Talk:Society for Evidence-Based Gender Medicine

Canada parliament brief

My edit citing SEGM’s original brief was reverted twice. How can SEGM’s position be accurately represented if we are not allowed to cite their own statement and must instead rely solely on three highly partisan sources? Wikipedia’s policies permit the use of primary sources for straightforward statements of fact, and my edit accurately summarized the main idea of SEGM’s brief. If the summary is considered insufficient, a direct quote could be used instead to ensure clarity:

"There is a very real risk that all forms of supportive and explorative psychotherapies for young patients who present with gender dysphoria will be classified as 'conversion.'"

Additionally, per WP:SBM, Science-Based Medicine should not be used for factual statements, and any other use should be properly attributed. Given this, there is no policy-based justification for removing SEGM’s directly stated position while allowing editorialized interpretations from sources that openly oppose the organization. Sean Waltz O'Connell (talk) 16:45, 11 March 2025 (UTC)

It is absolutely not a straightforward statement of fact, hence the reversions. I agree that using an explicit quotation might be a better way to inform our readers of their claim without tacitly endorsing it and its framing. DanielRigal (talk) 19:24, 11 March 2025 (UTC)

I have followed your suggestion and have now added a direct quote in lieu of the previous summary. Sean Waltz O'Connell (talk) 14:05, 12 March 2025 (UTC)

I find this rv by YFNS to be disruptive. WP:SBM states: "Material from this site should be used with caution, probably with attribution, and should not on its own be used to support negative or controversial content in BLPs." Yet, in this article, no such caution is exercised—a self-published article is used for factual statements in wikivoice, which is unacceptable. It is merely a personal opinion from a highly biased source. Additionally, when I summarized SEGM's brief, the edit was reverted on the grounds that the direct quote was needed. However, the same standard was not applied when a biased summary was merged with the quote and backed by an SPS. There is also no justification for Eckert being cited nine times in this article, often for factual statements without attribution. A brief summary of his views in the bottom section is sufficient, especially considering that his work was not reliably published Sean Waltz O'Connell (talk) 10:19, 14 March 2025 (UTC)

Of course, SBM shouldn’t be used without attribution. It may not be usable at all because RSP doesn’t consider it a generally reliable source and says "additional considerations apply." Those guidelines aren’t being followed here.--Colaheed777 (talk) 19:56, 16 March 2025 (UTC)

It is merely a personal opinion - which part? and justified their position by claiming that conversion therapy can only be applied to lesbian, gay, and bisexual people or noting that is a position not supported by any major medical organization.?

• The first part is an accurate summary of their statement Using the term “conversion therapy” in the context of gender dysphoria is not only misleading but also inaccurate. “Conversion therapy” refers to an ideological and, historically, religiously-motivated effort to “convert” lesbian, gay, and bisexual individuals to become heterosexual[11]
• The second is undeniably true, no major medical organization agrees with that.

This is not a WP:BLP and "probably" does not mean "always". Eckert is a recognized expert in the field and you've provided no evidence this factual statement requires attribution.

Additionally, when I summarized SEGM's brief, the edit was reverted on the grounds that the direct quote was needed. However, the same standard was not applied when a biased summary - we write things based on what WP:INDEPENDENT sources say. We do not summarize SEGM's positions, we turn to how RS summarize SEGM's positions. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 20:10, 16 March 2025 (UTC)

SBM is not considered a reliable source per its RSP entry. Its use requires caution, and attribution is recommended. Eckert is certainly not an independent source—being a WPATH leader, he has a clear conflict of interest in this context.

Regarding conversion therapy, SEGM does discuss the historical context, as the terms such as "transgender" and "gender dysphoria" are relatively recent concept, but their objection is not based on these relatively new terms and references. Instead, they cite various studies and the practices of European countries, which emphasize psychological treatment as a priority. Sean Waltz O'Connell (talk) 12:34, 17 March 2025 (UTC)

I was one of those who reverted the edit. It utilized a primary source from SEGM characterizing their own position, with the editor adding it summarizing it - rather than utilizing the secondary sources which discuss their position. As such, I don't believe it is a justified usage of a Primary source for information about the subject. Relm (talk) 08:13, 17 March 2025 (UTC)

There is no rule prohibiting the use of primary sources on Wikipedia. On the contrary, the rules state that "a primary source is generally the best source for its own contents" and that such sources may be used "to make straightforward, descriptive statements of fact." Primary sources can be cited without introducing personal interpretation, either through a neutral summary or a direct quote. Sean Waltz O'Connell (talk) 12:34, 17 March 2025 (UTC)

In citing just the third point of the policy, you're ignoring point 4 and point 2 which are more apt here which state:

4. Do not analyze, evaluate, interpret, or synthesize material found in a primary source yourself; instead, refer to reliable secondary sources that do so.

and

2. Any interpretation of primary source material requires a reliable secondary source for that interpretation. While a primary source is generally the best source for its own contents, even over a summary of the primary source elsewhere, do not put undue weight on its contents.

In this case we have reliable sources - despite however many times this gets rehashed here - saying that SEGM promotes conversion therapy and that GET = conversion therapy. Citing SEGM regarding their own view here creates a WP:FALSEBALANCE. False balance is policy, so as per the preface to WP:PRIMARY as well:

Policy: Unless restricted by another policy,

Relm (talk) 12:55, 17 March 2025 (UTC)

The SEGM brief is quite literally the actual topic of the section. Quoting an organization's own view when it is the subject of discussion cannot constitute false balance or undue weight. False balance pertains to something entirely different. I did not include any personal interpretation, just a brief summary, which I later replaced with a direct quote. Furthermore, per community consensus, SBM is not considered a reliable source to rely on its interpretations. It is recommended to be used with caution, if at all, and attribution is recommended. We must follow the community consensus on this source. Sean Waltz O'Connell (talk) 12:49, 18 March 2025 (UTC)

The SEGM brief is quite literally the actual topic of the section. - no, the section is about SEGM's views/advocacy on conversion therapy, not limited to one Canadian brief.

I did not include any personal interpretation, just a brief summary, You said in wikivoice that SEGM wrote a brief to the Canadian Senate expressing concern that overly broad legal definitions of conversion therapy in a proposed new law[12] - it is SEGM's opinion that the legal definition is "overly broad", not a fact as you framed it.

Source use is decided on a case by case basis and WP:PARITY applies. Again, which part of the sentence and justified their position by claiming that conversion therapy can only be applied to lesbian, gay, and bisexual people, a position not supported by any major medical organization are you disputing? Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 15:54, 18 March 2025 (UTC)

"SEGM wrote a brief to the Canadian Senate expressing concern that overly broad legal definitions" clearly attributes this as SEGM’s opinion, not a fact stated in Wiki voice. This accurately reflects the content of the brief, so I fail to see why this summary would be considered problematic.

As I previously noted, SEGM did not justify its position by referencing the history of conversion laws. Rather, it supported its argument with various studies and the national practices of European countries. SEGM also provided historical context, noting that conversion laws originally did not apply to transgender individuals, as they were only relatively recently recognized as a distinct identity.

Additionally, per WP:RSP, SBM is not considered a generally reliable source, and attribution is recommended. Why persist in ignoring the RSP entry on SBM? —which is based on community consensus. Sean Waltz O'Connell (talk) 18:43, 19 March 2025 (UTC)

WP:DROPTHESTICK

1) SEGM said Using the term “conversion therapy” in the context of gender dysphoria is not only misleading but also inaccurate. “Conversion therapy” refers to an ideological and, historically, religiously-motivated effort to “convert” lesbian, gay, and bisexual individuals to become heterosexual ... To suggest that this practice is being applied to gender-questioning youth is erroneous and will only serve to further inflame the already highly politicized field of transgender medicine.[13] - They don't mention historical context (except to say it was historically religiously motivated). They don't say these laws did not originally apply to trans people. They give a definition of conversion therapy that no medical organization in the world agrees with. That is a fact.

2) Additionally, per WP:RSP, SBM is not considered a generally reliable source, and attribution is recommended. Why persist in ignoring the RSP entry on SBM? - Attribution is "recommended", not "required". WP:PARITY applies. We are not going to say it's Eckert's opinion that SEGM's definition is wrong, because it is WP:FRINGE and factually wrong. Wikipedia is not in the business of pretending the views of WP:QUACKS are more supported than they are. Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 22:35, 19 March 2025 (UTC)

This edit combines SEGM’s own words with commentary from a non-RS source (SBM) to imply a claim that no single reliable source makes directly—this is WP:SYNTH. While attribution for SBM is not strictly required, the RfC clearly recommends it, especially in contentious areas like this. Neither standard is being followed here. Evathedutch (talk) 14:08, 28 March 2025 (UTC)

This is indeed WP:SYNTH, combining a primary source with an opinion in a source with questionable reliability. The latter needs proper attribution. JonJ937 (talk) 09:52, 2 April 2025 (UTC)

Undark

Why my edit was [14] reverted as "tendentious'? This is what the Undark states:

SEGM believes psychological support should be offered as an alternative treatment. This would include modalities like exploratory therapy, which aims to allow for a critical exploration of gender stereotypes as a way of addressing distress. This emphasis on psychological support aligns with current health policy in several other countries, including Sweden, Finland, and the U.K. [15]

What exactly is the problem with this information? JonJ937 (talk) 14:59, 28 March 2025 (UTC)

Nothing, it just doesn't say that Sweden, Finland and the UK believe in GET being the first line treatment for under 25s which is what the text you added said LunaHasArrived (talk) 09:42, 30 March 2025 (UTC)

The source actually does state that SEGM's approach aligns with health policies of Sweden, Finland and the U.K. In addition, the US HHS says the same thing about exploratory psychotherapy:

The United Kingdom, Sweden, and Finland have recently issued restrictions on the medical interventions for children, including the use of puberty blockers and hormone treatments, and now recommend exploratory psychotherapy as a first line of treatment and reserve hormonal interventions only for exceptional cases. [16]

The intro needs to be reworded, because SEGM supports not just exploratory therapy, but psychotherapy in general as the first line treatment, including modalities like exploratory therapy. The lead only mentions one type of therapy, which is not an accurate representation of SEGM's position. It would be better to reword as follows:

SEGM advocates for psychological support, including exploratory therapy, as the first line treatment, in line with health policies in some European countries.JonJ937 (talk) 10:05, 31 March 2025 (UTC)

Wikipedia:LEADFOLLOWSBODY. Find due weight secondary sources (not a primary interview with a co-founder) that discusses SEGM's promotion of psychological support (outside of GET) and add it to the body first. LunaHasArrived (talk) 10:31, 31 March 2025 (UTC)

Undark magazine quoted above is a secondary source. It is not an interview. JonJ937 (talk) 09:49, 1 April 2025 (UTC)

I updated the body of the article with this Undark text. There is a similar text referenced to SPLC in that section, but SPLC is a biased source that should not be used for statements of facts. JonJ937 (talk)|

Undark does not state that there is no evidence for effectiveness of psychotherapy. This edit is not an accurate interpretation of the source. [17] Undark only quotes the opinion of Dr D’Angelo:

Roberto D’Angelo, an Australia-based psychotherapist and psychiatrist and SEGM’s current president, acknowledged the need to study psychological interventions in youth who would otherwise receive gender-affirming care. But psychotherapy, he noted, has proven effective in resolving many kinds of psychological distress. “Yes, the evidence for psychotherapy for gender dysphoria is extremely limited,” he told Undark. But, “we have robust evidence to show that psychotherapy is helpful in a range of conditions that involve emotional distress, including problems about body self-image, identity problems, and so on.”

Dr. D’Angelo said that the evidence for psychotherapy for gender dysphoria is "extremely limited". However, "limited" does not mean "absent". Plus, this is the opinion of Dr. D’Angelo that needs to be properly attributed. Also, if we are to quote D’Angelo, we should provide the entire context, including his opinion that the psychotherapy is helpful in a range of other similar conditions. Undark does not state that European policies lack evidence. It is WP:OR to make such bold claims about health policies of the entire countries not supported by the source cited. JonJ937 (talk) 09:25, 2 April 2025 (UTC)

"Other critics of the group point out there isn’t much evidence to back up psychotherapy". This is directly stated in article voice and backs up the idea of a lack of evidence for psychotherapy (note that the article says the critics are pointing out a fact. It also notes that the final report of the Cass review noted the need for more robust evidence in psychotherapy. Whilst the direct language before may not be correct, some mention of the fact that the evidence behind psychotherapy is lacking seems due. There may well be more information from the SPLC (as that was cited) on this information. @LokiTheLiar as the person who added the content. LunaHasArrived (talk) 10:23, 2 April 2025 (UTC)

Again, this is an opinion held by some people and needs to be properly attributed. We cannot make definitive statements because the source does not do so. It states that some critics argue there is not much evidence. In addition, this area of medicine is relatively new and most treatments have limited evidence. For example, it is now generally accepted that the evidence for puberty blockers is weak and limited and even the WHO acknowledges this. There are ongoing debates about whether it is acceptable to administer treatments with low evidence of benefit. SEGM believes that psychotherapy is the preferable first-line treatment, as it does not result in irreversible consequences. And SPLC is a biased source. JonJ937 (talk) 13:52, 2 April 2025 (UTC)

It's not just an opinion. The article says it in article voice and uses the phrase "point out", not "claim" or "assert" or anything that would cast doubt on this expert's opinion. Furthermore, our guideline on WP:FRINGE is very clear that when there is not good evidence for a scientific theory we need to say that. Loki (talk) 07:24, 3 April 2025 (UTC)

The article states that "critics point out", which means that this claim is attributed to a group of critics and not a statement of fact from the journal itself. On the other hand, the line "This emphasis on psychological support aligns with current health policy in several other countries, including Sweden, Finland, and the U.K." is presented in the journal's own voice not followed by any statement that European policies lack evidence. Therefore, combining these opinions and facts into a single statement would constitute WP:SYNTH, as the source does not explicitly make such a connection. There is no consensus that prioritizing psychotherapy as the first-line treatment for gender dysphoria is a fringe theory. It is not an opinion held by a tiny minority but an official health policy in several developed countries and is supported by prominent MEDORGs. This hardly qualifies as fringe. SEGM's recommends to prioritize psychotherapy in line with the health policies of other countries, so it is not an independent or novel idea exclusive to SEGM. JonJ937 (talk) 09:09, 3 April 2025 (UTC)

Some mention of the lack of evidence for psychological interventions should be made, otherwise we're cherry picking and run the risk of being pro-fringe. HenrikHolen (talk) 22:05, 2 April 2025 (UTC)

I agree. "lack of evidence" is also an appropriate phrase to use when the evidence is "extremely limited". "lack" implies extreme insufficiency. I would also object to the sleight of hand that tries to associate SEGM's stance with some European countries' health policies as a kind of shield against criticism of that stance on the grounds that European policies were not mentioned in the criticism. In general with fringe topics, we need to be careful of granting fringe opinion equal weight simply on the grounds that it exists and was published somewhere. OsFish (talk) 05:58, 3 April 2025 (UTC)

There is no consensus within the Wikipedia community that psychotherapy as the first-line treatment for gender dysphoria is a fringe theory. As mentioned above, the official policy of many countries around the world cannot be considered fringe. It is not an opinion held by a tiny minority that goes against mainstream science, it actually is part of a legitimate scholarly discourse within the scientific community. I think we can quote Dr. D’Angelo’s opinion on this matter, providing the full context of his statement. JonJ937 (talk) 09:15, 3 April 2025 (UTC)

D'Angelo is employed by SEGM and is listed as its president in their 2023 tax filings. Needless to say he can't be used as a secondary source due to COI

https://projects.propublica.org/nonprofits/organizations/844520593/202423189349302147/full HenrikHolen (talk) 12:57, 3 April 2025 (UTC)

There is not, and has never been, evidence that psychotherapy helps GD. The latest top-tier MEDRS, a clinical practice guideline crafted by a few dozen medical organizations, notes there is no evidence psychotherapy helps GD.[18][19] Your Friendly Neighborhood Sociologist ⚧ Ⓐ (talk) 16:26, 3 April 2025 (UTC)

The Advocate is not a reliable source for interpreting a medical document. I'm not sure if you checked the document that you cited, but the German guidelines state that psychotherapy should be offered, but not required as a precondition for medical transition for ethical reasons (see p.116). The German Association for Psychiatry, Psychotherapy, Psychosomatics, and Neurology (DGPPN), which is Germany's largest medical association dealing with mental health, objects to the wording in the document and their objection is included in the document. DGPPN does not agree with the precondition part (p. 16 in the appendix).

Die DGPPN spricht sich für die Streichung des Hinweises aus, dass es aus ethischen Gründen des Respekts vor der Würde und Selbstbestimmung keine Verpflichtung zur Psychotherapie geben solle Selbstverständlich darf und kann niemand zu einer Psychotherapie gezwungen werden, weil diese seine freiwillige Mitarbeit erfordert. Eine psychotherapeutische Begleitung kann aber dabei helfen, mögliche Behandlungsentscheidungen gut abzuwägen sowie interferierende psychische Störungen fachgerecht zu adressieren. Eine Psychotherapie ist jedoch keine Unzumutbarkeit, wie es die Begründung in der Empfehlung suggeriert, sondern eine ergebnisoffene Unterstützung. Unstrittig ist, dass eine Psychotherapie nicht ohne spezifische Indikation angewandt werden soll und die Indikation nach den Vorgaben der Psychotherapierichtlinie zu stellen ist. Zur umfassenden Abklärung und Vorbereitung einer möglicherweise weitreichenden Lebensentscheidung in jungen Jahren kann eine Psychotherapie bestimmten Personen jedoch fachgerechte und individuelle Unterstützung bieten.

Google translate:

The DGPPN advocates deleting the note that there should be no obligation to undergo psychotherapy for ethical reasons of respect for dignity and self-determination. Of course, no one should and cannot be forced to undergo psychotherapy because it requires their voluntary cooperation. However, psychotherapeutic support can help to carefully weigh up possible treatment decisions and to professionally address interfering mental disorders. However, psychotherapy is not unreasonable, as the justification in the recommendation suggests, but rather open-ended support. It is undisputed that psychotherapy should not be used without a specific indication and that the indication must be made in accordance with the psychotherapy guidelines. However, psychotherapy can offer certain people professional and individual support for comprehensive clarification and preparation for a potentially far-reaching life decision at a young age.

So German guidelines are not against psychotherapy in general and German psychiatrists believe that offering psychotherapy might be helpful. I could not find any statement in the guidelines suggesting that psychotherapy is not helpful. Logically speaking, If psychotherapy was not helpful, why would the guidelines recommend offering it? JonJ937 (talk) 10:09, 4 April 2025 (UTC)

Does any bit of what you typed say that there's evidence that psychotherapy helps with gender dysphoria or helps people suffering with gender dysphoria. From the gender identity service series systematic review:

"There is limited research evaluating outcomes of psychosocial interventions for children and adolescents experiencing gender dysphoria/incongruence, and low quality and inadequate reporting of the studies identified. Therefore, firm conclusions about their effects cannot be made".

High tier medrs agree there's a massive lack of evidence.

Wikipedia:1AM Might be helpful here. LunaHasArrived (talk) 10:57, 4 April 2025 (UTC)

I'm not disputing that the evidence is limited, this is true for most aspects of trans care, including puberty blockers. The source that you cited does not state that the evidence for psychotherapy is absent. It suggests that while the evidence base is limited and further research is needed, the outcomes are either beneficial or show no change, with no indication of adverse effects: "Most analyses of mental health and psychosocial outcomes showed either benefit or no change, with none indicating negative or adverse effects". The same source notes that "National and international guidelines recommend that psychosocial support should be a key component of the care offered to children and adolescents experiencing gender dysphoria/incongruence". It would be too extreme to suggest that all such guidelines are entirely unsupported by evidence. Limited evidence is not the same as a lack of evidence. This revert inaccurately presents what the cited sources actually say. [20] Nowhere do the sources claim that “the evidence does not support” psychotherapy, nor do they state that European policies lack evidence. On the contrary, most sources indicate that these policies are based on the research conducted within each country. No reliable source states that "health policies in Sweden, Finland and the U.K., where psychotherapy is prioritized over medical interventions despite the lack of evidence". It is a WP:SYNTH. My suggestion is simply to reflect the sources accurately and avoid WP:SYNTH regarding European policies. It is Ok to state that the evidence is limited, in accordance with the sources. It would also be good to present SEGM president's position on this. By the way, SEGM's original statement does not mention support for GET. [21] It also needs to be linked to accurately reflect their position. JonJ937 (talk) 15:42, 4 April 2025 (UTC)

My issue here is that the original wording creates a false implication: normally country-level medical guidelines are based on evidence, so saying "these countries have X in their medical guidelines" implies that there is good evidence for X.

But there isn't good evidence for X and the source says that explicitly, so we need to say that there is no good evidence explicitly to avoid the implication that there is evidence. Loki (talk) 17:48, 4 April 2025 (UTC)

We can only write what the sources state. Undark twice mentions that SEGM refers to European guidelines. I provided one quote above and Undark mentions elsewhere in the article that "SEGM, citing guidelines in Finland and elsewhere in Europe, has described this (psychotherapy) as the preferred treatment for younger people". My edit was reverted again, [22] and incorrect interpretation of the Undark article was restored. I do not mind mentioning that the evidence is limited. But there is no need to repeat the same thing twice, and create WP:SYNTH in the second instance. This is my version that was reverted:

While the evidence supporting psychotherapy for gender dysphoria is considered to be limited, SEGM president Roberto D’Angelo believes that psychotherapy has proven effective for various emotional and psychological distress, including body image and identity issues.

I replaced the claim that the "evidence does not support it" not found in any source with "the evidence ... is considered to be limited". Can someone explain why we cannot write that the the evidence is limited, as per the source? There is a big difference between "no evidence" and "limited evidence". It is an important nuance that the sources make. The source that Luna cited also states that the evidence is limited, but the available limited data suggests either an improvement or no change in the patient's condition. Yet she reverted my edit that stated the evidence was limited, even though the source that she cited stated the same fact. Also, why cannot we cite D’Angelo’s opinion on this, when the article cited Malone in the same section? What is the reason for such selective quoting? The link to SEGM’s statement on psychotherapy was removed too. If we are stating that SEGM advocates for certain things, we need to link to the original source for the claim as well. JonJ937 (talk) 08:29, 6 April 2025 (UTC)

I see no reason to misrepresent or misquote the source. The word “limited” more accurately reflects the language of the reference and should be used accordingly. Additionally, linking this directly with the health policies of European countries is misleading, as it could imply—without support from reliable sources—that those policies are not evidence-based. In reality, European guidelines may favor psychotherapy precisely because the evidence for alternative treatments is even weaker. Jon’s version is generally good. We could consider rephrasing slightly or splitting the line in two, For example:

The available evidence for the effectiveness of psychotherapy in treating gender dysphoria is considered to be limited. However, SEGM president Roberto D’Angelo believes that psychotherapy has proven effective for various emotional and psychological distress, including body image and identity issues. Sean Waltz O'Connell (talk) 11:22, 6 April 2025 (UTC)

I think this wording is good. If there are no further objections, I’ll proceed with incorporating the suggested wording into the article. JonJ937 (talk) 09:58, 8 April 2025 (UTC)

The systematic review says all 3 of limited, low-quality and inadequate. I'm not sure why you're removing 2 of the criticisms here and making the evidence base sounds better than described. LunaHasArrived (talk) 10:45, 8 April 2025 (UTC)

I'm just quoting your source. It does not say that there is no evidence. It says that the evidence is limited, more research is needed. There is a difference with no evidence at all and limited evidence. But the research also states that "the existing evidence-based interventions tailored for children and/or adolescents with gender dysphoria/incongruence as well as those developed explicitly for this population have the potential to result in positive outcomes". Do you have any objections to the proposed wording? JonJ937 (talk) 14:09, 8 April 2025 (UTC)

It says, the research is limited, low-quality and inadequate. It also states that no conclusions can be drawn from it. I'm happy to add "The available evidence for the effectiveness of psychotherapy in treating gender dysphoria is considered to be limited, low-quality and inadequate." But removing criticism just seems like cherry picking. I should also note that our current wording "lack of evidence" does not say that there's no evidence, despite what you have claimed multiple times. LunaHasArrived (talk) 14:31, 8 April 2025 (UTC)

The sources do not use words like "lack of evidence" or "not supported by evidence". It is better to closely stick to the terms used by the sources. There is no referenced criticism to be removed, just personal interpretations repeated twice. Taylor et al state that "small number of low-quality studies limits conclusions about the effectiveness of psychosocial interventions". That said, if we rely on your source, how about the following wording?

The available evidence for the effectiveness of psychotherapy in treating gender dysphoria is considered limited, with existing studies generally being of low quality and inadequate. However, SEGM president Roberto D’Angelo believes that psychotherapy has proven effective for various emotional and psychological distress, including body image and identity issues. JonJ937 (talk) 17:24, 8 April 2025 (UTC)

The undark does say that there is not much evidence. We don't need to qualify the statement using terms like "the available evidence" (as opposed to unavailable evidence) or "considered to be" (considered by who). We can simply say "the evidence for the effectiveness of psychotherapy as treatment for in gender dysphoria is limited, low-quality and inadequate." For the quote from D'Angelo I don't personally see why it's due, but if you really want it in the text feel free (although you might want to change it so it says "he believes it's helpful in other conditions that involve..." as that's closer to his quote). LunaHasArrived (talk) 18:26, 8 April 2025 (UTC)

The reason why I used "considered to be" is because Undark refers to "critics". But if we use "critics", it would be weasel wording. Also, the evidence itself can't be described as "low quality and inadequate," but it can be described as "limited". Taylor et al. mention that the studies conducted so far are of low quality and have inadequate methodology and reporting, and conclusions that could be made are limited. So I worded it as closely as possible to the original source. We can drop the word "available". Would this wording be Ok for you?

The evidence for the effectiveness of psychotherapy in treating gender dysphoria is considered limited, with existing studies generally being of low quality and inadequate. However, SEGM president Roberto D’Angelo believes that psychotherapy has proven effective for various conditions that involve emotional and psychological distress, including body image and identity issues.

Where exactly does Undark state that "SEGM does not believe medical interventions to be appropriate treatment at any age"? [23] Undark states that "SEGM argued that psychotherapy was the preferred treatment for patients 25 and under, though it no longer specifies any age at which medical interventions would be appropriate, citing ongoing research into various age groups". It does not say that medical interventions are not appropriate at any age, it just does not say at what age medical interventions are appropriate. This part also needs to be quoted close to the source referenced. JonJ937 (talk) 09:27, 9 April 2025 (UTC)

Wikipedia:1AM (interesting!, but not applicable here)

Heathcote et al is also not applicable due to its Inclusion Criteria; more importantly this is OR Evathedutch (talk) 13:15, 18 April 2025 (UTC)

I agree that the implied agreement between SEGM and European health authorities is inaccurate. SEGM's suggested policies diverge substantially from the policies of these authorities. HenrikHolen (talk) 12:49, 3 April 2025 (UTC)

Undark article presents D’Angelo as SEGM president. No one questioned that. D’Angelo should not be used as a secondary source. He can be used as a primary source, with attribution. The article already quotes Malone, why not quote D’Angelo for his own views? He is the source regarding limited evidence for psychotherapy. Who says that SEGM's suggested policies diverge substantially from the policies of the European countries? If it is your personal opinion, we cannot use it in the article. Undark writes that SEGM's position on psychological support "aligns with health policy in several other countries, including Sweden, Finland, and the U.K." We must follow the sources and not engage in OR. JonJ937 (talk) 14:10, 3 April 2025 (UTC)

Totally agree with Jon. WP:SYNTH is something we need to avoid, and it’s important to stick to what the sources actually say. The Undark piece doesn’t say European policies lack evidence. That’s an interpretation, not something the source states outright, and presenting it that way is original research through synthesis. If the claim isn’t directly supported by a reliable source, we shouldn’t be adding it in.--Colaheed777 (talk) 17:57, 5 April 2025 (UTC)

But WP:NOTINDISCRIMINATE applies. This is a single sentence, given no real weight even in the source it's from, pulled out of a larger piece in a source that doesn't really have any relevant expertise on the topic and which is potentially advocating a fringe interpretation; if we don't have enough sources to provide proper context for it, the thing to do is to omit it entirely until more sources cover it. We avoid WP:SYNTH by waiting until we have proper coverage, not by trying to pluck out what we can and presenting it in ways that could lead readers to believing that fringe perspectives have more support than they actually do. We're already citing this Undark piece a bafflingly large number of times for such a low-quality source; we certainly shouldn't be using it for sweeping statements about an entire field of medicine in the article voice, not until / unless we have better sources backing it up. --Aquillion (talk) 11:01, 9 April 2025 (UTC)

What exactly is “fringe” about stating that SEGM advocates for prioritizing psychotherapy in alignment with the policies of several European countries? This is not based on a single line—it is stated multiple times in Undark, a reliable secondary source, and is also reflected in SEGM’s own publications (e.g., [24]). No source disputes that SEGM supports the U.S. adopting a more cautious approach, similar to that of several European countries where psychotherapy is prioritized as a first-line treatment for youth with gender dysphoria. So what, specifically, is the fringe view being claimed here? And what sweeping statement are you accusing users of making? We are accurately reporting SEGM’s position, which deserves fair and proportionate representation. Sean Waltz O'Connell (talk) 14:57, 9 April 2025 (UTC)

I think Undark is a better source overall than Aquillion does but I also think that the best source for whether SEGM's policies line up with these European countries would actually be the countries themselves, not Undark (and definitely not SEGM itself). Loki (talk) 16:01, 9 April 2025 (UTC)

• I don't see Undark's characterization of a European consensus stated more than once in that magazine article, no. And as a sweeping statement of the standard of care across an entire topic area, I would expect it to appear in other sources rather than as a one-line aside in just this one; if it's not FRINGE - and at the very least if it is WP:DUE - then you should easily be able to find higher-quality academic sources backing it up. --Aquillion (talk) 17:02, 9 April 2025 (UTC)

WP:NOTINDISCRIMINATE does not apply. The statement directly relates to SEGM's positions and their international context; it supports the article's comprehensiveness and neutrality. Evathedutch (talk) 16:42, 9 April 2025 (UTC)

But it's not just a statement about SEGM's position - it's a sweeping statement about the standard of care across Europe. That's an WP:EXCEPTIONAL claim requiring high-quality sources, not a single sentence in a magazine article with no relevant expertise. --Aquillion (talk) 17:04, 9 April 2025 (UTC)

Undark mentions SEGM's alignment with European policies multiple times. For example:

This emphasis on psychological support aligns with current health policy in several other countries, including Sweden, Finland, and the U.K.

SEGM, citing guidelines in Finland and elsewhere in Europe, has described this (psychotherapy) as the preferred treatment for younger people.

On key issues, the organization’s views were increasingly aligned with those of several major European medical institutions, which were beginning to restrict access to puberty blockers and cross-sex hormones.

Undark does not make "a sweeping statement of the standard of care across an entire topic area". It simply notes that certain European countries have adopted specific policies, which is an undisputed fact. No one denies that several European countries have banned or restricted the use of puberty blockers, this has been extensively covered in many reliable sources. It is also a fact that SEGM cites these policies and advocates for the U.S. to adopt a similar approach. We do not need academic sources to state that SEGM calls for alignment with certain European policies, SEGM’s own statements serve as primary sources and should be cited to accurately reflect the organization's official position. How can we reflect the official position of an organization without citing its own documents, with proper attribution? As for Undark, it remains the most comprehensive source that has covered SEGM to date. It is an award-winning, MIT-sponsored, non-partisan publication and is more reliable than many of the sources currently used in the article. JonJ937 (talk) 09:35, 10 April 2025 (UTC)

"lack of evidence" should be removed or changed to "limited evidence" because the source does not support this. The phrase "there isn't much evidence" suggests that evidence exists but is limited. Therefore, it is not accurate to say "lack of evidence." Also we can't elaborate how it is limited without going into WP:OR. Evathedutch (talk) 17:01, 9 April 2025 (UTC)

Just changed it to "evidence for psychotherapy as a treatment for gender dysphoria is weak" because I do agree we shouldn't imply that there's no evidence.

All of this is stuff I'd rather source to better sources, by the way, it's just that if we are using this Undark source we should be clear about what it actually says. Loki (talk) 17:20, 9 April 2025 (UTC)

I'm fine with stating that the evidence for psychotherapy is weak. It is no better or worse than the evidence for any other treatment in this relatively new area of medicine. But do we really need to state the same thing twice in the same paragraph? The very first line of the paragraph states that "even though evidence does not support it", but Undark does not say that the evidence does not support it, it says the evidence is limited. A similar statement appears at the end of the paragraph. We should keep just one of these to avoid redundancy. JonJ937 (talk) 09:40, 10 April 2025 (UTC)

Jon, on it being no worse than any other area I really don't believe it's true. The gender identity service series did a systematic review on all 3 of Cross sex hormones, puberty blockers and psychosocial treatments. They found 33 moderate quality studies and 1 high for cross sex hormones, they found 25 moderate quality studies and 1 high quality for puberty blockers and they found 1 moderate quality case study in psychosocial interventions. It is undeniable that this particular area has less research and lower quality research than the research for the other treatments. LunaHasArrived (talk) 11:12, 10 April 2025 (UTC)

The WHO states that the evidence for puberty blockers is limited. This organization usually reflects the global medical consensus. But my intention is not to debate which aspect of trans health care has more limited evidence. I do not dispute that the evidence for psychotherapy is also limited or weak. My point is that there is no need to repeat the same line twice within a short paragraph. JonJ937 (talk) 14:00, 10 April 2025 (UTC)

I removed the first statement about weak evidence. A single mention is sufficient in this short paragraph. JonJ937 (talk) 14:14, 10 April 2025 (UTC)

LokiTheLiar, could you please explain this revert? [25] Where does Undark state that "the evidence does not support it"? It uses no such wording. As we've discussed previously, Undark and other sources state that the evidence is limited, which is not the same as saying "not supported by evidence". You yourself stated that "we shouldn't imply that there's no evidence". Also, the point is repeated twice within a short 3 line paragraph, which feels redundant and gives the impression of trying too hard to make a case. Aren’t we already being "super clear" by stating that “evidence for psychotherapy as a treatment for gender dysphoria is weak”? JonJ937 (talk) 08:18, 11 April 2025 (UTC)

I saw that edit, and I read the edit summary, and the reason seems clear to me. It's important we don't, inadvertently or otherwise, give a false impression of the state of the medical evidence.OsFish (talk) 09:02, 11 April 2025 (UTC)

But the sources do not say that "the evidence does not support it". The user who made the revert also admits that. JonJ937 (talk) 11:02, 11 April 2025 (UTC)

That's not what I said, I said we shouldn't say there was "no evidence". The evidence does not, in fact, support it and that's clear in the Undark article. Loki (talk) 16:19, 11 April 2025 (UTC)

Here:

Other critics of the group point out there isn’t much evidence to back up psychotherapy. SEGM, citing guidelines in Finland and elsewhere in Europe, has described this as the preferred treatment for younger people. “As a researcher invested in evidence-based mental health practices, I’m concerned that SEGM has promoted untested alternatives to gender-affirming care,” Briana Last, a faculty member in the psychology department at Stony Brook University, wrote in an email to Undark.

The redundancy is fine and IMO even desirable. We need to be clear when the evidence for a treatment is weak and that's especially true if we're saying something that would imply something to the contrary. So we ought to say "the evidence is bad" up front and then say "the evidence is bad" at the point we say the thing that would imply the evidence is good. Loki (talk) 16:23, 11 April 2025 (UTC)

"There isn’t much evidence" is not the same as "evidence does not support". The first admits to some, albeit weak or limited, evidence, while the second implies complete absence of evidence, which is inaccurate. As discussed above, and agreed by you, some evidence does exist, though it is limited and mostly of low quality. Moreover, little evidence is reported by Undark as a viewpoint expressed by critics. Regardless, sources must be quoted accurately. It is still beyond me why repeating the same point twice in a three-line paragraph is so necessary. One mention is sufficient for the reader to grasp the idea. Opening and closing the paragraph with the same claim makes an iteration of the same point, which feels redundant. JonJ937 (talk) 14:58, 12 April 2025 (UTC)

The phrase is not “there isn’t much evidence”. The phrase is “there isn’t much evidence to back up psychotherapy”. By cutting out the second half of the phrase, you’re trying to portray it as meaning there isn’t much evidence either way. But with the second half, it is clearly meant to mean that there is a lack of evidence specifically for the psychotherapeutic approach here. The paraphrase is fine.OsFish (talk) 15:19, 12 April 2025 (UTC)

Could you explain how "there is not much evidence" means "the evidence does not support"? That distorts the meaning of what the source says. JonJ937 (talk) 15:28, 12 April 2025 (UTC)

Because the person that sentiment is attributed to straightforwardly describes psychotherapy in this area as “untested”, and that she is concerned by SEGM’s promotion of it. It’s clearly meant negatively. It’s meant that the evidence does not support it. Also, you really should not edit against the majority of editors opinion here in the middle of a discussion.OsFish (talk) 15:35, 12 April 2025 (UTC)

I changed the first instance to "evidence is limited" to align with what the source states. JonJ937 (talk) 15:20, 12 April 2025 (UTC)

And I have reverted. That is a straightforward misrepresentation of the source.OsFish (talk) 15:25, 12 April 2025 (UTC)

You need to decide whether the evidence is weak or whether it does not support the treatment method—these are not interchangeable. Either the evidence is limited/weak, or there is no supporting evidence at all; one cannot present both simultaneously, as they are mutually exclusive. I find it really disruptive to see the same user make one edit to change the wording to mention weak evidence ([26]) but then revert to restore the claim "the evidence does not support it" ([27]). We need to maintain consistency and reflect what the sources actually say. Sean Waltz O'Connell (talk) 16:37, 13 April 2025 (UTC)

The quoted source says the approach is "untested", and that she is concerned about SEGM's promotion of it. "Not much evidence" does NOT categorically mean that there is direct, supportive evidence, limited or otherwise. I agree that we should reflect what sources say. The source here is really negative about the evidence basis. OsFish (talk) 16:54, 13 April 2025 (UTC)

The claim that the therapy is “untested” reflects the opinion of an individual quoted in the article—it’s not how the journal itself frames it. Undark states: “critics of the group point out there isn’t much evidence to back up psychotherapy.” Saying there isn’t much evidence is not the same as saying there is no evidence. Your interpretation that - the evidence does not support the therapy, goes beyond what the source actually says. That is your subjective interpretation. In fact, the study referenced on this topic acknowledges that the evidence is limited, not nonexistent. (Check the talk thread above, where the study was referenced and discussed.) We should avoid presenting conflicting claims in the same paragraph—such as stating that the evidence is weak while also asserting that “the evidence does not support” the therapy—as this creates confusion and misrepresents the nuance in the sources. Sean Waltz O'Connell (talk) 10:49, 14 April 2025 (UTC)

This argument that the phrase "not much evidence", used to describe the general view of critics, has no connection to the verbatim comments of the critic the journal chose to immediately quote after by way of illustration, is...silly. It's just silly. OsFish (talk) 12:26, 14 April 2025 (UTC)

We don't present opinions of individual critics as facts. We must stick to what the article says in the article voice. Sean Waltz O'Connell (talk) 16:18, 14 April 2025 (UTC)

But we mustn't twist what the article says away from what it means. You are trying to make the article say something it does not based on the very odd claim that the comment used to illustrate the phrase has zero connection to the phrase. It's clear that "not much evidence" in this context means the practice is not supported by the evidence. "not much" is just a softening phrase like "not much good" or "not very honest". They're used all the time. The article follows exactly the same pattern in the same paragraph, where it says

"Others have accused people affiliated with SEGM of using inflammatory language. “It’s just pure bigotry, and really gives the game away of what they’re aiming to do,” said Alejandra Caraballo, a clinical instructor at Harvard University’s Cyberlaw Clinic."

Statement followed by illustration. It's silly to separate one from the other.OsFish (talk) 04:17, 15 April 2025 (UTC)

In addition to what OsFish said, when a news source quotes an expert on a topic, we can in fact rely on the expert's opinion as if it was in article voice.

Brianna Last, the person quoted there, isn't an activist. She's a psychology professor. She's being quoted as an expert. Loki (talk) 04:39, 15 April 2025 (UTC)

Sean is right. We cannot take a single opinion for a fact. The systematic review cited above explicitly states that the evidence is limited, not absent, and it reviews all available research on the subject. It's also important to distinguish between "untested alternatives" mentioned by Last and a lack of supporting evidence, as those are not the same. “Untested alternatives” implies that something has not been thoroughly studied or evaluated, which is not the same as saying there is no evidence or that evidence shows it doesn’t work. It simply means that sufficient in-depth research hasn’t yet been conducted, so its effectiveness remains uncertain. That is why Undark says "not much evidence". We should strictly follow the language of the source, avoiding personal interpretations. In this case, Undark itself does not claim the "evidence does not support" these practices. It reports that critics say that there is not much evidence and D'Angelo agrees that the evidence is limited. Also, Caraballo is an activist and lawyer, not a medical professional. JonJ937 (talk) 08:28, 15 April 2025 (UTC)

This area has not been thoroughly tested. Thats what the systematic review means when it says, the amount of research is limited and the output is low-quality and inadequate and that no firm conclusions can be made. It should also be noted that a separate systematic review on Gender exploratory therapy found no studies whatsoever so that practice really does have no evidence. We need to be very careful and make sure we don't accidentally imply that the evidence for GET is limited or low quality when talking about the general evidence basedfor Psychosocial interventions. Last saying that SEGM is promoting untested alternatives is a very accurate way of describing what SEGM does with GET. LunaHasArrived (talk) 09:08, 15 April 2025 (UTC)

"Untested" when directly attached to the phrase "not much evidence" means that evidence is lacking. I didn't cite Carabello as an evidence for the proposition under discussion here. I cited her as an example of the very common and established rhetorical pattern, used twice in the same paragraph, that demonstrates that the quotation illustrating the phrase "not much evidence" does actually mean "evidence does not support the practice". Please read other editors comments more carefully. OsFish (talk) 09:48, 15 April 2025 (UTC)

The claim that “the amount of research is limited and the output is low-quality and inadequate, and no firm conclusions can be made” is precisely what defines limited evidence. It means that while some data may exist, it’s not robust or conclusive enough to support strong claims either for or against a treatment. The source does not state that there is no evidence for the efficacy of psychotherapy—it only indicates that the existing evidence is insufficient to draw definitive conclusions.

Therefore, framing the treatment as “unsupported by evidence” misrepresents the source, as it implies a firm negative judgment that the data does not warrant. That interpretation is not directly stated in the source—it is a personal inference.

It’s also worth pointing out the irony in Last’s criticism of SEGM for promoting untested alternatives to gender-affirming care—when gender-affirming care itself is supported by limited evidence. This double standard gives the impression of activism rather than a neutral or academically balanced critique. Sean Waltz O'Connell (talk) 15:13, 15 April 2025 (UTC)

The international expert consensus is that the evidence supports gender affirming care, and that psychotherapy to “cure” being trans is unevidenced and harmful. That’s what Wikipedia should reflect. It’s your right in a democratic environment to disagree with that state of affairs, but Wikipedia is an inappropriate place to address that disagreement. OsFish (talk) 16:32, 15 April 2025 (UTC)

There is no established consensus on this issue, the field remains unsettled. The World Health Organization has acknowledged that the evidence supporting gender-affirming care is limited and has declined to issue formal guidelines. A number of countries have already banned or restricted puberty blockers to clinical trials. Wikipedia articles must adhere strictly to what reliable sources state and none of the sources state that the evidence does not support psychotherapy. As explained in detail above, "untested" or "not much evidence" is not equivalent to "evidence does not support". The systematic review of the available research also states that the evidence is limited and that further research is needed. Insisting on a personal interpretation of a source that is not directly supported by the source itself is disruptive. Wikipedia's policies require that sources must directly support the material being presented. According to WP:OR: "Even with well-sourced material, if you use it out of context, or to state or imply a conclusion not directly and explicitly supported by the source, you are engaging in original research". This is exactly what you are doing. JonJ937 (talk) 10:38, 16 April 2025 (UTC)

I have joined consecutive sentences in one article because it’s really obvious they are connected. That isn’t OR. On the other hand, it’s OR to bring what your interpretation of what WHO says about a different topic (ie not psychotherapy/conversion therapy) to combine it with what this article says to force an interpretation of what the article means. That consensus is against your preferred approach to transgender health matters for WP:FRINGE reasons. Multiple statements by expert bodies in the past couple of years have confirmed that gender affirming care is mainstream. Some of them have specifically stated that eg the non-expert review in the UK goes against best practice and was badly done. To repeat, it’s OK for you in a democratic environment to express your dislike of this state of affairs in terms of expert opinion, but Wikipedia is not how you go about changing things.OsFish (talk) 14:58, 16 April 2025 (UTC)

There is no consensus at this discussion. Multiple users agreed that the current interpretation of Undark reference in this Wikipedia article is not accurate. I am not proposing that this article should state that gender-affirming care is based on limited evidence. I mentioned this fact only as a general observation regarding the state of research in this emerging area of healthcare. You know that WP:OR applies only to article content and not to talk page discussions. On the other hand, inserting claims into the article that are not explicitly supported by the cited source is original research. Nowhere does the Undark say that the evidence does not support psychotherapy. That conclusion is a personal interpretation and goes beyond what the source actually says. JonJ937 (talk) 10:46, 17 April 2025 (UTC)

Except that it takes a preposterous approach to how rhetoric works to suggest that quotes used to illustrate a phrase have zero connection to the phrase they are cited to illustrate. It isn't a personal opinion that these quotes illustrate the phrases. It's common sense.OsFish (talk) 12:02, 17 April 2025 (UTC)

This is about providing an accurate summary of what the source says. Per WP:OR: "Source material should be carefully summarized or rephrased without changing its meaning or implication. Take care not to go beyond what the sources express or to use them in ways inconsistent with the intention of the source, such as using material out of context. In short, stick to the sources". The present interrelation goes beyond what the source says. JonJ937 (talk) 12:17, 17 April 2025 (UTC)

And your interpretation is inconsistent with the intention of the source. You are deploying a preposterous argument that quotes used to illustrate statements have zero connection to the statements they illustrate. You are, in effect, asking other editors to ignore the bits of the text that you don't like. OsFish (talk) 12:22, 17 April 2025 (UTC)

In EBM it’s important to distinguish between the amount of evidence and the certainty or quality of evidence, and they should not be conflated. Terms like "weak evidence" relate to certainty/strength, while "limited evidence" relates to amount/scope.  Looking at the Undark source and what we currently have on the SEGM article, neither "evidence does not support" nor “weak evidence” are accurate by EBM standards. Limited evidence would be the most appropriate; it’s actual EBM terminology and it matches the source. Evathedutch (talk) 13:20, 18 April 2025 (UTC)

Would you like to provide a) evidence that the authors of the article were applying the EBM hierarchy of evidence when they chose their wording and b) that “not much evidence” and “untested” are uncontroversially listed as meaning “limited evidence”? Because this argument you make seems like the sort of convoluted OR that Jon had been warning against. OsFish (talk) 17:57, 18 April 2025 (UTC)

I am not familiar that people do a) in Wikipedia. Can you give me an example? Evathedutch (talk) 05:07, 20 April 2025 (UTC)

I'm trying to make sense of your claim that the language used in the Undark article is somehow a reference to EBM terminology. OsFish (talk) 13:41, 21 April 2025 (UTC)

This is a valid point regarding EBM. Each term has a specific meaning in science, and it's important not to conflate them. As mentioned earlier by myself and others, phrases like “not much evidence” or “untested” do not mean that “the evidence does not support” a treatment.

There is a clear distinction between “untested,” “weak,” and “limited” evidence. The sources make it clear that there is not sufficient research on the effectiveness of psychotherapy to draw definitive conclusions either way.

According to standard dictionary definitions, “untested” refers to something that has not yet been tried, tested, or evaluated. For example, Merriam-Webster defines untested as “not put to a test or not having undergone testing or trials.” Similarly, the Cambridge Dictionary defines it as “not tried or examined to find out if something works or is effective.” These definitions make it clear that untested indicates a lack of testing, not a negative result. It simply means we don’t yet know if something works.

In contrast, describing a method as “unsupported by evidence” suggests that it has been tested and found to be ineffective. So, the two terms are not interchangeable. Untested means there is not enough evidence to draw conclusions. Unsupported means the available evidence indicates the method does not work.

Mixing up these terms misrepresents the actual state of the research and creates confusion about what the sources language explicitly states. Sean Waltz O'Connell (talk) 12:16, 22 April 2025 (UTC)

If everyone’s good with it, I'll change "weak" to "limited" and remove “the evidence does not support”, since the sources don't actually back that up Sean Waltz O'Connell (talk) 08:53, 27 April 2025 (UTC)

I'd be happy to change "weak" and "does not support" to "untested" (in both locations) as you support above, honestly speaking that seems like the most appropriate phrase here. Limited strikes me as being far far too generous for a field in which no (excluding one family) moderate or above quality study has been done. LunaHasArrived (talk) 09:19, 27 April 2025 (UTC)

"Untested" is the opinion of one interviewee, not the wording used by the source itself. It is not the best choice of wording, as it may be interpreted as that no testing has been conducted, whereas the systematic review you cited indicates that some limited testing has taken place. The source itself states that critics believe there is "not much evidence," meaning there is some evidence, but it is not sufficient. We should use language that accurately reflects the current state of research, rather than relying on individual opinions that could misrepresent the overall findings. Sean Waltz O'Connell (talk) 10:15, 28 April 2025 (UTC)

Language that accurately reflects the current state of research would be all 3 of "limited, low quality and insufficient to make conclusions." We could use "lack of evidence" instead as that's a good paraphrase of undark saying that "there's not much evidence". LunaHasArrived (talk) 10:51, 28 April 2025 (UTC)

Just to make clear, that no, I'm not OK with the suggestion to distort the source to say "limited" when the source clearly neither says nor implies that. Looking back on this conversation, it seems that the phrase "limited" is being promoted specifically to imply that there is positive evidence. However, such a claim is based upon a published metaanalysis of what that metaanalysis itself calls low quality studies, and most importantly, the critic cited as an illustration in Undark is not referring to that analysis. That is, "limited" is the product of OR with the express intent of implying positive evidence. OsFish (talk) 13:15, 28 April 2025 (UTC)

I think we can all agree that "evidence does not support" is not found in any source and thus constitutes WP:OR. That phrasing implies the treatment has been tested and shown to be ineffective, which no source claims. Therefore, it should be removed. I hope there is no objection to eliminating what is clearly original research.

That leaves us with the options: "untested," "not much evidence" (i.e., little or limited evidence), and "weak evidence." According to standard dictionary definitions, "untested" means that a treatment has not been subjected to testing, and therefore it is unknown whether it works. But that is not entirely accurate here—there has been some research into the treatment’s effectiveness, though it is not sufficient to draw firm conclusions. This is exactly what "limited" means.

Describing the evidence as "limited" is certainly not OR, as OsFish suggests, because "not much" clearly implies little or limited. Little evidence is still evidence—it is not the same as an absence of evidence. Moreover, the systematic review cited does not rule out the possibility of positive outcomes; it merely finds the current data insufficient.

Therefore, the only reasonable descriptors are "limited" (= little or not much evidence) and "weak". As Evathedutch rightly pointed out, in scientific contexts there is a meaningful distinction between "weak" and "limited". How about we use something like "evidence is insufficient to support firm conclusions about effectiveness"? This would reflect the state of research more accurately and avoid editorializing. Sean Waltz O'Connell (talk) 09:40, 29 April 2025 (UTC)

How about we just stick to what the undark author meant when they used a quote to illustrate what they meant, a quote that was clearly far more negative than some editors would have liked, but is, all the same, what the author chose to illustrate what they meant? "untested" is the word quoted. Otherwise it's an attempt to cover up.OsFish (talk) 05:05, 30 April 2025 (UTC)

Undark reported that there was "not much evidence", while also interviewing Last, who personally described the treatment as "untested." However, Undark itself does not describe the therapy as untested. In the article’s own words, it is believed to have little evidence, which is not the same thing. The term "untested" is not accurate in this context, as there is existing research on the treatment’s effectiveness—just not enough to draw firm conclusions. We cannot present a personal opinion, especially one that misrepresents the actual state of research, as if it were a factual summary of the source.

Let’s take this one step at a time. Does anyone object to removing the phrase "evidence does not support", which implies that the treatment has been tested and found ineffective since no source actually uses this wording? If so, please point to a specific source where that exact statement appears. Sean Waltz O'Connell (talk) 11:31, 30 April 2025 (UTC)

You are engaging in OR when trying to dismiss the expert quoted in undark. I support "lack of evidence" because that's a good paraphrase of the combination of "not much evidence" and "untested". Again, I think it's utterly preposterous to separate the two phrases as if the author meant them to have no connection whatsoever. OsFish (talk) 10:04, 1 May 2025 (UTC)