Irreversible Damage: The Transgender Craze Seducing Our Daughters by Abigail Shrier is a controversial book on account of its subject matter. The title and front cover image are alarming: a “craze” is taking over our young girls who are submitting themselves to hysterectomies, leaving gaping holes in their abdomens. Shrier was alarmed at the–apparent–sudden proliferation of girls and young women who in the past decade have suddenly declared themselves to be transgender. Now as a regular reader of the gay and lesbian media I wasn’t aware of any surge in transsexualism in girls and young women. Yet stories about trans awareness have been the sujets du jour in mainstream media for many years now, earning American legitimacy and heft when Time magazine gave Laverne Cox the cover story in June of 2014. TV shows now feature trans characters, and news magazines and talk shows have discussions with trans panelists. More and more applications include a choice for sex that is neither M nor F. This is the time for trans people to take the spotlight and make their claim for equal treatment under the law. I support their claims.
I avoid reading other reviews to avoid being influenced by other opinions. As I work in a library and am surrounded by educated colleagues and book review sources, keeping myself willfully ignorant is not easy, and is impossible of course if I find out about future book reads through the very source of reading reviews. While I was aware that Irreversible Damage was a controversial book, I did not know specifically why. I can imagine that one of the controversies about this book is that Shrier paints a portrait of modern society run rampant with pre-teen girls demanding to be boys. This is the “craze” she means in the book’s title, where, all of a sudden, young women with no history whatsoever of gender dysphoria are expressing discomfort in their female bodies. The author wants to get to the bottom of this: where did their sudden identity crises come from? Shrier provides plenty of facts and figures but I still find it hard to believe that we have a crisis of young women who are desperate to become men. Has the current trans revolution turned our teen girls against their bodies? Has increased trans awareness really triggered a craze where, according to Shrier, four times as many biological girls are expressing a trans identity over boys? Or is something else to blame? In the words of Childish Gambino, there is: because the Internet:
“That hideous public diary that calls itself ‘social media’ and mocks us with so many small-minded pronouncements and embarrassing images–it doesn’t matter. Not really. Sooner than we think, we may all regard it as little more than humanity’s most colossal distraction, an endless ledger of wasted time.”
The worldwide web has given us knowledge yet also polluted our minds with trash, and teens–emotional, grumpy and self-conscious with loathing during adolescence–have found communities of misery with their smartphones. With transgender issues now centre stage, young women who feel rejected and ridiculed and hate their bodies have a new focus: they might really be trans men. They dive right into the scruffy, smelly world of testosterone therapy and name reassignment. Shrier compares this rapid-onset gender dysphoria to anorexia, bulimia and repressed memories: all mental phenomena that dominated the media at different times decades ago that primarily affect affluent white girls whose best friend, this time around, is their smartphone:
“One key difference between this and past psychiatric crazes is that the transgender epidemic seems primarily induced by peers and the media and schools. Today’s teens don’t wait to talk to a therapist to find out what’s wrong with them. They simply park themselves in front of a screen, Google ‘Am I trans?’ and self-diagnose from the list of symptoms. If anything, therapists are merely exacerbating or encouraging a problem already begun.”
I believe Shrier has a point about the pernicious effect cellphones have on all people, not only our youth. No one has an attention span anymore, when swipes and pop-ups tempt your senses whenever you turn your phone on. People don’t need to stop and think when their phone provides instant Internet access. The myth that is ADD and ADHD is in my belief tied to the proliferation of cellphone technology. Cure your kid by limiting or, better, removing his cellphone access and you can toss the Ritalin prescription away.
This “transgender craze” is primarily a white western phenomenon, and while the author does give statistics for western Europe, the overwhelming number of cases are found in Canada and the US. American drug companies must be loving this. My neighbours to the south are the most drugged-up people on the planet, where every moment of gloom or insecurity seems to necessitate a prescribed regimen of little yellow pills:
“I wonder things I don’t say aloud, too: Whether this transgender craze isn’t partially the result of over-parented, coddled kids desperate to stake out territory for rebellion. Whether it is no coincidence that so many of these kids come from upper-middle-class white families, seeking cover in a minority identity? Or is it the fact that they overwhelmingly come from progressive families–raised with few walls, they hunt for barriers to knock down? And then there’s our modern-day obsession with mental health, medicating everyone toward the optimal level of happiness, as if we are all just tires in need of topping up. With the help of battalions of therapists, the upper-middle class has made a habit of extirpating anxiety, depression, and even the occasional disappointment wherever they find them. Perhaps we’ve trained adolescents to regard happiness as a natural and constantly accessible state. Perhaps they’ve come to believe momentary sadness amounts to a crisis–teenage doldrums a catastrophe to rectify rather than a phase to ignore.”
According to Shrier, a trans identity is a superstar identity. Unpopular gloomy teens become stars of their high school if they come out as trans. Who wouldn’t want a trip to the A-list by revealing that she is really a boy inside? I side with the author and the doctors and psychiatrists she interviews in their claims that other mental phenomena are at stake. Yet in spite of the statistics she cites, I do not believe that an epidemic of troubled girls would subject their bodies to radical surgeries and hormone therapy in order to be popular. I risk being called a denialist by the author but, as I seem to be stating over and over again, I am not reading about a surge of young women crying out to be men. To me, who is in general a supporter of this book, I find such a claim to be hysterical.
I do support Shrier’s claim that there is a chill within the medical establishment, where doctors and psychiatrists are afraid of voicing their opposition to the current popular (which doesn’t always mean it is right) academic opinion which promotes the autonomy of young women to assess their own gender identity. To question their mental acuity to do so renders one a misogynist or a transphobe:
“Expressing concern about teens suddenly identifying as trans has become politically unwise and socially verboten–hateful by definition–an alleged assault on all transgender people, genuine and ersatz.”
I will repeat what I said at the end of the first paragraph: I support trans people and their rights for equality under the law. Shrier says the same thing, over and over, throughout her book. How easy it is to forget who your allies are. By following the theory suggested by Dr. Lisa Littman does not make any of us anti-trans:
“Dr. Littman never suggested that gender dysphoria doesn’t exist or that these girls didn’t have it. What she hypothesized was that these adolescents’ gender dysphoria had an atypical etiology, that is, a set of causes that differed from the classic diagnosis. Unlike traditional gender dysphoria, this one seemed encouraged and intensified by friends and social media.”
Dr. Littman also stated:
“She theorized that the drive to transition might represent a ‘maladaptive coping mechanism’ for dealing with legitimate stressors and strong emotions. She considered the possibility that this atypical strain of gender dysphoria might itself constitute a form of intentional self-harm. She stated expressly that her analysis did not imply that no adolescents would benefit from transition. Instead, she concluded merely that ‘not all [adolescents] presenting at these vulnerable ages are correct in their self-assessment of the cause of their symptoms.”
My feminist hero Camille Paglia, a proud and loud lesbian, said it best in her collection of essays Free Women, Free Men: Sex, Gender, Feminism:
“As a libertarian, I believe that every individual has the right to modify his or her body at will. But I am concerned about the current climate, inflamed by half-baked postmodernist gender theory, which convinces young people who may have other unresolved personal or family issues that sex-reassignment surgery is a golden road to happiness and true identity.”
I agree entirely with the statement above. I lambasted Alex Gino for his thoughtless and extremely self-centred juvenile novel George: Gino is in-your-face soapboxing to his young reader base that if you’re a boy who enjoys dressing up and playing with makeup, you’d be better off with castration and penis-removal surgery. Likewise with girls facing transgender issues:
“Teens and tweens today are everywhere pressed to locate themselves on a gender spectrum and within a sexuality taxonomy–long before they have finished the sexual development that would otherwise guide discovery of who they are or what they desire. Long before they may have had any romantic or sexual experience at all.”
Not all gloom-and-doom teen girls are having gender issues, and indeed, as with most adolescents, they go through fashion and personality phases or struggles. Psychiatrists and therapists will get to the bottom of any mental issue and I do not believe Shrier when she claims that professionals are bound to accept patients’ assertions of gender dysphoria without any deep psychiatric probing. She makes it seem that once patients present themselves as trans, they have the run of the medicine cabinet and doctors have no power to deny them. The author presents a weak case for the integrity of the medical and mental health professions, where any patient who claims to be a boy trapped inside a girl’s body has the right to testosterone injections from a carte blanche prescription pad:
“Instead of immediately accommodating every adolescent’s demands for hormones and surgeries, doctors ought to be working to understand what else might be wrong. At best, doctors’ treatments are ineffective; at worst, doctors are administering needless hormonal treatments and irreversible surgeries on patients likely to regret them.”
You mean doctors aren’t already doing this? That they’d okay a double mastectomy and hysterectomy just because a patient–a teenage girl–asked for it? Shrier continues:
“Confused and suffering adolescents cry out–all of them certain that the next hormone or surgery will be the one that delivers relief. Doctors rush to appease.
“The consequence of satisfying the young patient’s demands can easily be the creation of a lifelong medical dependency, the introduction of profound health risks, and a succession of dangerous surgeries with unpredictable long-term results. All of which would suggest that medicalization should be a last resort, not an initial suggestion. Perversely, those who promote caution and restraint about transition are demonized.”
Over-the-top, but I understand Shrier’s point where alternative views about patient care–such as the need for more concentrated mental health analysis versus shooing the patient out with a prescription for testosterone and a date in the foreseeable future for a double mastectomy–are brushed under the carpet.
Shrier interviewed professionals like doctors, therapists and psychiatrists who are dissidents, as well as parents and women themselves who opted out of transition treatment. All too often these women realized that once they saw their bodies morph into men, transitioning was not for them. They had an epiphany where their problems were not solved by the growth of facial hair, a squarer chin or a more aggressive demeanor. Granted, there are plenty of FTM trans stories where such physiological changes are desperately wanted. We should continue to offer these treatments to these future trans men. But there are also stories of transition treatments terminated by the women themselves. Shrier wants these women and her reader base at large to consider this:
“It’s possible to live a transgender life, if that’s what feels right. But it’s also possible to have thought you should, only to decide you were wrong.”