Reversing the Damage of “Irreversible Damage: The Transgender Craze Seducing Our Daughters”
This is the first of what will be a series of articles that critically examine and critique the 2020 book “Irreversible Damage: The Transgender Craze Seducing Our Daughters” by Abigail Shrier. The book has been both celebrated and reviled[1]. Knowing it’s been celebrated, it seemed prudent to refute the many erroneous claims made.
As a quick summary, the basic premise is that there is some sort of social contagion at work that leads teenage girls to suddenly identify as transgender (Shrier, 2020). However, there isn’t sufficient evidence presented in the book to suggest this. I hope these articles can serve as a helpful resource for those might want to know why the book is controversial and/or delve into refutations to the claims made without reading the book cover to cover.
The Introduction
The author explains that the book is about teenage girls and not transgender adults, stating many trans adults she interviewed were kind, honest, brave, etc. Despite this she inserts several remarks about the transmen she interviewed (Shrier, 2020). These remarks come across as snide and are totally unnecessary to the context of the interviews. Instead, they effectively negate her earlier positive claims toward transgender adults, showing a much more biased perspective. These remarks will be explored further when discussing the respective chapters in which they appear.
A New Fad
Next is a comparison of testosterone and top surgery to exorcisms and binge eating, suggesting that while adolescent girls in the past might have suffered from demonic possession or eating disorders, today’s girls suffer from gender dysphoria (Shrier, 2020). Obviously, this is a wild comparison to make. Not to mention that while an exorcism could be considered the cure for demonic possession, binge eating is in no way the cure for an eating disorder.
Given this, it’s unclear if the author is attempting to suggest that:
1. Gender dysphoria being treated by testosterone and/or top surgery is not actually a treatment but a maladaptive response (like binge eating in eating disorders).
Or,
2. Gender dysphoria being treated by testosterone and/or top surgery does work but dysphoria itself isn’t actually real (like exorcisms curing a demonic possession that wasn’t ever real to begin with).
Regardless, the claim doesn’t hold up. Research indicates that the rate of eating disorders is higher in transgender individuals when compared to a cisgender sample [2]. In other words, gender dysphoria doesn’t serve as a replacement for binging and purging (or self-harm, which is also acknowledged in the author’s list of past “fads”). It can’t be considered the “new fad” that leads to hormones instead of diet pills because eating disorders are even more prevalent in trans individuals when compared to a cis sample.
Also, as an aside, for transgender men in particular, the rates of eating disorders significantly decreased if they had had a hysterectomy, top surgery, or were taking hormone replacement therapy [3]. Thus, treating the dysphoria may have helped reduce disordered eating. The more interesting question here is why are rates of eating disorders elevated in the trans vs. cis population and what can we do about it?
Misrepresentation of Legal Issues
A major problem with the book is when something is presented as fact but isn’t. Shrier (2020) claims that California law could put healthcare workers in jail if they don’t use the preferred pronouns of their patients. However, even the source she cited[4] clearly states that a fine or jail time is possible only when a healthcare worker has repeatedly and willfully used the wrong pronouns for a patient after having been informed of the right ones to use.
In other words, no one is being jailed for simply using the wrong pronoun. Legal action was to be considered when a healthcare worker intentionally used the wrong pronouns.
She also claims that this violates the First Amendment, using the West Virginia State Board of Education v. Barnette (1943) case as evidence. In that case, the Supreme Court stated that the government could not force students to salute the American flag because it could not force them to support a message mandated by said government [5]. This is not an example that applies to the law about healthcare workers, as using a patient’s preferred pronouns is not endorsing a government message.
Furthermore, the government does compel speech in many areas, and courts are reticent to rule in favor of the First Amendment if it means ruling against anti-discrimination laws [5]. Repeatedly and willfully using the wrong pronoun for a patient could certainly qualify as a discriminative act.
Example One
Shrier (2020)interviews several parents, and the first concerns a child I’ll refer to as “L”. Because I don’t know their gender identity, I won’t use the name used in the book, and I’ll use gender neutral “they” to describe them.
L began taking testosterone within a year of going to college, and according to L’s parents, had never shown any signs of gender dysphoria. L’s mother claimed that with testosterone, they became aggressive and very angry whenever their parents used their birth name or she/her pronouns. The mother also stated her child would not explain anything about being trans (Shrier, 2020).
The main issue with this narrative is that it excludes any context from L. Did L actually become hyper aggressive toward their parents and simply refuse to explain anything? Or did L become angry when their parents decided they knew L wasn’t actually trans and L became surlier in response? Maybe even dejected that their parents seemed so certain their identity wasn’t real?
Now, the author does concede that she doesn’t show the full story of these teens and that parents can’t be completely relied upon to provide accurate information about their child’s gender identity (Shrier, 2020). However, she presents these examples as if they’re evidence for adolescent onset gender dysphoria that is not true dysphoria, but a “social contagion” or “fad”.
Gender dysphoria is an internal state. While parents can certainly pick up on behaviors that might suggest dysphoria, their inability to recall any such behaviors, statements, etc., doesn’t mean their child never experienced gender dysphoria before a seemingly sudden onset. Shrier points out the definition of gender dysphoria includes that symptoms must be persistent and consistent, and children would have a difficult time hiding such discomfort from parents.
The problem with this is that, once again, dysphoria is experienced subjectively and internally. A child might feel persistent and consistent gender dysphoria yet be unable to find the words to describe it. They might express their dysphoria and experience shaming from their parents, which could lead to the child suppressing their feelings rather than talking about it again.
We know that gender roles are very often socially enforced, with it being seen as deviant or wrong to stray too far from one’s assigned role. This is not to suggest that it’s as extreme as parents never allowing their son to wear pink or daughter to play with toy cars, but for some children expressing transgender identification comes with being told they’re wrong, they can’t be X, they don’t know what they’re talking about, etc.
Chapter One
The first chapter discusses the rise of social media and adolescents spending more time on their phones and less with peers. This leads into a discussion of how teens are less mentally tough/emotionally mature and that’s the segue into teen girls identifying as trans (Shrier, 2020). It’s not made explicit how this connects; I believe the premise is that kids are isolated/lonely and fall into social media traps. She also says many of the interviewed parents said their children behaved younger than their chronological age would suggest (Shrier, 2020).
Lonely Teens Staring at Screens?
While the study indirectly referred to does show reduced rates of in-person social outings with peers in recent years (in a sample of over 8 million American adolescents surveyed between 1976 and 2017), the correlations with loneliness are small [6]. Moreover, these correlations are based on samples of over 33,000 people. Without going into detail on statistics, it suffices to say that when working with a very large sample size, the chance that you’ll stumble upon a correlation that meets significance increases. The small correlation also indicates that there is a lot more going on with increased rates of loneliness than just frequency of in-person gatherings with peers [7].
Perhaps more importantly, the study showed that loneliness was not correlated with social media use, which seems to be the premise Shrier asserted. In fact, adolescents who spent more time on social media were also having more in-person peer interactions. Those who spent less in person time with others while maintaining high social media use did report the most loneliness, however[6]. This is not a criticism of the authors of the study or their research design. Shrier did not cite this study; she referenced articles written by the primary author Dr. Jean Twenge. It was important to look at the source for these articles because Shrier seems to be drawing an association between smartphones, social media, and the “transgender craze”.
This is not to suggest that social media and smartphone use hasn’t had negative consequences for adolescents (or anyone), or that there’s no correlation between mental health, social media, and smartphone use. However, the evidence given does not support the claims made.
She seems to suggest that teen girls simply don’t have the same amount of in-person experiences with friendship, romance, dating, and sexual exploration that past generations did. Fewer such experiences are not inherently good or bad, however. For example, it’s most likely bad if a teen girl wants friends but has none. It’s probably good if she avoids a relationship she didn’t want to be in, even if doing so delays her first romantic experience by a year or more. There’s too much nuance to social interactions to make a value judgement based on quantity.
The Sex Problem
Shrier (2020) mentions that teens are having less sex, and that many trans-identified teens haven’t masturbated or had sex. She claims “Their bodies are a mystery to them, their deepest desires under-explored and largely unknown.” I don’t know the masturbation rates for gender dysphoric adolescents, but I do know there’s a major confound here.
Assuming none of the teens are asexual, if they have gender dysphoria, masturbation might make them feel worse (but not necessarily). Furthermore, intimacy with others is complicated by being trans. The adolescent might have to consider coming out to a crush/potential date (or be rejected for being trans if others are already aware). Sexual exploration can be even more difficult, as the individual has to deal with secondary sex characteristics they’re uncomfortable with already. The idea of sharing that part of themselves with another person might be a horrible one.
Disclaimer: This is not to say that a trans teen can’t engage in sexual exploration and enjoy it/be comfortable with themselves and/or another person intimately. This is only to point out some of the reasons it’s absurd to say that trans teens’ bodies are a mystery with their deepest desires unknown. There is an inherent conflict with bodily exploration when you have dysphoria, and this might explain the lower reported rates of sexual behavior from the adolescents treated by the therapist Shrier referenced.
Misunderstanding Manhood
Next Shrier (2020) discusses the movie Boys Don’t Cry, based on the true story of the life of Brandon Teena. Despite her earlier assertion that she respects trans adults, she refers to Brandon as “she” rather than “he”. Perhaps she was referring to Hilary Swank (who portrayed Brandon), but this seems less likely in light of her comments about some of the trans adults she interviewed.
How Brandon tries to fit in with the guys is emphasized, and Shrier (2020) says that today’s teens aren’t like him at all. Her argument is that they don’t try to mimic men’s habits like staring at women, watching sports and lifting weights. I want this to be a critical series that provides evidence and reason in a professional manner. However…How crazy is it to say that because these teens aren’t adopting habits/activities of an extremely stereotypical idea of manliness they don’t want to pass or be seen as men?!?!?! I don’t need to provide a breakdown on why that’s illogical.
Her next piece of evidence is the low percentage of trans-masculine individuals who have either had or want to have phalloplasty. She claims they have no desire to do so (Shrier, 2020). This is patently false. The low phalloplasty completion or desire rates could be attributed to several major factors.
Phalloplasty is not something you can have a single surgery for and be done. It’s a long and arduous process. There are also many possible complications, including flap failure (the newly constructed phallus basically doesn’t survive, although this is much rarer now), urethral strictures and fistulas (many people hate the idea of risking losing the ability to independently urinate), among others[8]. There is concern about maintaining erotic sensation, its functionality (both in terms of urination and sexual performance), as well as aesthetics. Not to mention that a metoidioplasty can also be performed instead, which allows patients to retain their natal genitalia and thus preserve erotic sensation fully.
Undergoing any surgery is a major decision, and opting not to have a phalloplasty isn’t evidence of not wanting a penis. Some might be dissatisfied with the aesthetics, concerned about complications, financially unable, desire a different procedure, comfortable with the anatomy they have, or even waiting for surgical methods to be improved upon (and surgeons to gain more experience) before having such a major procedure.
Back Online
Yet another totally unfounded claim is misleadingly made with a citation, leading the reader to believe said citation actually presented the claim. “Extensive daily internet use provides casual conversance with every sort of sexual fetish. They know what a “furry” is and have seen bondage porn. They’re au fait with the ‘“lesbian”’ videos so popular on PornHub. The average age at which they first viewed pornography is eleven” (Shrier, 2020, p. 53).
Perhaps she only meant the citation to account for the final sentence, which is included in the cited article, rather than the entire paragraph. However, I was led to believe that the factual statements being made were likely supported by the referenced source. They aren’t.
While yes, sexual fetishes are easily accessed online, the article made no mention of teens knowing about furries or watching bondage. Additionally, while the furry community can involve sexual interests, it’s not necessarily so[9]. In fact, the social belonging factor is often more important than the sexual factor[10].
There’s certainly value in discussing the impact early exposure to pornography has. However, the claims made aren’t supported by the evidence given. It’s misleading to lump the above quoted statements in a single paragraph with a citation, especially when said statements are made to sound factual.
Note
Other parents and their children were discussed in this chapter, but there’s a summary of where they are now at the end of the book, so they’ll be mentioned when covering that section.
The next article will detail chapters 2 and 3.
Non-hyperlinked References:
Shrier, A. (2020). Irreversible damage: The transgender craze seducing our daughters. Regnery Publishing, a division of Salem Media Group.
