Abigail Shrier has given us a gift—a valuable and costly one.
Her decision to write on transgender issues has introduced her to the abuse heaped on those who inquire more deeply into the popular trans narrative. As an opinion writer, she initially passed on telling this story, trusting someone else would. Yet when she received an e-mail from a mother desperate to get the word out about her beloved daughter identifying as trans “out of the blue,” she couldn’t get it out of her head. Shrier began meticulously researching, conducting almost 200 interviews and consulting with dozens of affected families.
This book is not about transgender adults, nor is it shaped by a particular faith perspective. Rather, it is an investigative report on the diagnostic craze of “gender dysphoria” that has swept over adolescent girls in the past decade.
Shrier uses the term “craze” in its technical sociological sense, referring to “a cultural enthusiasm that can spread” like a contagion. As she reminds us, numerous maladies have affected and been passed on by adolescent females throughout history, such as the eating disorders that plagued my generation. While these young women are dealing with genuine distress, their “self-diagnosis” is as influenced by others as it is erroneous, and the prescribed cure can take the form of “self-harm.”
Transgenderism is the latest manifestation of this phenomenon. As Shrier points out, only eight years ago, there was no clinical literature on females ages eleven to twenty-one suffering from gender dysphoria. None. Now, there are exponential increases in the number of girls who suddenly discover that they’ve been “born in the wrong body,” although they exhibited no hint of gender dysphoria before adolescence. In the space of one year, 2016–2017, “the number of gender surgeries for natal females in the U.S. quadrupled.” Currently, 70 percent of “sex-change” surgeries are performed on women. Shrier dared to ask the question: “What’s ailing these girls?” This book details her search for an answer.
Irreversible Damage: The Transgender Craze Seducing Our Daughters is an invaluable resource for parents, educators, church and community leaders, and anyone else who cares about the well-being of young women. Shrier has examined the transgender teen phenomenon from every conceivable angle, and she has woven her findings into a readable narrative that is as accessible as it is informative. Although regular Public Discourse readers are likely to be knowledgeable about transgender issues in general, this book—with its specific focus on girls and young women—is still well worth your time. Do not miss it.
The Pieces of the Puzzle
After introducing the “contagion,” Shrier begins with several stories of girls who have been affected. She immediately draws her readers in. You will care about these girls, and you’ll be grateful to find an update on their status in the afterword. Where is “Lucy,” whose Southern lawyer mother’s e-mail had started it all? What happened to “Julie,” the precocious ballet dancer whose adoring friendship with a trans-identified girl helped lead her to declare the same?
Chapter by chapter, Shrier introduces the major players involved in this complex drama, highlighting the parents, professionals, young trans social media “influencers,” and those who push radical gender ideology in school settings. Who knew that teachers’ associations were voting to allow minors to leave campus to access cross-sex hormones without parental consent?
Drawing from her robust interview collection, she lets each person speak in his or her own words. Pro-affirmation therapists articulate their views of adolescent gender identity declarations as unquestionable and inviolable, arguing that the only response should be agreement and support. Numerous professional “dissidents” also share their perspectives, each one giving a compelling case for their dissent. Shrier has gathered an impressive array of renowned experts in the field. There are too many to name here, but all are worth hearing on these matters.
For instance, psychologist Kenneth Zucker explains that social transition is not a “risk-free” and “nothing to lose” step, as it is commonly portrayed, but rather an “experiment in nurture.” Psychotherapist Lisa Marchiano explains the fascinating concept of “symptom pools,” which are defined as “lists of culturally acceptable ways of manifesting distress that lead to recognized diagnoses.” As humans, she observes, we are drawn to “prescribed narratives,” seeking to explain our troubles in ways that others will recognize, because that will make it more likely for us to “receive care and attention.” As Marchiano points out, “being born in the wrong body” has entered our current “symptom pool” with overwhelming force via the media (more evidence for this is continually emerging). She also shares great insights about therapy, dealing with suicide risk, and more.
Shrier’s research thoroughly demonstrates how differently transgender medicine operates from any other area of medicine. Patients are essentially placed in the driver’s seat, prescribing their own treatments. The doctor’s role is simply to affirm and enable patients’ access to the medicine chest and surgical procedures of their choosing. For instance, one Canadian plastic surgeon, Hugh McClean, readily admits on his website that “for us, the diagnosis is made by the patient, not the doctor.” Since 2019, McClean has conducted well over 1,000 “masculinizing mastectomies” for women as young as sixteen.
Shrier also highlights professionals who have displayed admirable courage in this arena. Lisa Littman—whose exploratory study into what she observed and termed “rapid onset gender dysphoria” created a firestorm—initially thought it was great when she heard that two girls had come out as trans in her small local community. However, when that number climbed to six, she grew curious. These numbers greatly exceeded expected prevalence rates. Given her knowledge of epidemiology, she began to investigate what was going on, and what she found was deeply troubling. Despite all the attacks, “nevertheless, she persisted” because of her concern for children and families.
The Aftermath of Medical Transition
Shrier also devotes an entire chapter to the perspectives of medically transitioned transgender adults. Scott Newgent, who has publicly acknowledged he is “Blake” in the book, speaks frankly about the benefits he feels he gained from testosterone. However, his arm is permanently handicapped from being sourced for his phalloplasty, and he nearly died from post-surgical complications. He emphasizes the stark contrast of the risks and difficult realities of transitioning versus the way it is “glamorized” in the media (and marketed, I would add) to children. He has become one of the most impassioned warriors in the battle to protect children from medical transitioning before they have the adult capacity to consent.
Critically, Shrier amplifies the voices of the rapidly growing number of “desisters” and “detransitioners”—voices that are regularly denied, suppressed, and shunned by their former communities of trans-identified individuals. Benji describes her six years of trans-identification (from ages thirteen to nineteen) as time spent in a “cult.” Erin discusses her experience with testosterone as one would a drug addiction. Helena maps a trajectory of internet immersion and a shift from an eating disorder to trans-identification over the course of just two weeks, describing how her profile popularity skyrocketed when she announced the change.
Psychologist and well-known researcher Ray Blanchard points out that there is “there is no apparent way to record a detransitioned patient for clinical or research purposes.” Trans activists don’t want people to know that detransitioners exist, but they do, and their numbers are growing. A subreddit web forum for detransitioners to discuss their experiences now has over 7,000 members.
Many of these young women experienced same-sex attraction and, after detransitioning, come to identify as lesbians, which raises another question: what of the “L” in “LGBT” these days? According to the young people that Shrier interviewed, if a girl comes out as lesbian, she gets a status demotion. But if she comes out as trans, she gets an immediate promotion. One girl shared that at her all-girls school of 500, there were fifteen trans students. That translates into 3 percent of the school being “born in the wrong body.” Compare these numbers to the DSM-5, published less than ten years ago, which listed an expected rate of 0.002–0.003 percent—less than 1 in 10,000. How many lesbians attend the school? None.
What will this “upgrade” to transgender cost a girl? Only her name; her natural voice, which will be permanently altered even if she one day gets off testosterone; her breasts, with their erogenous capacity and ability to breastfeed; and perhaps her ability to bear children at all. These are lifelong sacrifices, doled out on an “informed consent” basis to girls too young to legally get tattoos. Shrier poignantly writes, “No adolescent should pay this high a price for having been, briefly, a follower.”
The Bigger Picture: Girls Lose, Boys Win
No one is faring worse in the cultural landscape of the twenty-first century than girls. Citing numerous studies and hard data, Shrier exposes a multi-faceted, full-blown crisis for girls of this generation. They are lonelier, less valued, and increasingly depressed. Life is more online and less in person than ever, and social media, their main connection to others, is an instrument of angst—a megaphone and microscope that amplifies and exposes their (and others’) every flaw. Violence in pornography is ubiquitous; the girls are not unaware and are rightly frightened. Consider the horrifying practice of choking during sexual activity—now the porn du jour, and which a full 13 percent of sexually active girls ages fourteen to seventeen report already having experienced. Just as they do against the girls currently being forced to race against trans-identifying biological males, in our culture, boys seem destined to win every time.
As Shrier eloquently writes, girls today “flee womanhood like a house on fire, their minds fixed on escape, not on any particular destination.” Cue the siren call of transition, beckoning over the Internet and media waves, with doctors and therapists standing ready to encourage—and profit. According to Sasha Ayad, who works exclusively with gender-dysphoric adolescents, many of her clients are unsure they want to be boys, they only know they don’t want to be girls.
Nearly all of the families that Shrier interviewed identified as progressives and supporters of LGBT rights in general. From the PFLAG leader mom to the pair of lesbian moms, almost none were religious conservatives. Still, as one Christian mom whose daughter has been captured by the trans scene for years told me, “Don’t think this can’t happen to you. If it happened to our family, it can happen to anyone.” I have a number of friends whose daughters are trans-identified: some were homeschooled and came out as trans in college, others were in public schools and the disaffection with their natal sex (and their parents) began earlier. All of their stories share themes similar to those Shrier describes. This is a sweeping contagion, and no girl is immune.
Cause for Hope
But Shrier does not leave us without hope. She encourages detransitioners as they settle back into themselves, as well as those questioning whether to start the journey home, that wholeness can be found again. She shares wisdom that will benefit all parents, including the recommendations to “reintroduce privacy to the home.” Parents should start with themselves, giving up posting everything about their children’s lives online in favor of sharing updates and photos in private emails. She advises us on how to protect our girls and avoid troubles (begin with “no smartphones”) and shares practical steps taken by families who have successfully helped their girls escape the snare.
These issues hit home for me in a very deep way. At fifteen, I was hurting from childhood sexual abuse, same-sex attracted, and donning a tux for my high school dance. If transgenderism had been the “craze” of my day, I could easily have gone down the path of my own de-sexing. Instead, I got to simply grow up, which allowed me to navigate my life, sexual attractions, and choices in consonance with reality: as a woman. I now have two children, born of my body and nursed by my bosom. They are both girls, born into a culture that both devalues and “pathologizes girlhood.” I am determined to teach them the truth that, as Shrier puts it, “being a woman is a gift, containing far too many joys to pass up.”
Amazon blocked sponsored advertising for Irreversible Damage, even as the site advertises physically harmful chest-binders and trans-affirmative books to get our daughters started on their flight from themselves. Read Shrier’s book and then pass it on to pastors, parents, and grandparents. Let’s pay forward the costly gift she has given us. Because she is right—Irreversible Damage is “a story Americans need to hear.” And we need to hear it now.