# Talk:Trisomy X

This article lacks a flow when reading. Many sentences are too short and could be combined. For example, two sentences in the second line of the article could be combined to read "Those affected by Triple X Syndrome are often taller than average, but there are typically no other physical abnormalities." There are a few missing commas throughout the article. A sentence under "Psychological" should read "On average, those affected have IQs that are 20 points lower than normal."
Ddesalvo2016 (talk) 14:02, 11 September 2019 (UTC) Drew DeSalvo 

Of the last 250 edits to this page at least 170 were vandalism and its correction. People are obviously not finding the topic they are looking for. Have protected. Doc James (talk · contribs · email) 18:52, 13 January 2017 (UTC)

First paragraph, third sentence: Change "Usually there is no other physical differences" to "Usually there are no other physical differences" Shbert (talk) 14:10, 24 March 2017 (UTC)

 Done Thankyou for pointing that out! regards, DRAGON BOOSTER  ★ 14:58, 24 March 2017 (UTC)

In what way does the bit under the paragraph " Epidemiology" mentioning that; " On average, five to ten girls with triple X syndrome are born in the United States each day." 
contribute to clarification of the epidemiological aspect, unless that rate is somehow disproportional to the average ? ( which, in case, isn't mentioned ) I suggest either to delete that sentence or add numbers covering more globally. Flight714 (talk) 14:30, 11 May 2017 (UTC)

49.14.132.172 (talk) 14:00, 10 August 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Dolotta (talk) 14:27, 10 August 2018 (UTC)

Once the renaming debate is over, I plan to make some major edits to this page and the other pages regarding polysomy X syndromes for quality purposes. This article isn't bad, per se, but I'd argue it's a lot closer to the Start than B classification, and most sections can be massively expanded or revamped. I'd WP:BEBOLD and dive into it after the move, but I just want to make sure there isn't anyone who's particularly married to any short/undersourced sections or has their own plans to improve this and related articles. Also, given its status as a semi-protected article that previously saw extensive vandalism due to the name's connotations, I figured I'd leave a statement on the talk page so nobody gets surprised when the edit history reveals substantial changes. Vaticidalprophet (talk) 16:11, 8 September 2018 (UTC)

37.106.86.121 (talk) 12:00, 11 September 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. NiciVampireHeart 13:00, 11 September 2018 (UTC)

2405:204:A40C:3232:0:0:886:30A5 (talk) 13:08, 8 December 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. – Jonesey95 (talk) 13:37, 8 December 2018 (UTC)

Please add a remark on autism like features in triple X syndrome, also in adults: DOI: https://doi.org/10.1192/bjo.2021.8[Opens in a new window] to the references on psychological problems. DrTripleXsyndrome (talk) 16:31, 29 March 2021 (UTC)

 Done, and thank you for the reference, which is a new one to me. However, this edit may be challenged, as it's to a primary source rather than a literature review -- see our sourcing guidelines for medical articles. I'm planning to do a significant expansion of this article soon (as I recently did to tetrasomy X), so some of the autism-related information is likely to end up being moved around or cited to different places. Vaticidalprophet 16:41, 29 March 2021 (UTC)

This article gets somewhat more attention than the unwatched ones I've been sandbox rewriting, so I'm leaving a talk page note for transparency, so people who pay attention to the article can see what I'm doing before it goes into mainspace, and to allow people to raise any concerns they have as I go along. I'm currently rewriting this article at User:Vaticidalprophet/Trisomy X, as I previously did with tetrasomy X (now a GA undergoing pre-FAC peer review) and pentasomy X (now finishing up GAN). I'd estimate at the time of this message I'm about one-eighth through one-tenth of the way through. I prefer to work in sandboxes because my style for radical rewrites is too messy (leaving stuff half-finished for extended periods, linking stuff to refer to later, etc) to be mainspace-friendly. Feel free to take a look. Vaticidalprophet 23:54, 10 May 2021 (UTC)

It's the mainspace version now. Vaticidalprophet 15:31, 23 May 2021 (UTC)

This review is transcluded from Talk:Trisomy X/GA1. The edit link for this section can be used to add comments to the review.
Reviewer: Epicgenius (talk · contribs) 16:19, 26 May 2021 (UTC)

Hi Vaticidalprophet, I will review this article. I'll leave some in-depth comments later. It is quite a long article so I will note it may take a while to review this. Epicgenius (talk) 16:19, 26 May 2021 (UTC)


### Prose, POV, and coverage
General:

85-90, 5-10%, 80-90%, etc. - Per MOS:PERCENT, the percent symbol is fine. However, if it's a number range it should be an endash rather than a hyphen. I would recommend going through and changing instances of hyphens in number ranges, such as those I just listed, to endashes.
Fixed number ranges. Vaticidalprophet 18:03, 26 May 2021 (UTC)
Check that the English variant is consistent. I see both "criticised" and "dehumanizing".
My 'native' English is an ENGVAR-mashup, so these are, I have to admit, always a mess. Is this in the range of MOS stuff relevant at GA level, though? Vaticidalprophet 18:03, 26 May 2021 (UTC)
Per MOS:ARTCON, it is recommended to stick to a single style within an article. I won't require it, as MOS is after all just a guideline, but this is highly recommended. Epicgenius (talk) 19:25, 26 May 2021 (UTC)
I've standardized to Oxford spelling and placed a talk template and edit notice accordingly. Vaticidalprophet 00:07, 30 May 2021 (UTC)
Similarly, consistent quotes. I see 'superfemale' (single quote) and illegitimate product of a Graeco-Roman alliance" (double quote). Epicgenius (talk) 16:45, 26 May 2021 (UTC)
Lead:

no symptoms significant enough to inspire formal testing. - Is "inspire" the best word for this context? I think "require" or a synonym would work better.
I don't think 'require' is accurate. It's very hit-or-miss whether women with trisomy X, even symptomatic cases, get karyotyped, so a phrasing that implies "this definitely happens when X or Y symptom is there" would give a false impression that it's a routine procedure. Vaticidalprophet 18:03, 26 May 2021 (UTC)
I see. I would say "inspire" is still a strange wording. How about something like "prompt"? Epicgenius (talk) 19:25, 26 May 2021 (UTC)
increased height, with an average height around 172 cm (5 ft 7+1⁄2 in) - This may work better as a single clause like "increased average height of around 172 cm (5 ft 7+1⁄2 in)" or something like that, but this is optional.
Most women with trisomy X go on to live normal lives - "go on to" is probably unnecessary here, but "live...lives" can be seen as repetitive. I suggest "Most women with trisomy X have normal lives" or something similar.
This has been reworded. Vaticidalprophet 21:45, 29 May 2021 (UTC)
cohort studies on children with sex chromosome aneuploidies which followed them into adulthood found that people with these disorders are often mildly affected - This seems like a long clause without a comma. I would rephrase this a bit, but I don't have specific suggestions at the moment.
I've rephrased this a bit, but I think it actually, uh, got longer. Perhaps still more readable, though. Vaticidalprophet 21:45, 29 May 2021 (UTC)
Lol. That works, though. Epicgenius (talk) 19:22, 16 June 2021 (UTC)
More later. Epicgenius (talk) 16:33, 26 May 2021 (UTC)
Presentation:

40% of girls with trisomy X aged six to thirteen are above the 90th percentile in height. - Regardless of MOS:PERCENT, I think it is a bit strange to begin a sentence with a number.
slightly below one standard deviation above - Also, "below...above" is unusual, I would say something like "almost one standard deviation above..."
Reworded. Vaticidalprophet 03:22, 1 June 2021 (UTC)
These differences are usually minor, and do not have an impact on the daily lives of girls and women with the condition. - I'd suggest getting rid of the comma.
Removed comma. Vaticidalprophet 00:16, 16 June 2021 (UTC)
Precocious puberty has been reported,[6][23] but is not considered a characteristic of the syndrome.[3] - Likewise here.
In this case I do think the comma helps comprehension, due to the mid-sentence refs and the juxtaposition. Vaticidalprophet 00:16, 16 June 2021 (UTC)
Alright - in this case, the current wording works fine. Epicgenius (talk) 19:22, 16 June 2021 (UTC)
and some patients followed in the medical literature - Followed as in studied over a long period of time?
Correct -- is there a good way to make this clearer to a lay audience? Vaticidalprophet 03:22, 1 June 2021 (UTC)
I don't have a good way to say this without splitting it into a new sentence. "Some patients, tracked in the medical literature over several decades, have acquired advanced degrees or worked in cognitive fields."
After further thought, I just removed 'followed'. Vaticidalprophet 00:16, 16 June 2021 (UTC)
with 40% to 90% in different studies requiring it. - Does this mean, in the different groups studied?
I've reworded this for clarity. Vaticidalprophet 00:16, 16 June 2021 (UTC)
The psychological portrait of trisomy X is not entirely clear, and appears to be complicated by a more severe phenotype in postnatally than prenatally diagnosed groups - The comma here could probably also be removed.
This is a longer sentence, so I'm borderline on keeping the comma for readability. Vaticidalprophet 00:16, 16 June 2021 (UTC)
but by their mid-thirties having stronger interpersonal bonds and healthy relationships - Should "having" be changed to a subject-verb, like "they had"?
I'm leaning towards no; I previewed the sentence with the change and felt it flowed worse. Vaticidalprophet 00:16, 16 June 2021 (UTC)
Schizophrenia in trisomy X may be associated with intellectual disability - If I am assuming correctly, there is no conclusive evidence of such?
Not conclusively, but circumstantially, hence 'may'. Vaticidalprophet 00:16, 16 June 2021 (UTC)
For instance, psychogenic stomach pains - Psychogenic is a disambiguation page.
Disambiguated appropriately. On the comma notes: I think this is personal style. I trend towards a slightly comma-heavy sentence structure, and I don't think any of those trend into grammatical inaccuracy. Vaticidalprophet 03:22, 1 June 2021 (UTC)
Don't worry, I think the comma is fine. I also use it this way. I should have just highlighted "psychogenic" as the dab page was my sole concern with this fragment. Epicgenius (talk) 20:22, 1 June 2021 (UTC)
Mosaicism, where both 47,XXX and other cell lines are present occurs in approximately 10% of cases. - Should there be a comma between "present" and "occurs"?
Fixed. Vaticidalprophet 01:21, 3 June 2021 (UTC)
Cognitive development is more typical, and long-term outcomes improved - On the contrary, I do not think this comma is necessary, as "long-term outcomes improved" isn't a complete sentence.
Reworded a little, although it still has a comma. Vaticidalprophet 01:21, 3 June 2021 (UTC)
little-understood - I also think there shouldn't be a hyphen here, since "little understood" isn't an adjective here but rather an adverb and verb.
Removed. Vaticidalprophet 00:16, 16 June 2021 (UTC)
Causes:

Mosaic is a duplicate link.
This is an intentional duplink -- it's in contravention of what the MOS currently says, but I strongly suspect it's what the MOS will say in two years. Most (~60%) readers are on mobile. Readers don't generally read articles as one block, even though writers often assume they do. Because mobile readers have all sections collapsed by default, their patterns are even more jumpy/spread-out. For a concept like genetic mosaicism that's unfamiliar to most of the general population, there should (IMO) be links available anywhere a reader might reasonably be expected to begin reading the article from, like the beginning of a section. Mobile readers can't just scroll up conveniently to a link in another section that'd be nearby for a desktop reader, so an article written to be navigatable/useful to the majority of Wikipedia's audience needs to treat sections as fairly self-contained, including in links. Vaticidalprophet 01:21, 3 June 2021 (UTC)
Trisomy X is a random event; it is not caused by lifestyle factors or parental fault - I think this sentence can be combined without using a semicolon, e.g. "Trisomy X occurs randomly and is not caused by lifestyle factors or parental fault".
Tweaked. Vaticidalprophet 01:21, 3 June 2021 (UTC)
trisomy X occurs randomly and has nothing to do with the chromosomes of the parents, and little chance of recurring in the family. - But in a minority, it isn't a random occurrence? Also, the comma after "chromosomes of the parents" may be unnecessary.
It isn't random in some cases (although that's a bit speculative), which the next sentence handles -- is there a way to make this clearer? Vaticidalprophet 01:21, 3 June 2021 (UTC)
Vaticidalprophet, I missed this comment, and I see now that the next sentence deals with the minority of cases which aren't random. I would basically say something like "The vast majority of cases of trisomy X occur randomly; they have nothing to do with the chromosomes of the parents and little chance of recurring in the family." Epicgenius (talk) 16:23, 20 June 2021 (UTC)
Epicgenius, done. Vaticidalprophet 00:35, 21 June 2021 (UTC)
Diagnosis and differential diagnosis:

Nothing of concern here.
Prognosis:

while oft-delayed - Do the sources specify the magnitude to which this delay exists?
It's not quite quantified in the way that makes that easy to check, no. (Most reviews of long-term outcomes use the cohort studies more than anything else, and those didn't check in often enough to get an obvious picture.) Vaticidalprophet 04:44, 11 June 2021 (UTC)
Compared to age-matched women in the general population - Of these 37, or a different study?
Different study -- can you think of a good way to make that clearer? I only noticed it's abrupt on a reread. Vaticidalprophet 04:44, 11 June 2021 (UTC)
@Vaticidalprophet: how about this; "Another study found that, compared to age-matched women in the general population, ..." Epicgenius (talk) 19:22, 16 June 2021 (UTC)
Specified accordingly. Vaticidalprophet 23:16, 16 June 2021 (UTC)
Epidemiology:

Trisomy X only occurs in females, as the Y chromosome is in most cases necessary for male sexual development - Seems strange to have this paragraph be its own sentence at the end. Actually, for those of us who are not good at biology (not me, but other people), I think it is worth considering mentioning this earlier on. Epicgenius (talk) 16:45, 26 May 2021 (UTC)
So, this bit is a bit of a WIP and an "improve between GAN and FAC" thing -- that is, when transforming the coverage from 'broad' to 'comprehensive'. There's a bit more to write in this section to get it really sparkling, but it's still a good overview of the topic. This sentence is currently set off as its own section, but I plan to expand the topic in a way that gets it reading a bit more naturally -- it's just that, at the current level of resolution, this is taking a backseat to other issues and making sure the core of the article is fully fleshed out. Vaticidalprophet 01:45, 28 May 2021 (UTC)
Definitely. I am only conducting a GA review here, not an FA review, so the standard is a bit lower. I was just pointing out that, even in good articles, it is a bit weird to see standalone sentences (but not by any means disallowed). Epicgenius (talk) 20:29, 1 June 2021 (UTC)
History:

even at the time - "Even" may not be necessary here.
It was more criticised after the fact, so I specified 'even' to make it clear that even then they thought it was weird, even though now we think it's more weird. Vaticidalprophet 16:42, 27 May 2021 (UTC)
have since been criticized - Within how many decades did these come to be viewed as dehumanizing?
Good question! Not really discussed in sources in a way that lets you obviously track a timeline (see S&C section noting that it's not very sociologically researched), so I went evasive on dates. Vaticidalprophet 16:42, 27 May 2021 (UTC)
Ah I see. Epicgenius (talk) 20:29, 1 June 2021 (UTC)
until the death of one of the researchers - same for both cohorts?
I only know about Denver. I've clarified it as that. Vaticidalprophet 21:45, 29 May 2021 (UTC)
due to the then-present perception that XYY syndrome was associated with violent criminality - this could probably be recast in active voice, e.g. "because [the public] perceived that XYY syndrome was associated with violent criminality" or something like that, but it's optional. It just read a bit clunkily to me.
condition's discoverer Patricia Jacobs - I feel like this can be mentioned earlier in the section.
Moved up to the beginning of the section. Vaticidalprophet 16:26, 28 May 2021 (UTC)
professor of pediatrics - how about "pediatrics professor"?
Reworded. Vaticidalprophet 18:03, 26 May 2021 (UTC)
around one-fifth of patients at the clinic have trisomy X - Is this when it was founded, or currently? Or is the clinic intending to seek patients for which one-fifth have trisomy X?
Clarified the date -- I don't have a more recent number. Vaticidalprophet 18:03, 26 May 2021 (UTC)
Society and culture:

Awareness of these conditions is accentuating - Is "accentuating" the right word?
Reworded. Vaticidalprophet 16:42, 27 May 2021 (UTC)
in the late 2010s, state governments across the United States declared May to be National X & Y Chromosome Variation Awareness Month. - Kind of unrelated, but some or all?
I can't get a good idea of exactly how many; the cited is for Massachusetts (which specifies 'National') and Georgia (which doesn't). Vaticidalprophet 16:42, 27 May 2021 (UTC)
Alright, in that case I would specify something like "several state governments...". Epicgenius (talk) 20:22, 1 June 2021 (UTC)
Added. Vaticidalprophet 04:44, 11 June 2021 (UTC)
Campaigns led by parents and caregivers of children with sex chromosome aneuploidies to raise awareness and increase available support made significant strides over the course of the 2010s to increase awareness,[82] decrease stigma, and improve the state of research.[85] - The portion of the sentence before the first comma is a little confusing because of the lack of punctuation. I get what this is saying: "The parents and caregivers of children with sex chromosome aneuploidies have created campaigns to raise awareness and increase available support. These campaigns made significant strides over the course of the 2010s to increase awareness, decrease stigma, and improve the state of research." Maybe a wording like this would be better.
Reworded. Vaticidalprophet 16:42, 27 May 2021 (UTC)
In other animals:

Six cases of trisomy X have been recorded in dogs, for which the karyotype is 79,XXX compared to 78,XX for an euploid female dog.[87] Unlike in humans, trisomy X in dogs is strongly linked to infertility, either primary anestrus or infertility with an otherwise normal estrous cycle. - if only six cases have been recorded, wouldn't the characterization of "strongly linked" suffer from small sample bias? Especially since these six cases may have been severe enough to be recorded, and that these cases resulted in infertility. However, I understand this may be what the source said.
As far as I can get from the sources, they're assumed fully connected. (So far as I can tell, in all nonhuman species where it's been observed trisomy X is always associated with infertility, although this is slightly too OR to say in wikivoice; the thing you pointed out with the other clause here will hopefully make it a bit clearer.) Vaticidalprophet 01:38, 28 May 2021 (UTC)
In addition to domesticated cattle, trisomy X has been observed in river buffalo. - Any effects of this? Epicgenius (talk) 16:34, 27 May 2021 (UTC)
The only symptom I could clearly associate with it in river buffalo is again infertility, so making that clearer in the article. Vaticidalprophet 01:38, 28 May 2021 (UTC)
Alright, I see. Both of these comments make sense. Epicgenius (talk) 20:22, 1 June 2021 (UTC)


### References
This is a medical article so I will check whether the sources largely follow the guideline Wikipedia:Identifying reliable sources (medicine). Epicgenius (talk) 16:33, 26 May 2021 (UTC)
Notes:

'Karyotype' as a term has multiple meanings, all of which are used here. It may refer to a person's chromosome complement, to the test used to discern said chromosome complement, or to an image of chromosomes ascertained via such a test - this is fine, but I would basically clarify whenever you are referring to a test (I would assume the images and the complement themselves are unlikely to be confused).
References:

The references are either journals or books, mostly. The websites tend to be for organizations affiliated with chromosomal disorders and/or medical facilities.
I will do a few spot checks later. Epicgenius (talk) 20:29, 1 June 2021 (UTC)
I have done spot checks on roughly 10% of the sources. For some reason my previous comment did not publish. Epicgenius (talk) 19:01, 15 June 2021 (UTC)


### Images and copyright
All images are licensed properly (though they don't contain alt text, which is optional for the purposes of the criteria). Image captions are appropriate.
Looking through Earwig's copyvio detector, I can't immediately find any.


### General comments
There have not been any edit wars in the past few months. Actually, not too many edits at all before the nominator expanded the article.
 On hold Epicgenius (talk) 19:01, 15 June 2021 (UTC)
Sorry for the delay. I will take a final look in the morning. Epicgenius (talk) 04:14, 20 June 2021 (UTC)

We propose that we write Two girls and a young woman with trisomy X, because this is a formal context, and we consider it pejorative to be calling a mature adult a "girl" here. Elizium23 (talk) 17:40, 22 June 2021 (UTC)

Yeah I also thought the phrasing of the caption was a little off Dracophyllum 06:22, 23 June 2021 (UTC)
I don't necessarily mind that compromise, though I think it a little clunky. It's better than 'females'. Vaticidalprophet 05:38, 25 June 2021 (UTC)

Pinging Elizium23 and Sandstein. Every possible rendition of "female", "girl", and "women" in different parts of the lead has been litigated quite extensively since the period the article's been brought to FAC, and I suspect it needs fuller discussion than the current pattern of undiscussed changes. The prior discussion on the infobox caption led to the conclusion "girls and women" was an acceptable wording, although no one's changed it to that yet. The alt text is still "females", which I think is pretty clunky and should be standardized to the caption. IMO, "female" is the correct phrasing for the first sentence of the lead, even though it's inappropriate for the caption/alt text (IMO, "female" > "females"). This is a medical article, and it's standard practice for disorders that affect one sex to refer to patients as "male" or "female" (rather than "men" or "women") in at least the very opening when the condition is a congenital one that affects patients over the entire lifespan, and so the adult implications of "man/woman" are inappropriate. See e.g. Turner syndrome, Tetrasomy X, Pentasomy X. I think at any rate these disputes at least need to be resolved, though. Vaticidalprophet 16:52, 5 July 2021 (UTC)

Vaticidalprophet, thanks for the ping. I'm a layperson, but I find "a female" to be insulting and objectifying, whereas "a female patient", where "female" is an adjective rather than a noun, to be perfectly normal. The age issue can be circumvented by writing "girls or women", as is occasionally done elsewhere in the article. I'm ready to convinced otherwise though if this is standard for medical articles; do we have a MOS on this?  Sandstein  17:22, 5 July 2021 (UTC)
WP:MEDMOS covers medical matters broadly. It doesn't mention this specific matter, which is more de facto practice than de jure MOS-holy-writ (inasmuch as the MOS is... etc, etc), but it does disavow the "female patient" wording you propose -- "patients/cases" language is cautioned against where possible. I find the consistency between similar articles persuasive; in addition to the use in Turner's/tetra/penta X, the equivalent wording of "where a male has" is seen in Klinefelter syndrome, XYY syndrome, and related disorders. I do think it's a wording that shouldn't be overused, because it's certainly a clinical one, but medical articles can handle a degree of clinical wording. Vaticidalprophet 17:30, 5 July 2021 (UTC)

Hey Ajpolino hey I keep noticing you “declinicalizing” the text can you explain further in depth why?CycoMa (talk) 05:41, 18 August 2021 (UTC)

Hi @CycoMa:, yes of course. The article is currently being weighed against the featured article criteria at Wikipedia:Featured_article_candidates#Trisomy_X. One of the reviewers there expressed concern that the article "seems to be written for clinicians..." and that the "prose needs some polishing." So I'm giving it another readthrough and attempting to (1) make it a bit more accessible to those without backgrounds in medicine (e.g. reducing the use of words like "phenotype", "presentation", referring to people as "cases", et al.), and (2) spruce up the prose a bit by trimming extraneous words and hopefully improving flow (e.g. removing repeated sentences, trimming filler words that don't contribute to sentences' meaning)... maybe "de-clinicalize" was not the best made-up word for the edit summary...
Two reviewers had concerns about some of the rarer sources in the article as well, so once I finish the prose cleanup, I'll loop back to take a look at their concerns there. Sadly, Vaticidalprophet, who did much of the heavy lifting updating this article, has marked "semi-retired" on his userpage, so I fear he may not have time to address reviewers' concerns.
If you have specific questions, concerns, et al. I'm happy to chat about it. Also you're welcome to participate in the WP:FAC process at the page I linked above. There are some instructions at the top of this page if you haven't participated before (I know I've seen your username around, but I can't remember where. So no offense meant if you're already well-versed in the process). Thanks for checking in! I hope all is well on your end. Happy to hear your thoughts. Ajpolino (talk) 05:57, 18 August 2021 (UTC)
Is it actually a problem for a primarily medical article to sound a bit... medical? Seems to come with the turf to an extent. I can probably understand where it's just alterations in language, but changes like e.g. "a karyotype test"-->"testing" IMO seem to harm the actual specificity/accuracy of the text. ‑‑Volteer1 (talk) 06:17, 18 August 2021 (UTC)
Well sure, but it's not a binary question of whether the article sounds medical. Rather it's a question of degree. As to any specific change, I claim no exquisite mastery of English prose, I'm just trying to make this article clear. If you have questions about a change I'm happy to discuss my thinking. If you feel it's not an improvement you can just change it back with an edit summary to that effect. I won't be offended. Ajpolino (talk) 03:59, 19 August 2021 (UTC)
On closer look the changes mostly seem fine, I think my view of them was a bit soured by that one example. I've reverted that but left the rest of it as is. ‑‑Volteer1 (talk) 04:21, 19 August 2021 (UTC)

Hi all, per some comments at the current 
FAC, I'm taking a closer look at the use of primary sources in the article. The goal is to make this article as reliable as possible by using the highest quality, most recent sources we can. I've trimmed a few unneeded primary sources already, and may end up trimming a few more as I go through, but the less straightforward ones I'll post here as a reminder to myself to return to, and as an invitation for anyone else to share thoughts. Pardon the big blob of text. I'll add to it as I have time:

Wigby, et al. 2016 (current #4) - for the conclusion that folks diagnosed prenatally with trisomy X tend to have better outcomes than those diagnosed postnatally (which is the conclusion of this primary study of ~75 women). This could be cited to the review Tartaglia, et al. 2010 instead. Turns back the clock (less reliable) but defers to a review (more reliable).
Lähdesmäki and Alvesalo, 2010 (#9) supports Dental abnormalities are associated with sex chromosome aneuploidy, including trisomy X; taurodontism, increased enamel thickness, and increased root length have been connected to the condition.. The beefy reviews that would cover this are from 2009 and 2010, so they don't mention it. The Unique report (which I think was updated in 2021?) says only "Research into dental development in girls with triple X syndrome is sparse. A Unique study day found that 14/20 families said their daughter had some sort of dental problem. Problems described include poor enamel formation, pitting and need for fluoride coating." So they do not seem to take up this study. Can't find mentioned anywhere else (though apparently it is a feature of pentasomy X) so let's cut for now.
Tartaglia, et al. 2015 (#11) is used four times: twice to say that a given symptom is common to various aneuploidies (based on table 2 of their intro), once to reference the founding of the clinic described, and once for Awareness and diagnosis of sex chromosome aneuploidies is increasing,. Not to pick nits on that last bit, but the reference notes that diagnoses are increasing but doesn't mention awareness. Does one imply the other? Kind of... Replaced that last use with a textbook chapter. Ajpolino (talk) 21:44, 2 September 2021 (UTC)
Liu, et al. 2016 (#12) is used twice. Once for One study found that the autoimmune disorders lupus and Sjögren’s syndrome are more common in trisomy X than in the general population., the other for prevalences of those two autoimmune disorders in folks with trisomy X.
Linden et al 1995 (#13) review and case study used twice for Although heart defects are common in some more severe X-chromosome polysomy (multiple chromosomes) conditions, and is one of three refs for Like trisomy X, tetrasomy X has a variable phenotype muddled by underdiagnosis. The tetrasomy is generally more severe than the trisomy; intellectual disability is characteristic, dysmorphic features more visible, and puberty often altered.. Seems these could likely be replaced. I'll note the book chapter Jones et al, 2013 (#6) describes heart defects in pentasomy X but not tetrasomy or trisomy. Replaced both uses.
Tuke, et al. 2019 (#14) - used four times. Twice in context (a large population study found... and Amongst the 244,000 women in the UK Biobank research sample...), once to reference the average age of menopause, and once for reduced household income.
Otter, et al. 2021 (#24) supports Though much of the research is in children, research in adult women with trisomy X suggests higher rates of autistic symptomatology than the general population. which is the conclusion of the cited study.
Will add to this as I go but feel free to add thoughts however you find convenient. Ajpolino (talk) 18:31, 24 August 2021 (UTC)

I plan to speak my mind over the next few days. On reference #4 i prefer Wigby over the review. I don't like how the review refers back to a study on mosaicisms when making this point. Even if we disregard the results of Wigby, its assesment of preexisting evidence in the introduction seems more solid. Dr Bowser (talk) 21:08, 25 August 2021 (UTC)
On (#9): so they partly contradict each other then? I'm not sure whether to keep or exclude, but maybe it's best to be very vague on the specifics when it comes to dental issues in trisomy X pending further evidence. Dr Bowser (talk) 21:18, 25 August 2021 (UTC)
 Done cut for now. Updated (and hopefully didn't mess up) the other numbering. Ajpolino (talk) 21:41, 2 September 2021 (UTC)
(#11):I'm undecided. (#12) If we keep this, doesn't it make more sense to present the relative risk, rather than the prevalence of Trisomy X in "SLE/SS women"? Dr Bowser (talk) 18:52, 26 August 2021 (UTC)
(#12) Actually, since the numbers are uncertain, maybe we should do away with them altogether and only mention that these autoimmune disorders are more common?
(#14) I'm impressed with the size of this study. How unfortunate that we don't have any recent reviews mentioning it. If we are allowed to keep it I suppose context should be added to the remaining two mentions, since this is most likely a subpopulation as described after Amongst the 244,000 women in the UK Biobank research sample... Dr Bowser (talk) 16:04, 30 August 2021 (UTC)
Part two!

Lim, et al. 2017 (#29) a case report and review, though an estimate from it's review section is all it's cited for.
Tang, et al. 2019 (#30) a case report and systematic review. Cited three times based on the latter.
Sybert 2002 (#31) a somewhat unusual multi-case-report + review. Used to cite average IQ in women with Turner syndrome/Trisomy X mosaic.
Blair, et al. 2001 (#32) study of seven girls with mosaic Turner's/Trisomy X. Cite for Women with mosaic Turner syndrome tend to have similar dysmorphic features to those with non-mosaic Turner's syndrome, but less marked, and some have none of the traditional Turner's stigmata.
Attfield 2020 (#43) used to cite Parents report their daughters' struggling both academically and socially at school and later Descriptions of trisomy X overwhelmingly consider the karyotype from a medical perspective, rather than a sociological or educational one. The second bit is based on the author's substantial introductory review. The first based on the actual study (interviews of 12 sets of parents).
Berglund, et al. 2019 (#47) is explicitly called out as a large Danish study in both uses.
Stockholm, et al. 2010 (#48) same idea. Explicitly notes that it's a study of the Danish cohort.
Barr, et al. 1969 (#53) is used to backup Early studies on sex chromosome aneuploidy screened patients residing in institutions, giving an image of the karyotypes as incapacitating; even at the time, this research was criticized for giving an inaccurate portrait of sex chromosome aneuploidy.. It's a case report and review, and presumably it criticizes contemporary studies. Do we fill that's strong enough for this sentence?
Attfield 2021 (#54) Ditto the above. Cites Early reports of women with trisomy X have since been criticized for a dehumanizing ableist perspective, showing nude photographs of institutionalized women described as "mental deficiency patients". Presumably this (interviews with 10 women + author's review) provides that criticism?
Gruchy, et al. 2016 (#66) Large retrospective French study. Supporting Abortion rates in sex chromosome aneuploidies have decreased over time with improved counselling..


### Query
Ref 17 ([4]) is used to support "some women with trisomy X  [...] have acquired advanced degrees or worked in cognitive fields". Unless I'm missing something, I don't see where the last part of this sentence is supported by the source. The only mention of occupational history in women with trisomy X is Sixteen females were followed into adulthood in the Edinburgh cohort and were described as gaining employment in non-academic occupations such as hairdressing or waitressing, with four being housewives. Is this information in some other source? Spicy (talk) 17:21, 4 September 2021 (UTC)

Huh, weird. The previous source (#19, Kliegman and St. Geme textbook chapter) gets at a similar idea with There is marked variability within the syndrome, and a small proportion of affected females are well coordinated, socially outgoing, and academically superior but that doesn't quite support what's in the article. I rejiggered the wording to something supported by the textbook chapter. If I find where the "advanced degrees" bit came from, I'll add it back. Ajpolino (talk) 23:41, 4 September 2021 (UTC)