Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, published by Regnery Publishing, which endorses the controversial concept of rapid-onset gender dysphoria (ROGD).[1][2][3] ROGD is not recognized as a medical diagnosis by any major professional institution nor is it backed by credible scientific evidence.[1]
Shrier states that there was a "sudden, severe spike in transgender identification among adolescent girls" in the 2010s, referring to teenagers assigned female at birth.[4][1] She attributes this to a social contagion among "high-anxiety, depressive (mostly white) girls who, in previous decades, fell prey to anorexia and bulimia or multiple personality disorder".[4] Shrier also criticizes gender-affirming psychiatric support, hormone replacement therapy and sex reassignment surgery (together often referred to as "gender-affirming care") as treatment for gender dysphoria in young people.[5]
Response to the book has been mixed. Positive reviews mostly endorsed Shrier's thesis, while much of the criticism focused on the book's use of anecdotes and other issues with its evidence. There were several boycotts aimed at the book which characterized it as anti-trans and its use of "she" to refer to teenagers identifying as transmasculine and non-binary as misgendering.
Summary
Shrier states that she began to investigate adolescent-onset gender dysphoria after being contacted by the mother of a young adult with no apparent history of childhood gender dysphoria, who identified as transgender in college.[6] She describes what she sees as difficulties facing teenagers who were assigned female at birth, whom she refers to as "girls":[1][7] isolation, online social dynamics, restrictive gender and sexuality labels, unwelcome physical changes and sexual attention. She profiles several teenagers who questioned their gender identities or came out as transgender while experiencing mental health or personal issues.[8] She discusses Lisa Littman's 2018 journal article on rapid onset gender dysphoria and the ensuing controversy and endorses Littman's findings.[9] She states that online trans influencers, on websites like Twitter, Tumblr and TikTok, frequently encourage questioning youth to identify as trans, experiment with breast binding and testosterone, and disown or lie to unsupportive family members.[10]
Shrier criticizes transgender-related curricula and policies in schools.[11] She describes parents distressed by their children's transgender identification or transition.[12] She critiques the gender-affirming model of care[13] and profiles its critics: Kenneth Zucker, Ray Blanchard, J. Michael Bailey, Lisa Marchiano, and Paul R. McHugh.[14] Shrier discusses trans activism and related controversies, including sex-specific privacy concerns; passing versus trans visibility; the role of celebrities in increasing trans acceptance; conflict between transgender people and lesbians or radical feminists; transfeminine/male-to-female athletes competing in girls' and women's sports; the use of trans-inclusive language; intersectionality; and identity politics.[15] She argues that medical interventions such as puberty blockers, cross-sex hormones, and surgeries include risks. As an example, she describes a transgender person who became disabled after a failed surgery.[16] She also profiles detransitioned young women.[17]
The contentious concept of rapid-onset gender dysphoria (ROGD), which Irreversible Damage endorses, was first proposed in a 2018 paper by Lisa Littman.[1][2][3] ROGD is not recognized as a medical diagnosis by any major professional institution and is not backed by credible scientific evidence.[1]
Irreversible Damage was first published in June 2020 by Regnery Publishing, a conservative publisher.[20] An audiobook narrated by Pamela Almand was released by Blackstone Audio.[21] In the UK, the book was published by Swift Press, with the subtitle "Teenage Girls and the Transgender Craze".[22] In a July 2020 interview on The Joe Rogan Experience, Shrier called the desire to transition a "contagion" and compared it with eating disorders and self-harm.[23] She associated transgender youth with autism.[24] Her remarks sparked calls by Spotify employees for the Rogan podcast episode to be removed from the platform,[24][25] but the company denied the request.[26]
Chase Ross, a transgender YouTuber interviewed by Shrier for Irreversible Damage, apologized in 2021 for his participation in the book, claiming he was misled about the book's contents and the author's intent.[1]
Marketing and distribution
In June 2020, Amazon suspended a paid advertising campaign for the book one week prior to publication. Amazon stated this was because the book "infers or claims to diagnose, treat, or question sexual orientation."[2] In April 2021, employees petitioned Amazon to stop selling the book; a company official responded that the book did not violate Amazon's content policies and the company would continue to offer it.[27] In March 2022, a group called No Hate at Amazon circulated a petition demanding that Amazon stop selling Irreversible Damage and Johnny the Walrus and demanded that Amazon set up an oversight board that would allow employees to democratically determine what content can be sold on Amazon. At least 500 people signed the petition, which was presented to Amazon leadership in the summer of 2021. Some employees quit working for Amazon over the company's refusal to stop selling Irreversible Damage and Johnny the Walrus.[28]
In November 2020, Target briefly stopped selling the book following criticism online, but made it available for purchase again a day later.[29][30] Several LGBT commentators expressed support for the book's removal. The Daily Dot columnist Ana Valens wrote that it contained obvious transphobia and encouraged conversion therapy.[31][32] In Them, the writer James Factora stated that almost every claim in the publisher's description of the book was a "blatant lie".[30] In Gay City News, the journalist Matt Tracy criticized Shrier for misgendering subjects. Shrier had stated, "I refer to biologically female teens caught up in this transgender craze as 'she' and 'her'", which Tracy wrote is "a choice by the author that disrespects transgender teens' gender identity and falsely assumes that all trans boys or non-binary individuals assigned female at birth have the same biological makeup."[7] In February 2021, Target again withdrew the book from sale.[27]
In April 2021, a petition was launched to have the Halifax Public Library system remove their two copies of the book from circulation. The library refused, citing intellectual freedom and stating that removal would constitute censorship. Following this, Halifax Pride announced it would no longer hold events at any Halifax library locations.[33]
In July 2021, the American Booksellers Association, a non-profit trade association that promotes independent bookstores, issued an apology for including the book in a monthly mailing, calling the decision to do so a "serious, violent incident" and characterizing the book as "anti-trans".[20] This set off further controversy, with some arguing the association was now trying to censor the book, and others saying the apology was insufficient.[34]
Chase Strangio, an attorney for the American Civil Liberties Union (ACLU), tweeted that "stopping the circulation of this book and these ideas is 100% a hill I will die on." Strangio later deleted the tweet, saying he was not calling for a government ban but "to create the information climate for the market to be more supportive of trans self-determination".[35]
The book has been translated into multiple languages and foreign-language versions have been released in other countries such as Spain,[36] France, Hungary[37] and Israel where a speech by Shrier drew protesters.[38]
Backlashes against the book have led to termination of its publication in Japan.[39]
The Economist included Irreversible Damage among its books of the year for 2020.[52]The Economist called the book "one of the first accessible treatments of a subject that has generated much fascinated coverage" but remarked it had not received many reviews in mainstream papers. It credited Shrier with "[telling] the stories of those she interviews with great care", but suggested that she might have overstated the extent to which teenagers were receiving medical interventions.[42] Madeleine Kearns reviewed Irreversible Damage alongside Debra W. Soh's The End of Gender. She stated that Shrier's book provided "a personal, inquisitive, and often moving narrative".[44] Naomi Schaefer Riley wrote that Shrier was correct to ask "what's ailing" adolescents who appeared to suddenly begin identifying as transgender. She endorsed Shrier's criticisms of transgender healthcare and online transgender activism.[46] Janice Turner called the book "fearless", remarking on the controversy surrounding it and endorsing its conclusions.[47]
Tina Beattie called the book "a disturbing, infuriating and compelling study". She criticized Shrier's use of anecdotes from parents or professionals, apparently unbeknownst to the subjects themselves. She wrote that, while "many of Shrier's claims may be open to challenge", the reported increase in cases of adolescent-onset dysphoria "should be a cause for much greater caution and disquiet than is currently the case".[22] Christopher Ferguson wrote that Shrier had "some valid ideas" and that he was "not willing to dismiss her thesis entirely", but also that she failed to "carefully hew" to science and that "high-quality, preregistered, open science, scientific efforts" were needed in the area.[48]
Sarah Fonseca condemned the book for its presentation, substance, and sourcing.[49] Historian Ben Miller compared the cover's design, "with the little white girl's reproductive organs obliterated by a black hole," to that of Nazi propaganda posters.[53][54] Psychiatrist Jack Turban accused Shrier of promoting the denial of gender-affirming medical care from transgender youth, which he called a fringe position rejected by several professional societies. He also accused Shrier of misinterpreting and omitting scientific evidence to support her book's claims and criticized her for portraying transgender youth based on interviews with parents, and for "crass and offensive language."[5]
Skeptic and physician Harriet Hall published a positive review of the book on the website Science-Based Medicine in June 2021, stating that Shrier "brings up some alarming facts that desperately need to be looked into", that care centered on gender affirmation "is a mistake and a dereliction of duty", and that the current political climate has made scientific study of these matters nearly impossible.[51][50] The site's two other editors, Steven Novella and David Gorski, took the unprecedented step of retracting this review, which was republished in Skeptic.[50] Novella and Gorski later explained the retraction, concluding that both Hall's and Shrier's claims are "not supported by any evidence and [are] cobbled together with a gross misreading of the scientific evidence", and are based on "anecdotes, outliers, political discussions, and cherry-picked science". In the following weeks, the site published a series of articles about the book by guest authors and physicians Rose Lovell and AJ Eckert that also criticized the book for scientific errors, cherry-picked data, and misinformation.[19][1][51][55]
↑ Ellis, Philip (July 22, 2020). "Joe Rogan Is Spreading Transphobic Hate Speech and It's Putting Lives in Danger". Men's Health. ISSN1054-4836. Retrieved December 19, 2020. Shrier invalidated the lived experience of trans and nonbinary kids and teens, and made numerous dangerous, entirely unsound false equivalencies. She compared transitioning among teenagers to historic adolescent phenomena such as eating disorders, self-harm, and (bafflingly) the occult, calling this age group 'the same population that gets involved in cutting, demonic possession, witchcraft, anorexia, bulimia.' She even described wanting to transition as a 'contagion' with the potential to infect other children with the same ideas, drawing yet more scientifically baseless parallels with eating disorders.
Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.
Matt Walsh is an American right-wing political activist, author, podcaster, and columnist. He is the host of The Matt Walsh Show podcast and is a columnist for the American conservative website The Daily Wire. He has authored four books and starred in The Daily Wire online documentary film What Is a Woman?.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
Marci Lee Bowers is an American gynecologist and surgeon who specializes in gender-affirming surgeries. Bowers is viewed as an innovator in gender confirmation/affirmation surgery, and is the first transgender woman to perform such surgeries.
Paul Rodney McHugh is an American psychiatrist, researcher, and educator. He is currently the University Distinguished Service Professor of Psychiatry at the Johns Hopkins University School of Medicine and the author, co-author, or editor of seven books in his field.
Harriet A. Hall was an American family physician, U.S. Air Force flight surgeon, author, science communicator and skeptic. She wrote about alternative medicine and quackery for the magazines Skeptic and Skeptical Inquirer and was a regular contributor and founding editor of Science-Based Medicine. She wrote under her own name or used the pseudonym "The SkepDoc". After retiring as a colonel in the U.S. Air Force, Hall was a frequent speaker at science and skepticism related conventions in the US and around the world.
Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. In addition to their use in treating precocious puberty, which involves puberty occurring at an unusually early age in children, puberty blockers are also used for transgender children to delay the development of unwanted sex characteristics, so as to allow transgender youth more time to explore their gender identity.
Science-Based Medicine is a website and blog with articles covering issues in science and medicine, especially medical scams and practices. Founded in 2008, it is owned and operated by the New England Skeptical Society, and run by Steven Novella and David Gorski.
Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social pressure, or discrimination and stigma.
Rapid-onset gender dysphoria (ROGD) is a controversial, scientifically unsupported hypothesis which claims that some adolescents identify as transgender and experience gender dysphoria due to peer influence and social contagion. ROGD is not recognized as a valid mental health diagnosis by any major professional association, which discourage its use due to a lack of reputable scientific evidence for the concept, major methodological issues in existing research, and its stigmatization of gender-affirming care for transgender youth. The paper initially proposing the concept was based on surveys of parents of transgender youth recruited from three anti-trans websites; following its publication, it was re-reviewed and a correction was issued highlighting that ROGD is not a clinically validated phenomenon. Since the paper's publication, the concept has frequently been cited in legislative attempts to restrict the rights of transgender youth.
Jack L. Turban is an American psychiatrist and writer who researches LGBTQ health, with a focus on the mental health of transgender youth. His writing has appeared in The New York Times, The Washington Post, and Vox. He is an assistant professor of child and adolescent psychiatry at The University of California San Francisco and affiliate faculty in health policy at The Philip R. Lee Institute for Health Policy Studies.
Transmedicalism is the idea that being transgender is primarily a medical issue related to the incongruence between an individual's assigned sex at birth and their gender identity, characterized by gender dysphoria. There are divides and debates within the transmedicalist community on the exact definition of who is or is not transgender. Many transmedicalists believe individuals who identify as transgender without experiencing gender dysphoria or desiring to undergo a medical transition through methods such as hormone replacement therapy or sex reassignment surgery are not genuinely transgender. They may also exclude those who identify themselves as non-binary from the trans label.
"I Sexually Identify as an Attack Helicopter" is a military science fiction short story by Isabel Fall, published on 1 January 2020 in Clarkesworld Magazine. The story relates the experience of Barb, a woman whose gender has been reassigned to "attack helicopter" so as to make her a better pilot. It was a finalist for the 2021 Hugo Award, under the title "Helicopter Story".
Trans: When Ideology Meets Reality is a 2021 nonfiction book by journalist and gender critical activist Helen Joyce that criticizes the transgender rights movement and transgender activism. It is published by Oneworld Publications, their fifth book in the Sunday Times bestseller list. Reviews of the book ranged from positive to critical. In 2023 it was shortlisted for the John Maddox Prize.
Transgender Trend is an anti-trans British pressure group, which describes itself as a group of parents, professionals and academics who are concerned about the number of children diagnosed with gender dysphoria. It was founded in 2015 by Stephanie Davies-Arai.
Stella O'Malley is an Irish psychotherapist and author, with three books on parenting and mental health. She is a regular contributor to Irish national newspapers, podcasts, and TV. She made a documentary about gender dysphoria in children for Channel 4, and is the founder of Genspect, a self-described gender critical organisation opposed to gender affirming care.
What Is a Woman? is a 2022 American online film about gender and transgender issues presented by conservative political commentator Matt Walsh. The film was released by conservative website The Daily Wire, with direction by Justin Folk. In the film, Walsh asks various people "What is a woman?". Walsh said he made the film in opposition to "gender ideology". It is described in some sources as anti-transgender or transphobic. The film was released to subscribers of The Daily Wire on June 1, 2022, coinciding with the start of Pride Month.
Genspect is an international group founded in June 2021 by psychotherapist Stella O'Malley that has been described as gender-critical. Genspect is known for criticizing and opposing gender-affirming care, as well as social and medical transition for transgender people. Genspect opposes allowing transgender people under 25 years old to transition, and opposes laws that would ban conversion therapy on the basis of gender identity. Genspect also endorses the unproven concept of rapid-onset gender dysphoria (ROGD), which proposes a subclass of gender dysphoria caused by peer influence and social contagion. ROGD has been rejected by major medical organisations due to its lack of evidence and likelihood to cause harm by stigmatizing gender-affirming care.
The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. The group routinely cites the unproven proposal of rapid-onset gender dysphoria and has falsely claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. SEGM is often cited in anti-transgender legislation and court cases, sometimes providing evidence briefs themselves. It is not officially recognized as a scientific organization by the international medical community.
Abigail Shrier is an American author and former opinion columnist for the Wall Street Journal.
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