Irreversible Damage: The Transgender Craze Seducing Our Daughters

by Abigail Shrier

She theorized that the drive to transition might represent a “maladaptive coping mechanism” for dealing with legitimate stressors and strong emotions.

Never before had identification as “transgender” preceded the experience of gender dysphoria itself.

“I went through a couple of years of ‘Yes-I-am, no-I’m-not, Omigod, that’s gross.’ To the point where when I was eighteen, I really sat down with myself and said, ‘I can’t really ignore this anymore. This is really who I am.’ ” This back-and-forth is a common experience of trans influencers. The way many gurus like Chase explain it, the trans identity is more the handsome stranger they learn to love than the stalker they’re desperate to escape.

It turns out that breasts—glandular tissue, fatty tissue, blood vessels, lymph vessels and lymph nodes, lobes, ducts, connective tissue, and ligaments—are not really meant to be squashed flat all day long.

“Saying ‘No you’re not, you’re wrong, or this is just a phase’ just leaves your child feeling unsupported because really, they’re not going to change because there’s nothing to ‘fix.’ ”24 This message is ostensibly directed at parents. But what parents troll YouTube looking for advice from teens on how to raise their children? Of course, the advice isn’t for parents, not really. It’s a method of coaching their children, helping them to fend off adults who might otherwise convince them to desist.

Trans influencers claim to be having the times of their lives and exude genuine enthusiasm for the transgender identity, but they also seem to spend more time focused on their bodies than the average runway model.

It isn’t hard to imagine that this might be the first time a young girl even hears of these stereotypes. Her Gen X parents may never have found it necessary to tell her that sports were once allegedly the exclusive province of boys or that art, after being male-dominated for most of history, later came to be associated with girls. But gender ideologues make sure she learns that things like sports and math are for boys. It’s essential that she learns gender stereotypes because, without them, “gender identity” makes no sense at all. And when a boy realizes that he enjoys some of the “girl” activities, like painting or dancing, the revelation that he is not entirely a “boy” readily tees up.

to those of my generation and older who might be inclined to think: “No adolescents would choose a transgender life unless they were truly, painfully gender dysphoric,” I would suggest a caveat—nobody in your generation.

You grew up differently. You didn’t suffer the acute isolation of today’s teenagers.

As Jungian analyst Lisa Marchiano has observed, “When we construe normal feelings as illness, we offer people an understanding of themselves as disordered.”2 Nearly all of the mothers I spoke to offered me diagnoses of their daughters provided by therapists, the internet, or a book.

By the time they reached adolescence, self-focus and self-diagnosis had become an ingrained habit, a way to handle feelings that confused them. With the rest of the culture, they had been reared to participate in a therapy language game, in which everyone has some mental illness and the only question is what code to offer insurance.

In small children, sadness and dread may naturally worry us, depending on the severity and duration. But with teens, careening between doldrums, rage, and euphoria was long understood to be relatively normal, the psychological analog to puberty itself. Today’s adolescents, practiced in therapy, have assimilated its vocabulary. They can tell you what sorts of social situations they find emotionally challenging and the precise contours of the psychological problem that’s to blame—“social anxiety,” “testing anxiety,” “panic attack,” and so forth. Such diagnoses have a way of reifying the problems they describe.

standard asks—against much evidence, and sometimes contrary to their beliefs on the matter—that mental health professionals “affirm” not only the patient’s self-diagnosis of dysphoria but also the accuracy of the patients’ perception.

Erik Erikson called identity formation the key task of adolescence for a reason: identity isn’t already formed.

What teenagers fail at so miserably is avoiding risky behaviors that their peers approve of.

Turns out, adolescents really care what their friends think—quite a lot, in fact—and this distorts all kinds of choices they make. Teenagers take more risks than any other age group. They may even be neurologically inclined toward risk, especially where peer approval is on the line.13 It isn’t just that teenagers do dumb things. It’s that, when faced with their peers, they almost can’t help themselves. The prefrontal cortex, believed to hold the seat of self-regulation, typically does not complete development until age twenty-five.

Nursing, I discovered, is its own kind of lullaby, a private mother-and-baby song. But the thought that forgoing it would be any kind of loss was as foreign to me in adolescence as it is obvious to me now. I offer this personal story as a reminder of how imperfect our knowledge of our future desires is, how cavalier adolescents often are with risks they are in no position to assess, especially when faced with the encouragement of friends.

“The truth is that our identities are socially negotiated,” said Lisa Marchiano, Jungian analyst and an outspoken critic of gender-affirmative therapy. It’s a heckuva point: Social transition, by definition, is a communal activity, requiring the buy-in of others.

But the story also exposes the vulnerability of adults in the face of teenage defiance. There is one way any adolescent can bring parents to surrender: with a compelling threat of self-harm.

In order to justify the peculiar mandate that therapists immediately accept patients’ self-diagnosis when presented with someone claiming gender dysphoria, we must answer two questions: 1) Is the gender dysphoria causing the suicidal ideation? And 2) Do we have any evidence that affirmation ameliorates mental health problems? The answer to both questions, it seems, is no.

In a recent academic study, Kenneth Zucker found that the mental health outcomes for adolescents with gender dysphoria were very similar to those with the same mental health issues who did not have gender dypshoria. In other words, we have no proof that the gender dysphoria was responsible for the suicidal ideation or tendency to self-harm. It may have been the many other mental health problems that gender dysphoric adolescents so often bear.

But it is not true that gender dysphoria or “being trans” is similarly immutable. We know this, because before “affirmative therapy” was the vogue, gender therapists practiced “watchful waiting,” a therapeutic process whose goal was to help a child grow more comfortable in his or her biological sex. As we’ll see in the next chapter, watchful waiting was remarkably successful. Several studies indicate that nearly 70 percent of kids who experience childhood gender dysphoria—and are not affirmed or socially transitioned—eventually outgrow it.

Dr. Zucker believes mental health professionals need to look at the whole kid. Some children latch onto gender dysphoria as a way of coping with trauma or other distress. A therapist needed to question the patient’s understanding of gender in order to determine why the patient might have fixated on that as a source of their problems. What beliefs did the patient have about boys or girls? Why did the child or adolescent come to believe changing gender would lead to a happier life? The goal of the questioning was often to challenge the notion that biological sex was the source of the patient’s problem and, wherever possible, to alleviate the dysphoria. He was stunningly successful. Zucker’s colleague Devita Singh examined the outcomes in the cases of more than one hundred boys who had been seen by Dr. Zucker at his clinic.3 In cases in which a child had not been socially transitioned by parents, she found that 88 percent outgrew their dysphoria.4

If a therapist believes he might be able to help a gender dysphoric patient feel better in her body, Dr. Bailey believes he ought at least to be allowed to try. But the current gender-affirmative therapists leap straight to affirmation. “At best, they’re keeping these girls from adjusting to their natal sex. And at worst, they’re encouraging them to take these harmful and unnecessary medical steps.”

the idea developed by historian of psychiatry Edward Shorter, and popularized by journalist Ethan Watters: Patients are drawn to “symptom pools”—lists of culturally acceptable ways of manifesting distress that lead to recognized diagnoses.13 “ ‘Patients unconsciously endeavor to produce symptoms that will correspond to the medical diagnostics of the time,’ ” Watters credits Shorter with discovering.14 “Because the patient is unconsciously striving for recognition and legitimization of internal distress, his or her subconscious will be drawn toward those symptoms that will achieve those ends.”15 Many social contagions are spread this way.

“Our early 21st century symptom pool includes the notion that children can suffer extreme distress as a result of being born in the wrong body,” Marchiano wrote.17

“The whole premise of therapy is that you explore,” she told me. “It’s that you open things up and you approach a symptom with curiosity. Affirmation is the exact opposite of curiosity. It’s saying, I already know what this is. It’s taking things at face value.” In fact, Marchiano says, genuine therapy pushes patients to question their own self-assessments.

Patients claiming gender dysphoria, she says, ought to be treated according to the same therapeutic principles as any other troubled patients. “When someone walks in and says, ‘I think I want to leave my marriage, that’s why I’m here.’ I don’t know what’s going on. We have to listen and find out, and the way that I work, that could take months of listening. This idea that a kid’s going to come in and tell us that they’re trans and that within a session or two or three or four, that we’re going to say, ‘Yep, you’re trans. Let me write you the letter.’ That’s not therapy.”

In fanning the flames of an epidemic, mental health professionals are withholding the independent judgment and therapeutic help that confused adolescents desperately need. If anything, “affirmative therapy” encourages a confused adolescent’s most dangerous impulses.

Johns Hopkins University distinguished professor of psychiatry and behavioral sciences Paul McHugh has an answer. Gender dysphoria is an “overvalued idea” or ruling passion. This is “an idea held by many people in the world, but held intensely by the patient or the person, who is making a life of that idea,” Dr. McHugh told me. Many people believe that it is good to be thin, for instance. Many adolescent girls believe it’s better to be a boy. But for anorexics and those with gender dysphoria, those ideas become all-consuming.

Dr. McHugh does not doubt that those under the sway of an overvalued idea are suffering real distress. What he doubts is that they have accurately located its source.

The problem is that doctors have no way of knowing who will be healed and who will be harmed by it. “Well, I know this,” he told me. “That some people are satisfied and live happily ever after. And some, of course, get suicidal, depressed, and regretful. And nobody can tell the difference between the ones in the beginning that will and will not regret it.” Even Dr. McHugh’s critics admit that scientists have yet no reliable means of predicting who will be helped and who will be hurt by a gender surgery.

Dr. McHugh believes the transgender craze will likely end as the multiple personality craze did: in the courts, with patients suing their doctors.

Remember that the overwhelming majority (over 90 percent of the parents) of the girls suddenly identifying as transgender—according to Littman’s surveys—are white.

Other girls her age have breasts, hair under their arms, struggle to manage their periods, say things that indicate sexual awakening—all things she knows little about. She is likely to feel more alienated from womanhood—not less—after she’s been cut from the team, endocrinologically speaking. No surprise, then, that in a clinical trial 100 percent of children put on puberty blockers proceeded to cross-sex hormones.6 That is a stunning statistic, especially considering that when no intervention is made, roughly 70 percent of children will outgrow gender dysphoria on their own.7 Far from being “neutral,” the psychosocial effects seem closer to radical.

When we allow parents to consent to medical procedures for teens or tweens, it is typically to permit doctors to save, cure, or alleviate an observable medical problem.10 But in the singular instance of transgender medicine, we allow a parent to consent to intervention that halts normal, healthy biological functioning—essentially, introducing the “disease state” brought on by a pituitary tumor—all based on self-reported mental distress.

Weight drops away from your thighs, hips, and bottom. Sure, testosterone renders you “cloudy”-headed, as more than one woman who had been on it told me—less able to evaluate your decision to use it in the first place. But in the place of mental sharpness, it offers the compensatory gifts of mood elevation and a satisfying spurt of heedlessness. A newfound sense of bravado, but also punchiness, descends. Anxiety that shook you and depression that wrapped you in chains have relaxed, relented, drifted away.

Testosterone is typically justified as a treatment for “gender dysphoria,” but the endocrinologists who administer it rarely seem even to be evaluating its progress with the patient’s dysphoria. What they examine instead are blood levels to ensure that testosterone stays within normal range for a man. This seems to place endocrinologists (and just as often, nurse practitioners) in the position of hair stylists, who aim to satisfy, rather than medical professionals who seek to cure.

Although alleviation of gender dysphoria was supposed to be its justification, doctors administering T very often seem less interested in treating “gender dysphoria” than in giving trans-identified patients the look they want. As long as the hair is growing in and the blood work shows that testosterone is maintained at men’s levels, the dosage is unlikely to be questioned or altered.

there are no good long-term studies indicating that either gender dysphoria or suicidality diminishes after medical transition.

Kids her generation may be sophisticated when it comes to utilizing technology, Benji told me, but they are strikingly naïve about the truthfulness or completeness of the content. “They think that the mainstream news is full of lies and garbage, but when it comes from an independent person, that must be more realistic or something, more authentic in some way,” she said. Postmodern queer theory regards experience as more valid than fact,

She came to believe, in fact, that the only people she could trust were trans-identified. That, she says, is a mantra you hear frequently in the gender ideology world: you can’t trust “cis” people—you can only trust trans. “They tell you that you cannot emotionally or psychologically depend on your family or any cis-hets [cisgender heterosexuals] or non-queer people because they can’t possibly understand you or empathize with you or love you for who you really are.”

She soon learned that a lot of young lesbians are uncomfortable with their female parts as they wrestle against internalized homophobia and come to terms with their emergent sexuality. Gender dysphoria, she decided, did not necessarily make her “trans.”

“I would like to ask those people under what conditions do they think a lesbian can go to a gender therapist and be told, ‘No, you’re not trans, you are a lesbian.’ Because I have never heard of any situation where that happens ever. How is it possible for any medical condition that every single person who walks in the door definitely has it?”

like the kind of thing where I couldn’t look away,” she said. It wasn’t only the social justice that intrigued her, but the trans testimonials. “People’s individual stories of like why they identify as trans and their struggles. And it was stuff like, ‘Oh, I hate my boobs, I hate my body, I hate everything.’ ” Helena binge-watched videos of trans testimonials and began to strongly empathize with the people in them. She soon realized that her views were converging with theirs. “The more I got into it, the more prominent these feelings were of not being a girl.” At first, she didn’t believe she was a boy. Instead, she would think, “I’m anything besides a girl.”8

Her best friend from class felt the same sense of failure as a girl—not nearly feminine or glamorous enough. At a male friend’s house, they began exploring together the possibility that they might be trans—or at least non-binary. “We were sitting at this house and we started talking and I was just like, ‘You know, I don’t think I’m a girl. I don’t feel like a girl.’ ” The boy was gay, and his parents had been giving him a hard time for how feminine he was acting. He decided he was trans, too. When they told another friend of theirs what the three of them had decided, the fourth friend came to the same conclusion—she was trans, too.

Helena abandoned all of her hobbies, including painting. By the end of high school, her only hobby was “being trans.” “All the passion for life went out the window and I just was focused on the possibility that someday I would transition and live again.”

Like Benji, Helena also told me—unprompted—that the world of gender ideology felt like a cult. It was an assessment I would hear often from detransitioners: walking away didn’t feel like an option.

With three other young women, in 2019, she founded Pique Resilience Project, a group of detransitioners

Each of the desisters and detransitioners I talked to reported being 100 percent certain that they were definitely trans—until, suddenly, they weren’t.