Written By: Andy Kovaleski | May 1, 2021

Transphobia is nothing new, but the forerunners of the warped ideology come and go. Recently, PragerU has played a significant role in its perpetuation. On March 29, 2021 PragerU teamed up with Abigail Shrier, the author of the book Irreversible Damage: The Transgender Craze Seducing Our Daughters. She has been a strict advocate for legal reform against transgender people, especially young trans men.

This article will delve into the arguments made by Abigail Shrier in the PragerU video titled “Why Girls Become Boys.”  Which is just as poorly researched and transphobic as her book. Both are also no more than thinly veiled attempts to spread transphobia directly into homes that include young trans people, putting them at risk and possibly removing the most important support system they have. If you are interested in Abigail Shrier herself and the controversy surrounding her book, I would recommend listening to Ty Turner’s discussion. They are one of the trans people Shrier used to further her own agenda,  yet she never informed them that they would be part of this book (Turner; Shrier, 2020). In this article, however, I will be looking into the specifics of her claims to fully explain their falsehood. The first assertion is that more young people, especially young girls, than ever before are trans, and that there are some clear reasons why.

It is certainly true that more people are being diagnosed or identifying as transgender as there has been a steady increase since 2002 with a spike in 2006 (Briefing; Dhejne). This is widely attributed to the growing acceptance of transgender people and the broadening of the definitions of gender dysphoria and gender in general. This does mean that more trans people are out and proud lately, but it doesn’t mean that there are more trans people now than there were in 2002, or at any point before that. When Abigail Shrier says “if you graduated high school over a decade ago, it was unlikely that you knew anyone who was transgender,” she is simply incorrect. You may not have known that they were trans because it is unlikely they were out at that time, but that does not change the fact that they are just as trans as those today who are out at that age. Shrier further claims that this is “because, according to the Diagnostic and Statistical Manual of Mental Disorders, the condition [gender dysphoria] underlying it [being transgender] afflicted roughly 1 in 10,000 people, or .01% of the population.” Today, this number has jumped all the way up to 0.6%. Even today, less than 1% of the population is diagnosed with gender dysphoria (Briefing; Dhejne).

PragerU also alleges that before 2012 there was no scientific or medical literature about assigned female at birth (afab) adolescents who wanted to transition. It also says that gender dysphoria “suddenly began affecting…girls” in the last decade. A simple search on Google Scholar provided me with scientific literature from 1993 and earlier discussing afab trans people, including teens. Not only is this incredibly easy to disprove, but it also has no real relevance to the topic Shrier is talking about. To draw a comparison, before the 2000s there was no research on heart attacks in women, and by extension afab trans people,  therefore very few heart attacks were diagnosed in afab people (Nedelman). Does that mean that cis women and afab trans people didn’t have heart attacks until 2000? Or that there was a sudden increase in heart attacks in 2000? Personally, I think it’s more likely that science was unwilling to study afab bodies before that.

Gender dysphoria is defined in the Diagnostic and Statistical Manual (DSM) as

A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). In children, the disturbance is manifested by four (or more) of the following: 

1. repeatedly stated desire to be, or insistence that he or she is, the other sex

2. in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing

3. strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex

4. intense desire to participate in the stereotypical games and pastimes of the other sex

5. strong preference for playmates of the other sex

6. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.

7. The disturbance is not concurrent with a physical intersex condition.

8. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

(Beauregard)

As you may have guessed, this does not align with what Shrier claims in the video; “Gender Dysphoria—the severe discomfort in one's biological sex—has been studied for nearly one hundred years. It almost always involved boys who began feeling it between the ages of 2 and 4 and were strong and persistent in their assertions to everyone around them that they were really girls.” The important part of this to remember is that it is neither the norm nor a requirement that gender dysphoria begin in early childhood. The norm is actually for gender dysphoria to emerge in early to late adolescence (Beauregard; Needham).

The video also cites Lisa Littman and her study very consistently, despite her research being widely questioned and controversial. In her article, Littman essentially makes three arguments. First, that social media and peer pressure can play a role in developing gender dysphoria. Second, that familial conflict may play a role in the coping mechanisms utilized by adolescence. And third, that maladaptive coping mechanisms may play a role in the development of gender dysphoria (Littman). The rhetoric of this research is clearly transphobic; older trans people are “turning kids trans” when they would have otherwise been cisgender and  a lack of healthy coping mechanisms leading to their acceptance of being trans. Essentially saying that kids think they’re trans because they are coping poorly with average amounts of stress.

I could spend my time proving these claims false with the many, many contradictory studies that exist, but I would rather discuss how PragerU uses this rhetoric to further their own harmful narratives and why those narratives are incorrect. If you are interested in why people are trans, why more children are identifying as trans, and what role social media plays in that identity, I would like to recommend a number of resources linked at the end of this article labeled “Extra Sources”.

TW Self-Harm, Suicide, Anxiety, Depression, violence against trans people

Abigail Shrier moves on to discuss the high rates of anxiety, depression, and self-harm among adolescent girls. What she fails to mention is that all three of these mental health issues, as well as suicide, are more commonly experienced by trans people because of the hate and lack of acceptance they experience in day-to-day life (Boghani; Boskey, 2020; Johns MM; Canner; Lehman). In Shrier’s view, the high rates of mental health issues make young girls more susceptible to influences from their peers and from social media to find a quick fix for their problems (Shrier, 2021). She also seems to think that when older trans people discuss how important physical transition was for their mental health they are convincing children who are not trans that their problems would also be solved by physically transitioning. However, it seems to me that young people understand that what solves one problem will not solve all of them.

Shrier also claims a cause and effect relationship between poor mental health and transgender identity that is opposite from the widely accepted and proven relationship (Boghani; Boskey, 2020; Johns MM; Canner; Lehman). Trans kids aren’t trans because of their poor mental health, they have poor mental health because they are trans and being trans can come with more stressful and harmful experiences than a young person should need to be equipped to handle (Boskey, 2020). When she explains that poor mental health leads young people to make rash decisions about their physical health and their body, she maintains that children as young as sixteen could have double mastectomies or testosterone prescriptions without a therapist’s or parental consent or knowledge.

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I love when the sources provided by PragerU actually prove them wrong. The fear-mongering claims made in the video cite Minor Rights: Access and Consent to Health Care by the Adolescent Health Program of Oregon Health Authority Public Health Division . In reality, this source explains that the options for health care for minors are quite limited. It says “Minors who are 15 years or older are able to consent to medical and dental services without parental consent. This includes hospital care, as well as medical, dental, optometric and surgical diagnostic care. This would include services such as: Treatment for illnesses or injuries (colds, sprained ankle), Sports or camp physicals, Dental visits (check-ups, cleanings, fillings), X-ray services, Emergency room visits, Vision care (except for first time contact lens visit), and Immunizations (Oregon, p. 2).” This also only discusses parental consent and does not mention what kind of background therapy or diagnostic criteria are necessary for any procedures. Minors’ resources are always limited by their parents opinions and consent, and these procedures are no different.

To get a prescription for testosterone, a mental health evaluation is preferred, and mental health support is recommended for the whole family. The only reason it is not required is that the cost of these resources is often prohibitive (Snapp; Stroumsa). Gender therapy can be as expensive as $100 each session and building the bond necessary to get the referral can take multiple sessions. Especially for teens whose parents are unsupportive of their transition, $100 per session is too much to ask. Even without therapy being a requirement, a six-month supply of testosterone costs about $70 which doesn’t include the costs of puberty blockers which teens will need to take prior to hormones. The average cost of a double mastectomy in Oregon is between $3,000 and $10,000 (Snapp; Stroumsa). More commonly throughout the United States, it is closer to $124,000 (Snapp; Stroumsa). The assertion in this video that a 16-year-old could get a double mastectomy with no oversight from parents or therapists seems to assume that a 16-year-old would be able to pay that out of pocket.

 Knowing this, it is difficult to take PragerU seriously when they try to say that transition is “predictably hasty” because “we’re talking about teenagers.” While regrets about physical transition are a genuine issue and can be heartbreaking, it is only present in 1% of cases (Boghani; Boskey, 2021; Danker). One study by the American Society of Plastic Surgeons found that “The most common reason cited for detransition was change in gender identity (22 patients) followed by rejection or alienation from family or social support (8 patients) and difficulty in romantic relationships (7 patients).” Aside from the fluidity of gender, the lack of acceptance as their true gender, the one they transitioned to appear to be, was the primary reason for detransition. 

This points to a very harmful bit of cyclical reasoning in Abigail Shrier’s logic. More people are regretting surgery because of a lack of acceptance, as shown in the study, and Shrier says that because more people regret it we should not accept young people’s experiences as they understand them. The lack of acceptance that is perpetuated by people like Shrier is proven to be the reason for the very problem she claims to be against. It is easy to see that PragerU is not interested in helping young girls with poor mental health or trans people who regret their transition. They are only interested in using these people to perpetuate the transphobic narratives that caused their problems in the first place.

If you are not convinced that these are the goals of PragerU and Abigail Shrier, “Why Girls Become Boys” ends with three suggestions for how to “protect your daughter from being drawn into this dangerous and growing trend.” To limit their exposure to social media, oppose teaching young people about gender, and disagreeing with every “identity proclamation” from young girls. Kids experiencing gender dysphoria often turn to social media for community and validation that are difficult or impossible to find in person (Fish et.al.; Johns; Katz-Wise, Sabra L, et al.; Lehman; Needham; Roe; Snapp).

I do not want to dispute that social media is harmful for young people, especially young LGBTQA+ people. However, they often reach out online when there is no support in their personal lives, so removing that option can be detrimental (Fish et.al.; Johns; Katz-Wise, Sabra L, et al.; Lehman; Needham; Roe; Snapp). If a parent is going to cut off access to transgender-related resources, they also need to provide a different way of obtaining that information. For instance, supporting schools’ and libraries’ efforts to provide resources to young people who are questioning their gender. But of course, Shrier also vehemently opposes schools teaching any LGBTQA+ friendly information, especially gender related.

TW: Bullying of LGBTQA+ and associated mental health risks, suicide

 Countless studies from all professions have found that educating children about LGBTQA+ identities and families is the most and only effective way to significantly reduce bullying of trans and LGBQA+ students (GLSEN; Johns MM; Page; Weingarten). Which in turn improves the mental health and wellbeing of LGBTQA+ students. If Abigail Shrier was really concerned with the mental health of young girls who may be starting to identify as trans, she would support all efforts to improve their lives, especially in ways that are proven to be effective.

Another factor in young peoples’ mental health and wellbeing, especially for LGBTQA+ youth, is the support and care provided by their parents (Fish et al.; Johns; Katz-Wise, Sabra L, et al.; Lehman; Needham; Roe; Snapp). 

An increase in poor health outcomes is associated with lack of support for LGBTQ youth (Needham & Austin, 2010). Knowing that many LGBTQ youth are not raised in supportive home environments may be especially damaging, as coming out at a younger age has been associated with LGBTQ youth being more comfortable with their sexual identity (Floyd & Stein, 2002). …Youth who have disclosed their LGBTQ sexual orientation to their family have higher rates of physical and verbal abuse as well as higher suicide attempt rates (D’Augelli et al., 1998; Ryan, Huebner, Diaz, & Sanchez, 2009). Family rejection can have devastating consequences for LGBTQ youth, as this rejection has been associated with higher rates of suicide, substance abuse, … (Rosario, Schrimshaw, Hunter, & Braun, 2009; Ryan et al., 2009) and contributes to the disproportionate number of homeless LGBTQ youth (Coker, Austin, & Schuster, 2010). 

Family connectedness and the presence of other caring adults at school were significant protective factors for LGBTQ adolescents and those participants with higher levels of either of these protective factors were half as likely to be at risk for suicide. … Family connectedness accounted for more variance in their study than did sexual orientation or the other protective factors. Learning how to improve relationships between LGBTQ youth and their parents is vital, given the importance that the role of a supportive family members can play in the lives of LGBTQ youth (Katz-Wise, Sabra L, et al.).

PragerU explicitly recommending that parents withhold support from their children as an effort to curtail “transtrending” in young people is actively increasing the risk of suicide for those children. I am deeply concerned by the blatant transphobia, and it is even more concerning when you consider that they are definitely aware of the research I have been referencing in the last few paragraphs. Not only are they increasing the risk of suicide, they are doing so as an intentional targeted effort to reduce the number of transgender children by any means necessary.

End TW

Sources

Beauregard, Eric. “Handbook of Sexual and Gender Identity Disorders.” Wiley Online Library, John Wiley & Sons, Inc. , 2008, onlinelibrary.wiley.com/doi/book/10.1002/9781118269978. 

Boghani, Priyanka. “When Transgender Kids Transition, Medical Risks Are Both Known and Unknown.” PBS, Public Broadcasting Service, 30 June 2015, www.pbs.org/wgbh/frontline/article/when-transgender-kids-transition-medical-risks-are-both-known-and-unknown/. 

Boskey, Elizabeth. “Gender Often Evolves, But Retransition Is Relatively Rare.” What Is Retransition or Detransition? Affirming a Cisgender Identity After Affirming a Transgender One, Verywell Health, 18 Jan. 2021, www.verywellhealth.com/detransition-or-retransition-5093126. 

Boskey, Elizabeth. “Why Minority Communities Are at Increased Risk of Health Problems.” The Role of Minority Stress in Health Disparities, Verywell Health, 22 Oct. 2020, www.verywellhealth.com/minority-stress-in-health-disparities-4691231. 

Briefing, Daily. “Study Shows Rise in Sex-Reassignment Surgeries in the US.” Advisory Board, Advisory Board, 5 Mar. 2018, www.advisory.com/en/daily-briefing/2018/03/05/gender-affirming. 

Danker, Sara, et al. “A Survey Study of Surgeons’ Experience with Regret and/or Reversal of Gender-Confirmation Surgeries.” Plastic and Reconstructive Surgery Global Open, Wolters Kluwer Health, 26 Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6212091/. 

Dhejne, Cecilia, et al. “An Analysis of All Applications for Sex Reassignment Surgery in Sweden, 1960–2010: Prevalence, Incidence, and Regrets.” Archives of Sexual Behavior, Springer US, 29 May 2014, link.springer.com/article/10.1007/s10508-014-0300-8. 

Fish, Jessica N., et al. “‘I'm Kinda Stuck at Home With Unsupportive Parents Right Now’: LGBTQ Youths' Experiences With COVID-19 and the Importance of Online Support.” Journal of Adolescent Health, Elsevier, 23 June 2020, www.sciencedirect.com/science/article/pii/S1054139X20303116?casa_token=zSulM-KkJY4AAAAA%3AZsxa2GCV7ee-BCW4MQwYj1KljvZOlsenS1kIJXsDWqooqqGQiWNEC260qCu5lVnfEbQJKIeBIAY. 

GLSEN (2011). Teaching Respect: LGBT-Inclusive Curriculum and School Climate (Research 

Brief). New York: GLSEN.

Johns MM, Lowry R, Andrzejewski J, et al. Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students — 19 States and Large Urban School Districts, 2017. MMWR Morb Mortal Wkly Rep 2019;68:67–71.

Canner, Joseph K. MHS. “Trends in Gender-Affirming Surgery Among Transgender Patients in the United States.” JAMA Surgery, JAMA Network, 1 July 2018, jamanetwork.com/journals/jamasurgery/fullarticle/2673384. 

Katz-Wise, Sabra L, et al. “Lesbian, Gay, Bisexual, and Transgender Youth and Family Acceptance.” Pediatric Clinics of North America, U.S. National Library of Medicine, Dec. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5127283/. 

Lehman, Charles Fain. “5 Questions with Family Studies: Dr. Sarah Coyne on Social Media and Teen Suicide.” Institute for Family Studies, 21 Feb. 2021, ifstudies.org/blog/5-questions-with-family-studies-dr-sarah-coyne-on-social-media-and-teen-suicide. 

Littman, Lisa. “Parent Reports of Adolescents and Young Adults Perceived to Show Signs of a Rapid Onset of Gender Dysphoria.” PLOS ONE, Public Library of Science, 16 Aug. 2018, journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0202330. 

Nedelman, Michael. “For Decades, Women Had Heart Attacks in Silence.” CNN, Cable News Network, 14 Feb. 2017, www.cnn.com/2017/02/10/health/women-heart-attack-research. 

Needham, BL, and EL Austin . “Sexual Orientation, Parental Support, and Health during the Transition to Young Adulthood.” Journal of Youth and Adolescence, U.S. National Library of Medicine, 2010, pubmed.ncbi.nlm.nih.gov/20383570/. 

Oregon Health and Science University. “Doernbecher Gender Services.” OHSU, 2020, www.ohsu.edu/doernbecher/doernbecher-gender-services. 

Page, Michelle L. “From Awareness to Action: Teacher Attitude and Implementation of LGBT-Inclusive Curriculum in the English Language Arts Classroom.” SAGE Journals, SAGE Journals, 1 Nov. 2017, journals.sagepub.com/doi/full/10.1177/2158244017739949. 

Roe, Stuart. “‘Family Support Would Have Been Like Amazing’: LGBTQ Youth Experiences With Parental and Family Support - Stuart Roe, 2017.” SAGE Journals, 16 Nov. 2016, journals.sagepub.com/doi/full/10.1177/1066480716679651?casa_token=PaRi0mq6_ssAAAAA%3Anm0BGUIELPK7KQtOJgg5KxMYKyaErIKS_i_I3bF8mbcvT5shbi022_ijAS-H_m_C09PM0CZFXTAkkA. 

Shrier, Abigail. “Irreversible Damage: the Transgender Craze Seducing Our Daughters.” Amazon, Swift Press, 30 June 2020, www.amazon.com/Irreversible-Damage-Transgender-Seducing-Daughters/dp/1684510317. 

Shrier, Abigail. “Why Girls Become Boys.” PragerU, 29 Mar. 2021, www.prageru.com/video/why-girls-become-boys/. 

Snapp, Shannon D., et al. “Social Support Networks for LGBT Young Adults: Low Cost Strategies for Positive Adjustment.” Wiley Online Library, John Wiley & Sons, Ltd, 5 June 2015, onlinelibrary.wiley.com/doi/full/10.1111/fare.12124?casa_token=xdqOAF88s9cAAAAA%3AKGPp86Yne9NoV_WN3EYTXr8NPgYQ2qHx5EhO8wV-7D9D_mv0Iy5wMgbG2Oc9fLyWofYXzd_4DMkqYWxa. 

Stroumsa, Daphna. “The State of Transgender Health Care: Policy, Law, and Medical Frameworks.” American Journal of Public Health, American Public Health Association, Mar. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3953767/. 

Turner, Ty. “Transphobic Book Targets Me & Other Trans Creators, LGBT YouTubers Promote It.” YouTube, YouTube, 12 Sept. 2020, www.youtube.com/watch?v=B5kkg90rL1M. 

Weingarten, Randi, et al. “More Than a Safe Space: How Schools Can Enable LGBTQ Students to Thrive.” Quarterly Journal of Educational Research and Ideas, American Educator, 2016, www.aft.org/sites/default/files/ae-winter2016.pdf. 

Extra Resources:

https://www.apa.org/topics/lgbtq/transgender

www.sciencedirect.com/science/article/pii/S1054139X20303116?casa_token=zSulM-KkJY4AAAAA%3AZsxa2GCV7ee-BCW4MQwYj1KljvZOlsenS1kIJXsDWqooqqGQiWNEC260qCu5lVnfEbQJKIeBIAY

https://www.tandfonline.com/doi/abs/10.1080/19419899.2011.576696

https://journals.sagepub.com/doi/abs/10.1080/00986280902739446?casa_token=DJ2y4wLVYvwAAAAA:K_AJczb4vyeyTwbpshFoyN1H-JNMSi86ZVEtPgoEOmVnPkOVzSo1qilAoqbxm-CWa0hXBbzxY_Id7g

https://psycnet.apa.org/doiLanding?doi=10.1037/cpp0000229

https://books.google.com/books?hl=en&lr=&id=JGOpCwAAQBAJ&oi=fnd&pg=PP1&dq=transgender+psychology&ots=ZoK0l7OZVz&sig=0DWPzqqEfBxxkyHrhSkFWTPPodc

www.aft.org/sites/default/files/ae-winter2016.pdf

https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/nylshr17&section=29&casa_token=8UK6U0_h6fYAAAAA:PRIn1jSMyFo6bprXV4OR4eSlkAsn-eNfe7mcvvJf1ks43IDqh1RLDVWpPZwuX3GWyCV9KvCZIA

https://www.jstor.org/stable/27649781

https://jamanetwork.com/journals/jamasurgery/fullarticle/2673384

https://journals.sagepub.com/doi/full/10.1177/1066480716679651?casa_token=PaRi0mq6_ssAAAAA%3Anm0BGUIELPK7KQtOJgg5KxMYKyaErIKS_i_I3bF8mbcvT5shbi022_ijAS-H_m_C09PM0CZFXTAkkA

https://books.google.com/books?hl=en&lr=&id=GYgwCgAAQBAJ&oi=fnd&pg=PT13&dq=why+are+people+trans&ots=0dqyRsuHCs&sig=uZQrC8oYtQ2-LV-xBzU-4ws5HmA

Transphobia, Gender Dysphoria, Mental Wellness