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Is it ok to comment on a draft? I saw this being created and was surprised we didn't have an article.
I think the statement "The clinic follows international best practice guidelines, including the WPATH Standards of Care,[4] and the Endocrine Society Guidelines for the Treatment of Gender Incongruent Persons.[6]" isn't supported by the sources. The first source says 'The company, which operates in more than 40 countries, says its practices are consistent with WPATH and other international care guidelines'. The second source (which ultimately cites this source) says 'GenderGP told Independent Community Pharmacist that...“All treatments are prescribed in accordance with The Endocrine Society Guidelines for the Treatment of the Gender Incongruent Person.”' Both sources make it very clear that we only have GenderGP's word for it that they follow said guidelines. Given that their notability rests on the controversy of whether they are indeed following guidelines and best practice, Wikipedia can't simply take their word for that and claim it to be true.
A later statement in the article 'Jay concluded that Helen's practice matched the Department of Health and Social Care's guidance' is potentially ambiguous. Is this referring to the practice of GenderGP as a whole or just one specific aspect in one specific patient. I found the court documents which say 'I consider that the Appellant’s practice matched DoH guidance. This requires parental involvement in the decision-making process.'. So it is just one aspect. Further comments in the documents suggest the judge did have concerns (such as that the doctor could not know the child understood the risks) but this 'was not sufficiently short of amounting to good clinical care as to constitute serious misconduct. In my judgment, she may just about have done enough in the emails to explain the fertility risks to Patient C’s mother, and it is certainly a reasonable conclusion that the Appellant did believe that information given to this parent would be transmitted and explained to the child'. There's clearly some shortcoming identified, but not sufficient to warrant suspension. Have we got other secondary sources for that. I think concluding the doctor did nothing wrong, that their practice was entirely in line with guidelines and without criticism would be a wrong impression to give? -- Colin°Talk17:30, 5 March 2024 (UTC)[reply]
Commenting on a draft is fine :)
So to start with, this is a very hard topic to write about. There's a lot of misinformation about the clinic, and blatant culture war attack pieces from certain elements of the British media (particularly The Times, Telegraph, and Daily Mail) that makes filtering the reliable information difficult. I've tried my best here, but my biggest overall concern is passing WP:NORG. We only really have one WP:SIRS source, the Reuters Investigates report. The content on the cases against the Doctors Webberley helps somewhat towards notability, as the cases against them are pretty inseparable from any other coverage on the clinic, but at the same time those sources aren't strictly in depth about the clinic itself.
On the "clinic follows international best practices guidelines", if you think it's more appropriate to attribute that to the clinic's voice then we can easily make that change. Outside of certain media elements however, I don't think anyone has actually successfully disputed that the clinic follows international best practices. The MPTS hearing, despite its error in finding misconduct, did find in paragraph 237 that Webberley relied on the UCSF trans health care guidelines, and in paragraph 402 that although she wasn't bound to the WPATH SoC 7 or Endocrine Society 2009 guidelines, she did avail herself of the guidance therein while she was acting as a doctor for the clinic. Also just to note, I'd have linked to the MPTS copy of the tribunal judgement in this reply, however they seem to have removed it from their website and the only copy I was able to find was on GenderGP's website.
On "Jay concluded that..." we don't actually have that many secondary sources on the High Court ruling. Despite the rather intense coverage of the earlier parts of the proceedings, particularly when there were findings against Helen Webberley, the only accurate sources I could find on the ruling are the BBC, i News, and BMJ pieces already cited in the article, as well as The Independent and Telegraph which I did not cite in the article. I didn't use the later two, as I didn't feel they added any information that wasn't verifiable to other sources. Of those five sources, none included the "was not sufficiently short" quote you've highlighted. Sideswipe9th (talk) 18:08, 5 March 2024 (UTC)[reply]
I think regardless of whether anyone has successfully disputed the clinic practice, the fact that both our sources only feel able to attribute these claims rather than state them for themselves, means we can't do that either. This is really true for anything on Wikipedia, but all the more so for controversial subjects. In terms of whether any GP practice follows guidelines, these only ever get examined for exceptional cases where misconduct is suggested. I'm quite sure most GP practices fall short regularly just as none of us are fully compliant with the Highway Code when driving but this only ever gets tested if we have an accident or a police officer pulls us over. So it is a bit like if Colin says he's an excellent driver who always obeys the speed limit. You and I both know we don't need evidence of speeding fines, or appealed speeding fines, to know we couldn't possibly then state, in Wikivoice, that Colin is an excellent driver who always obeys the speed limit.
I agree that a lack of secondary sources is a difficulty. Sometimes though we have to use our judgement from reading the primary source whether to omit when a secondary source gets it wrong or gives an unbalanced impression. The BMJ says 'Webberley should have discussed the risk to fertility with C directly, he added, but “it is far from clear to me that what did take place should be strongly criticised.”' among other remarks, which make it clear the judgement was still critical but at a level below that which warrants suspension. Along with the idea that some mitigating aspects were not considered, I think that's the gist we should be giving, not that everything in fact was totally fine and dandy nothing to see here move along now. -- Colin°Talk18:29, 5 March 2024 (UTC)[reply]
attribute these claims rather than state them for themselves, means we can't do that either Yeah that's fair, and I think the rest of your analysis in that paragraph is good. In terms of phrasing for this, the simple version would be to alter the start of the sentence The clinic follows... to The clinic says it follows..., though maybe it's a bit jilted? Is there phrasing you have in mind for this?
Sometimes though we have to use our judgement...whether to omit when a secondary source gets it wrong Yeah, 100% agree. That's why I've tried to avoid using the hit pieces, particularly on the earlier parts of the tribunal process. The sources that are currently in the draft I think reasonably represent the respective judgements, without engaging in the sadly typical sensationalism we currently see for any doctor who follows gender-affirming care for trans youth.
The BMJ says So the exact text for that is in paragraph 157 of the ruling. Although I have concerns about certain aspects of the Appellant’s practice in relation to Patient C including a failure to have a face-to-face consultation on the issue of fertility, it is far from clear to me that what did take place should be strongly criticised. I'm not sure how to work that into the paragraph on the High Court ruling though, as paragraph 101 also states it is not entirely clear if the real complaint is that there was no discussion at all (i.e. with anyone), or there was a discussion but it was not with Patient C. I can't really reconcile those two views of the same issue. Is there specific phrasing or even a general gist for what you have in mind for this?
Along with the idea that some mitigating aspects were not considered Sorry, which mitigating aspects here? Is this the email to patient C's mother? Or something else? My working memory is kinda shot, so keeping track of all the separate threads of information here is a bit difficult. If there's specific phrasing you have in mind, I'm always more than happy to read and consider it :) Sideswipe9th (talk) 18:51, 5 March 2024 (UTC)[reply]
Remember I'm not as familiar with this case as you. By "mitigating" I thought this was a reference to an email that wasn't in the earlier tribunal. But maybe that was me getting something wrong. I think your "it is not entirely clear if" is more a comment on the earlier tribunal than a comment on GenderGP and perhaps getting away from the point of the article. Surely everyone agrees, both the earlier tribunal and the later appeal, that the doctor should have earlier pointed out the fertility issue with the child along with their parent, and that to only do that with the parent was something to criticise. I think beyond that it is a matter for judges to decide how strongly that criticism is regarded and enacted upon. But I don't think you can get away from that "finding of fact", and I don't think it would be right for us to suggest that only telling the parent about fertility issues was in accordance with any sort of guideline for that age group at all.
One solution for the "says" attribution issue is simply not to mention it. After all, if Mr Great Actor boasts that his latest film was his finest work, we probably wouldn't give that the time of day here, even though it may appear in print, perhaps as an example of their boastfulness. It might only become encyclopaedic if a source juxtaposed that with critical assessment of their work. After all, most hospitals and GPs don't go around verbally affirming their correspondence with guidelines to journalists. So mentioning that X "says" they confirm to Y sort of implies there is an allegation or suggestion they don't. Which I guess there is. Sort of like our Mr Great Actor saying he never hits his wife. Why would anyone say that unless accused.
Wrt "hit pieces" while I agree this topic is affected by that, we do have to put our "writing for the enemy" hat on. Plenty people would think all the articles reminding us about Wakefield's fraudulent paper are hit pieces on a fine gentleman. One person's hit piece is another's investigative journalism. Once this goes live, you will face efforts to include "facts" from such excellent sources (sarcasm alert) as The Times and The Telegraph. Which brings us to your initial point about the topic being barely notable. The question then is whether giving them a Wikipedia article is wise. If your sources are reliant mostly on news articles, and most news articles are (unfairly) negative about the subject (going quiet, say, when the appeal came in), how will you argue the WEIGHT of this article should not be similarly negative? -- Colin°Talk20:53, 5 March 2024 (UTC)[reply]
By "mitigating" I thought this was a reference to an email that wasn't in the earlier tribunal Aah, following you now. Yes, MPTS tribunal did seem omit reference to an email between the administrative assistant and patient C's mother. We already remark on that in the draft however, It also found that the tribunal had erred by omitting reference to an email from Helen's administrative assistant to the patient's mother. Are you suggesting we should make that more prominent.
I think your "it is not entirely clear if" is more a comment on the earlier tribunal than a comment on GenderGP and perhaps getting away from the point of the article Yes, and no. It is a comment on the MPTS tribunal, but it's also relevant to why she was suspended. Per paragraph 3 of the High Court ruling, the only adverse finding from the MPTS hearing that lead to a ruling of impairment of fitness to practice was that she failed to provide advise on the risks of fertility to patient C. We currently mention this in the first paragraph of the suspension section: The tribunal also found her fitness to practice to be impaired as she failed to provide adequate advise to a 11 year old patient about the risks to fertility arising from treatment.
That the High Court judge later found that the charge was unclear per paragraph 101 is half of the reason why the tribunal's findings were overturned at appeal. The other half is the mitigating circumstances surrounding the email sent by the administrative assistant, that the MPTS tribunal seemed to overlook. Because the charge simply stated that Helen failed to provide good clinical care because she failed to [discuss] the risks to Patient C’s fertility, and because her assistant sent an email to the patient's mother, the lower tribunal made an error in finding that she did not discuss the risks to the patient's fertility. That error is why the tribunal's finding of impaired fitness to practice was overturned.
Surely everyone agrees, both the earlier tribunal and the later appeal, that the doctor should have earlier pointed out the fertility issue with the child along with their parent, and that to only do that with the parent was something to criticise. Surprisingly no. Per paragraph 157 Although I have concerns about certain aspects of the Appellant’s practice in relation to Patient C including a failure to have a face-to-face consultation on the issue of fertility, it is far from clear to me that what did take place should be strongly criticised. (emphasis mine). Yes she should have had the discussion with the patient and their parent directly, but that she had the discussion with the parent does not seem to be something the judge was critical of.
I don't think it would be right for us to suggest that only telling the parent about fertility issues was in accordance with any sort of guideline for that age group at all After re-reading everything you've said, I think I better see the point you're making now. It seems as though we could remove that sentence, as yeah i News do seem to be taking that sentence in a different context than the ruling said it in.
After all, most hospitals and GPs don't go around verbally affirming their correspondence with guidelines to journalists. True, but most hospitals and GPs don't have a great deal of misinformation following them either suggesting they don't follow any standards whatsoever.
Once this goes live, you will face efforts to include "facts" from such excellent sources (sarcasm alert) as The Times and The Telegraph Oh absolutely. The only reason I'm even here is I had the mainspace redlink on my watchlist, and the original revision was a NPOV and V nightmare. The reason why I've put so much effort in here is to make sure that something that complies with our policies could at least be attempted, and that there is a neutral base to go back to if problems arise if the article goes live.
I do also have the same concerns about whether there is wisdom in creating an article about the clinic, because of the sheer amount of misinformation, and how our policies and guidelines are in some ways vulnerable to it. And this isn't the first time where I've had to deal with culture war sources that disparage the subject of one of our articles, see the history and talk page of Mridul Wadhwa for another example. That article had the benefit though of a significantly in depth piece being put out by openDemocracy detailing how The Times and The Herald had run multiple attack pieces against Wadhwa. Unfortunately we don't really have that here, outside of a brief mention by Novara Media and a tangential mention in a research paper about how those same elements of the British press attack Mermaids (charity) as part of the same culture war. Depending on the nature of the content added, an argument might be possible under the WP:ATTACK policy however for either deletion or reversion to a more neutral state.
As for why I've not yet moved this back to the mainspace, after draftifying it after the original creation, notability is the biggest concern. I'm not convinced this draft would pass AfD, and from reviewing the sources (even the negative ones that have blatant falsehoods in them), there is an overall lack of indepth coverage of the clinic itself. Though given what I said in my last paragraph, that might also be a blessing in the circumstances, as article recreation after AfD is much more difficult. Sideswipe9th (talk) 00:56, 6 March 2024 (UTC)[reply]
My reading of "it is far from clear to me that what did take place should be strongly criticised" emphasises the "strongly", the presence of which presumably implies a sanction is warranted. He didn't say ""it is far from clear to me that what did take place should be criticised".
I guess what I'm saying about the adherence to guidelines is that you have the option to not mention it and then the reader of our article has no reason to question why this might be an issue. You are coming to it after reading "great deal of misinformation" but it isn't our job to right-that-great-wrong, or to write it from a "despite what you may have heard elsewhere..." angle. I think we are required to attribute this and also that doing so weakens and give suspicion about the claim. Sort of like being damned with faint praise? How would you feel if you read an article on your local maternity hospital where the lead said that the trust CEO told the press that they were fully in compliance with NHS guidelines on postnatal care. It has an overall negative effect. And anyway, if readers are coming to this from a negative POV, reading that the subject claims to be following guidelines will be treated with a huge degree of suspicion. After all, medical cranks routinely claim they are operating within the law/regulations and helping their patients. I'm sure Wakefield stands by his research to this day.
I hope, from the comments on your user talk page, this isn't "NPOV hell". There's no rush to reply and you don't have to respond to everything as I'm not planning to fight you in any edit war! I am rather disillusioned about editing in this area as I think newspaper-based articles will tend to be weighted according to the bias in the media rather than neutrality. For all the right-wing press writing about how terrible trans this and trans that are, the neutral or LGBT-friendly press may simply write nothing at all. You can't balance shit against nothing. Personally I think the Telegraph and its mates are "flooding the zone" with anti-trans and anti-immigrant stories in order to distract us from concerns that affect everyone but which our current government is unwilling or incompetent to fix. The effect on Wikipedia of this political game is our articles on such subjects can inevitably be filled with this shit. Add to this that editors on all sides of these culture wars like nothing better than to fill articles with whatever tittle-tattle they find in the press in order to dump shit on a subject they hate. The stronger you can make this article, by eliminating the more obvious weaknesses, the better you may be able to defend it. But I remain unsure it won't just end up more like that earlier draft. -- Colin°Talk08:48, 6 March 2024 (UTC)[reply]
According to his own LinkedIn page, Mr. Imrie left the company in January. He described his CEO position as an "interim appointment to assist in transformation". However, the company hasn't announced his successor (if there indeed is one), so I'll make sure to note in the infobox that he's the latest CEO, instead of outright removing him. --ElKabong888 (talk) 16:20, 29 March 2024 (UTC)[reply]