''Irreversible Damage: The Transgender Craze Seducing Our Daughters'' is a 2020 book by Abigail Shrier, published by

Regnery Publishing Regnery Publishing is a politically conservative book publisher based in Washington, D.C. The company was founded by Henry Regnery in 1947, and is now a division of radio broadcaster Salem Media Group. It is led by President & Publisher Thomas Sp ...

, which endorses the controversial concept of

rapid-onset gender dysphoria Rapid-onset gender dysphoria (ROGD) is a proposed subtype of gender dysphoria said to be caused by peer influence and social contagion. It has not been recognized by any major professional association as a valid mental health diagnosis, and use o ...

(ROGD). ROGD is not recognized as a

medical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. The information re ...

by any major professional institution and is not backed by credible scientific evidence. Shrier states that there was a "sudden, severe spike in

transgender A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through tr ...

identification among adolescent girls" in the 2010s, referring to teenagers

assigned female at birth Sex assignment (sometimes known as gender assignment) is the discernment of an infant's sex at or before birth. A relative, midwife, nurse or physician inspects the external genitalia when the baby is delivered and, in more than 99.95% of bi ...

. She attributes this to a

social contagion Social contagion involves behaviour, emotions, or conditions spreading spontaneously through a group or network. The phenomenon has been discussed by social scientists since the late 19th century, although much work on the subject was based on un ...

among "high-anxiety, depressive (mostly white) girls who, in previous decades, fell prey to anorexia and bulimia or multiple personality disorder". Shrier also criticizes gender-affirming psychiatric support,

hormone replacement therapy Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal ...

and

sex reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a transgender or transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender, and alle ...

(together often referred to as "

gender-affirming care Transgender health care, also known as gender-affirming care, includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as sex reassignment therapies, for transgender individuals.Gorton N, Grubb HM (2014) ...

") as treatment for gender dysphoria in young people. 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 Transphobia is a collection of ideas and phenomena that encompass a range of negative attitudes, feelings, or actions towards transgender people or transness in general. Transphobia can include fear, aversion, hatred, violence or anger tow ...

and its use of "she" to refer to teenagers identifying as

transmasculine A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through tr ...

and

non-binary Non-binary and genderqueer are umbrella terms for gender identities that are not solely male or femaleidentities that are outside the gender binary. Non-binary identities fall under the transgender umbrella, since non-binary people typically ...

misgendering Transphobia is a collection of ideas and phenomena that encompass a range of negative attitudes, feelings, or actions towards transgender people or transness in general. Transphobia can include fear, aversion, hatred, violence or anger tow ...

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. She describes what she sees as difficulties facing teenagers who were

, whom she refers to as "girls": 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. She discusses

Lisa Littman Rapid-onset gender dysphoria (ROGD) is a proposed subtype of gender dysphoria said to be caused by peer influence and social contagion. It has not been recognized by any major professional association as a valid mental health diagnosis, and use ...

's 2018 journal article on rapid onset gender dysphoria and the ensuing controversy and endorses Littman's findings. She states that online trans influencers, on websites like Twitter,

Tumblr Tumblr (stylized as tumblr; pronounced "tumbler") is an American microblogging and social networking website founded by David Karp in 2007 and currently owned by Automattic. The service allows users to post multimedia and other content to a sho ...

and

TikTok TikTok, known in China as Douyin (), is a short-form video hosting service owned by the Chinese company ByteDance. It hosts user-submitted videos, which can range in duration from 15 seconds to 10 minutes. TikTok is an international version ...

, frequently encourage questioning youth to identify as trans, experiment with

breast binding Breast binding, also known as chest binding, is the flattening of breasts with constrictive materials such as cloth strips, purpose-built undergarments, often using spandex or other synthetic fiber, and shirts layered from tight to loose. Binder ...

and

testosterone Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testes and prostate, as well as promoting secondar ...

, and disown or lie to unsupportive family members. Shrier criticizes transgender-related curricula and policies in schools. She describes parents distressed by their children's transgender identification or transition. She critiques the gender-affirming model of care and profiles its critics:

Kenneth Zucker Kenneth J. Zucker (; born 1950) is an American-Canadian psychologist and sexologist. He was named editor-in-chief of ''Archives of Sexual Behavior'' in 2001. He was psychologist-in-chief at Toronto's Centre for Addiction and Mental Health (CAMH) ...

Ray Blanchard Ray Milton Blanchard ( ; born October 9, 1945) is an American-Canadian sexologist, best known for his research studies on transsexualism, pedophilia and sexual orientation. He found that men with more older brothers are more likely to be gay tha ...

J. Michael Bailey John Michael Bailey (born July 2, 1957) is an American psychologist, behavioural geneticist, and professor at Northwestern University best known for his work on the etiology of sexual orientation. He maintains that sexual orientation is heavily ...

, Lisa Marchiano, and

Paul R. McHugh Paul Rodney McHugh (born May 21, 1931) 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-autho ...

. 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. 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. She also profiles

detransition Detransition is the cessation or reversal of a transgender identification or gender transition, whether by social, legal, or medical means. Some individuals detransition on a temporary basis. Estimates of the rate at which detransitioning occurs ...

ed young women.

Background and publication history

Shrier attended Columbia and

Oxford University Oxford () is a city in England. It is the county town and only city of Oxfordshire. In 2020, its population was estimated at 151,584. It is north-west of London, south-east of Birmingham and north-east of Bristol. The city is home to the ...

and earned a J.D. at

Yale Law School Yale Law School (Yale Law or YLS) is the law school of Yale University, a Private university, private research university in New Haven, Connecticut. It was established in 1824 and has been ranked as the best law school in the United States by ''U ...

. The contentious concept of

(ROGD), which ''Irreversible Damage'' endorses, was first proposed in a 2018 paper by

. ROGD is not recognized as a

by any major professional institution and is not backed by credible scientific evidence. ''Irreversible Damage'' was first published in June 2020 by

, a

conservative Conservatism is a cultural, social, and political philosophy that seeks to promote and to preserve traditional institutions, practices, and values. The central tenets of conservatism may vary in relation to the culture and civilization i ...

publisher. An audiobook narrated by Pamela Almand was released by

Blackstone Audio Blackstone Audio is one of the largest independent audiobook publishers in the United States, offering over 30,000 audiobooks. The company is based in Ashland, Oregon with five in-house recording studios. Blackstone distributes directly to consu ...

. In the UK, the book was published by Swift Press, with the subtitle "Teenage Girls and the Transgender Craze". In a July 2020 interview on ''

The Joe Rogan Experience ''The Joe Rogan Experience'' is a podcast hosted by American comedian, presenter, and UFC color commentator Joe Rogan. It launched on December 24, 2009, on YouTube by Rogan and comedian Brian Redban, who was its sole co-host and producer until ...

'', Shrier called the desire to transition a "contagion" and compared it with

eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...

and

self-harm Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilatio ...

. She associated transgender youth with

autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...

. Her remarks sparked calls by

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employees for the Rogan podcast episode to be removed from the platform, but the company denied the request. Chase Ross, a transgender

YouTuber A YouTuber is an online personality and/or influencer who produces videos on the video-sharing platform YouTube, typically posting to their personal YouTube channel. The term was first used in the English language in 2006. Influence Influent ...

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.

Marketing and distribution

In June 2020,

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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." 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. 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''. In November 2020,

Target Target may refer to: Physical items * Shooting target, used in marksmanship training and various shooting sports ** Bullseye (target), the goal one for which one aims in many of these sports ** Aiming point, in field artillery, fi ...

briefly stopped selling the book following criticism online, but made it available for purchase again a day later. Several

LGBT ' is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity. The LGBT term is a ...

commentators expressed support for the book's removal. ''

The Daily Dot ''The Daily Dot'' is a digital media company covering the culture of the Internet and the World Wide Web. Founded by Nicholas White in 2011, ''The Daily Dot'' is headquartered in Austin, Texas. The site, conceived as the Internet's "hometown ...

'' columnist Ana Valens wrote that it contained obvious

transphobia Transphobia is a collection of ideas and phenomena that encompass a range of negative attitudes, feelings, or actions towards transgender people or transness in general. Transphobia can include fear, aversion, hatred, violence or anger tow ...

and encouraged

conversion therapy Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, gender identity, or gender expression to align with heterosexual and cisgender norms. In contrast to evidence-based medicine and cli ...

. In ''

Them Them or THEM, a third-person plural accusative personal pronoun, may refer to: Books * ''Them'' (novel), 3rd volume (1969) in American Joyce Carol Oates' ''Wonderland Quartet'' * '' Them: Adventures with Extremists'', 2003 non-fiction by Welsh ...

'', the writer James Factora stated that almost every claim in the publisher's description of the book was a "blatant lie". In ''

Gay City News ''Gay City News'' (stylized as ''gcn'') is a free weekly newspaper based in New York City focusing on local and national issues relating to the lesbian, gay, bisexual and transgender (LGBT) community. It was founded in 1994 as ''Lesbian Gay New Y ...

'', the journalist Matt Tracy criticized Shrier for

misgender Transphobia is a collection of ideas and phenomena that encompass a range of negative attitudes, feelings, or actions towards transgender people or transness in general. Transphobia can include fear, aversion, hatred, violence or anger tow ...

ing 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." In February 2021, Target again withdrew the book from sale. In April 2021, a petition was launched to have the

Halifax Public Library Halifax Public Libraries (HPL) is a Canadian public library system serving residents of Halifax, Nova Scotia. It is the largest public library system in Nova Scotia, with over 2.8 million visits to library branches and 172,520 active registered ...

system remove their two copies of the book from circulation. The library refused, citing

intellectual freedom Intellectual freedom encompasses the freedom to hold, receive and disseminate ideas without restriction. Viewed as an integral component of a democratic society, intellectual freedom protects an individual's right to access, explore, consider, and ...

and stating that removal would constitute censorship. Following this,

Halifax Pride Halifax Pride is an LGBT pride festival, held annually in Halifax, Nova Scotia, Canada. It is the largest 2SLGBTQ+ event in Atlantic Canada, In July 2021, the

American Booksellers Association The American Booksellers Association (ABA) is a non-profit trade association founded in 1900 that promotes independent bookstores in the United States. ABA's core members are key participants in their communities' local economy and culture, and t ...

, 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". This set off further controversy, with some arguing the association was now trying to censor the book, and others saying the apology was insufficient.

Chase Strangio Chase Strangio (; born October 29, 1982) is an American lawyer and transgender rights activist. He is the Deputy Director for Transgender Justice and staff attorney with the American Civil Liberties Union (ACLU). Early life and education Strang ...

, an attorney for the

American Civil Liberties Union The American Civil Liberties Union (ACLU) is a nonprofit organization founded in 1920 "to defend and preserve the individual rights and liberties guaranteed to every person in this country by the Constitution and laws of the United States". T ...

(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 The right of a people to self-determination is a cardinal principle in modern international law (commonly regarded as a ''jus cogens'' rule), binding, as such, on the United Nations as authoritative interpretation of the Charter's norms. It stat ...

". The book has been translated into multiple languages and foreign-language versions have been released in other countries such as Spain, France, Hungary and Israel where a speech by Shrier drew protesters.

Reception

Responses to the book have been divided. It was positively reviewed by

Nick Cater Nicholas Charles Cater is a British-born Australian journalist and author who writes on culture and politics. He is a columnist for ''The Australian'' newspaper. Early life and education Cater was born in Billericay, Essex, and grew up in Hyth ...

in ''

The Spectator Australia ''The Spectator'' is a weekly British magazine on politics, culture, and current affairs. It was first published in July 1828, making it the oldest surviving weekly magazine in the world. It is owned by Frederick Barclay, who also owns ''The ...

'', by ''

The Economist ''The Economist'' is a British weekly newspaper printed in demitab format and published digitally. It focuses on current affairs, international business, politics, technology, and culture. Based in London, the newspaper is owned by The Econo ...

'', by Emily Hourican in the ''

Irish Independent The ''Irish Independent'' is an Irish daily newspaper and online publication which is owned by Independent News & Media (INM), a subsidiary of Mediahuis. The newspaper version often includes glossy magazines. Traditionally a broadsheet new ...

'', by Madeleine Kearns in the ''

National Review ''National Review'' is an American conservative editorial magazine, focusing on news and commentary pieces on political, social, and cultural affairs. The magazine was founded by the author William F. Buckley Jr. in 1955. Its editor-in-chief i ...

'', by

Christina Patterson Christina Mary Patterson (born 1963) is a British journalist. Now a freelancer, she was formerly a writer and columnist at ''The Independent.'' Biography Patterson was born in Rome to a Swedish Lutheran mother and Scottish Presbyterian father wh ...

in ''

The Sunday Times ''The Sunday Times'' is a British newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of News UK, whi ...

'', by

Naomi Schaefer Riley Naomi Schaefer Riley ( Schaefer; born c. 1977) is an American conservative commentator and author. Her writings have appeared in the ''Wall Street Journal'', ''The New York Times'', ''The Boston Globe'', ''The Los Angeles Times'', ''The New Yo ...

in ''

Commentary Commentary or commentaries may refer to: Publications * ''Commentary'' (magazine), a U.S. public affairs journal, founded in 1945 and formerly published by the American Jewish Committee * Caesar's Commentaries (disambiguation), a number of works ...

'', and by

Janice Turner Janice Turner (born 8 April 1964) is a British journalist, and a columnist and feature writer for ''The Times''. Early life Turner was born in Wakefield, West Yorkshire. She went to Ridgewood School in the north of Doncaster. She attended the ...

in ''

The Times ''The Times'' is a British daily national newspaper based in London. It began in 1785 under the title ''The Daily Universal Register'', adopting its current name on 1 January 1788. ''The Times'' and its sister paper ''The Sunday Times'' (fou ...

'' of London. It received mixed reviews from the theologian

Tina Beattie Tina Beattie (born 16 March 1955) is a British Christian theologian, writer and broadcaster. Until August 2020, she was the Professor of Catholic Studies at the University of Roehampton in London and Director of the Digby Stuart Research Centre ...

in ''

The Tablet ''The Tablet'' is a Catholic international weekly review published in London. Brendan Walsh, previously literary editor and then acting editor, was appointed editor in July 2017. History ''The Tablet'' was launched in 1840 by a Quaker convert ...

'' and the psychologist

Christopher Ferguson Christopher J. "Fergy" Ferguson (born September 1, 1961) is a Boeing commercial astronaut and a retired United States Navy Captain and NASA astronaut. He was the pilot of Space Shuttle ''Atlantis'' on his first mission to space, STS-115, which ...

in a ''

Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. It began as a bimonthly magazine, which first appeared in 1967. The ''Psychology Today'' website features therapy and health professionals direct ...

'' blogpost. It was negatively reviewed by Sarah Fonseca in the ''

Los Angeles Review of Books The ''Los Angeles Review of Books'' (''LARB'' is a literary review magazine covering the national and international book scenes. A preview version launched on Tumblr in April 2011, and the official website followed one year later in April 2012. ...

'' and by

Jack Turban Jack L. Turban is an American psychiatrist and writer who researches LGBT Health, 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 (webs ...

, a fellow in psychiatry and researcher in transgender mental health, in a ''Psychology Today'' blogpost. ''

Science-Based Medicine ''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 N ...

'' retracted a positive review by the physician

Harriet Hall Harriet A. Hall (born July 2, 1945) is a U.S. retired family physician, former U.S. Air Force flight surgeon and skeptic who writes about alternative medicine and quackery for ''Skeptic'' and ''Skeptical Inquirer''. She writes under the name The ...

and subsequently published a series of articles criticizing the book. ''The Economist'' included ''Irreversible Damage'' among its books of the year for 2020. ''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 "

elling ''Elling'' is a Norwegian Black comedy film directed by Petter Næss. Shot mostly in and around the Norwegian capital Oslo, the film, which was released in 2001, is primarily based on Ingvar Ambjørnsen's novel ''Brødre i blodet'' ("Blood brot ...

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. Madeleine Kearns reviewed ''Irreversible Damage'' alongside

Debra W. Soh Debra W. Soh is a Canadian columnist, author, and former academic sex researcher. Education and research Soh holds a Ph.D. degree in neuroscience from York University in Toronto. Her dissertation was titled ''Functional and Structural Neuroi ...

's ''The End of Gender''. She stated that Shrier's book provided "a personal, inquisitive, and often moving narrative". 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. Janice Turner called the book "fearless", remarking on the controversy surrounding it and endorsing its conclusions. 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". 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. Sarah Fonseca condemned the book for its presentation, substance, and sourcing. Psychiatrist

accused Shrier of promoting the denial of gender-affirming medical care from transgender youth, which he called a

fringe Fringe may refer to: Arts * Edinburgh Festival Fringe, the world's largest arts festival, known as "the Fringe" * Adelaide Fringe, the world's second-largest annual arts festival * Fringe theatre, a name for alternative theatre * The Fringe, the ...

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."

Skeptic Skepticism, also spelled scepticism, is a questioning attitude or doubt toward knowledge claims that are seen as mere belief or dogma. For example, if a person is skeptical about claims made by their government about an ongoing war then the pe ...

and physician Harriet Hall published a positive review of the book on the website ''

'' 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. The site's two other editors,

Steven Novella Steven Paul Novella (born July 29, 1964) is an American clinical neurologist and associate professor at Yale University School of Medicine. Novella is best known for his involvement in the skeptical movement as a host of ''The Skeptics' Guide t ...

and

David Gorski David Henry Gorski is an American surgical oncologist, professor of surgery at Wayne State University School of Medicine, and a surgical oncologist at the Barbara Ann Karmanos Cancer Institute, specializing in breast cancer surgery. He is an out ...

, took the unprecedented step of retracting this review, which was republished in ''

''. Novella and Gorski later explained the retraction, concluding that both Hall's and Shrier's claims are "not supported by any evidence and recobbled 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. 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.

Citations

References

* {{Authority control 2020 controversies 2020 non-fiction books English-language books LGBT-related controversies in literature Regnery Publishing books Transgender non-fiction books Transphobia in the United States 2020 LGBT-related literary works