''Irreversible Damage: The Transgender Craze Seducing Our Daughters'' is a 2020 book by

Abigail Shrier Abigail Shrier is an American author and former opinion columnist for ''The Wall Street Journal''. Early life and education Shrier is the daughter of Peter B. Krauser and Sherrie L. Krauser, both judges in the state of Maryland. She grew up in a ...

, 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. In December 2023, Regnery was acquired from Salem Media Group by Skyhorse Publishing, with Skyhorse ...

, which endorses the controversial concept of rapid-onset gender dysphoria (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 a diagnosis with the medical context being implicit. The information ...

by any major professional institution nor is it backed by credible scientific evidence. Shrier states that there was a "sudden, severe spike in

transgender A transgender (often shortened to trans) person has a gender identity different from that typically associated with the sex they were sex assignment, assigned at birth. The opposite of ''transgender'' is ''cisgender'', which describes perso ...

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

assigned female at birth Sex assignment (also known as gender assignment) is the discernment of an infant's sex, typically made at birth based on an examination of the baby's external genitalia by a healthcare provider such as a midwife, nurse, or physician. In the ...

. 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 ...

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. Effects of menopause can include symptoms such ...

and

sex reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a person's physical appearance and sexual characteristics to resemble those associated with their gender identity. The phrase is most often associat ...

(together often referred to as "

gender-affirming care Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions which affect transgender individuals.Gorton N, Grubb HM (2014). General, Sexual, and Reproductive health. In L. Erickson-Schroth. ...

") as treatment for gender dysphoria in young people. The book has received mixed responses. Several positive reviews were published endorsing Shrier's claims about trans people, but the book was also criticized for repeating

anti-trans Transphobia consists of negative attitudes, feelings, or actions towards transgender or transsexual people, or wikt:transness, transness in general. Transphobia can include fear, aversion, hatred, violence or anger towards people who do not co ...

medical misinformation. Several retailers refused to sell the book in response to these criticisms.

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'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 (pronounced "tumbler") is a microblogging and Social networking service, social networking website founded by David Karp in 2007 and is owned by American company Automattic. The service allows users to post multimedia and other content ...

and

TikTok TikTok, known in mainland China and Hong Kong as Douyin (), is a social media and Short-form content, short-form online video platform owned by Chinese Internet company ByteDance. It hosts user-submitted videos, which may range in duration f ...

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

breast binding Breast binding, also known as chest binding, is the flattening and hiding of breasts with constrictive materials such as cloth strips or purpose-built undergarments. Binders may also be used as alternatives to bras or for reasons of propriety. H ...

and

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

, 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 known for the living in your own skin model, a form of conversion therapy targeted towards pre-pubertal children with the goal of making their gender identity ...

Ray Blanchard Ray Milton Blanchard III ( ; born October 9, 1945) is an American-Canadian sexologist who researches pedophilia, sexual orientation and Transgender, gender identity. He has found that men with more older brothers are more likely to be gay than m ...

, J. Michael Bailey, Lisa Marchiano, and Paul R. McHugh. 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 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 ...

ed young women.

Background and publication history

Shrier attended Columbia and

Oxford University The University of Oxford is a collegiate research university in Oxford, England. There is evidence of teaching as early as 1096, making it the oldest university in the English-speaking world and the second-oldest continuously operating u ...

and earned a J.D. at

Yale Law School Yale Law School (YLS) is the law school of Yale University, a Private university, private research university in New Haven, Connecticut. It was established in 1824. The 2020–21 acceptance rate was 4%, the lowest of any law school in the United ...

. The contentious concept of rapid-onset gender dysphoria (ROGD), which ''Irreversible Damage'' endorses, was first proposed in a 2018 paper by Lisa Littman. 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 and ideology that seeks to promote and preserve traditional institutions, customs, and values. The central tenets of conservatism may vary in relation to the culture and civiliza ...

publisher. An audiobook narrated by Pamela Almand was released by

Blackstone Audio Blackstone Audio is an independent audiobook publisher in the United States, offering over 25,000 audiobooks. The company is based in Ashland, Oregon, with five in-house recording studios. Blackstone distributes directly to consumers via their ...

. 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 was initiated on December 24, 2009, on YouTube by Rogan and comedian Brian Redban, who was its sole co-host and produce ...

'', 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 adversely affect a person's health, physical or mental health, mental health. These behaviors may include eating too much food or too little food. Types of eatin ...

and

self-harm Self-harm refers to intentional behaviors that cause harm to oneself. This is most commonly regarded as direct injury of one's own skin tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and s ...

. She associated transgender youth with

autism Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder characterized by differences or difficulties in social communication and interaction, a preference for predictability and routine, sensory processing d ...

. Her remarks sparked calls by

Spotify Spotify (; ) is a List of companies of Sweden, Swedish Music streaming service, audio streaming and media service provider founded on 23 April 2006 by Daniel Ek and Martin Lorentzon. , it is one of the largest providers of music streaming services ...

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 a content creator and social media influencer who uploads or creates videos on the online video-sharing website YouTube, typically posting to their personal YouTube channel. The term was first used in the English language in 2006 ...

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,

Amazon Amazon most often refers to: * Amazon River, in South America * Amazon rainforest, a rainforest covering most of the Amazon basin * Amazon (company), an American multinational technology company * Amazons, a tribe of female warriors in Greek myth ...

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 mid-2021. Some employees left Amazon over the company's refusal to stop selling ''Irreversible Damage'' and ''Johnny the Walrus''. In November 2020,

Target Target may refer to: Warfare and shooting * 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 artille ...

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

LGBT LGBTQ people are individuals who are lesbian, gay, bisexual, transgender, queer, or questioning. Many variants of the initialism are used; LGBTQIA+ people incorporates intersex, asexual, aromantic, agender, and other individuals. The gro ...

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. It was founded by Nicholas White in 2011, and is headquartered in Austin, Texas. The site, conceived as the Internet's "hometown newsp ...

'' columnist Ana Valens wrote that it contained obvious

transphobia Transphobia consists of negative attitudes, feelings, or actions towards transgender or transsexual people, or transness in general. Transphobia can include fear, aversion, hatred, violence or anger towards people who do not conform to socia ...

and encouraged

conversion therapy Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, romantic orientation, gender identity, or gender expression to align with heterosexual and cisgender norms. Methods that have ...

. In ''

Them Them or THEM, a third-person singular or 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-fict ...

'', 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 LGBT newspaper based in New York City focusing on local and national issues relating to LGBT community. It was founded in 1994 as ''Lesbian Gay New York'', later ''LGNY'', and was sold ...

'', the journalist Matt Tracy criticized Shrier for

misgender Transphobia consists of negative attitudes, feelings, or actions towards transgender or transsexual people, or transness in general. Transphobia can include fear, aversion, hatred, violence or anger towards people who do not conform to social ...

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 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 to ...

, 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, an attorney for the

American Civil Liberties Union The American Civil Liberties Union (ACLU) is an American nonprofit civil rights organization founded in 1920. ACLU affiliates are active in all 50 states, Washington, D.C., and Puerto Rico. The budget of the ACLU in 2024 was $383 million. 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 Self-determination refers to a people's right to form its own political entity, and internal self-determination is the right to representative government with full suffrage. Self-determination is a cardinal principle in modern international la ...

". 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. Backlashes against the book have led to termination of its publication in Japan.

Reception

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

Nick Cater Nicholas Charles Cater (born 7 July, 1958) 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, ...

in ''

The Spectator Australia ''The Spectator'' is a weekly British political and cultural news magazine. It was first published in July 1828, making it the oldest surviving magazine in the world. ''The Spectator'' is politically conservative, and its principal subject a ...

'', by ''

The Economist ''The Economist'' is a British newspaper published weekly in printed magazine format and daily on Electronic publishing, digital platforms. It publishes stories on topics that include economics, business, geopolitics, technology and culture. M ...

'', by Emily Hourican in the ''

Irish Independent The ''Irish Independent'' is an Irish daily newspaper A newspaper is a Periodical literature, periodical publication containing written News, information about current events and is often typed in black ink with a white or gray backgrou ...

'', 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 William F. Buckley Jr. in 1955. Its editor-in-chief is Rich L ...

'', by Christina Patterson in ''

The Sunday Times ''The Sunday Times'' is a British Sunday 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 N ...

'', by Naomi Schaefer Riley 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 in ''

The Times ''The Times'' is a British Newspaper#Daily, daily Newspaper#National, national newspaper based in London. It began in 1785 under the title ''The Daily Universal Register'', adopting its modern name on 1 January 1788. ''The Times'' and its si ...

'' of London. It received mixed reviews from the theologian Tina Beattie in ''

The Tablet ''The Tablet'' is a Catholic Church, 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 ...

'' 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 l ...

in a ''

Psychology Today ''Psychology Today'' is an American media organization with a focus on psychology and human behavior. The publication began as a bimonthly magazine, which first appeared in 1967. The print magazine's reported circulation is 275,000 as of 2023. ...

'' 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 201 ...

'' and by Jack Turban, 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 Steve ...

'' retracted a positive review by their co-editor the physician

Harriet Hall Harriet A. Hall (July 2, 1945 – January 11, 2023) was an American family medicine, family physician, U.S. Air Force flight surgeon, author, Science communication, science communicator, and scientific skepticism, skeptic. She wrote about alterna ...

and subsequently published a series of articles criticizing the book. Dr Hall published a revised review on her own website describing it as "An important book that is flawed but raises serious questions". ''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 bro ...

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'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. 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. Psychiatrist Jack Turban accused Shrier of promoting the denial of gender-affirming medical care from transgender youth, which he called a

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

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 ( US) or scepticism ( UK) 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 p ...

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 neurology, clinical neurologist and Professors in the United States#Associate Professor, associate professor at Yale University School of Medicine. Novella is best known for his involvement ...

and

David Gorski David Henry Gorski is an American surgical oncologist and professor of surgery at Wayne State University School of Medicine. He specializes in breast cancer surgery at the Karmanos Cancer Institute. Gorski is an outspoken skeptic and critic ...

, 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.

Citations

References