Thursday 29 June 2023

Irreversible Damage by Abigail Shrier: A Defense

In this blog I discuss Abigail Shrier’s Irreversible Damage: The Transgender Craze Seducing Our Daughters (Washington; D.C., Regnery Publishing, 2020). Many people think you should not read this book: I think you should.

A Canadian Case

In late April, 2023, Lane Tredger, the first non-binary member of the legislature of Yukon Territory, Canada (population 44,000) complained to the library at Yukon’s capital city, Whitehorse (population 28,000). They had noticed that the library had posted Abigail Shrier’s book, Irreversible Damage, as a staff pick. This is a common procedure in Canadian libraries, where members of staff advertise a book they consider particularly worthwhile.  Tredger argued that Schrier’s book was “blatantly transphobic.”

The library eventually decided that the book would remain in the Whitehorse collection, but without the staff pick sticker, and that it would be more rigorous in selecting staff picks. To its credit, the director of the Yukon Public Libraries said that “Libraries aren’t the arbiters of hate speech: that’s for the courts to decide.”.

What Shrier Argued

I wonder if Lane Tredger actually read Schrier’s book. I have. Shrier does not claim that no one is genuinely trans: she interviewed several adult trans people whose chosen trans identities she respected. She specifically stated “I have nothing but respect for the transgender adults I’ve interviewed. They were among the most sober, thoughtful, and decent people I have come to know in the course of writing this book” (219).

But Shrier is concerned that far too many young girls believe that they are actually boys, and that far too many parents, teachers, medical professionals, and other adults are willing to “affirm” these statements about identity. Her book is full of stories of girls who thought they were boys.

In the 2010s, Shrier states, claims of adolescent gender dysphoria increased by 1,000 per cent in the US (32). She is particularly concerned with what she considers the “craze” of rapid-onset gender dysphoria (ROGD), often found within girls’ friendship groups, several members at a time of such groups identifying as trans (26). Shrier attributes this craze in part to “transgender influencers” on social media. These influencers, she asserts, coach girls to lie to doctors, inventing histories of gender dysphoria while omitting details of their mental health history, to convince doctors to immediately start gender transition treatments even though ROGD might mask other mental health problems (34, 55).

 Girls are susceptible to this RODG craze, Shrier argues, because of several factors affecting their sense of identity. These include the social isolation of today’s adolescents, compounding the normal stresses of female puberty. Such problems are also influenced, paradoxically, by the current narrowing of gender roles, so that girls who “act like” boys begin to believe they actually are boys (pp. 3-18). “Gender-nonconforming” females are seen as actually, or somewhat, male, overturning the long-ago gains of the feminist movement that defended women seen as unfeminine because of their interests in “male” pursuits such as athletics or engineering (63). Notably, there does not appear to be a reverse trend, in which unprecedentedly large numbers of boys suddenly claim they are girls. Perhaps this is in part because being female is still lower status than being male.

In general, Shrier believes that patients are often drawn to “symptom pools,” or “culturally acceptable ways of manifesting distress that lead to recognized diagnoses” (136). Thus, young girls who are distressed about several different aspects of their lives might self-diagnose as in need of gender transition. Such other aspects could include being sexually attracted to girls and women, instead of boys or men; dressing or acting in ways not conforming to pervasive gender stereotypes; or having interests not typical for young girls. Shrier states that several young girls she interviewed told her that lesbians were mocked for being girls who could not admit they were boys, “trans” identities being higher status in high schools than “lesbian” identities (151).


Young women who “failed” at being girls, according to Shrier, could transfer their identity to being male, and as trans people, moreover, could enjoy the “pleasure” of being “oppressed.” This particularly appealed to young white girls who otherwise had to categorize themselves as members of the oppressor class. Now they could “take cover” in being members of a victim group, women no longer being considered oppressed (154-7).


Shrier is concerned about the effects on girls’ health of early transitioning. Future infertility, she maintains, is one such problem. Others are a higher risk of osteoporosis as bone density is suppressed, interference with brain development, possible loss of sexual function, cancer, endometriosis, hysterectomies, and even heart attacks (82-83, 165, 169-70). Gender surgeries, Shrier argues, are experimental and lack proper oversight (142). Even binding one’s breasts can have detrimental health consequences (47).


At least one medication, Lupron, prescribed to block puberty had not been approved by the US Food and Drug Administration for that purpose at the time of writing, yet it was commonly used  (164). In general, “The dangers [of trans medications and surgery] are legion. The safeguards absent” (183). Yet gender reassignment clinics are multiplying in the US, in part because insurance companies are obliged to pay for gender reassignment treatment on the grounds that otherwise they would be discriminating. In 2007 there was only one gender-reassignment clinic, at the time Shrier wrote there were over fifty (167).


Shrier’s allegation are backed up by the personal testimony of one transgender man, who accumulated one million dollars in medical bills for treatment that left them with several severe medical complications. Yet they could not sue their doctors as there were no standards of care in transgender medicine to which the doctors were obliged to adhere. ( (


Shrier argues that many health professionals who presumably would not accept patients’ self-diagnosis in any other situation, be it physical or mental health, are now convinced that they should accept and affirm children’s self-diagnosis of gender identity (97-121). Yet, Shrier asserts, several studies show that about seventy per cent of young children who experience childhood gender dysphoria grow out of it, if they are not encourages to socially transition (119). One study showed that 85 per cent of children exhibiting gender dysphoria outgrew it (256, n. 11).

Shrier’s book should not be censored.  Yet this is what the American Booksellers’ Association essentially did in July 2021 when it apologized for its “violence” in sending free copies of Shrier’s “anti-trans” book to 750 member bookstore.  The apology backfired, however, as publicity surrounding it resulted in an increase in the book’s sales.


Evaluate and Disagree: Don’t Censor


People who disagree with Shrier should first carefully read her book.  Then they should address her evidence, as a professional psychologist, Christopher Ferguson, did. He criticized Schrier for not being sufficiently conversant with the scientific evidence that sex is not determined only by X or Y chromosomes but instead resides in the hypothalmus, and as such, “is largely immutable.”


Some evidence is now emerging from countries other than the US that supports Shrier’s point of view. In Sweden, there was a 1,500 per cent increase between 2008 and 2018 in gender dysphoria among people “born as girls” between 13 and 17 years old.. In the UK, 1,806 girls were referred for gender treatment in 2017/18, as compared to only 40 in 2009/10. As of August 2022, a class action suit against the Tavistock Institute, the UK’s former center for gender dysphoria treatment, was in preparation, claiming that children were “rushed into taking life-altering puberty blockers without adequate consideration or proper diagnosis.”


As I said at the outset of this blog, I am very concerned by people who denounce books and advocate their withdrawal from the public view, rather than taking authors’ arguments seriously. Maybe Shrier has it all wrong. But maybe, as the evidence from other countries suggests, she doesn’t. In any event, the thing to do is read her book and make up your own mind.


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