Talk:Gender-affirming hormone therapy

Requested move 15 July 2024

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: There is consensus that the menopausal context remains the primary topic for "Hormone replacement therapy". The usage of the term in high-quality medical sources was particularly persuasive. However, there is clear consensus (unanimous among those who opined, if I'm not mistaken) that "Gender-affirming hormone therapy" is a preferable title to "Transgender hormone therapy". Thus, Transgender hormone therapy is moved to Gender-affirming hormone therapy and Hormone replacement therapy is not moved. (closed by non-admin page mover) -- Tamzin^{[cetacean needed]} (they|xe) 09:12, 18 August 2024 (UTC)

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• Transgender hormone therapy → Hormone replacement therapy (transgender)
• Hormone replacement therapy → Hormone replacement therapy (menopausal)

– It has become clear that the current article at Hormone replacement therapy for menopausal application does not qualify as a clear WP:PRIMARYTOPIC after reviewing of page navigation flows for Hormone replacement therapy, Hormone therapy and Transgender hormone therapy. An outsizedly large amount of traffic that currently navigates straight from Hormone replacement therapy to Transgender hormone therapy, since HRT is also referred to for it (as outlined in the lead of the article), or to the current disambiguating article Hormone therapy, which combined account for 30% of the navigation from the current HRT article. So I propose that Hormone replacement therapy doesn't have a clear primary topic and as such we should rename the two articles to both use "Hormone replacement therapy" (or HRT in short) as their WP:COMMONNAME with the specific application in parenthesis. And then turn the current "Hormone replacement therapy" into a simple disambiguation page, or redirect it to Hormone therapy (which kind of already acts as a disambiguation page, as also shown from the traffic of the hat note). Raladic (talk) 20:21, 15 July 2024 (UTC) — Relisting. – robertsky (talk) 07:33, 23 July 2024 (UTC)

I note you've listed this shortly after I pointed out here that your rewording on that article didn't match the source or the WP:COMMONNAME.

A quick google shows that the clear primary topic of "Hormone Replacement Therapy" is menopause. Everything in the top 20 results is menopause.

Eg:

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/

https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms

https://www.nhs.uk/conditions/menopause/treatment/

The first that does mention for transition is this, which this says:

Hormone replacement therapy (HRT) is a treatment doctors may recommend for managing menopause symptoms such as hot flashes and night sweats. It helps balance estrogen and progesterone levels. However, HRT may not be safe for everyone. Also known as menopausal hormone therapy, HRT can help relieve sweating, hot flashes, and other symptoms of menopause. It can also reduce the risk of osteoporosis.

Further down, under other uses of sex hormones it says:

A doctor may also prescribe different types and combinations of sex hormones for: birth control, low blood testosterone levels, a transition from the sex assigned at birth, prostate cancer

This is a passing mention. Nobody calls birth control HRT.

Your renaming is unnecessary and not supported by sources. That some people incorrectly call gender affirming hormones "HRT" does not make it the primary topic, when menopause is something that affects half the species. Void if removed (talk) 21:23, 15 July 2024 (UTC)

There is nothing incorrect, when people use the term HRT for transgender application and there is plenty of reference to it, both in medical and popular use.

We have policies on Wikipedia on article titling, and as I outlined above, Primary Topic is one such policy and deals with the question of what do users come to for Wikipedia when they are looking for something. Based on that and the nav flows, it has become clear that a large amount of users are expecting to land on Transgender hormone therapy when they were searching for Hormone replacement therapy or HRT.

"a quick google search..." is not a policy based factor in determining whether a topic at a current article title is a WP:PRIMARYTOPIC or if there is too much ambiguity, then we instead turn it into disambiguating terms for all applicable terms that go by the same name, such is the case here, since even currently the Transgender hormone therapy article is already also clearly having HRT as one of the 3 primary terms that it is referred to. Our primary topic policy has two very clearly defined points and in this case in particular, the current article is failing WP:PT1 as 30% of the traffic is going straight from the current article to where they actually wanted to navigate to as I outlined above.

Language evolves and Wikipedia as an encyclopedia is trying to name articles based on policies, which are informed by what users most likely are searching for, which is why we have countless articles with (disambiguations) when multiple articles use the same common term as the most common shared search term. Raladic (talk) 21:36, 15 July 2024 (UTC)

I've now checked the WPATH SOC8 - they use "hormone replacement therapy" when referring to replacing endogenous hormones for someone who has eg. undergone a gonadectomy.

Everywhere else they stick to eg. gender-affirming hormones. This rename is going to introduce significant confusion.

Also - not sure how you're getting "30% of the traffic is going straight from the current article to where they actually wanted to navigate to as I outlined above."

From my reading of those page flows the vast majority of people looking for HRT end up on the HRT page and that's it, because that's the page they were looking for. Meanwhile some 13% of the traffic for Transgender hormone therapy comes via Hormone replacement therapy. WP:PRIMARYTOPIC seems pretty clear from those.

The point of the google was you're answering a WP:COMMONNAME question too. HRT overwhelmingly refers to menopause, while for this subject "gender-affirming hormones" or "gender-affirming hormone therapy" are more common names and, if anything, that's what this page should be renamed to. Void if removed (talk) 21:46, 15 July 2024 (UTC)

Agree with @Void if removed. These are two different and very distinct indications with different effects and different side-effects and harms for entirely different cohorts. A woman looking for information on HRT (which I suspect would be by far the majority) would not expect - and could be extremely confused by - an article that also talked HRT being prescribed for transgender patients. Keep them separate. Zeno27 (talk) 22:35, 15 July 2024 (UTC)

I agree with Void and Zeno27 – I oppose the suggested moves. Sweet6970 (talk) 22:48, 15 July 2024 (UTC)

Oppose – just to make this clear. Sweet6970 (talk) 13:47, 16 July 2024 (UTC)

• Support-ish: I do support something like this, but I'd suggest instead changing hormone replacement therapy into a broad-concept article, and moving the article for menopausal HRT to menopausal hormone therapy. Loki (talk) 01:06, 16 July 2024 (UTC)
• Strong Oppose: For the above stated reasons. WPATH make a clear distinction between GAHT and HRT, and the present article fails to make this clear. HRT arguably shouldn't even be in the lede, as usage of these two distinct treatments as synonyms is an obvious misnomer, per the best available MEDRS. And the supplied evidence doesn't demonstrate any WP:PRIMARYTOPIC confusion, but simply demonstrates that the overwhelming majority of people looking for "hormone replacement therapy" end up on the right page, ie relating to menopause, a subject of relevance to vastly more readers. Void if removed (talk) 10:36, 16 July 2024 (UTC)
• Support, HRT is still the terminology most often used, and it’ll be more recognizable to a lay reader. Snokalok (talk) 17:59, 16 July 2024 (UTC)
• Oppose - Hormone replacement therapy gets double the pageviews of Transgender hormone therapy. A significant minority of users ending up at Hormone replacement therapy erroneously is a problem that I believe should be solved with the redirect HRT (transgender), as this is likely due to Transgender hormone therapy not showing up when "HRT" is typed into the search bar. Flounder fillet (talk) 18:32, 16 July 2024 (UTC)

Maybe instead of changing it to HRT, the title of this article should be changed to "Cross-sex hormone therapy" or "Gender-affirming hormone therapy" per WP:COMMONNAME

Google Ngram shows that both of these terms are more commonly used than "transgender hormone therapy" Urchincrawler (talk) 18:54, 17 July 2024 (UTC)

• Definite support for the first move, per WP:COMMONNAME. Tentative support for the second move with a disambiguation page taking the old name. I can see the argument that HRT for menopausal cis women remains the primary topic, and should retain the prime position, but both are hot button issues at the moment to the point where it would probably be best to disambiguate separately. Another advantage of a separate disambiguation page, which might swing it, is that it could also include other types of hormone replacement therapies unrelated to either menopause or gender affirmation e.g. Hypothyroidism#Hormone replacement, Androgen replacement therapy and maybe others. Even without digging into it deeply, that's four items for the list, which sounds like a credible disambiguation page to me. --DanielRigal (talk) 00:46, 18 July 2024 (UTC)
• Not sure where this vote goes but I have thought a disambiguation page would be the neatest solution for a whole now.LunaHasArrived (talk) 11:27, 18 July 2024 (UTC)
• I'd rather move this page to gender-affirming hormone therapy, which seems to be the term that WPATH prefers. I oppose renaming the menopause-focused page. WhatamIdoing (talk) 19:20, 18 July 2024 (UTC)

  Agreeing with WAID here. As I said in my previous comment, Ngram shows gender-affirming hormone therapy is more commonly used. Urchincrawler (talk) 16:16, 19 July 2024 (UTC)

• +1 for what WAID said just above and in "Navigation numbers" below. Ajpolino (talk) 11:51, 19 July 2024 (UTC)
• agree as well with WAID (and Ajpolino)--Ozzie10aaaa (talk) 11:56, 19 July 2024 (UTC)

I support a disambiguation page, but oppose using Hormone replacement therapy (transgender) as the title of this page. Rather I would support renaming this page "gender-affirming hormone therapy" as per my initial comment regarding Google Ngram and WAID's comment. Urchincrawler (talk) 18:39, 19 July 2024 (UTC)

Support first move; Oppose second move: move to Gender-Affirming Hormone Therapy instead. @Void if removed appears to have raised some issues regarding the distinction between hormone replacement therapy and gender-affirming hormone therapy, but if I'm reading it right gender-affirming hormone therapy is an umbrella term. Also Support disambiguation page Mrfoogles (talk) 16:58, 20 July 2024 (UTC)

HRT is pretty much the common name for what Wikipedia currently calls "Transgender hormone therapy", so using an alternative common name + a disambiguation page + labeling the other HRT page HRT (menopausal) seems like a reasonable solution. Mrfoogles (talk) 16:59, 20 July 2024 (UTC)

I disagree it is an umbrella term. Gender affirming hormone therapy is the application of cross sex hormones to masculinise or feminise the body.

Hormone replacement therapy, in the context of transgender healthcare per WPATH is the replacement of the body's natal hormones after eg. a gonadectomy, to preserve musculoskeletal health. They are orthogonal processes, undertaken for different reasons. Right now "HRT" is an unsourced alternative name in this article, because the only two prior sourced references I removed, because that's not what the sources actually said. Void if removed (talk) 17:07, 20 July 2024 (UTC)

Just adding support to the claim by @Void if removed that

"I disagree it is an umbrella term. Gender affirming hormone therapy is the application of cross sex hormones to masculinise or feminise the body."

The Canadian Paediatric Society similarly uses gender-affirming hormone therapy to describe using testosterone or estradiol to achieve masculine or feminine body changes to match one's gender experience. Urchincrawler (talk) 18:24, 20 July 2024 (UTC)

• Oppose second move based on pageview numbers. No opinion on first move. Blythwood (talk) 18:02, 20 July 2024 (UTC)
• Support, as the article at Hormone replacement therapy meets neither criteria of WP:PRIMARYTOPIC. The usage criteria requires the article to be much more likely than any other single topic, and it just isn't. It only gets a pageview ratio of less than 2:1 (over 90 days - 47,761 vs. 25,313: [1]) despite being in the primary topic position already, which always inflates pageviews. If there was a proposed RM citing primary topic by usage as the reason, and the pageviews were only 2 to 1 over the other possible article, that RM would fail. That's not enough at all. There is also no indication that the subject has substantially greater enduring notability and educational value. Since the article at Hormone replacement therapy meets neither of the primary topic criteria, it should not be the primary topic. This should be much more straightforward than this conversation is trying to make it, really. Egsan Bacon (talk) 23:07, 22 July 2024 (UTC)
• Disambiguate Hormone replacement therapy to Transgender hormone therapy and Menopausal hormone therapy. I don't personally like the parenthetical titles. Per WP:NCDAB, natural disambiguation ... is generally preferable to parenthetical disambiguation. Both treatments are commonly called HRT, but each has a natural alternative name which is unambiguous, commonly used, and clear. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 05:10, 23 July 2024 (UTC)
• Move hormone replacement therapy to hormone replacement therapy (menopausal), move transgender hormone therapy to hormone replacement therapy. Obviously this is the primary topic for "hormone replacement therapy", and the fact that it goes to anything other than here is absurd. LilianaUwU ^{(talk / contributions)} 05:21, 23 July 2024 (UTC)

  What is obvious and absurd will differ from person to person. WP:PRIMARYTOPIC explicitly calls out "what first comes to mind" as an unacceptable criteria, invariably subject to personal biases. It feels natural to me (a trans person who cannot undergo menopause) that "HRT" means trans HRT, but Wikipedia is written for a general audience who probably don't share my exact experiences. –RoxySaunders 🏳️‍⚧️ (💬 • 📝) 05:38, 23 July 2024 (UTC)

  As someone who would also think of trans HRT first upon hearing "hormone replacement therapy" without qualifiers, I think before saying that it's "obviously" the primary topic and that anything else is "absurd" you should google "hormone replacement therapy" in quotes.

  When I do this, I see almost exclusively articles about menopausal HRT, and it takes me until page 6 until I find one page that is primarily about trans HRT. Loki (talk) 23:51, 23 July 2024 (UTC)

• Oppose both support move to GAHT per WAID's analysis. Draken Bowser (talk) 15:47, 24 July 2024 (UTC)

  • Support this alternative suggestion.

  Ortizesp (talk) 16:34, 24 July 2024 (UTC)

Navigation numbers

Raladic, I don't understand your claim about the navigation flow. Using June (i.e., Pride Month, when we would expect traffic to be up on all LGBT+ pages) as an example, I see:

• Number of visits to the menopause-focused page: 16,413 page views
• Number of visits from the menopause-focused page to the trans-focused page linked in the hatnote and ==See also==: 1,188 clicks (7.2%)
• Number of visits from the menopause-focused page to the generic Hormone therapy page linked in the hatnote, the first sentence, and ==See also==: 210 clicks (1.3%)
• Number of visits to the menopause-focused page that result in clicking on anything: about 3,000 (about 20%)
• Number of visits to the menopause-focused page that don't go to any other article: about 13,500 (about 80%)
• Number of visits to the menopause-focused page that likely click through to a trans-focused article: less than 1,000 (less than 5%)

That last number – more than four out of five readers stay right where they are, and most of the rest are clicking through to articles that are related to menopause – suggests that there really is "a clear WP:PRIMARYTOPIC".

BTW, the most popular articles for clicking through to, after GAHT, are: Atrophic vaginitis, Hormone therapy, Menopause, Estrogen (medication), Hot flash, Venous thrombosis, Progestogen, Sexual dysfunction, Progesterone, Androgen replacement therapy, Vaginal lubrication, Bioidentical hormone replacement therapy, Endometrial hyperplasia, Chorea, Fatigue, Estrogen, Route of administration, Contraindication, and Osteoporosis. All of these are menopause-related subjects (as you would expect, since subjects unrelated to menopause shouldn't be linked in a menopause-focused article). These are not links that suggest a substantial percentage of readers are looking for trans-focused information. Looking at the numbers above, I think that more than 90% of readers arriving at this page last month were looking for non-trans-focused content. WhatamIdoing (talk) 17:23, 18 July 2024 (UTC)

Note: WikiProject Pharmacology, WikiProject Women's Health, WikiProject LGBT studies, and WikiProject Medicine have been notified of this discussion. RodRabelo7 (talk) 16:08, 21 July 2024 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

HRT/GAH in WPATH SOC8

@Raladic I ask you to self-revert this: https://en.wikipedia.org/w/index.php?title=Transgender_hormone_therapy&diff=1234735329&oldid=1234734920

The current section misrepresents the source, and your edit comment is not responsive to mine. The section in question says:

The WPATH Standards of Care, most recently published in 2022, outlines a series of guidelines which should be met before a patient should be allowed transgender hormone replacement therapy

But then goes on to list the criteria for what SOC8 describes as "gender-affirming hormone therapy". This is a misrepresentation of the source because at no point are what's described here criteria for "hormone replacement therapy" which, in SOC8, is something completely different. Despite your edit comment, the terms are not at all synonymous in SOC8.

By a rough count, SOC8 says "gender-affirming hormones" or some variation thereof 4-5 times as much as "hormone replacement therapy", and the two are not used interchangably, but to refer to different things.

All of the latter that I can see are referencing gonadectomies, eunuchs etc. The use case described is, eg. in the case of a male who has had a gonadectomy, to replace the body's endogenous testosterone. Void if removed (talk) 22:16, 15 July 2024 (UTC)

At present, the article says "hormone replacement" in five places:

• The lede (not directly sourced, but lede follows body)
• WPATH SOC (misrepresents the source wording, where what is referenced is gender-affirming hormone therapy)
• Accessibility (three times - two unsourced, one where the source actually says "cross-gender hormones")

I have now corrected the WPATH reference and accessibility reference to use the actual wording from the sources, and expanded the explanation under the WPATH section. Wrongly paraphrasing MEDRS like this is confusing, and conflates different treatments. Void if removed (talk) 10:47, 16 July 2024 (UTC)