe, but in fact fits with part of the medical mainstream.

If you feel the Cass review is not sufficient evidence for this assertion, then similar stances have been taken by e.g. the Swedish medical society and the Norwegian medical authorities (if you have problems understanding these sources, then understand why I did not post them to begin with). This is the state of the field. This is part of the medical mainstream. Thus so is the main message of Irreversable damage, and the Wikipedia page must reflect that.

A list of criticisms of the Cass review on a Wikipedia page is not a source, but an illustration of how science and policy development works. As scientists and public servants we know this, and know how to read and navigate it. The public browsing Wikipedia doesn’t necessarily. DJHellduck (talk) 07:41, 29 June 2026 (UTC)

What you have linked is not the views of the Norwegian Health Authority, but of an unrelated review. The official recommendations of the Norwegian health authority is found here: https://www.helsebiblioteket.no/innhold/nasjonal-faglig-retningslinje/kj%C3%B8nnsinkongruens#utredning-behandling-og-oppfolging-ved-kjonnsinkongruens-bor-generelle-prinsipper-for-utredning-og-behandling-folges.

This report recommends gender affirming care and makes no mention of ROGD (nor does the paper you linked for that matter). I urge you to scrutinize your sources more thoroughly before proposing changes. HenrikHolen (talk) 14:23, 29 June 2026 (UTC)

Sorry, I seem to have mischaracterised the Norwegian source - it’s a Norwegian government commission report, not policy. My mistake. Though, weren’t you one who suggested to disregard policy as evidence in the first place? Then this characterisation must surely be a higher quality source? ;)

Joke aside, no-one is suggesting that physicians should stop giving gender-affirming care. That’s what we call a straw-man argument. Though: all the sources I have provided either recommend on medical grounds restriction of irreversible treatments for children, or lament that this restricting is indeed taking place (quote: «Health authorities in Norway and several other countries have recently tightened access to puberty blockers for transgender adolescents»). Not categorically banning it, but restricting it because the evidence is poor that the treatments are safe. This is also the main message of the book Irreversible damage.

To reiterate: a source doesn’t have to have «ROGD» or «Irreversible damage» show up in a word search to address the validity of the underlying claims. That doesn’t mean the sources mentioned should be cited on the page as direct support for the book, but they should inform us the editors about whether the book deserves to be discredited in the main text, or whether the (rightful) criticism should be put under a Criticism section. Of course, we could use them to support it explicitly as well, but in my opinion that would probably take this too close to WP:NOR. DJHellduck (talk) 19:29, 29 June 2026 (UTC)

• I don't think your summary is accurate, and you wildly overstate the significance and impact of Cass' opinions; but even beyond that, we have to use sources that actually discuss this book. If your assertion that the political positions taken by the British government have somehow changed the position of the best available academic sources on the subject, such that the reception of this book has shifted, you'd have to demonstrate it by showing sources that actually demonstrate that the reception of this book shifted. If you can't find those, then it's likely that you misunderstood the larger situation. --Aquillion (talk) 21:55, 28 June 2026 (UTC)

  I’m unsure if you understand the nature of what we discuss here. The problem isn’t the sources, it’s the underlying assumptions. Currently, these are that the premise of the book is fringe, and should be described as such on the page, discrediting the book in the process. This is demonstratively false. I gave some more sources to Snokalok2 above (the Cass review was apparently not sufficient for some), that demonstrate how the premise of the book (that early treatment of gender dysphoria might be hurting children) is in fact medically mainstream. Here’s an additional reputable source that also state explicitly that the medical paradigm is changing (first paragraph). DJHellduck (talk) 13:35, 29 June 2026 (UTC)

No, the book's position remains fringe; if you think you can demonstrate otherwise, you have to demonstrate it. That link is to an opinion piece, which obviously can't be used to rebut the mountain of high-quality peer-reviewed academic sourcing establishing that ROGD is a fringe theory; but even if it weren't, it doesn't mention ROGD, it doesn't mention the book, and so on. You need a source that mentions Irreversible Damage in its text if you want to use it on this article; and you need a source that mentions ROGD if you want to talk about that. --Aquillion (talk) 14:34, 29 June 2026 (UTC)

I’m not sure what you’re going at here. The sources used as justification for the fringe label is a few blog posts. The «opinion piece» I linked to is from a respectable peer-reviewed medical outlet indexed in pub-med and others. The author also generally disagrees with the conclusions of the Cass review, which makes the assertion of its impact on the medical field more credible.

Whether or not there is an explicit reference to ROGD in particular in the supporting sources, is irrelevant when deciding on the fringe classification for the totality of Irreparable damage. The book should have the same treatment as any other book with conteoversial content. Put the criticism where it belongs: under Criticism. DJHellduck (talk) 18:20, 29 June 2026 (UTC)

Wikipedia:Criticism May be a useful read as to why we join the criticisms of the book into the larger reception section. Reliable sources do say that she specifically endorses ROGD which is a concept widely condemned by MEDORGS and to which there is no published evidence currently for (at last time I checked) so it's notable to say that this theory which is popular politically is fringe medically speaking which is why we place it prominently in this article. If you have any specific complaints with article content or with sourcing please be specific. LunaHasArrived (talk) 20:08, 29 June 2026 (UTC)

That the criticism is currently in a Reactions section is to ensure a neutral point of view, am I right (cf. Wikipedia:Criticism)? How does this intention square with the blatant discreditation placed in the main part of the introduction? DJHellduck (talk) 20:47, 29 June 2026 (UTC)

We aren't descriditing the book in the opening, we are accurately displaying the medical consensus on ROGD as per WP: fringe. LunaHasArrived (talk) 22:35, 29 June 2026 (UTC)

I get why it is written like that. My problem is that this takes a legitimate criticism of aspects of the book, the ROGD hypothesis, which according to the blog posts is not medically mainstream, and uses it to discredit the whole message of the book, which in itself is not fringe as I have demonstrated with the sources provided in this conversation. Isn’t this abusing the fringe label to suppress one side in a societal debate? DJHellduck (talk) 06:18, 30 June 2026 (UTC)

Isn’t this abusing the fringe label to suppress one side in a societal debate? Half of the English speaking world believes that vaccines are a plot to microchip your children. Wikipedia isn’t about catering to societal opinions, it’s about giving the most accurate information possible based on reliable and vetted sources Snokalok2 (talk) 07:01, 30 June 2026 (UTC)

True, there is little debate in the mainstream medical field on whether vaccines are safe or not. This in contrast to the safety of gender affirmative treatment for children, where there is great debate, and where practices are tightening. The sources I have provided is a documentation of this. DJHellduck (talk) 10:55, 30 June 2026 (UTC)

Since few convincing objections have been added to this discussion, I propose moving forward with revising the page according to the concerns in the original post.

This means reframing the page so the central message of the book is no longer framed as fringe, but as resonating with parts of mainstream medical discourse (the appropriate caveats vrt. the inadequate scientific evidence underlying the ROGD hypothesis should still be mentioned, but severely toned down especially in the page body, and possibly be moved to the Reception section altogether).

Thorough work should also be done with regards to the overall content and tone of the entire page. This especially goes for the Summary section, the majority of which is awkwardly phrased, and does not seem to summarise the actual content and message of the book very clearly or neutrally. Whether the lack of clarity is because of a lack of fluency or cherrypicking of content, can be debated, but as it stands now it is not presentable.

I can take it upon myself to revise the body, and will do so once I get around to it. I’d appreciate if someone else could eventually do the rest of the page and especially the summary section. DJHellduck (talk) 13:12, 22 July 2026 (UTC)

That's not how this works. You don't get to say "I'm not convinced" and rewrite the page on those grounds. As it stands, you have no consensus in this thread for anything of the sort - especially not based on your own opinion counter to what the medical community has settled its opinion on.

On those grounds, if you try, I will revert. Snokalok2 (talk) 13:16, 22 July 2026 (UTC)

I haven’t supplied opinion, but argumentation based on reputable, mainstream sources. There has been little convincing pushback so far, but if you have something new to share, please do.

As it stands now, and which I have also communicated earlier, a main principle of Wikipedia is the neutral point of view (WP:NPOV), and the current state of this particular Wikipedia page does not conform to this. Reading the discussions in this particular talk, but also in previous talks, there is little consensus wrt. the appropriateness of the current version of this page. However, even if there was a consensus (there seem to be a substantial number of people apparently watching this page) that agrees with the current state, that is quite irrelevant — as explicitly stated in the guidelines: WP:NPOV «… is non-negotiable, and the principles upon which it is based cannot be superseded by other policies or guidelines, nor by editor consensus».

It you are intent on initiating a revert war, then go ahead, but that is not constructive (some might even call it WP:disruptive). I guess this would eventually go to arbitration then, which is pleasant to no-one. DJHellduck (talk) 16:00, 22 July 2026 (UTC)

The book's position is obviously fringe according to reliable sources and that's true whether or not you want to hear it. Consensus is not based on whether any individual editor thinks the consensus is "convincing". Loki (talk) 16:10, 22 July 2026 (UTC)

Which reliable sources? The only sources I have been given that support the fringe label are mediocre things like blogposts. Meanwhile, Cuñado supplied a perfectly reasonable review of the ROGD hypothesis, written by actual medical researchers in a peer-reviewed journal, which did not discard it at all, but instead described ROGD as a potential subgroup of gender dysphoria along late- and early onset. I quote from the conclusion of the paper:

In summary, it becomes clear that neither prematurely adopting ROGD as a valid explanatory model nor its hasty condemnation as transphobic is an appropriate response. It is hard to deny that Littman’s research has made an important contribution to the discourse. It is now the task of the scientific community to take up this contribution and build on it with further research. We have to face the fact that ROGD may provide a convenient pathogenic explanatory model for those who are fundamentally opposed to medical transitioning of adolescents. In our opinion, however, the correct response to such possible tendencies is not to suppress research in this direction, but to strengthen it, so that evidence-based judgments of its validity are possible.

This clearly categorises the ROGD hypothesis as an Alternative theoretical formulation, or at worst Questionable science, cf. the pseudoscience section of WP:NPOVFAQ. In addition, the public health perspective of the book, that early treatment of gender dysphoria is potentially harmful, is clearly among the medical mainstream, as demonstrated by my earlier sources. DJHellduck (talk) 16:48, 22 July 2026 (UTC)

Yeah fun thing about that "review", it never actually calls itself a review - it calls itself an "article". The only times the word "review" are even used are in the citations, and in a line about how the fact that Littman's work got through peer-review means it's rigorous. It's not a review, it's an opinion piece with citations. Drop the stick. Snokalok2 (talk) 16:58, 22 July 2026 (UTC)

From the abstract:

The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

That’s the literal definition of a scientific review buddy. DJHellduck (talk) 17:02, 22 July 2026 (UTC)

Well that's a very nice opinion you've formed for yourself, but as was said above, your own personal opinion does not trump the word of countless MEDORGS that ROGD is fringe. Snokalok2 (talk) 17:06, 22 July 2026 (UTC)

«Countless MEDORGS» do not think ROGD is fringe, they (quite appropriately) think the hypothesis needs more testing and fleshing out before it could be taken into clinical use. Those are not the same thing.

This is a case of Alternative theoretical formulation, or at worst Questionable science, not Generally considered pseudoscience (cf. WP:NPOVFAQ), as the scientific community is clearly taking the hypothesis seriously. Hence, discrediting the book Irreparable damage by labelling ROGD fringe breaks with WP:NPOV. DJHellduck (talk) 17:33, 22 July 2026 (UTC)

Look at basically any source on the page for ROGD. In fact the first cite on the page helpfully lists four sources for the lack of scientific backing: Restar (2019), Rider (2021), Kesslen (2022) and Broderick (2023). You can also have this open letter that calls for eliminating the use of ROGD and similar concepts for clinical and diagnostic application given the lack of empirical support for its existence and its likelihood of contributing to harm and mental health burden, which is signed by a boatload of MEDORGs including the APA and WPATH, and this separate statement by WPATH alone. And many other sources on the same page. This is very settled. Loki (talk) 22:36, 22 July 2026 (UTC)

I agree, it’s pretty controversial. Does those sources mention the book we’re discussing here though? Because the ROGD endorsement is not the message of the book, nor is it essential to its premise… DJHellduck (talk) 13:37, 23 July 2026 (UTC)

At a certain point mate this just becomes IDHT Snokalok2 (talk) 17:42, 23 July 2026 (UTC)

What statement in the article are you actually objecting to?

The lead says that the book endorses ROGD and that ROGD is not scientifically supported, which is true and well-sourced, as I've just established. It then goes on to describe the general narrative of the book without criticizing it further. After that, it says the book received some positive reviews, which is true, and that it was criticized for repeating anti-trans medical misinformation, which is also true, and we cite the reviews that say that. And the rest of the article is just an elaboration of the lead.

So as far as I can tell there are only really four things you could want to change: the ROGD statement (very well sourced), the narrative of the book (citable to the book itself, not controversial), the positive reviews (easily citable, not controversial) or the negative reviews (easily citable). Do you see why I'm confused? It seems like you're insisting that something needs to be changed but everything that could be changed is easily verifiable and much of it isn't particularly controversial either. Loki (talk) 19:09, 23 July 2026 (UTC)

Yeah, I don’t really disagree with any of the content, so I’m a bit surprised by how this became such a huge discussion (though, that’s probably mostly my fault, for trying to argue with absolutely everyone). I went ahead and just made an edit based on the discussion, that I thought was not very controversial (I didn’t delete anything, and even put in an additional source on the poor scientific evidence underpinning ROGD), but that got immediately reverted, and an admin gave me a strike for disruptive editing, so I’m dropping the whole thing for my part.

Not gonna push the issue further, but if you’re open to it, it would have been interesting to get your thoughts on the concrete edit, since I’m starting to get the impression that we don’t really disagree on the fundamentals. DJHellduck (talk) 15:40, 24 July 2026 (UTC)

DJHellduck, if you want to make reasonable edits to the article, you'll need an RFC, and I will support you. Cuñado ☼ - Talk 05:10, 28 July 2026 (UTC)