{ "model": { "rank": 13536, "code": "thing-q1053501", "model_id": "vr.tr.gender-affirming-surgery", "name": "gender-affirming surgery", "purpose": "Let an agent explain gender-affirming surgery and its procedures and care pathways with reference to clinical guidelines, describe regulation and debates with positions attributed, support respectful and accurate information, and route personal medical questions to qualified clinicians.", "family": "Thing Registry", "category": "Activities and processes", "status": "research-draft", "kind": "thing", "plane": "ACT", "domain": "ACT.PRC", "industry": "", "version": "", "url": "/models/thing/q1053501/", "tier": 2, "score": 37, "payload": { "layer": "wikidata", "aliases": [ "male chest reconstruction", "androgynoplasty", "gender neutralization surgery", "feminizing surgery", "gender-affirming vaginoplasty", "glottoplasty", "Feminization laryngoplasty", "facial gender-affirming surgery", "Gender reassignment procedures for minors", "non-binary surgery", "phalloplasty", "metoidioplasty", "masculinizing surgery", "De Castro technique" ], "aliasCount": 14, "merged": 14, "knownIn": 37, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q1053501", "url": "https://www.wikidata.org/wiki/Q1053501", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T04:34:36Z", "providers": [ "Claude" ], "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify", "pass": 2, "wave": 2, "engine": "claude" }, "metaModel": { "id": "THING-Q1053501", "registryId": "vr.tr.gender-affirming-surgery", "name": "gender-affirming surgery", "version": "0.2.0-wave.2", "entryKind": "thing", "family": "Thing Registry", "domain": [ "ACT.PRC" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q1053501/", "model": { "registry_id": "vr.tr.gender-affirming-surgery", "name": "gender-affirming surgery", "purpose": "Let an agent explain gender-affirming surgery and its procedures and care pathways with reference to clinical guidelines, describe regulation and debates with positions attributed, support respectful and accurate information, and route personal medical questions to qualified clinicians.", "definition": "Surgical procedures undertaken to align physical characteristics with a person gender identity as part of gender-affirming care and transitioning, including chest reconstruction and breast augmentation, genital procedures such as vaginoplasty and phalloplasty, facial and voice surgery such as glottoplasty, and other reconstructive procedures; such surgery is provided under clinical guidelines with assessment, consent and multidisciplinary care, and its availability, regulation and public debate vary by country and are described here with attribution.", "what_it_is_for": "Surgery aligning body with gender identity.", "affordances": [ "explain procedures and pathways", "describe regulation and debates with attribution", "support respectful information", "route personal questions" ], "distinguishing_features": [ "Part of transitioning", "Guideline-based care", "Multiple procedure types", "Varied regulation" ], "appearance": "Not physical as a concept; surgical procedures.", "visual_identification": [ "Surgery as part of gender-affirming care", "Chest, genital, facial and voice procedures", "Hormone therapy is non-surgical; cosmetic surgery is not tied to gender identity" ], "physical_properties": [], "families_and_kinds": [ "chest surgery", "genital surgery such as vaginoplasty and phalloplasty", "facial gender surgery", "voice surgery such as glottoplasty", "other reconstructive procedures" ], "related_models": [ { "relation": "is a kind of", "target": "reconstructive surgery", "why": "category" }, { "relation": "is a kind of", "target": "gender-affirmative care", "why": "category" }, { "relation": "is related to", "target": "transgender", "why": "people who may seek such care" }, { "relation": "is related to", "target": "hospital", "why": "settings for surgery" } ], "identifiers": [], "standards_and_regulation": [ "International and national clinical guidelines for gender-affirming care", "Consent and assessment requirements", "Health insurance and legal frameworks by country" ], "failure_modes_and_hazards": [ "Agents giving personal medical advice", "Unattributed or stigmatising presentation", "Outdated guideline information" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "understand", "name": "Understand", "description": "What the surgery is.", "rationale": "General information.", "layers": [ { "id": "procedures", "name": "Procedures", "description": "Procedures.", "findings": [ { "id": "procedures-finding", "name": "Procedures", "description": "Procedures.", "questions": [ { "text": "What procedures are included in gender-affirming surgery, and what do they involve in general terms, according to clinical sources?", "kind": "provenance" }, { "text": "Is the user asking about their own care, which needs qualified clinicians?", "kind": "boundary" } ] } ] }, { "id": "pathway", "name": "Pathway", "description": "Care pathway.", "findings": [ { "id": "pathway-finding", "name": "Pathway", "description": "Pathway.", "questions": [ { "text": "How do assessment, consent, multidisciplinary care and aftercare work under clinical guidelines?", "kind": "provenance" }, { "text": "Which entry fits gender-affirming care?", "kind": "action" } ] } ] } ] }, { "id": "access", "name": "Access", "description": "Access and regulation.", "rationale": "Attribution.", "layers": [ { "id": "regulation", "name": "Regulation", "description": "Regulation by country.", "findings": [ { "id": "regulation-finding", "name": "Regulation", "description": "Regulation.", "questions": [ { "text": "How do availability, eligibility, age rules and funding differ by country, with sources attributed?", "kind": "provenance" }, { "text": "Is the information current for this jurisdiction?", "kind": "boundary" } ] } ] }, { "id": "debates", "name": "Debates", "description": "Public debates.", "findings": [ { "id": "debates-finding", "name": "Debates", "description": "Debates.", "questions": [ { "text": "What debates surround gender-affirming surgery, with positions of medical bodies, advocates and critics attributed?", "kind": "provenance" }, { "text": "Is the presentation neutral, attributed and respectful?", "kind": "boundary" } ] } ] } ] }, { "id": "evidence", "name": "Evidence", "description": "Outcomes and research.", "rationale": "Research.", "layers": [ { "id": "outcomes", "name": "Outcomes", "description": "Outcomes.", "findings": [ { "id": "outcomes-finding", "name": "Outcomes", "description": "Outcomes.", "questions": [ { "text": "What does research say about outcomes, satisfaction and complications, and where is evidence limited?", "kind": "provenance" }, { "text": "Which findings are uncertain or contested?", "kind": "boundary" } ] } ] }, { "id": "support", "name": "Support", "description": "Support.", "findings": [ { "id": "support-finding", "name": "Support", "description": "Support.", "questions": [ { "text": "What support organisations and services exist for people considering or recovering from surgery?", "kind": "provenance" }, { "text": "Is someone in crisis, needing urgent help?", "kind": "boundary" } ] } ] } ] }, { "id": "learn", "name": "Learn", "description": "History and teaching.", "rationale": "Education.", "layers": [ { "id": "history", "name": "History", "description": "History.", "findings": [ { "id": "history-finding", "name": "History", "description": "History.", "questions": [ { "text": "How did gender-affirming surgery develop historically, according to historians of medicine?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "teach", "name": "Teach", "description": "Teaching.", "findings": [ { "id": "teach-finding", "name": "Teach", "description": "Teaching.", "questions": [ { "text": "How can the topic be taught in medical education with accuracy and respect?", "kind": "action" }, { "text": "Which misconceptions arise?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Should each procedure be a separate entry?", "How should clinical guidelines be linked?", "How should legal frameworks be linked by country?" ], "statistics": { "bundles": 4, "layers": 8, "findings": 8, "questions": 16 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "abstract concept", "method": "Written from the archetype playbook - what this kind of thing needs beyond identity and provenance - and from the structure that recurred across 6,333 models already researched by two engines. Applied to this entry by rule. No source was read for this thing and no claim here is researched. This entry carries no facets of its own, so they were inferred from its domain - a guess about a whole domain applied to one thing.", "facetsInferred": true, "nextPass": "A researcher replaces this draft with a sourced specification. Treat every sentence below as a proposal to argue with.", "purpose": "Give an agent a durable, checkable way to recognise a gender-affirming surgery, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain gender-affirming surgery and its procedures and care pathways with reference to clinical guidelines, describe regulation and debates with positions attributed, support respectful and accurate information, and route personal medical questions to qualified clinicians.", "characteristics": { "substance": "activity", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: male chest reconstruction, androgynoplasty, gender neutralization surgery, feminizing surgery, gender-affirming vaginoplasty, glottoplasty, Feminization laryngoplasty, facial gender-affirming surgery, Gender reassignment procedures for minors, non-binary surgery, phalloplasty, metoidioplasty.", "14 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 37 Wikipedia languages, which is a measure of how widely the thing is known, not of how important it is." ], "openQuestionsForResearch": [ "Which of the bundles below does a real task actually need, and which are ceremony?", "What does this thing have that the facets do not capture at all?", "Which neighbouring kind is most often confused with a gender-affirming surgery, and on what evidence are they told apart?" ], "whatItIsMadeOf": "something that happens over time", "physicalCharacter": [ "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "observe it, measure it, record its state" ], "howItIsRecognised": [ "Nothing to see. What is recognised is an instance of it, and which instances count is exactly what is argued about." ], "relatedModels": [ { "relation": "covers", "note": "Finer kinds folded into this entry because telling them apart needs a task that asks for it. Each is a model waiting to be split out when one does.", "targets": [ "male chest reconstruction", "androgynoplasty", "gender neutralization surgery", "feminizing surgery", "gender-affirming vaginoplasty", "glottoplasty", "Feminization laryngoplasty", "facial gender-affirming surgery", "Gender reassignment procedures for minors", "non-binary surgery", "phalloplasty", "metoidioplasty" ] } ], "standing": "Described in 37 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 14 finer distinctions are held inside this entry as names rather than as separate models.", "structure": { "bundles": [ { "id": "identity-and-classification", "name": "Identity, naming and classification", "description": "How an agent tells one gender-affirming surgery from another, and a gender-affirming surgery from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a gender-affirming surgery sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a gender-affirming surgery from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a gender-affirming surgery passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a gender-affirming surgery between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a gender-affirming surgery, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a gender-affirming surgery is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "process-and-outcome", "name": "Process, inputs and outcome", "description": "How a gender-affirming surgery proceeds, what it needs and what it leaves behind.", "rationale": "An activity is known by its steps and its results, and both have to be recordable while it is still running.", "layers": [ { "id": "steps-and-sequence", "name": "Steps and sequence", "description": "The steps of a gender-affirming surgery, their order and what may run in parallel.", "findings": [ { "id": "steps-and-preconditions", "name": "Steps, preconditions and completion", "description": "What has to be true before each step of a gender-affirming surgery and what marks it done.", "questions": [ { "id": "steps-and-preconditions-q01", "text": "What identifies and describes a step of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "steps-and-preconditions-q02", "text": "Who or what asserted this about a step of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "steps-and-preconditions-q03", "text": "What may an agent decide or do once a step of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "inputs-and-results", "name": "Inputs, resources and results", "description": "What a gender-affirming surgery consumes and what it produces.", "findings": [ { "id": "inputs-and-outputs", "name": "Inputs, outputs and side effects", "description": "The resources a gender-affirming surgery takes and the results it leaves, wanted or not.", "questions": [ { "id": "inputs-and-outputs-q01", "text": "What identifies and describes the inputs and results of a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "inputs-and-outputs-q02", "text": "Who or what asserted this about the inputs and results of a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "inputs-and-outputs-q03", "text": "What may an agent decide or do once the inputs and results of a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "definitions-in-contest", "name": "Definitions and who holds them", "description": "What gender-affirming surgery is taken to mean, and by whom.", "rationale": "When a field disagrees about a concept, the disagreement is the content. A model that picks one definition silently destroys the information.", "layers": [ { "id": "competing-definitions", "name": "Competing definitions", "description": "The main readings and the traditions behind them.", "findings": [ { "id": "definition-map", "name": "Definitions and their holders", "description": "Each definition with the school or body that holds it.", "questions": [ { "id": "definition-map-q01", "text": "Which definitions of gender-affirming surgery are in use, and which tradition or body holds each?", "kind": "definition" }, { "id": "definition-map-q02", "text": "What turns on the difference between them in practice?", "kind": "boundary" } ] } ] }, { "id": "operationalisation", "name": "Operationalisation", "description": "How it is measured or applied when it has to be.", "findings": [ { "id": "operational-record", "name": "Measures and proxies", "description": "Instruments and indicators used to stand in for it.", "questions": [ { "id": "operational-record-q01", "text": "How is gender-affirming surgery operationalised or measured in practice, and by what instrument?", "kind": "measurement" }, { "id": "operational-record-q02", "text": "What does that operationalisation leave out, and when does that matter?", "kind": "boundary" } ] } ] } ] }, { "id": "instances-and-use", "name": "Instances, use and consequence", "description": "What counts as an instance of gender-affirming surgery and what follows from calling something that.", "rationale": "Applying a concept is an act with consequences, so a model must say what the label licenses and what it does not.", "layers": [ { "id": "instances", "name": "What counts as an instance", "description": "Clear cases, borderline cases and non-cases.", "findings": [ { "id": "instance-tests", "name": "Tests for an instance", "description": "What would settle whether something falls under it.", "questions": [ { "id": "instance-tests-q01", "text": "What would settle whether something is an instance of gender-affirming surgery?", "kind": "boundary" }, { "id": "instance-tests-q02", "text": "Which borderline cases are argued about, and on what grounds?", "kind": "definition" } ] } ] }, { "id": "consequence", "name": "Consequence of application", "description": "Rights, duties or decisions that follow from the label.", "findings": [ { "id": "consequence-record", "name": "What the label licenses", "description": "What an agent may do once something is classified this way.", "questions": [ { "id": "consequence-record-q01", "text": "What follows practically once something is treated as gender-affirming surgery?", "kind": "action" }, { "id": "consequence-record-q02", "text": "What must an agent not infer from the label alone?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a gender-affirming surgery came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a gender-affirming surgery and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a gender-affirming surgery is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a gender-affirming surgery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a gender-affirming surgery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a gender-affirming surgery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 6, "layers": 12, "findings": 14, "questions": 38 } } } }