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Detail of cover of Irreversible Damage, by Abigail Shrier

Trans Science:
A review of Abigail Shrier’s Irreversible Damage: The Transgender Craze Seducing Our Daughters

Editor’s Note

The following review, by Dr. Harriet Hall, of Abigail Shier’s 2020 book Irreversible Damage: The Transgender Craze Seducing Our Daughters was originally published on the website for Science-Based Medicine. It was removed with this Editors’ note:

“This post is currently under review by the founding and managing editors of SBM due to concerns expressed over its scientific accuracy and completeness. Until that review is complete, it has been removed from the blog.”

Subsequently, the Editors of SBM issued another statement:

“After careful review, the editors of SBM decided to retract this book review. Because we allow trusted authors to publish without prior review for the sake of efficiency and timeliness, occasionally corrections need to be made post-publication. In this case we felt there were too many issues with the treatment of the relevant science, and leaving the article up would not be appropriate given the standards of SBM.

“Already there are false accusations that this move was motivated by pressure from readers. This is not the case. SBM had and never will cave to outside pressure. We have endured a great extent of such pressure, including the threat of lawsuits and actual litigation.

“Our review of the article in question and the decision to retract was entirely internally generated by the editors.”

Since Dr. Hall writes a regular column — The SkepDoc — for Skeptic magazine, we offered to publish her review here.

Until just a few years ago, gender dysphoria — severe discomfort in one’s biological sex — was vanishingly rare (less than .01% of the population). In episode 160 of my podcast, The Michael Shermer Show, I spoke at length with Abigail Shrier about her book Irreversible Damage. Listen to episode 160.

—Michael Shermer, Publisher

In 2018 I wrote about a research study by Lisa Littman. She coined the term rapid onset gender dysphoria (ROGD) to describe reports she had been reading about gender dysphoria appearing rapidly around the time of puberty in adolescents and young adults who would not have met the criteria for gender dysphoria in childhood. Her study raised the possibility that rather than always being an innate, immutable sense of incongruence between anatomical sex and personal sense of gender, some cases of gender dysphoria might be due to social contagion from peer pressure and online influences.

I thought that was worthy of investigation. I got a lot of criticism for writing about it. I was even called transphobic, which I absolutely am not. I only want the best for each individual. If that means transitioning, I fully support that. If it means some individuals transition for the wrong reasons and later change their minds, that’s regrettable and we need to find a better way to identify those individuals and treat their dysphoria without subjecting them to irreversible interventions. I hesitated to tackle this controversial subject again, but in 2020 Abigail Shrier wrote a book that shares my and Littman’s concerns. It combines well-researched facts with horrifying stories about botched surgeries, people who later regret their choices, and therapists who are not providing therapy but just validating their patient’s self-diagnosis. The title is Irreversible Damage: The Transgender Craze Seducing Our Daughters.

Littman’s Research Methods Were Flawed but She was Unfairly Vilified

Littman’s research was widely criticized for its flaws, which I described in my article. It was not good science and didn’t set out to establish that ROGD was real; it was meant to be exploratory and hypothesis-generating. Transgender activists accused Littman of having hurt people with her research; they called it “dangerous.” Her paper drew praise from some world experts on gender dysphoria and from many parents, but she was also tarred as a bully and a bigot. She was denounced by activists to her employer, the Rhode Island Department of Health, and they fired her, even though her job had nothing to do with transgender youth or even young children. She was unfairly attacked, her reputation was tarnished, and she lost a job she loved.

The Numbers are Alarming

Historically, the conviction that one’s gender doesn’t match one’s anatomical sex typically began around age 2–4. It affected only .01 percent of children, almost exclusively boys. And in 70% of cases, they eventually outgrew it. Prior to 2012, there was no scientific literature on girls age 11–21 ever having developed gender dysphoria at all.

The picture has changed dramatically. Natal girls now constitute the majority. Clusters of adolescents are discovering transgender identities together and are clamoring for hormones and surgery. In 2018 the UK reported a 4,400% rise over the previous decade in teenage girls seeking gender treatments; similar spikes have been observed in many other countries. In the US, the prevalence of adolescent gender dysphoria has increased by over 1000% in the last decade. In 2016, natal females accounted for 46% of all sex reassignment surgeries; a year later it was 70%.

We are starting to see desisters (those who stop identifying as transgender) and detransitioners (those who had undergone medical procedures, regretted it, and tried to reverse course). No statistics are available on how often this happens.

Those who transition rarely adopt the stereotypical habits of men (like buying a weight set) and only 3% have had a phalloplasty (to create an artificial penis) and only 13% say they want one. A common response is “I don’t know exactly that I want to be a guy. I just know I don’t want to be a girl.” Girls who previously would have been classified as tomboys or lesbians are now classified as transgender; sometimes the idea of transgender is first suggested by a therapist. In one school where 15 students had come out as transgender, there wasn’t a single lesbian. Shrier looked for instances where a counsellor suggested to a patient that they might be lesbian rather than transgender; she couldn’t find a single example. In the last decade, lesbians have seen the disappearance of lesbian bars and publications. Lesbians have been denigrated as transgender males who won’t admit they are supposed to be boys.

The Mantras of Trans Influencers

There are many social media sites and online forums that facilitate the discovery of a trans identity. Trans influencer gurus commonly offer advice like this:

  • If you think you might be trans, you are.
  • You can start trying out trans by using a binder to flatten your breasts.
  • Testosterone is amazing and it may just solve all your problems. You don’t have to be certain you are transgender to go on hormones.
  • If your parents loved you, they would support your trans identity. If your parents are not supportive, it’s OK to cut off contact.
  • If you’re not supported in your trans identity, you’ll probably kill yourself.
  • Deceiving parents and doctors is justified if it helps transition. Scripts are provided that will convince doctors to give you hormones. It’s OK to lie and say you have always known you were trans even if it’s not true.
  • You don’t have to identify as the opposite sex to be “trans.” You can be “genderfluid” and reserve the right to change your mind. One said she wanted to be identified as a woman only some of the time.
  • If you’ve ever felt different, anxious, or afraid, or felt like you don’t fit in, there is a transgender community ready to accept you and become your new family.
The Schools are Not Helping

In California, students can opt out from sexual health education instruction but cannot opt out of gender identity and sexual identification instruction. Gender stereotypes are taught in kindergarten. Children are taught that they might have a girl brain in a boy body or vice versa; never mind that that is biologically nonsensical. Teens are asked to imagine what it would be like to be the other gender. When a child comes out as trans, schools frequently adopt their preferred new name and pronouns without informing the parents (ostensibly to protect the child’s privacy). The achievements of gender-nonconforming women are downplayed because they don’t count as true women.

One of the tasks of adolescence is establishing an identity. Adolescents are still trying to figure out who they are and which sex they are attracted to. Many of the adolescent girls who adopt a transgender identity have never had a single sexual or romantic experience and have never been kissed.

Shrier gives a personal example of how teens can’t always predict what they will want later in life. She wanted breast reduction surgery. Her father objected that it might interfere with breast feeding, but she was absolutely sure there was no chance she would ever want to nurse a baby. More than a decade later she breast-fed three babies and found it one of the most rewarding experiences of her life. She says, “We are very good at knowing what it is we want right now; far less good at predicting whether the object of our desire will produce the satisfaction we take for granted.”

The Customer is Always Right

A new “affirmative care” standard of mental health care has been adopted by nearly every medical accrediting organization. The American Psychological Association guidelines go much further than respecting and supporting trans identities; they mandate that therapists adopt gender ideology themselves. Therapists must accept and affirm the patient’s self-diagnosis. Shrier likens this to telling an anorexic teen “If you think you are fat, then you are. Let’s talk about liposuction and weight-loss programs.” She asks whether a standard guided less by biology than by political correctness is in the best interests of the patient.

We don’t provide affirmative care for anorexia. We don’t say “Yes, you are fat” and offer to help them reduce their weight even more. Part of a therapist’s role is to question a patient’s self-assessment.

Parents are asked to believe that they never had a daughter but have always had a son. They are told if they don’t affirm, the child may commit suicide: “Would you rather a dead daughter or a live son?” We are asked to disregard DNA and accept the ineffable feelings of an eight-year-old. This amounts to emotional blackmail, and it is not based on good evidence. Suicide is common, but there is evidence that factors other than gender dysphoria may be causing the suicidal ideation, and there is evidence that affirmation does not ameliorate mental health problems. In one study of adult transsexuals, there was a rise in suicidality after sex reassignment surgery.

The Dissenters

Some therapists think the affirmative model is a mistake, but they dare not speak out. Nineteen states prohibit conversion therapy for homosexuality, and they equate questioning a patient’s self-diagnosis of gender dysphoria to a kind of conversion therapy, banning it as well. Dissenting therapists have lost their jobs and risk losing their license. Dr. Kenneth Zucker is a case in point. A highly respected expert on gender dysphoria, he refused to reduce the source of distress to one problem; he insisted on looking at the whole kid. In a series of 100 boys he treated who had not been socially transitioned by parents, a whopping 88% outgrew their dysphoria. He was accused of practicing conversion therapy, was fired, and his reputation was ruined.

Dr. Ray Blanchard questions whether adolescent girls who suddenly identify as trans even have gender dysphoria. He believes they are a mixture of those who will be transgender no matter what, those who will outgrow their dysphoria and live as gay adults, and those who have borderline personality disorders and have identified a kind of faux gender dysphoria as the locus of their unhappiness. Rigorous empirical study is needed to guide diagnosis, understanding, and treatment; but in the current political environment good science has become almost impossible.

Since doctors have no way of predicting whose dysphoria will respond to gender surgery, it should be clearly labeled experimental and should be restricted to patients participating in controlled studies overseen by an institutional review board (IRB). Testosterone can seem like a miracle; it can lift depression and anxiety and make young women feel bold and unafraid. Planned Parenthood, Kaiser, and Mayo all dispense it, often on an “informed consent” basis on the first visit, with no referral or therapist’s note required. It is given to patients as young as 15 (the age of consent in Oregon). There are plenty of risks, which Shrier describes. She also describes the risks for puberty blockers like Lupron. Delaying puberty is supposedly harmless, but it isn’t. Studies have shown that when a kid is put on puberty blockers, almost 100% will go on to take cross-sex hormones. This essentially guarantees infertility. “Top surgery,” or bilateral mastectomy, is advocated by surgeons who think adolescents can make logical decisions, and is done on girls as young as 13 (legal in California). The surgeons don’t require input from a therapist; they accede to the patient’s wishes and rarely turn anyone away.

Conclusion: An Important Book
Irreversible Damage: The Transgender Craze Seducing Our Daughters (book cover)

This book will undoubtedly be criticized just as Lisa Littman’s study was. Yes, it’s full of anecdotes and horror stories, and we know the plural of anecdote is not data, but Shrier looked diligently for good scientific studies and didn’t find much. And that’s the problem. We desperately need good science, and it’s not likely to happen in the current political climate. Anyone who addresses this subject can expect to be attacked by activists. Is ROGD a legitimate category? We don’t know, since the necessary controlled studies have not been done. I fully expect Shrier to be called a transphobe and to be vilified for harming transgender people, and I’m sure I will be labeled a transphobe just for reviewing her book.

She brings up some alarming facts that desperately need to be looked into. The incidence of teen gender dysphoria is rising and seems to be linked to internet influences and social peer groups. The number of people identifying as lesbians is dropping. Therapists are accepting patients’ self-diagnoses unquestioningly, and irreversible treatments are being offered without therapist involvement. We know at least some of these patients will desist and detransition, and we have no way to predict which ones. Children are being instructed in how to lie to parents and doctors to coerce them into providing the treatments they want. Families are being destroyed.

For what it’s worth, I will stress again that I am not a transphobe. I support hormones and gender surgeries for adults who will benefit from them. I care about the welfare of these adolescent girls and it bothers me that some of them may be unduly influenced and take irreversible steps they will later regret.

What to do? I think limiting surgeries to patients enrolled in a research trial is a good idea. I think the affirmative care model is a mistake and a dereliction of duty and should stop. Shrier advocates not letting girls have cell phones. I disagree. I think refusing to get your daughter a cell phone is a sure way to make her hate you and may make her suffering worse, not better. END

About the Author

Dr. Harriet Hall, M.D., The SkepDoc, is a retired family physician and Air Force Colonel living in Puyallup, WA. She writes about alternative medicine, pseudoscience, quackery, and critical thinking. She is a contributing editor to both Skeptic and Skeptical Inquirer, an advisor to the Quackwatch website, and an editor of sciencebasedmedicine.org, where she writes an article every Tuesday. She is author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon. Her website is SkepDoc.info.

This article was published on June 17, 2021.

 

43 responses to “Trans Science:
A review of Abigail Shrier’s Irreversible Damage: The Transgender Craze Seducing Our Daughters

  1. GEORGINA says:

    As soon as I see these two men being quoted as experts in the field I know that the referenced is out of date and doesn’t recognize advances in the field since the 1980’s. Those of us that are bisexual had to lie and jump through the hoops of behaviour
    to receive life affirming treatment.

    “Dr. Kenneth Zucker is a case in point. A highly respected expert on gender dysphoria, he refused to reduce the source of distress to one problem; he insisted on looking at the whole kid. In a series of 100 boys he treated who had not been socially transitioned by parents, a whopping 88% outgrew their dysphoria. He was accused of practicing conversion therapy, was fired, and his reputation was ruined.”

    Yes one of the old guard of transexual medicine. Who insisted that you couldn’t transition if you were not sexually attracted to men. His claim of 88% out grew it is closer to they repressed it to maintain acceptance by parents and peers. When the only place you saw a trans person was on the street working survival sex you only transitioned if you were desperate.

    “Dr. Ray Blanchard questions whether adolescent girls who suddenly identify as trans even have gender dysphoria.”

    Here we have one of other gatekeepers who according to some of his clients I have talked to insisted on you being sexually attractive to have permission to medically transition. In addition he insisted on a two year life test (living in public as a women) before you could have hormones or surgeries. Attempted suicide would make you ineligible for treatment. I am pretty sure this kind of gate keeping led to suicides.

  2. Dani Tofte says:

    Excellent book review, Dr. Hall. It makes me sad to see it was retracted.

    When I wanted to talk about detransitioners on the Center for Inquiry Portland Facebook page, that I managed as branch manager, the Trans Mafia had me canceled, coordinating a social media mob, demanding Center for Inquiry fire me (as a volunteer, which they didn’t know).

    CFI should have been the one place safe to discuss controversial topics–the mission statement is to promote “science, reason and freedom of inquiry,” for goodness sake.

    Robin Blumner told me, “These girls are not our problem,” even though the mission statement also includes “promoting humanist values.”

  3. SensitiveStevo says:

    The politics of transgenderism has gone beyond empathetic to bullying and this affects everything from science to politics. It has to stop. Critical appraisals of the science and pathologies are crucial to developing the appropriate treatment and improve understanding of the condition. Without out this we are just trepanning or adding metaphorical leeches. So thank you for exploring this subject. Any ‘science’ which cannot deal with a critical process is not
    science, and worse, one that actively suppresses scientific examination is religion.
    What is apparent is that our understanding of gender dysphoria is not absolute. Far from it. The current treatments are the best that we have. But the reasons for why it occurs and proper diagnosis are not biological, they are based on psychological cues. The patient does not display any physical symptoms, and yet this is the manner in which we treat this condition, by changing the physical to meet the mental. Is this a pathology we follow anywhere else in science? I understand the rationale which comes to this position. We are a complex social creature and controlling external influences is very difficult. But for such a complex and extreme phenomenon we have a very simplistic approach. Much work needs to be done to understand what and why it occurs, and if it is more than a mental state. This then gives credence or otherwise to diagnosis and whether the treatment is the correct one. Patients need to be informed that this is not the only way – in fact trying to reconcile patients to their body and/or sex – this has no irreversible effects and aligns with their biology. At the moment the orthodox treatment is little more than a crap shoot, and, as well meaning as the transgender lobby are, their dogged perseverance in their cause perverse.
    More work is needed before we jump both feet into saying hormones and blockers are the only way. Scientific enquiry is required if we are really going to treat this condition. This in no way should detract from the fact that empathy for those with the Condition is required.

  4. mittimithai says:

    SBM’s most recent post by a family physician is nothing short of anti-science quackery.

    The author claims that Shrier claims:

    • “Biology is a binary and differences of sex development (DSDs) are vanishingly rare”. False. DSDs are as common as 1 in 5,000 births, and increase to 1 in 200 or 1 in 300 if you include hypospadias and cryptorchidism. Biology is very, very well known to be a spectrum.

    I don’t think Shrier made a claim about “biology” is a binary. What would that even mean? Biology is a subject of study. Humans are a oogamous gonochoric species which directly implies that we come in two sexes with the exception of very rare individuals that do not have consonant genetic and phenotypic sex or have a phenotype that isn’t classifiable as male or female.

    Hypospadias and undescended testicles (“cryptorchidism”) are specific to *males*, every single clinical paper on the subject knows that. SBM has lot all credibility.

    • Marla Boome says:

      Sorry to break it to you but humans are a sexually dimorphic species and biology is indeed binary, as indicated by our reproductive systems and terms like “bisexual”. The binary is implicit and gender (which is based in ideological theory) is not interchangeable with sex (which is based in biological reality). Intersex conditions are not the same as gender dysphoria and should not be erroneously conflated with all other DSDs. The available evidence (that militant trans ideologues haven’t been able to suppress) suggests that an over whelming majority of kids with dysphoria grow up to be homosexual, so your belief in a ambiguous yet rigid “gender spectrum” treated with permanent surgery and experimental cancer drugs like Lupron essentially amounts to a form of homophobic conversion therapy and is doing lasting damage to many young women such as myself who detranstioned in my 20s after discovering that I am a lesbian. Gender theory is entirely faith based and rooted in the same anti scientific misogyny that informs evangelicalism. Your ignorance causes real harm. Your comment is either internationally misleading or based in abject delusion influenced by your retrograde ideology.

      • mittimithai says:

        I think you are replying to the wrong comment or did not read mine carefully?

  5. Don McLarsen says:

    It’s too bad that SBM took down your review, Dr. Hall. You had the courage to give your honest assessment of the medical aspects of the situation, despite the fact that you must have realized you would come in for criticism. And that is the hallmark of a scientist.

    Of course, the SBM editors insist that the censorship of your review is not censorship, and that the intense criticism leveled in the comment section (and God knows what kind of criticism in private) had absolutely nothing to do with their decision.

    Unfortunately, that is the hallmark of a sycophant. And it speaks quite clearly to those with an open mind that those editors necessarily are more concerned with remaining “acceptable” to a certain population than they are with presenting relation scientific information and opinions.

    Most horrendous of all is that they hid behind the façade of “inaccurate scientific information”, as if they aren’t aware that this was a book review.

  6. Tobi Lynne Walker says:

    I agree, this is some sort of behavioral meme easily exploited by a sensation-seeking media. Sex sells, always has.

    Why is it difficult to understand that the most logical way to fend off the post-pubertal aggression of heterosexual cis-males on cis-females (not to mention the princess/whore social dichotomy forced on young females by a binary culture), would be to posit one’s self as male?

    When someone under the age of four is strongly drawn to opposite-gender identity, we are forced to assume biology as a strong causative factor and yet we can’t deny that a child who wants to nurture dolls and wear ruffles is viewed as feminine long before they express sexual preferences. When somebody over the age of puberty does the same, social causation is more likely. And yet how much of this is biology and how much is culture even at an early age? That females are nurturers in the safe confines of home whilst men are out getting dirty in “fields?”

    Is an affinity for nurturing and ruffles and an avoidance of dirt what makes a person “female?”

    I’m all about allowing EVERYBODY to explore both gender identity and sexual preferences along every spectrum known to Kinsey and beyond, but the nineteen-year-old transgender people I knew back in 1975 and the ones I meet today are coming from very different places. Forty-five years ago those folks came across as COMPELLED. The new ones seem reactive, even logical.

    At 65, having long led a gender and sexual preference-fluid lifestyle, I’ve decided that if identifying as male would bring me more believability at the doctors’ offices, I’d change my identity in a heartbeat, I’d sew a penis to my forehead. So, I get it. I feel like a male, I want to be treated like a male, I’m post-menopause so I’m even biologically not female naturally — why can’t I be treated as male?

    As usual, it’s the culture needing fixing, not the females. (I’d suggest we’d fix males but that sort of statement scares them, it smacks too much of the veterinarian.)

    These “daughters” are trapped in the heterosexual battle zone and too young to sort out the ramifications of culture. The question we need to ask is: Is becoming male preferable to having to relate as a female to hordes of teenage boys and the world at large?

    • GEORGINA says:

      Tobi Lynne Walker: I agree with what you are saying here. The main reason to accept a teenager stating that they are Trans is to assist them through a very troubling time of life. There are many more people coming out as trans or exploring gender now than when it could be a death sentence. If we look at those who are left handed now it would appear that there are 100’s more than were around when you were punished and forced to change or even treated as a witch to be burned at the stake. As we shake off old taboo’s and religion we find that supporting and accepting people for who they are is better than denying and discrediting them. I can understand young women wanting to get away from the misogyny of the modern world, getting away from leering old men and being objectified or told that they are a baby machine.

  7. Baci says:

    I don’t know how woke liberals live with themselves

    • Woke Liberal says:

      The confusion is mutual. We don’t know how you bigots live with yourselves either.

  8. John says:

    So let’s get some facts straight about the book review by Dr, Harriet Hall. Its structure is loosely congruent with the typical book review and this seems to have confused some commenters. I see the review as first stating some personal history of the reviewer’s experience with the topic, secondly al long liting of some of the material from the book, and then a conclusion.

    I personally think that in the lengthy second section where the reviewed book’s content was outlined, Dr. Hall might have more frequently used language to indicate that she was only repeating what the book’s author (Abigail Schrier) had written. Too often in reading this section it sounded as though Dr, Hall was agreeing with what she was reporting, even as she was only paraphrasing the highlights of what she had read.

    In the last (“Conclusion”) section Dr. Hall speaks for herself about author Abigail Schrier’s writing. Dr. Hall criticizes the portions of the book that emphasize “anecdotes and horror stories” as not being helpful as it is good data that is needed. Dr. Hall sates that Schrier looked for good studies (data) on the topic but found little. Then Dr. Hall says that a serious problem is that good science on the topic addressed is apparently not available and is not likely to happen soon given the current political climate. Then in the next paragraph lists a series of topics that Schrier has raised in her book that “desperately need to be looked into.”

    This, friends, is the essence of the book review. In my opinion, attacks on Dr. Hall herself have little merit as she basically is saying that more study and good data are needed, In the very last paragraph, she personally comments that irreversible (surgical) interventions should be appropriate only in research trials, and that any counseling that blindly supports a minor child’s self assessment is unethical counseling practice, and according to the published ethical standards of the profession, she is absolutely correct.

  9. Starskeptic says:

    Melissa Etheridge was asked not long after coming out, “is being gay a choice?”
    I’ve been using her answer ever since,
    She said, “what difference does it make?”

  10. Elise says:

    Dr. Hall, why would you repost this here instead of addressing the problems with scientific accuracy and ethics in your previous post? such as those highlighted by Dr. Lovell and others in the comments; not to mention the concerns Dr. Novella and Gorski would have brought up as basis for the retraction. Republishing this here without any edits or clarifications just makes us question your dedication to scientific rigor.

    • mittimithai says:

      Why don’t you have the courage to concisely enumerate those problems?

    • Matej says:

      Which concerns by Dr. Novella and Gorski do you refer to? As far as I’m aware, they didn’t bring up any concrete one.

      • Linda Rosa, RN says:

        I’m not surprised that it is Novella and Gorski who pulled Hall’s review. I have considered their ethics suspect since they once supported religious exemptions for K-12 vaccine mandates.

    • Marla Boome says:

      If you read the above review or the book in question you would know that any serious scientific investigation into the claims of gender theorists has been repressed. Trans activists are actively trying to prevent controlled studies into ROGD and the efficacy of gender transitioning. Not to mention studies that examine the pattern of male violence retained by trans women or the effect transitioning has on young homosexuals.

  11. Annie says:

    Thanks for taking this on. I imagine in 30-50 years what is happening to this generation of kids will be looked at in dismay, but I won’t be around to see it. Meanwhile, thousands of impressionable and vulnerable children will have their lives and bodies messed up by this nonsense. If youngsters want to try out various gender identities, great. Surgery and hormones should be restricted to adults.

    • Mimi says:

      You offer NO evidence for your opinions–and let’s be clear, your comments are nothing more than an uninformed opinion,

  12. Richard says:

    I’ve gotta be honest here. For two very intelligent people, you two are woefully uninformed on this issue. Your comments and inferences that this is is somehow a left issue or a social media issue is very hurtful to this community. There are many medical experts in the field, you should have talked to more of them. It is a multiple disciplinary field, so there are not necessarily comprehensive reports for you to google for your book.

    I am not LBGTQ but have been involved with the community for 20+ years. Your awkward sexual comments seem to equate sexual preference to Identity. These are two distinct and separate things.

    Your approach to the subject is essentially a hot mess. You needed about 5 more years of research before writing this book.

    Perhaps the cohort of hyper social media influenced teen girls has some validity, but in general you are doing damage to this extremely marginalized group.

    Respect for Michael Shermer=gone, unfortunately.

    • mittimithai says:

      “There are many medical experts in the field, you should have talked to more of them?”

      You mean keep talking to them until they have an opinion you agree with? Evidence and reason aren’t popularity contests, it’s a matter of what good reasoning shows you with good evidence.

      What, precisely, are your complaints about the article?

      • Marla Boome says:

        Evidence and reason don’t support treating ambiguous cognitive disorders with permanent surgery and experimental cancer drugs.

        • Mimi says:

          “… ambiguous cognitive disorders…”

          You are putting words in that aren’t part of any of this. This is just you own word salad opinion.

    • Starskeptic says:

      Shermer seems more interested in his own views on the subjest rather than his guest’s.

    • Marla Boome says:

      You really need to learn to distinguish between actual scientific evidence and the emotional subjectivity of your chosen ideology. The book and review present the facts clearly and concisely while stating that more study is needed. The ones preventing further studies are bigoted ideologues that don’t want their pharmaceutical lobbyist talking points challenged especially by feminists.

  13. Monica says:

    My critical reading of this review is as a skeptic or one who challenges the ‘truth’ of knowledge claims. The book makes certain knowledge claims and the review of the book reiterates them as factual. The ‘truth’ of these claims has been challenged before, and yet the claims persist.

    The first and most pressing challenge is the basis from which the book establishes its argument; the transgender craze.

    Does a transgender craze exist? If this ‘craze’ cannot be shown to exist as described, then everything that follows in this book and in the review would be better described as based on unjustified and uncritically examined assumptions and beliefs.

    The review provides the figure of .01 percent of children whose sex assigned at birth as male expressed that their gender and anatomical sex were not aligned (dates and actual numbers not stated). Prior to 2012 for children whose sex assigned at birth was female there were no records. Though the 4.400% rise in children expressing misalignment between their assigned sex and their gender sounds quite large, there is no clarity on the base number, which would likely have been quite small. Granted, perhaps there is a general movement toward younger persons being able to more freely express a gender identity that doesn’t align with the sex they were assigned at birth, but could this be solely attributed to a ‘transgender craze’? Is it more likely that the rise in numbers of those reporting gender variance is due to the information now being recorded coupled with a wider acceptance of gender variance in general?

    For this to be an actual craze, and for it to be alarming, we would have to ignore the number of persons who have transitioned in adulthood, but were, presumably questioning their gender well before that. A 2017 study of transgender persons in the US stated that “Future national surveys are likely to observe higher numbers of transgender people. The large variety in questions used to ask about transgender identity may account for residual heterogeneity in our models.” They estimated that the number of adult transgender persons in the US is about 1 million, though “These numbers may be more typical of younger adults than of the entire US population. We expect that future surveys will find higher numbers of transgender people and recommend that standardized questions be used, which will allow a more accurate population size estimate.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227946/

    In order to establish that a transgender craze exists, it would have to be based on more rigorous numbers. The review highlighted some of the other reasons a transgender craze might exist, though the associations were quite spurious. For example, the heading ‘The mantras of trans influencers’ associates trans activism with the guru internet influencer who has an enormous fan base, is famous, and has leverage over a large community. By falsely situating trans activism as enormously influential the terms alarming and craze can be justified, without a craze actually existing.

    The very basis of the book has not been established. The existence of a transgender craze should be the first point of interrogation for any critical and scientific-thinking person or organization.

    • mittimithai says:

      You are clearly confused about “alignment”. Clinical criteria for gender dysphoria have nothing to do with “alignment”. They have to do with distress associated with the accurate cognitive knowledge of one’s sex.

      Prior to 2012 for children whose sex assigned at birth was female there were no records.”

      Do you really think that there are no clinical records of female children diagnosed with gender dysphoria before 2012? Do you have any awareness of what the clinicians and researchers in this field do?

      • Marla Boome says:

        Do you have any idea how the definition of gender dysphoria has morphed due to trans activism? Transexuals and transvestism have existed forever but Transgenderism has erased those categories because of the inconvenient statements made by a generation of adults who have lived with dysphoria which didn’t support the unsubstantiated theories professed by trans adolescents. Typically a diagnosis of dysphoria was hampered by the cultural stigma of regressive gender roles and homophobia which is clearly manifested in modern trans activism. That’s why TRAs can’t even distinguish between sex and gender, define sexual dimorphism or even understand the concept of same sex attraction. If you were so interested in clinical records maybe you’d support a controlled study of ROGD with an IRB but that may undermine your precious ideological preconceptions.

  14. Robert Sheaffer says:

    It is now beyond dispute that “woke” activists have been ‘cancelling’ science papers, not because they are incorrect, but because they run counter to some political narrative. And then we wring our hands that people do not ‘trust science.’ But people are not stupid (not all of them, at least), and smart people can see that what passes for “science” these days is often “politics by other means.”

    • Mimi says:

      “It is now beyond dispute that “woke” activists have been ‘cancelling’ science papers,…”

      Is it? Evidence? Please define “smart people” while you’re at it.

  15. mittimithai says:

    I would like to ask Harriet to explain her claims from a few years ago where, as a medical doctor, she did not seem to have a good grasp on the idea of male and female:
    https://sciencebasedmedicine.org/sex-gender-and-sexuality-its-complicated/

    the specific claims:
    “Males are XY, females are XX. But there are individuals who are XXY (Klinefelter syndrome), XYY, a mosaic of XX and XY cells, XXX, XO (Turner’s syndrome), and various other accidents of cell division gone awry. How are these anomalies to be categorized?”
    “Sex is a spectrum on several axes”
    “Science has not been able to categorically distinguish a male from a female.”

    • Marla Boome says:

      Still waiting for you to demonstrate a cogent grasp of sexual dimorphism or even offer a conclusive definition of homosexuality. But since you don’t seem to understand that intersex birth conditions are not evidence of a third sex we can assume you still struggle with distinguishing basic biology from your preferred ideology.

  16. Alan Apar says:

    “Until just a few years ago, gender dysphoria — severe discomfort in one’s biological sex — was vanishingly rare (less than .01% of the population)”

    It must be caused by vaccines then…

  17. mittimithai says:

    Bravo to Harriet and Skeptic magazine. The anti-science views of David Gorski in this domain should be taken note of:

    https://twitter.com/gorskon/status/1279903181431078913

    I’ve long highlighted such dissonant ideas in the SBM forums only to be banned.

    • Don McLarsen says:

      Gorski is a left-wing front masquerading (badly) as an objective scientist.

      His “science” is this simple-minded:

      Is it on the left-wing agenda? It’s correct.
      Is it on the right-wing agenda? It’s evil.

      Dr. Hall, on the other hand, in being unwilling to simply write a “review” of this book which as an outright condemnation, as demanded by the Left, has shown herself to be a scientist in the true meaning of the word.

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