REVIEW of Irreversible Damage by Abigail Shrier

Photo Credit: TitiNicola under CC licence

The issue of transgenderism has moved into the very centre of politics, culture, education and healthcare. It is the subject of much argument, activism and controversy. Historically, .01% of the population were affected by, what was then called, gender identity disorder and it predominantly affected males. In 70% of cases, the condition was temporary. Today, the numbers presenting with, what is now commonly called, gender dysphoria have risen by thousands of percentiles and the condition predominantly affects teenage girls. Transgenderism is now defined as a fixed part of a person’s identity rather than a pathology.  Wall St Journal columnist, Oxford and Yale Law School alumnus, Abigail Shrier has written a very well researched and referenced book on the factors underlying these changes, focussing on the demographic most affected, young teenage girls with no previous symptoms of dysphoria.

Shrier traces the rapid rise in cases to the advent of the smartphone in 2007. In multiple ways, the relationship of young people with their phones and other devices has both fed the anxiety underlying dysphoria and led them to see transgenderism as the solution to their problems. Saturation in online platforms, such as utube, tumblr and Tik Tok, and social media means that many young people live life virtually and vicariously for much of the day. The normal insecurities of adolescence are magnified in a world where image is honed and personal profiles carefully curated, where bloggers and podcasters, known as ‘influencers’ for good reason. open the way to magic, life transforming new identities. This immersion in a virtual world isolates young people from their real life peers and family and so deepens whatever feelings of not fitting in they may be experiencing.  For Shrier and her peers, growing up in America, ‘the Mall’ was the concourse where friends met to chat and share and find mutual support. Now, that concourse is often the shadow world of strangers who come and go in virtual chatrooms. Not merely strangers either but quite often adult imposters.

Troubled and insecure young girls can easily access platforms that validate anorexia, bulimia and cutting as well as gender dysphoria. There is advice there for everything from suppressing appetite to accessing hormone treatment, from procuring breast binders to tips on how to deceive anxious parents. Tricks like filing a bowl with cereal and milk, tipping it into the garbage and leaving the empty plate and spoon on the kitchen counter. Those who declare an interest in coming out as transgender are immediately ‘love bombed’ and welcomed into the trans online community. Parental opposition, they are advised, is cue to cut ties with parents and find a new belonging within ‘the glitter family’. The enthusiastic affirmation and unreserved encouragement that comes with the new gender identity creates a momentum of its own that can make turning back very difficult for fragile youngsters who, in the majority of cases studied, show a previous history of poor mental health, ranging from depression and anxiety to self-harm in close to half of them.

The correlation between the advent of smartphones and the rapid rise in girls contemplating suicide, self-harming and, incresingly more and more, adopting new gender identities, ‘out of the blue’, is undoubtedly significant. But of course not every teen fails to negotiate the challenging years of adolescence without having a major crisis so the focus must move upstream from internet culture to the social and familial milieu of the children concerned. Shrier’s exploration of the factors she identifies as significant are fascinating and may suggest trains of thought to readers that the book explores only sketchily,

From the case studies she cites and those she recounts, the girls affected tend to come from ‘upper class, white families’. Parents tend to be successful professionals with liberal views on abortion and gay rights. The mothers she speaks to are mostly the ‘lean-in’ type. Shrier concludes their children are ‘over-parented’ and ‘over-protected’ and the parents ‘safety obsessed’. We can see what she means by those terms when she offers, as an example, an East Coast editor taking her child to a counsellor to help her deal with the death of a kitten. The social milieu in which these parents work and socialise is a heavily medicated one. Nearly one in six Americans take a psychiatric drug. There is a tendency towards  ‘obsessive rumination’, ‘to categorise everything’, to see everything as a condition. To find a fix for everything. However, once children reach puberty, they inevitably pull away from the safe spaces their parents have created for them.  Most of them start viewing porn online at 11.

Shrier identifies porn as a significant factor in leading girls towards transgendering. Online porn is easily accessible, graphic and very often involves extreme depravity and violence. It debases sexuality and objectifies women. Shrier writes that this engagement with online sex is connected to many trans kids never having had a sexual experience.  Instead, they have ‘avant-garde gender theory’.  The prevalence of porn in the culture is also seen as a factor in decreased sexual activity among college students generally. It offers one explanation of why so many previously ‘girly girls’, no longer ‘want to be girls’ and why there is so much ‘peer contagion’ within social and school clusters.

But there are other things about the families of the girls Shrier writes about that are striking. Divorce and emotional abuse fearure in some cases. Typically, they have troubled siblings, usually involving addiction.  Whatever the dysfunctionalities, social, cultural and familial, underlying what Shrier calls ‘the trans epidemic’ among girls, it appears they give rise to a plethora of other problems too.

Shrier sees the new pattern of gender disorder as another manifestation of the anxiety and depression that led to the ‘nervous disorders’ affecting women a century or so ago, disorders now categorised as depression, anorexia, bulimia, cutting or self-harm, and psycho-somatic illness. Given the evidence of ‘social contagion’ or copying, one might expect the medical profession to be at least sceptical about re-classifying gender disorder among this group as a ‘an identity, not a mental illness’,

Yet, this is what has happened. ‘Gender affirming care’ is the standard before even the patient is examined. Most of the main medical representative bodies in the US support this approach, something that happens, Shrier points out, ‘no where else in medicine’. The back history of anxiety, self harm, depression, even autism count only in so far as they support the subject’s case for transition. Teenage girls are administered puberty blockers and sex hormones that many researchers believe are likely to affect their neurologial and brain development. The physical consequences include infertility, raised risk of heart attack, ovarian cancer and hysterectomy, as well as many other bizarre and uncomfortable side effects for the sexual organs. Shrier points out that it is very difficult both physically and psychologically to change direction once the course is set.  Testosterone can indeed  be a mood booster in the short terms because it emboldens and lifts depression. However, in the longer term there is strong evidence that the ‘rate of self-harm and suicidality does not decrease’ following treatment. The weight of this evidence, from a leaked scientific paper, led to the resignation of Dr Marcus Evans and a number of other medics from Britain’s Tavistock Clinic, the Gender Identity Development Service (GIDS) run by the NHS.

‘Gender identity development’ may also include surgical intervention. Breast binding is not always considered enough. Many girls opt for ‘top surgery’, the term for the double mastectomy that the medical profession is happy to provide for physically healthy young women. Medical insurers are obliged by both federal and state law in the US to provide cover for ‘transition-related’ treatment under anti-discrimination law.

However, the buy-in of the medical profession is nothing compared to the active and enthusiastic promotion of transgenderism in the school and college environments.  Taught modules on bullying are used for indoctrination by LGBT groups. Children are told you can have  ‘a boy brain in a girl body’ and vice versa, that certain interests are ‘gender non-conforming’.  Apart from contradicting standard teaching on gender stereotyping and gender equality in the same schools, there is no scientific evidence whatsoever for the claim. Every body cell has either XX or XY chromosomes.  The pattern is the same for all organs including the brain. The prompting goes further with questions like, ‘how would you feel if you were a different gender?’ and ‘what could you do that you can’t do now?’

Children can appropriate new names and pronouns in school against parents’ wishes. In California, children over twelve can leave school for hormonal treatment without parents’ consent.  This according to Shrier is a logical extension of the expanded idea of the nurturing role schools have already adopted by providing children with three daily meals. The age of medical consent is 15 in Oregan and no medical referrals are needed for hormone treatment. There is little evidence that parents are considered rightfully interested parties in their child’s decisions and development. There is no sense that neither schools nor the medical profession believe parents can bring anything of value to inform decisions taken by their teenage children with their help.

If the educational and medical profession are capitulating to ideology without due diligence, the buy-in of academia is even more extraordinary. Shrier writes about obstetrician, gynaecologist and public health researcher for Rhode Island Dept. of Health, Lisa Littman who became an international pariah among LGBT groups because of peer reviewed research that produced the kind of evidence Shrier cites in her book. Lisa Litttman has impeccably liberal credentials; she worked for Planned Parenthood. However, the mob came for her after she advanced the hypothesis that ‘peer contagion’ was significant in the high number of teenage girls identifying as transgender. The most disturbing thing of all is that the academic journal, PLoS One, that published her paper apologised and undertook a review into Littman’s  ‘possible methodical errors’.  Littman lost her position before any review took place. The findings of the review that vindicated her research were not widely flagged and did not restore Littman to her position.  Research such as Littman conducted is also hampered by the fact that there is no record of detransitional patients for clinical research.

It is truly shocking that scientific research and the integrity of the educational and medical systems are so in thrall to political correctness. Usually politics is downstream of general culture but it looks like it is very much the other way around on this issue. But closer reflection may show this is not quite the case perhaps. At the end of her book, Shrier looks at the way our society has rebranded womanhood and motherhood.  ‘ We allow denigration of motherhood. We treat stay-at-home mothers as the most contemptible of life’s losers’, Shrier writes.  As our birth rates plummet, as our diminishing birth rates are seen as a marker of environmental responsibility as well as of female empowerment, how is a young girl, who may enter menarche as young as twelve today, likely to feel about the awkward and messy bodily changes that puberty ushers in?  All specifically to enable her to conceive and give birth, to become a mother. Not a CEO or a magazine editor or a medical consultant. Does it make her feel as one of Shrier’s subjects said, ‘ I just don’t want to be a girl’?  Do these girls think their  own mothers would define themselves primarily as mothers or primarily as career women?  How do they feel about their competitive, careerist mothers suddenly ‘abandoning a lucrative job’ to care for them in their teens, or take them on an extended tour abroad after they had taken the first steps to ‘dissociate from the person my parents thought I was’.  We might ask have these girls ever felt loved just for themselves, as they were, whether or not they were capable of emulating their successful mothers, whether or not they conformed to perceived parental ideas of what they should be or should aspire to be ?

Shrier’s book is definitely one to ponder as our age goes hell bent after the delusion that we can manufacture identities for ourselves that will free us from  disappointed expectations, whether our own or those of other



Irreversible Damage

  • AuthorL Abigail Shrier
  • Publisher : Regnery Publishing (June 30, 2020)
  • Language : English
  • Hardcover : 276 pages
  • ISBN-10 : 1684510317


This article was first published on Position Papers

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