Irreversible Damage by Abigail Shrier review — the risks of transgender activism

Irreversible Damage by Abigail Shrier review — the risks of transgender activism

This controversial book warns about the toxic online diet being fed to teenage girls

The Sunday Times
Rights and wrong? Pro-trans messages at Leeds Pride
Rights and wrong? Pro-trans messages at Leeds Pride
ALAMY

“Like a virus.” That’s the phrase one teenage girl in this book used to describe her gender identity in an online post, along with the words “trans, genderfluid, non-binary, demiboy”. At the time she was being ironic, or semi-ironic, but it didn’t take long for the sense of irony to fade. After swapping her “pro-ana” (pro-anorexia) Tumblr sites for “social justice” sites full of “trans testimonials”, she, along with four of her closest friends, decided to change her pronouns and her life. She bound her breasts, swapped her diet pills for testosterone jabs and waited to be happy. Unfortunately she wasn’t, and nor, it seems, was anyone else. “They’re all goddamn miserable,” she told Abigail Shrier.

Helena was lucky. She changed her mind about her new identity as “a member of an oppressed minority” before she had a double mastectomy or a phalloplasty, the high-risk surgery that leaves some people with incontinence and permanent pain. Many “detransitioners” weren’t so lucky. In one clinical trial 100 per cent of the adolescents given puberty-blocking drugs went on to take hormones that cause infertility and increase their risk of cancer, heart disease and strokes. A new study from the Gender Identity Development Service at the Tavistock Centre shows that the figure here was 98 per cent. This is the “irreversible damage” that forms the title and subject of Shrier’s explosive new book.

It sprang out of a column Shrier wrote in The Wall Street Journal about a Californian law that made it illegal for healthcare workers to refuse to use the gender pronouns requested by patients. It seemed to her a clear breach of the First Amendment commitment to free speech. After a flood of emails from parents desperate to tell the stories of their trans-identifying daughters, she decided to do more research. What she found shocked her so deeply that she felt duty-bound to write this book.

She has been attacked for being “anti trans” and her book has faced protests. But it is not, she says, a book “about transgender adults”. The ones she has met and interviewed are “kind, thoughtful and decent” and “do not seek to be celebrated for the life they have chosen”. It’s about “an epidemic” and one, she argues, that’s wrecking the lives of many adolescent girls. The trans activism of today, she says, bears more relation to the Salem witch trials than to traditional trans life.

It’s an emotive statement, but Shrier marshals her evidence. She talks to parents, psychologists, doctors, therapists, educationalists and, of course, young women and trans men who “came out” as trans as teenagers and have transitioned or started to transition. She talks to Lisa Littman, a public health researcher who studied the stories of 256 girls who discovered their trans identity in adolescence, and was hounded out of her role at the Rhode Island Department of Health. She talks to social media influencers, social workers and plastic surgeons. And what emerges are some heartbreaking stories and some very clear patterns.

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The key message is perhaps the saddest: that adolescent girls are in trouble. A constant online diet of social media has fed and magnified every traditional insecurity, fuelling anxiety, cutting, eating disorders, body dysmorphia and offering online platforms tailored to each. Girls mix socially less than they used to. They are less independent and emotionally less mature. Stuck in their bedrooms with their smartphones, many have stumbled on a new solution to their problem. Feeling inadequate as girls, they discover they are probably not girls! An online army is waiting to cheer them into their new identity, and along the path to the hormones and surgery that will make them feel whole.

Historically, Shrier points out, gender dysphoria has affected 0.1 per cent of the population. Before 2012 there was no scientific literature on gender dysphoria affecting girls between the ages of 11 and 21. In 2018 the UK reported a 4,400 per cent rise over the previous year in the number of teenage girls seeking gender treatment. The prevalence in some friendship groups, Littman points out, is more than 70 times the expected rate. A “craze”, Shrier says, “is a technical term in sociology, not a pejorative term.” And if this isn’t a craze, it’s hard to know what is.

These girls are nearly all white and upper-middle-class. They didn’t always feel they were trapped in the wrong body, although that’s what their cheerleaders coach them to say when they set out on the path to hormones and the knife. But they don’t really need coaching, because they won’t meet much resistance. Schools are running clinics on site. Therapists have swapped questions about mental distress for an “affirmative care” model ready to endorse whatever the patient says. So have doctors and surgeons. Imagine, Shrier says, if a black girl asked to have her skin bleached and her nose narrowed because she didn’t “feel” black. “I can’t think,” says one doctor she quotes, “of any branches of medicine outside of cosmetic surgery where the patient makes the diagnosis and prescribes the treatment.”

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It’s too early to say what will happen to the girls who have already made the physical and hormonal journey to trans man. Shrier speaks to quite a few who have regretted it, and in this country we have the story of Keira Bell, who recently won a landmark judicial review against the NHS for prescribing puberty blockers to children. Perhaps many of them will live happily ever after. We should certainly hope so, but we can’t bank on it. Some appear to be trapped in what Shrier calls “a sad cult of asexuality” where being trans is a full-time, and rather exhausting, job.

Irreversible Damage is punchy, analytical and written with the zest and elegance of a journalist at the top of her game. But what it describes is not a game. It is, to use Helena’s word, a virus and it has spread beyond children to the people who are meant to keep them safe. They haven’t. We haven’t. Shame on them and shame on us.

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Irreversible Damage: The Transgender Craze Seducing Our Daughters by Abigail Shrier
Swift £16.99 pp288

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