User talk:Colin

Archives

6 December 2005 – 14 July 2006 4 August 2006 – 18 March 2007 19 March 2007 – 8 November 2007 11 November 2007 – 26 June 2008 1 July 2008 – 28 September 2008 1 October 2008 – 24 November 2009 16 December 2009 – 4 July 2010 30 August 2010 – 30 September 2012 22 October 2012 – 25 April 2013 30 April 2014 – 1 October 2014 19 November 2014 – 3 April 2018 25 September 2018 – 3 June 2020 6 June 2020 – 25 December 2023

Wikipedia:Featured picture candidates/delist/King's Cross Western Concourse

One of your featured pictures, File:King's Cross Western Concourse.jpg, has been nominated for delisting because it is no longer used in any articles. Your comments are welcome at Wikipedia:Featured picture candidates/delist/King's Cross Western Concourse. MER-C 11:19, 4 February 2024 (UTC)

Numbers

You might be interested in this collection of stats about last year's editors. (Just ignore if you're not interested.) WhatamIdoing (talk) 22:06, 6 February 2024 (UTC)

Wikipedia:Featured picture candidates/London King's Cross railway station

An image created by you has been promoted to featured picture status Your image, File:King's Cross Western Concourse - central position - 2012-05-02.75.jpg, was nominated on Wikipedia:Featured picture candidates, gained a consensus of support, and has been promoted. If you would like to nominate an image, please do so at Wikipedia:Featured picture candidates. Thank you for your contribution! Armbrust The Homunculus 00:18, 8 February 2024 (UTC)

Some question about the Cass Review

Dear Collins, I'm translatring the "Cass Review" for the French wiki and I have some question about it. Please excuse my weak english.

1- Cass Review led to a change in care for the use of hormanal treatemnt England and Walles, what about Sclotland ?
2- In France we use "Commission" with a president and a "rapporteur" who write the report. Is there any "Comission" aroound Dr Cass or is She the only responsable about the report.
3- About the BMJ : there is  systematic reviews and  an appraisal of international guidelines and an international survey. Is there systemactic review about international survey and international guidelines ?

Best regards GoldenFork (talk) 11:42, 15 April 2024 (UTC)

@GoldenFork

1. Scotland has its own health service and law and devolved government, which is responsible for many things. Scotland has not changed its guidance but I'm sure will be under pressure by some to do so. At the moment we can't say if it will change.
2. Cass chaired the review and ultimately the opinions and guidance is hers rather than a group of people in a committee or commission. They formed a "Clinical Expert Group" to help review the results of the various systematic reviews that were commissioned, along with existing evidences and guidelines.
3. The reviews about international guidelines are at PMID 38594049 and PMID 38594048. You can find all the relevant BMJ papers here. -- Colin°^Talk 12:10, 15 April 2024 (UTC)

thks GoldenFork (talk) 12:25, 15 April 2024 (UTC)

If you have time

Hi Colin. I've been working on getting ME/CFS ready for FAC. I've nearly finished working through the detailed feedback from User:Ajpolino, but would really appreciate to have another (1 or 2) pairs of eyes on the article. I'm still quite new to medical articles, so I'm sure there is more to improve. If you have time, would you be willing to give some feedback? Thanks in advance :). —Femke 🐦 (talk) 13:09, 5 May 2024 (UTC)

Hey can we talk?

Hey listen, I wanted to talk here because, when we discuss things, there are a lot of behaviors on your end that I feel make it difficult to effectively collaborate (and I'm sure that I'm probably guilty of some as well) and I asked about them on teahouse (I didn't mention your name)[1], and they said to go to ANI or AE and I briefly thought over it but honestly the idea made me kinda nauseous because you're a really good editor and even if my case was airtight and I myself was a perfect angel completely free from ever doing anything wrong ever (which I'm not), ultimately in my opinion there is no scenario of you getting sanctioned that wouldn't be an immediate detriment to the project. So instead, I want to talk through it here, and see if we can just, work some of this out for the sake of future collaboration. If you're not open to it, if you're too tired, or whatever else, you don't need to respond. Like I said, I'm not taking this to ANI or whomever, regardless of what happens or doesn't happen here. But I get the sense we're going to keep running into each other, so I'd like to try and, make that as frictionless as possible for the sake of good collaboration. Snokalok (talk) 14:08, 9 May 2024 (UTC)

@Snokalok, thanks for reaching out. Your teahouse post is interesting! I have no wish to take anyone on that talk page or similar to ANI/AE. Maybe we can figure things out away from the heat on that page. You mention a lot of things at the teahouse. Pick one and we can try to a solution. -- Colin°^Talk 15:54, 9 May 2024 (UTC)

So, let's start with the largest one that I think has fueled conflict between us - the United Kingdom. I feel like, very consistently when topics regarding the UK come up, I am saying one thing, and you're hearing something different, and I think to some degree it comes just from a breakdown of communication and to another degree it comes from the fact that we're approaching it from very different life perspectives that perhaps inadvertently skew each of our perceptions one way or the other, and I think that it's important going forward to try and discuss that here to gain a better understanding of what we're actually saying and why.

So, I want to start with your perspective. When I (or editors that often share similar opinions to me) talk about the UK in regards to things like source reliability, general (media, professional, government, etc) consensus, and every other subject we've ever covered relating to the UK in talk, what do you usually hear, where are you coming from in regards to that interpretation, and what do you think I should change? Particularly, though not exclusively, when I or another editor brings up the UK media, government, etc's record regarding trans topics. Snokalok (talk) 16:04, 9 May 2024 (UTC)

Firstly, discussing source reliability in a general way is one way that talk page has deteriorated of the last few weeks. It is rarely a useful approach. Specific source text. Specific article text. Specific point one wants to make. Is that source good for that? Then we can discuss. But the general way that was done is really bad and just leads to people talking past each other. For example: is a medical study published in the Lancet a reliable source? Many people new to Wikipedia might think "of course" and in some ways they would be right if this were a publication other than Wikipedia, and in other ways they might still be right even on Wikipedia. Our answer to that question is far more nuanced than Yes or No for it being a reliable source for absolutely anything one might use it for on Wikipedia.

What would happen if you went to ANI and asked that an editor be topic banned from trans topics because they live in the UK and the UK is "Terf Island". Why might your request be rejected?

Maybe because not everyone in the UK is Liz Truss or writes transphobic opinion pieces in the Daily Mail or is a famous children's author with a bad twitter habit. Very few people in the UK are like that. Suggesting we are would be a bit like I had suggested Americans all go about shooting children at school rather than educating them. Or if I suggested nobody in America should be trusted on medical issues, because you had (and may soon again have) a president who suggested injecting bleach or taking horse medicines to cure COVID while the UK was doing evidence based medicine with the RECOVERY Trial. Population polls suggest the UK and US are not that different on trans issues and nor is most of Europe. But the US has 10 times the trans murder rate than the UK.

Most people in the NHS have a very dim view of our current government. Our medical journals are generally highly critical of it. Most medical professionals want to treat their patients with respect and with the best possible practice. If you read the foreword of the Cass Review, both the interim and the final reports, I see someone sharing those NHS values of compassion and respect and wanting to understand and do their best. Compare that with any of the filth written in the Times or Telegraph or spouted by our less intelligent politicians, who bang on about the cult of gender ideology and how trans women are just men in dresses, and should all be feared for the sex offenders they clearly are.

-- Colin°^Talk 17:10, 9 May 2024 (UTC)

So to mitigate the possibility of talking past each other, I'm going to respond to your words point by point, and then add additional points on my end as I feel are relevant.

On source reliability:

I fully agree with what you're saying here, and I think to some degree on the talk pages - particularly with regards to the Cass Review - it tends to be very singularly flattened into "This is built on or is a systematic review, therefore it is automatically reliable evidence according to MEDRS" vs "This paper was put together by numerous names listed as major figures in fringe group SEGM who have expressed some wildly bigoted views on trans people in the past and have taken an active role in conservative politics, therefore it is not reliable evidence". And I can't pretend that I don't very much have a side I lean towards in that, but I agree with everything you're saying here. Every source is reliable for something, trying to discount sources altogether is not a productive use of time or energy. I think probably the hottest flashpoints are in regards to weight and conflicts between sources. My personal view is very much WP:YESPOV, I think that if there's a conflict - particularly with a contentious topic like this - it's best to describe the conflict rather than choosing one or the other, but at the same time, the actual implementation of that tends to be where it all crashes and burns, because when you're framing a conflict, there are a million ways to frame it and no one likes all of them. For instance if we implement a theoretically top MEDRS source that was ghostwritten by a fringe medical org, are we giving undue weight to harmful fringe ideas in a credible wrapper?

On transphobia in the UK:

So, I definitely don't want this to turn into just each of us fighting over which country is more transphobic, but I do think that we may well need to touch on it to some degree - just for the purpose of establishing our feelings. So I'm just going to, rip away the bandaid here and get this out of the way. Before you react to this, please read the section after.

Ahem. It's not just the Times or the Telegraph or Liz Truss or Kemi Badenoch. In media it's also the BBC, the Guardian, the New Statesman, every outlet big or small across the entire political spectrum regularly runs pieces on how "trans women are here to replace biological women" or "should seeing a trans person in the bathroom be considered rape" or something like that, in government it's also Keir Starmer, it's also Wes Streeting, it's both major political parties, like half the SNP, half the Green party, a surprisingly small amount of the libdems but also they're the libdems so who's paying attention to them. It's not just the elected politicians either, it's the EHRC, it's the courts that rule GC is a legally protected belief on the same level as religion, it's the Queen of England giving the BEM to the founder of Transgender Trend for founding Transgender Trend. I mean, what's the moderate viewpoint in an environment like that? "I don't think trans people should be stabbed to death for being trans but also I think they should be stripped of all rights, healthcare, and recognition to protect the real women"? Hell, what's the progressive viewpoint there?

Now with that out of the way,

On the UK in relation to Wikipedia:

All of the above that I just said, should not be used to automatically discount the opinions or contributions of British editors, British journalists, British academics, etc. That would be incredibly bigoted. My view on the NHS for instance is not “NHS run by British people and British bad”, my view is “The NHS practices ‘gender exploratory therapy’ which is widely recognized as a form of conversion therapy on a good day and on a bad day the NHS is just openfacedly abusive, carceral, and discriminatory in its treatment of trans patients. Why would we give page-reshaping weight to something they put out on the matter as though any semblance of objectivity or epistemic good faith can reasonably be expected? That’s not to say to exclude the NHS, just don’t treat its word as the gospel. Give it weight, just not ALL the weight.” And I think that in the heat of the talk page, with a feeling of pressure to quickly respond, I sometimes articulate this less well than I should. I also think right now as I type this that I might unconsciously blend this somewhat with my perception of the UK media, because I remember how much the media circus from all sides influenced things like Tavistock, whose greatest crime, as I understand it from reading, was that they gave trans kids treatment without trying to convince them to desist (again, conversion therapy) - because everyone (including the Cass Review) seems completely unanimous in their agreement that a trans person transitioning is a systemic failure (see: puberty blockers don’t give them proper time to think because the majority still chose to transition anyway).

Regardless, I don’t think being British is ever disqualifying, just that an organization’s track record and position on a topic should inform how exactly we deploy the source. If the Department of Health under Trump put out guidance saying “Actually trans people should be given SSRI’s to make them desist”. If ACPeds put out a systematic review on abortion, saying that the evidence of it leading to positive psych outcomes is very low or nonexistent and recommending it be banned, how much weight would we give that? It just happens that the UK government and most of its subsections, have a terrible record on the topic.

And I think that when I (or any of the other usual editors that ends up arguing with you) raise this point, you tend to mistakenly interpret it as an attack on anyone of English blood, when no, not at all. Some of the greatest trans advocates and allies I’ve seen are from the UK, it’s not an impugnment of the British people or anyone on the grounds of being from the UK, it’s not that all British people are transphobic or should be assumed as such, it’s simply that - to put it in American terms - if tomorrow the Trump admin’s Department of Health put out its own review saying latinos were predisposed to laziness or something, while not all Americans are racist against latinos, the Trump Admin pretty indisputably is. How would we use that to inform our use of that review? I mean hell, the State of Florida under DeSantis put out its own review on trans healthcare that was pretty blatantly done by starting with a conclusion and working backwards, and was criticized by much of the medical field as such, and we don’t use it to rewrite entire pages or exclude viewpoints that contradict it.

I also feel like, when defending UK institutions in talk, you approach it with a certain degree of exceptionalism that I feel like you’re maybe not entirely aware of. I think to some degree this is a place where our different experiences come in. I was five years old when you started editing Wikipedia (and most of the trans editors you see arguing with you can probably say the same). The idea of any first world government that helped carpet bomb Iraq as being inherently enlightened somehow and therefore more trustworthy, holds absolutely no sway to me. You say “The UK is a liberal democracy” like it’s the most obvious thing in the world to discount any criticism that rises above a certain level of severity. That to me just feels, strange and arbitrary, and it makes it feels like it makes it harder to come to a reasonable point of agreement.

On compassion in healthcare:

This is also something where I think our disparate life experiences lead us to read the same sentence very differently. Quoting you for a moment, “Most medical professionals want to treat their patients with respect and with the best possible practice. If you read the foreword of the Cass Review, both the interim and the final reports, I see someone sharing those NHS values of compassion and respect and wanting to understand and do their best. Compare that with any of the filth written in the Times or Telegraph or spouted by our less intelligent politicians”. Without checking, I fully believe what you’re saying here. I just don’t think you realize what “compassion” and “the best possible treatment” can take the form of.

That is, the wrong doctor might see compassion and the best treatment towards trans people as compassion towards a mentally ill person that needs to be saved with the best possible psychiatric care to make them stop being mentally ill. There were a few names on the Cass Review board who openly take that stance. I mean, look back at the section on puberty blockers. The review disagreed that puberty blockers gave trans kids time to think because too many were choosing to continue on to HRT. That implies that it sees a trans kid transitioning, as a failure, and a trans kid desisting, as a success, because a lot of doctors still see transitioning as a bad thing and something to only be done in a worst case scenario. So they need to show them “compassion” by giving them general psychiatric meds instead. The same general psychiatric meds they once “compassionately” gave to gay people to “save them from a life of degeneracy". They “want to understand” with GET the same way those who used psychotherapy to “repair” homosexuality “wanted to understand”. No tyrant is so severe as the tyrant who genuinely believes it’s for your own good.

You see a difference between the doctor that practices conversion therapy because they genuinely believe it’s the best thing for a trans patient, and the journalist who advocates conversion therapy because they hate trans people. There is none. Snokalok (talk) 19:11, 9 May 2024 (UTC)

What source are you referring to as "ghostwritten by a fringe medical org". Reliable sources on this please, not social media gossip.

I think some of the debate in press and online has fuelled this culture war by giving voice to those with the most extreme views. I don't think your characterisation of UK politics is accurate. Those in the middle ground end up with labels because of one thing they said or one aspect they say they agree on or are concerned about. People are complex and boxing so many people into a "group I hate" is not I think a wise thing to do. I see people on both sides of this war who are hateful idiots, to be frank, and I see people on both sides of this war who are thoughtful and considerate and who are capable of disagreeing with others without hating them.

I also don't think your characterisation of the NHS is fair or even remotely accurate. For example: "The NHS practices ‘gender exploratory therapy’" is simply untrue. Reliable sources please if you disagree. Tavistock had multiple failings but the idea that medical critics complained they should have been "trying to convince them to desist" also isn't true. Cass does not regard a "trans person transitioning" as a failure. They have been quite clear about that.

I've lived through two long periods of Tory government. The first time around, schools were banned from mentioning that gay people exist. Apartheid South Africa was our business friend and Nelson Mandela a murderer. Pinochet was our ally in the war against Argentina. The second time around, Europeans are hated, refugees are called "asylum seekers" as though that was a bad thing to be, people long term sick with depression are told to pull themselves together and get a job, trans is made a culture war, global warming is ignored and the driver loved, etc, etc. These Tory views were and are not shared across the country. We don't live in North Korea where everyone is brainwashed to believe what the government line is. The stuff politicians and opinion columnists say and write are not representative of most people. But also people can change: it was the second Tory government that introduced gay marriage.

Importantly the arguments you present against Cass and the systemic reviews are based on prejudice, rather than identifying factual errors or improper methods and so on. Even before the report was published, you were on the talk page talking about the Council of Europe and saying anything our government might publish is thus unreliable on this topic. Our government has been widely criticised for not taking global warming seriously. Some Tory MPs who actually did make an effort have ended up resigning and protesting from the back benches. Other Tory MPs claim it is all made up or that technology will give us the answer. The current leadership says it is the friend of the motorist and wants more oil exploration. I've no doubt there's an equivalent document to your "Council of Europe" document that trashes the UK government, the right wing press and a fair chunk of gullible public. But strangely this has zero effect on our climate change research, which is some of the best and most critical-of-government/business in the world. I don't think you'd complain about climate research in the UK, published by government funded universities, being unreliable because Sunak. So why does your argument hold on trans research because Truss? Prejudice is the weakest argument.

I think also it is important to separate the two aspects of the Cass Review. One is on gathering evidence and data (e.g. about the population group being referred). The other is making decisions and recommendations. My main interest, from a MEDRS point of view, is in the former. I think that has been done in a well regarded manner and has not been criticised in any sensible way currently, and also didn't find anything that wasn't already widely known and had appeared in previous reviews. The latter, especially as the evidence for most things is so weak, falls into an area where I think wise sensible people can come to different conclusions. And some of the latter will be affected by whether the government (or future government) stump up the money to pay for all the clinics and actually manage to attract staff for them. It is far easier for Wikipedia to neutrally describe multiple treatment guidelines recommended by different governments or bodies. It is much more difficult for Wikipedia to talk about the evidence as though there is any serious dispute. There comes a point, like we have with COVID and climate change and vaccines, where best current knowledge is clear, and dissenting voices are not given weight. There are simply too many systematic reviews all saying more or less the same thing, and none at all giving the kind of wholesome support that activists are claiming. Those reviews are open to inspection and can be criticised for real flaws, should they have them. One doesn't have to invent a conspiracy of TERF ghostwriters. -- Colin°^Talk 10:45, 10 May 2024 (UTC)