This review grew out of a discussion with a dear friend who, at the time, supported gender identity ideology. I, on the other hand, had become increasingly frustrated with the loss of women’s rights to female-only spaces and laws protecting us from sex discrimination, as well as with the silencing of dissent to transgender dogma, and had urged her to examine the available information for herself. Then, I told her, we could revisit the conversation. She did, we did, and together we found pockets of dissent where we could speak further. These small spaces for critical thought on the topic of transgenderism continue to grow across the political spectrum. While we are not alone, as feminists concerned with gender identity ideology, we are — through the loss of access to social and other media, and due to threats of firings and physical violence — effectively silenced.

My friend — herself an academic and writer — noted the eerie (apparent) disinterest in Abigail Shrier’s new book, Irreversible Damage, by political and literary communities. Last month, she wrote to me via email, saying “I, too, have been surprised by what appears to be a deliberate silence around [Irreversible Damage] by newspapers and magazines ‘of record.’” She named it, aptly, “a reception vacuum,” calling book reviewers “taste makers and opinion diffusers.” By pretending the book doesn’t exist, they are ensuring the book will not exist for potential readers either, depriving the public sphere of the research and arguments Shrier presents.

Shrier contributes frequently to the Wall Street Journal, and among her degrees is a Juris Doctor from Yale University. She is a skilled writer who offers complex ideas with accessible delivery. It is possible the media would have covered her work had she resorted to obfuscating postmodernist jargon. Shrier has received no reviews from the established liberal press — not from the New York Times, The Atlantic, the Kirkus Review, nor any other mainstream online publications. Amazon, which still sells and thus profits from Irreversible Damage — garnering rave reviews there — has refused to allow sponsored ads to promote the book.

My friend wrote to me:

“Book reviews are a way of creating and nurturing readers by guiding them toward understanding the meanings and significance of a work. That no politically or culturally ‘liberal’ publications online or in print have even dared to acknowledge the existence of Shrier’s exposé of ROGD [Rapid Onset Gender Dysphoria], the medical issues endemic to medicalizing children for life, infertility-producing surgeries, mental distress masked as dysphoria, and the real presence of de-transitioners, is no surprise for many of us.”

Shrier is terribly careful. She only addresses a narrow subset of “dysphoria”: RODG — the apparent social contagion spreading among circles of adolescent girls who have never previously expressed discomfort with their sex or sex role (“gender”). She explicitly acknowledges and interviews (favourably) adults who identify as transgender, and concedes that young children who insist they are the opposite sex consistently, from the time they are toddlers, may have a legitimate form of dysphoria. From a feminist perspective, because “transgender rights” mean women and girls must sacrifice their rights (for example, female-only shower rooms, shelters, and washrooms must allow males access, under gender identity legislation and policy), and the concept of fighting women’s oppression is undermined (seeking to become a member of the dominant sex is an absurdly individualist solution), Shrier’s acceptance of transgenderism itself is a great deal of ground to cede! Despite this, Shrier is silenced.

There are networks of power behind this silencing, and so we must ask who benefits from the transgender trend. Pharmaceutical companies will have lifelong prescribers, as sex cannot actually be changed, so the body must be forced — continually and for life — into conformity. Surgeons, especially those who stitch saline bags into male chests and surgically remove healthy breast tissue from young females, are well supplied with patients. Scott Newgent, a woman who transitioned to become a man and is now speaking out about the process, says hormones amount to “$24,000 per year per trans-identifying child that starts hormone blockers.” Newgent has spent a total of $247,000 USD (to date) for  phalloplasty surgery and its resulting complications.

A mastectomy for women attempting to become “men” costs around US$11,000,  and phalloplasty starts at US$25,000 — with each set of complications adding to the price. (This remains an experimental surgery, and complications are not uncommon.) Facial masculinization and liposuction for reshaping female hips and thighs can cost tens of thousands more.

Psychologists and psychiatrists who offer “affirmation” therapies and encourage children’s proclaimed desire to change sex, often bullying the parents into acceptance, are rewarded with referrals and official — often legal — approbation.

These groups profit from this “conversion” effort, as healthy, young, and often lesbian and gay bodies are sacrificed to heterosexual conformity. And yet, in a decidedly Orwellian twist, any practice not “affirming” a child as transgender has been decreed “conversion therapy.” Conflating the efforts to “turn” homosexual individuals straight, practiced in the past, with trying to find an underlying cause for a child’s desire to change sex or alter their bodies, is absurdly inaccurate. Allowing or encouraging the child to explore the reasons underlying feelings of discomfort with gender roles or their birth sex is not “conversion.” The immediate, unquestioned affirmation of transgender identity is, increasingly, required by credentialing medical and psychological organizations’ rules of practice, and codified in law.

Today, young women who might see themselves as lesbian are pressured to claim transgenderism instead, yet the costs of desisting after transitioning are vastly different than if one changes their mind about homosexuality. To misdiagnose oneself as lesbian or gay doesn’t require later attempts to reverse the effects of dangerous medications, surgeries that are mostly permanent, or the potential loss of sexual response.

Some of the effects of testosterone on young women soon become irreversible: after just three months, her voice is permanently deepened. Facial and body hair remain. Though breast tissue taken with mastectomy can be later replaced with saline implants, breast function cannot be restored. And if a young woman attempts phalloplasty, the tissue removed from her arm to create the faux phallus may never heal. One transitioner Shrier interviews who received this “de-sleeving” has little use of the arm, and is now unable even to hold a fork. The surgically created penis may never heal, and complications, including gangrene, can result in disfigurement and internal deterioration.

These are among the irreversible damages of the affirmation model.

The US National Education Association’s policy demanding affirmation of self-identified trans students means that if a child “comes out” at school, name and sex in school records can be changed without the parents even being notified. Shrier quotes a fifth-grade public school teacher, who says, “[T]heir parental right ended when those children were enrolled in public schools.” This, of course, has never been parents’ understanding, nor was it subject to a vote, or even to a signed agreement. The reason given for such protective affirmation of children is the schools’ anti-bullying mandate. However, to Shrier, “the anti-bullying effort is only a pretext for gender identity education,” which starts in kindergarten, with no opt-out as there is with sex education. This makes “Mom” and “Dad” the bullies from whom children supposedly need protection. This has become common practice in schools across America.

If sex-role non-conformity (meaning disinterest in or refusal to conform to the rules of “femininity” imposed on girls or “masculinity” imposed on boys) is at the root of of bullying, as claimed by trans activists and the California Board of Education, this doesn’t necessarily have anything to do with transgenderism, as most non-conforming people see gender as the issue, not their bodies. Further, it is absurd and unnecessary to offer up girls’ rights and spaces to boys. Yet this is what transgender “rights” do. Indeed, girls have been found to evade restrooms, or even school, because of a lack of privacy.

Many girls who are gender non-conforming would otherwise grow up to be lesbian, but today, “lesbian” is not a word girls often claim. Though their parents might use the term, in the current parlance, young women choose “queer,” “genderqueer,” “non-binary,” or “gay” (a word generally referring to male homosexuals but used to demonstrate “inclusivity”). Trans activism construes same-sex attraction as “transphobic” and antithetical to gender identity ideology, so much so that lesbians are bullied by trans activists, should they not accept males as intimate partners.

In her research, Shrier found that the majority of girls who experience ROGD are white and economically privileged. In an effort to discover why this is, she finds that the mothers of this particular group are inclined to avoid strong disagreement with their children, working relentlessly to keep them emotionally comfortable. Familiar with — and consumers of — mental health services, Shrier notes that, “[b]y the time [these girls] reached adolescence, self-focus and self-diagnosis had become an ingrained habit, a way to handle feelings that confused them.” Shrier quotes Lisa Marchiano, Jungian therapist and affirmation dissenter, who explains, “When we construe normal feelings as illness, we offer people an understanding of themselves as disordered.”

Shrier writes:

“Nearly all of the mothers I spoke to offered me diagnoses of their daughters provided by therapists, the internet, or a book. They suspected their daughters might be a touch autistic or have auditory processing issues or agoraphobia. They may all be right, but I couldn’t help wondering whether the process of diagnosis wasn’t itself altering the outcome, helping to convince suggestible daughters that there really was something wrong with them.”

As a feminist, I’m not wholly comfortable with Shrier’s mother-blame. Still, I think she may be on to something. Women and girls are expected to be agreeable and to alleviate or minimize conflict, and this appears more expected, the higher the class status. Marchiano’s take seems fairer. I would push both ideas further: our culture demands mothers make life easier for other adults, but they damage their daughters in the process of socializing them to do the same.

Shrier sees ROGD as yet another example of disorders plaguing teen girls, similar to anorexia. When considering diagnostic criteria, the comparison is chilling. What if surgeons were forced to accept patient diagnoses in the same way, and to “affirm” the delusions and desires of severe anorexics? Should self-starving young women be “affirmed” in their feelings of grotesque fatness, encouraged toward further weight loss, and given bariatric surgeries on demand? While this comparison is derided by trans activists, we should not be too eager to discard it.

One might take this a step further (Shrier does not), and compare transgender surgeries like breast fabrication or breast removal, as well as other forms of elective cosmetic surgery. When perfectly healthy body tissues are removed — or remade to resemble what they are not — this should be seen as elective, rather than necessary or a form of “treatment.” Can you imagine a surgeon being required to amputate a healthy leg because a patient has self-diagnosed gangrene? Yet gender affirmation therapies have become mandatory, “adopted by nearly every medical accrediting organization,” Shrier explains. “The American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Psychological Association, and the Pediatric Endocrine Society have all endorsed ‘gender-affirming care’ as the standard for treating patients who self-identify as ‘transgender’ or self-diagnose as ‘gender dysphoric.’” This is a standard no other therapy endorses.

The concept of transgenderism is a con job. Shrier, overly kind, calls gender transformation “an uphill battle.” But no one can actually change sex — one cannot turn male sexual organs into female ones, and vice versa.  Every cell in the body is sexed. Biological and physical anthropologists can look at a skeleton and determine sex easily, even without DNA testing. Even though people like New York Times columnist and transgender author Jennifer Finney Boylan will insist the creation of a sexually responsive neo-vagina out of penile tissue is quite possible, this is chicanery. More commonly, the result resembles the useless hand of the “de-sleeve” victim mentioned above. Tales abound of necessary and multiple dilations of neo-vaginas, which may end up rotting, as do the faux phalluses, leaving organ damage in their wake. Frequent surgical corrections may be required, even if “successful.” Shrier writes, “Even just connecting all the veins and arteries to allow blood flow to the new appendage” requires surgery “under a microscope, using sutures about one-fourth the thickness of a human hair.”

A real virtue of Shrier’s book is her addition of humour and genuine interest in those she interviews to her clarifying analysis. She includes the views of experts; stories from parents; the words of ROGD girls; analyses from radical feminists, some of whom are lesbians; and interviews with adults who are now transgender, or who have desisted and returned to identifying as their birth sex. Rarely have these perspectives come together in any single piece of accessible and easily readable writing. No prior knowledge of the issue or medical expertise is necessary to understand Shrier’s book. It should be a staple of book clubs, the general public, those interested in the issues involved, and anyone with an open mind. We urgently need to move beyond the “affirmation” dogma if we are to have a more sensible public discussion about gender identity.

My friend compares the silencing of opposing perspectives to blasphemy laws. While not operational in the United States, she told me:

“The questions raised in every chapter of her book do amount to blasphemy. These questions are sins condemned by the gender orthodoxy and its unquestionable tenets. Unquestioned ideas, from the ‘mutability of gender’ to the erasing of material sex — and the limits of physiology and such — that now has achieved legal or quasi legal status in the U.S., Canada, the E.U., and Australia, for example. The strength of NGOS like the Arcus Foundation pouring cold cash into the sort of activism that creates ‘truths’ that give the feel of inevitable groundswells of progress and liberation.”

As we sat in social distance and discussed further on my tree-shaded porch, we realized the parallels to the battle Andrea Dworkin fought against pornography. Just as the exceedingly well-funded pornographers could wage intellectual and legal war against Dworkin and Catharine MacKinnon, the many medical industries allied behind transgenderism have followed suit. So has the Cancel Culture of the “woke” Left, which has framed radical feminists and those concerned with rights for women and girls as the enemy, deserving of physical violence and forcible loss of income. While continuing to defend the sex industry as harmless “work,” the woke Left now also demands women forgo rights to placate male desires and identities. Backed by institutions, charities, and wealthy investors like Martine Rothblatt, Jon Stryker, the Pritzker family, and George Soros’ Open Society Foundations, the trans lobby seems untouchable.

To the detriment of girls and women of all races and social classes, the current combining of socially progressive movements with the obligatory inclusion of all manner of trans issues has worked. In fact, the trans lobby has jumped on the “intersectionality” train and is now sitting next to the conductor giving everyone direction as to where to go.

It shouldn’t surprise us that Shrier addresses identitarian politics in her book. Her nod to white being a hated identity, however, is an overstatement of the current dogma on college campuses, and a misunderstanding of the idea of privilege. For whites, a bizarre campus culture requiring the confessing of the “sin” of being white at every turn does exist. Some of this is necessary, though, as we in the US address racist police violence and the consequent protests. Comfortable people do not change, and clearly change is needed, in the form of racial reparations and deep revisions in institutions. Many of us are eager for a more mature and focused form of protest, with well-considered demands for real change at the centre.

Shrier does not deal well with the concept of privilege. Privilege means better treatment compared to a logical reference group, not “living in elegance or luxury.” As an old, fat, working class white woman, I have witnessed the fact that I am regarded as having more value, honour, and acceptance while moving within the culture, as compared to an old, fat, working class black woman, and this is confirmed by others’ experiences, too. The sons of my class can usually walk in any neighbourhood or drive any car without being stopped and questioned by the police. This is not the case for the sons of working class black women.

Shrier is correct in pointing out that many of those with white and class privilege are using manufactured marginalizations — mental disorders disguised as oppression — to  escape that privilege. Shrier’s claim that white girls hold “the most reviled identity on campus” is questionable, and she fails to name patriarchy as an issue.

Our only hope in dialogue is to hear all sides of an issue and discuss them. As an old radical feminist I am painfully aware that in reaching out to young sex-role non-conformists, my voice is preemptively discounted. The culture is rabidly ageist: my decades’ worth of experience is viewed as worthless, and labelled bigotry. Young women are denounced for listening to the experiences of old women, and we are forced to sit by and watch as they learn to hate their natural bodies and their womanhood. We are silenced online, on the job, and in our communities if we are found to have tried. And still, we do. And still, we are increasingly finding young women as allies, and as leaders.

If schools and other institutions that spread knowledge were to acknowledge sex roles and how they limit what individuals of either sex can be, and work against bullying on account of difference — sex, race, class, ability, or impairment — and sex role deviation, it would be great. But when that could have been implemented, during second wave feminism’s challenge of sex roles and stereotypes, there was no funding for or interest in doing so.

Clearly, unless a woman is a doormat, and unless a man is a stone wall, we all defy our assigned sex role. I’ve heard so many women of my generation and even younger say that they are relieved they were not born later. The pressure, especially for lesbians — but truly for all non-doormat women — to see themselves as transgender would have been immense for us, too. Conforming, and all the positive attention attached to a declaration of trans identity — the claims of “courage” lavished on the acolytes of genderism — would have been ego-assuaging for us, too. Feminism of the radical kind saved our generations and offers a lifeline to young women today. Instead of the backlash that passes for liberation, we need to reclaim the analytical tools of 1970s feminism. The generation gap is a way to cut the transfer of knowledge from one generation to another. We cannot afford this.

Shrier — not a radical feminist — understands the need for a transfer of feminist ideas, which may encourage other women to take a deeper look. Girls’ lives matter. I give Shrier credit for authoring this necessary book. It is the first to put the many pieces together clearly and accessibly. Read Irreversible Damage and share it with others — it is a brave and daring book that ought to be part of the public discussion.

Abigail Shrier’s “Irreversible Damage: The Transgender Craze Seducing Our Daughters” is published by Regnery Publishing, June 2020.

Megan Mackin is a 50-years’ duration working class fat activist and radical feminist (including, inherently, anti-racism), from Washington state, now residing in the Midwest.

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