Part 2: Reversing the Damage of “Irreversible Damage: The Transgender Craze Seducing Our Daughters”. Interpreting Research.
See here for part one.
Chapter Two
The focus of chapter two is the relatively notorious study by Lisa Littman, originally published in 2018 with a correction in 2019. The focus is going to be on said study and briefly pointing out why the outcry and subsequent correction is valid and not some “activist mob mentality” as the author seems to suggest.
Qualitative but not Quality
The study used an online survey to assess parent’s views concerning their child(ren) who were trans-identifying [1]. There’s nothing problematic about that, but the execution was.
Methodological Flaws
Research involves limitations. Even the best study design won’t lead to flawless results. However, a study ought to be designed so as to minimize major limitations. One such limitation is sampling bias. Parents who frequented websites that are primarily anti-trans were targeted [1]. Automatically we have to question if the data collected isn’t representative of parents’ attitudes generally, instead being biased towards those who have specific (and negative) attitudes about their children being trans.
Additionally, the survey’s content was questionable. Littman modified the DSM criteria for gender dysphoria to be more understandable to parents but didn’t provide an example of how this was done. She asked about emotional coping measures with newly constructed questions instead of pre-existing, validated questionnaires [2].
Psychometrics section for those interested: When doing research, you want your measures to be both reliable (similar or identical results are obtained when measure is repeated) and valid (they measure what they’re supposed to). There’s nothing wrong with creating measures yourself. However, they would ideally be tested on a pilot basis prior to being used on a study that’s utilizing those measures.
Sometimes you need to create a measure because nothing else exists that’s validated. Littman had the opportunity to measure things like emotional coping with validated questionnaires but didn’t. Essentially, the entire study’s results (even aside from the problems with the sample and framing of questions) are questionable and not generalizable on this basis alone.
Results
Online calculators were used for the statistical analyses. It’s unclear which calculators were used and leads me to wonder if the analyses were performed correctly. But even if done right, the results are still based on a flawed method.
Shrier (2020) notes that none of the study’s results changed when the correction was issued. This is not indicative of the study being valid while still being “cancelled” by some mob. It shouldn’t have been published as it was originally, and perhaps would not have made it through a more rigorous peer review process.
Open Access Troubles
Littman’s article was published in PLoS One, an open access mega journal (not limited to a specific discipline; any science/medicine paper has a shot at being published). It’s beyond the scope of this article to go into detail, but the peer review process at PLoS One has been called into question over the last few years. The journal has had to retract dozens of articles. There is concern about manipulation of the peer review process and conflicts of interest [3].
So it doesn’t necessarily matter that Littman’s paper was peer-reviewed prior to publication. Unfortunately, just because something has been peer-reviewed doesn’t mean it can be read without scrutiny.
It Makes No Sense
The term “Rapid Onset Gender Dysphoria” came from the Littman paper. It isn’t a real medical term or diagnosis, but that hasn’t stopped it from circulating in both academic and non-academic circles. It matters because the study has been used to justify policy; South Dakota passed a bill to prohibit teaching about gender dysphoria to avoid a social contagion [4].
Although this study has been criticized and scrutinized, it’s still being used as evidence in arguments that have an impact on the world. This is why it’s critical to understand what the study was and why/how it was flawed.
Chapter Three
This is the part where Shrier can’t claim she has respect for trans adults (despite saying she does). The chapter is filled with snide and unnecessary comments about the bodies of several people she calls “influencers”. She misgenders some but not others for unclear reasons. I’m not going to name them because some have chosen not to read what was written about them.
Shrier (2020) uses phrases such as “convincingly masculine”, “much smaller than the average man, petite hands, slenderer faces”, and in reference to someone trying on a binder: “a bulldozed version of a woman’s profile”. These comments only serve as hateful remarks that attempt to de-legitimize the transitions and/or appearances of the transmen discussed. She claims many of them struggle to pass and get stares from passersby on the street. This isn’t true and feeds into the narrative of “well you can always tell”. You can’t “always tell”, and she doesn’t know what they experience in their lives. It’s extremely doubtful that some (I say some because I don’t know the gender identity of each person mentioned or what they look like) of the guys mentioned have any trouble passing, however.
If the derisive remarks weren’t enough to demonstrate bad faith, she also misled a popular YouTuber about the purposes of the book. She said she was doing a book about teens with gender dysphoria and wanted to do an interview because some teens look up to him (Shrier, 2020). There’s a clear lack of integrity and basic respect as she intentionally leaves out the purpose of the book, which is basic information you ought to provide when you request an interview.
Over-dramatic or Under-dramatic?
The author talks about how transguys relish the pain of a testosterone injection, that it’s the “trans bar mitzvah” (Shrier, 2020, p. 85). It’s presented as if the injection is a harmful act that provides entry to a cult. The pain shouldn’t be severe, and getting an injection (or doing it yourself) is not nearly as dramatic as she makes it out to be.
She says that trans “influencers” talk about testosterone like it’s just a protein shake and top surgery is no more of a big deal than a haircut (Shrier, 2020). If anyone actually sincerely said this, that’s a problem. However, to my knowledge, a lot of the discussion about surgery is serious, even if joyous. There’s talk about recovery, risks, pain involved, cost, logistics, etc. The same goes for testosterone.
The author spends time going into all the ways trans “influencers” influence kids, tell them they must go on hormones, lie to their parents, etc (Shrier, 2020). None of this is accompanied by sufficient evidence, of course, and ought to be dismissed as a form of fear mongering.
Binders
The side effects of wearing a binder are outlined, but the source used doesn’t support the statement. The authors of a poster presentation noted a reduction in overall lung volume when transmen were wearing their binders vs. when they were not, but acknowledged a small sample size and lack of controls indicates systematic error can’t be ruled out [5]. This is cited when she says breast tissue isn’t meant to be compressed flat all day, which is in no way what is said in the presentation. This shows either a lack of understanding of the source, that the source wasn’t actually reviewed (perhaps reading the title and citing it without checking the content), bad faith by means of intentionally providing “evidence” that isn’t actual evidence, or sheer carelessness.
The funny part is that people are generally instructed not to bind all day and there’s genuine concern of side effects when binding improperly or for too long [6]. Her claim about symptoms is true, but she didn’t cite the proper source, which should call into question the rigor involved in writing the book. Especially when other factual claims are made that are patently false after reviewing the source she cited.
Back to binding: The possibility of side effects doesn’t mean binders are bad. It means a proper binder should be used, not worn all the time (ideally with days off if possible), and people should be aware of side effects in order to recognize them.
As a bit of an aside, here’s what one study shows on binding: Research indicates rib fractures can occur, albeit this was a retrospective study and people were self-reporting if they’d had a rib fracture (no X-rays were reviewed). Rib fractures were among the rarest of events, and individuals were likely to experience them after a longer period of binding. However, the authors noted that symptom occurrence did not seem to be correlated with duration of binding. In fact, some individuals reported that common symptoms like pain occurred within the first month of using a binder, and said pain got progressively worse as the years went on [7].
Non-Hyperlinked References
Shrier, A. (2020). Irreversible damage: The transgender craze seducing our daughters. Regnery Publishing, a division of Salem Media Group.
