Irreversible
Damage is a must-read
for those interested in understanding transgenderism, especially its
contemporary manifestations. Abigail Shrier focuses on claims about
transgenderism in children and interviews experts, social influencers, parents,
counselors, activists, people who are happy with their decision to
transition, and those who regret it profoundly. (For a shorter version of ID, check out her Imprimis/Hillsdale essay/speech. For a review in Salvo by Nicole King, click here.)
The catalyst for Shrier was free speech and defending others' rights to disagree
with the establishment on this topic. Since publishing the book, her interest
in free speech has become more personal—as her work has been attacked. (For
this reason, I expected the book to be less measured, but was pleasantly
surprised.) In this, she is in good company: an array of academics and
advocates who have been criticized, crushed, and cancelled for holding
reasonable, alternative views of the science involved.
Much of the
opposition comes from valuing ideology over science. Shrier discusses the
hubbub over Lisa Littman and her famous PLoS One article in chapter 2.
And she devotes chapter 7 to a litany of other scientific
"dissidents": experts in their respective fields who ended up on the
wrong side of the ideology that dominates for now—if not the wrong side of history (or certainly,
science). The rabid response against those with dissenting views is more about
bad religion and fundamentalism than liberal values or a respect for science. (And of course, this has led to all sorts of sad/funny semantics gymnastics.)
Devaluing
science is evident in other ways. The usual scientific and bureaucratic
requirements to permit drug and surgical treatment are overlooked (164-165).
The biology of male and female is quite clear but ignored. Shrier discusses the
ease with which coroners can pick out adult males and females by skeletons:
different size, sex-specific morphology, foreheads, mastoid regions, jaws,
pelvis, and leg angles into the pelvis (162).
The standards
for medicine differ as well. Some advocates compare the relevant trans
surgeries to breast reduction or enhancement (175). But even there, biological
function is not compromised or destroyed (173). Its prevalent use among teens
is unusual, when plastic surgery is usually reserved for adults. And the ethics
of plastic surgery usually require many more questions to be asked than
advocates of transition want for teens.
All of this has
obvious connections to a range of other ideological issues: the prevalence of
asexuality (23) and the denigration of motherhood (208) in the culture—and its
alignment with anti-human philosophies and policy positions such as
anti-population, birth control, abortion, and eugenics. (In terms of Scripture, there are no direct references-- other than some hyperbole that happens to apply in Jeremiah 30:6-- but plenty of indirect references that would align it with any number of other misalignments between perception and reality, sin nature and the ideal.)
All of this has an impact on lesbians: "Gender ideology puts transgender individuals into direct conflict with radical feminists who believe sex is the defining feature of one's identity." (150-151) More broadly, it's not at all clear how T fits into the gender/sexual alphabetical pile. More famously, it has an effect on all women and young girls, especially athletes who may be forced to compete with biological males (151-152).
Ideology aside: the greatest value
of the book is distinguishing between modern and "traditional" transexualism in five crucial ways. It is now:
1.) much more prevalent (vs. exceedingly rare);
2.) predominantly female (vs. male);
3.) mostly emerging during puberty (vs. apparent from
early childhood);
4.) connected to peer groups (vs. random); and
5.) often "treated" aggressively (vs. often resolving by adulthood).
All of these provide at least weak evidence for peer
effects as a primary factor. In any case, transexualism is clearly
different today—whatever the reasons (xxi, 26, 32).
On those who might be labeled "old-school"
trans adults, Shrier reports: "Their dysphoria never made them popular;
more often than not, it was a source of unease and embarrassment...they didn't
want or need mentors; they knew how they felt...They do not need to be
celebrated for the life they have chosen...That so much trans activism claims
to speak in their name is neither their fault nor their intention. They have
very little to do with the current trans epidemic plaguing teenage girls."
(xix) "For many classic sufferers of gender dysphoria, celebration of
their trans identity is anathema." (146) [She also offers some
history as well, including an exception to this rule: Christine Jorgenson, the
original "Caitlyn Jenner" (147-148). This article talks about DIY transitions for adults, outside even the fringe medical aspects of this.]
Another important connection: because gender dysphoria
typically emerged in early childhood, parents were aware that their children
were different from an early age. These days, parental influence and input are
assumed away—in deference to the teenager's self-diagnosis (xxiii). This gets
to the strangest and most disturbing aspect of this topic: psychologists
and counselors frequently rely on their clients to analyze themselves (ch. 6).
As Shrier notes, professionals are required to offer "respectful" and
"supportive" care. But advocates want much more than this, including
full acceptance of a teenager's self-diagnosis. Shrier asks the reader to
imagine treating anorexia, race, or any psychological condition in the same way
(99-101).
The assumptions required for a heavy reliance on
self-diagnosis are somewhere between dubious and laughable: 1.) adolescents
know who they are; 2.) transition has little or no cost, harm, or risk; 3.)
gender identity is immutable; and 4.) suicide becomes more likely without
transitional treatments. This approach also ignores that teens often test
boundaries with parents and society, take unfortunate risks without a mature
ability to weigh benefits and costs well, and face a wide range of negative
peer effects (107-120). All that said, Shrier still proceeds cautiously
here: None of this is "a reason to proscribe all identity alterations or
body modifications for teenagers," but it should be "cause for
hesitation." (111)
In all of this, Shrier believes that there are real
problems at hand for these teens, particularly for young women. She argues
repeatedly, powerfully, and poignantly that it is really tough to be a girl going
through puberty (1, 3, 144, 209), especially today with social media (4-5,
18). But she notes the oddity—if not the perversity—of letting struggling
people self-diagnose. "Her distress is real. But her self-diagnosis, in
each case, is flawed—more the result of encouragement and suggestion than
psychological necessity." (xix)
There are
psychological factors (or temptations) at hand: "it satisfies the deepest
need for acceptance, the thrill of transgression, the seductive lilt of
belonging." (xxiv) Or more broadly, it may rarely be about gender, per
se, at all (211). Proponents and practitioners also seem to be
body-obsessed in a way that doesn't seem healthy (55b).
Sociology and
peer effects are also involved in a way that at least mimics what we see in epidemiology (25).
The "epidemic" could be caused by a benevolent form of acceptance
that allows the condition to safely emerge. But other more-troubling hypotheses
are at least as compelling in explaining "rapid-onset gender
dysphoria" or ROGD (26-27).
"Psychologists
who study peer influence ask what it is about teenage girls that makes them so
susceptible to peer contagion and so good at spreading it. Many believe it has
something to do with the ways girls tend to socialize...Girls are much more
likely to reply with statements that are validating and supportive than
questioning...[This] can be a productive and valuable social skill...But it
also leads friends to take on each other's ailments...co-rumination, excessive
reassurance seeking; and negative feedback-seeking"—all intensified by
social media (35-36).
Contemporary
culture also has an impact. Intersectionality is one angle:
"upper-middle-class white families, seeking cover in minority
identity...they overwhelmingly come from progressive families..." (31)
Notably, ROGD'ers are disproportionately white (90%). As one professor notes,
"Of all of these badges of victim status, the only one that you can
actually choose is trans." (154)
There are many
other contributing factors. Shrier provides a subset in her
preface: "Our cultural frailty; parents are undermined; experts are
over-relied upon; dissenters in science and medicine are intimidated; free
speech truckles under renewed attack; government health care laws harbor hidden
consequences; and an intersectional era...encourages individuals to take cover
in victim groups." (xxiii)
But there are
others too: In a pharmacological society, pills are an attractive option (19,
150a), including testosterone (discussed throughout the book). Shrier points to
a "modern-day obsession with mental health, medicating everyone toward the
optimal level of happiness..." (31) Another quick "fix"
(that may never satisfy or end): surgery (176). (That said, breast augmentation for teens still dominates the rapidly-growing "top surgeries" for transitions.) Government-subsidized health
insurance provides an additional subsidy for drugs and especially surgery (180). Add
to this the capitalistic work of "influencers" (ch. 3)—those who
attract an audience on social media, gaining popularity and money. Schools
often oppose parents (chs. 4-5)—yet another occasion when the government
schools' monopoly power is deeply troubling. (Check out this video.) Anti-bullying is the top stated
concern—or a preferred cynical strategy—depending on whose wielding it.
Parents, counselors, and doctors are in a rough spot
here. In particular, what's the cause/effect with suicide? Suicide rates are
high among trans youth, but that could be cause and/or effect (51). And Shrier
documents how kids, sympathetic authorities, and influencers often use suicide as a
weapon—a brutal and cynical strategy against caregivers and especially parents
(52, 55, 103).
Unfortunately, suicide as a strategy undermines those who
are actually struggling with suicide—one of many ways to know that this topic
cannot be primarily about mental health (theirs or others). Another
indication: the hypocrisy in heavily weighing subjective feelings that are
consistent with trans ideology and utterly denigrating those whose subjective
feelings change. If the top priority were mental or physical well-being, both
would be celebrated.
Detransitioners
are the strongest manifestation of this phenomenon. Shrier documents some of
the nascent blooms here, including groups like the Pique Resilience Project. (See also: a new movie.) In
each case among those she interviewed, "they were definitely trans—until,
suddenly, they weren't. Nearly all of them blame the adults in their lives,
especially the medical professionals, for encouraging and facilitating their
transitions." (201-202)
Shrier
ultimately compares the contemporary trend in transsexualism to other damaging
fads that have plagued young women over the years: the Salem witch trials,
nervous disorders in the 18th century; the "neurasthenia epidemic" in
the 19th century—as well as anorexia nervosa, repressed memory, bulimia, and
cutting in our times (xix). She also compares the trans movement to a cult
(xxi)—with its highly subjective claims (many of them metaphysical or at least
transphysical); non-falsifiable propositions (192); claims of salvation and the
only path to happiness; "love-bombing" for potential adherents
(185-186); shunning those who disagree; and ostracizing those who
leave (191).
Irreversible
Damage is a
passionate but balanced critique of the latest social problem faced by young women.
If you're interested in understanding the moment or ministering to the
movement's members in the short-run—or in the long-run as the trend
fades and the regrets increase dramatically—Shrier's book is a great
resource.
