Abigail Shrier on the waning gender fever

When dining with friends last night and talking about Trump’s controversial executive orders, I realized that there was some serendipity in these orders, which covered a variety of topics.  And the serendipity was that suddenly it has become okay to discuss things that were previously either taboo or fraught topics—things like the binary nature of human sex, whether DEI is a good thing, and how immigration needs to be reformed. That can only be to the good, for a taboo topic is one that doesn’t go away, but just goes underground where it simmers slowly until it boils over. Now we can talk about them, even if arguing why some of Trump’s orders are malign.

One of the topics newly airing, a topic with which I’ve had some acquaintance, is sex and  gender issues.  How many human sexes are there? To what extent must we respect people’s claims of being nonbinary or transsexual? Should the rights of transsexual people ever be curtailed to further the rights of others?  Should trans-identified men compete with women in sports, or be put in women’s prisons?  Previously, even asking these questions got one labeled a transphobe, and I well know that accusation (I reject it).  But it’s time to air these questions civilly and using data, though that is hard to do given the rancor of gender extremists.

Perhaps the first person demonized by gender fever was Abigail Shrier, whose views I’ve defended extensively.  She has maintained that there is such a thing as rapid onset gender dysphoria, that its rapidity comes from social contagion (people urging others to transition), and that therapists who engage in “affirmative therapy” are engaged in malpractice, for they promote medical treatment (hormones and surgery) to kids who are too young to understand what they’re getting..

Shrier’s first book broaching these topics, Irreversible Damage: The Transgender Craze Seducing Our Daughters (2020), was praised by some (including me) but demonized by many, especially those with “gender fever”. You may remember that the ACLU’s LGBTQ+ law expert, trans-identified woman Chase Strangio, called for banning Shrier’s book in a tweet that he later deleted:

It’s shameful that an ACLU bigwig called for censorship of a book he didn’t like. Clearly, for Strangio, ideological purity takes precedence over free speech. That attitude will spell the death of the ACLU–at least as we knew it.

Shrier’s second book, Bad Therapy: Why the Kids aren’t Growing Up, deals not just with affirmative therapy but the “therapization” of all of life for young people in America, imbuing many with the idea that they suffer from some mental disorder that needs professional assistance.  I read that book, too, and gave it a glowing review on this site. Both books are well worth reading.

But my point here is twofold. First, it’s now okay to talk about the topics of her books without being demonized. Second, Shrier was pretty much right about all of her theses: there is social contagion causing gender dysphoria, accounting for its sudden rise, and, especially, that giving surgery, puberty blockers, or cross-sex hormones to children or adolescents is a bad idea.

In her new piece at the Free Press (click below or find a free version at this archived link), Shrier takes a victory lap: it’s now okay to seriously consider and discuss her ideas (except, of course, among extreme gender activists, who will never discuss any idea that contradict their ideology), and, importantly, she was right about social contagion and especially about the dangers of willy-nilly dispensing affirmative therapy, puberty blockers, and cross-sex hormones to children and adolescents.

I’ll give a few quotes. Shrier, who previously wrote op-eds for the Wall Street Journal, is a clear and engaging writer, a pleasure to read, and she starts her new piece with a real hook:

When the history of 21st-century gender mania is written, it should include this signal entry: In 2020, a website called GoFundMe, usually a place to find disaster-relief appeals and charities for starving children, contained more than 30,000 urgent appeals from young women seeking to remove their perfectly healthy breasts.

Another entry, from June 2020: The New England Journal of Medicine, America’s platinum medical publication, published a piece explaining that biological sex is actually “assigned at birth” by a doctor—and not a verifiable fact, based on our gametes, stamped into every one of our cells. In fact, biological sex ought to be deleted from our birth certificates—the authors claimed—because a person’s biological sex serves “no clinical utility.” Breaking news to gynecologists.

Public schools began asking elementary kids whether they might like to identify as “genderqueer” or “nonbinary.” Any dissent from this gender movement was met with suppression. The American Civil Liberties Union’s most prominent lawyer, Chase Strangio, announced his intention to suppress Irreversible Damage, my book-length investigation into the sudden spike in transgender identification among teen girls. “Stopping the circulation of this book and these ideas is 100% a hill I will die on,” he tweeted. Weeks later, Amazon deleted Ryan Anderson’s book criticizing the transgender medical industry.

I could go on. But as of January 28, 2025, I don’t have to.

On that day, President Donald Trump signed an executive order announcing that the federal government would no longer “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” and that it would “rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

Did you know that a lot of the damaging gender policy came from Obama?

If it seems odd that the spell of pediatric gender medicine should have been ended by politicians and not physicians, consider that in America, politics is how it began. Specifically, it began with Obamacare.

Section 1557 of the Affordable Care Act, President Barack Obama’s signature legislation incentivizing and coercing private insurers to offer their products on a government exchange, prohibited those companies from discriminating on the basis of sex. And in May 2016, six years after the bill’s enactment, the Obama administration’s Department of Health and Human Services added this fateful qualification: Discrimination on the basis of “sex” was to include discrimination on the basis of “gender identity.”

“Obama effectively wrote into law, through healthcare, that gender identity is a protected class,” healthcare executive and gender-medicine researcher Zhenya Abbruzzese told me. And that opened a huge new source of funding for these treatments. “Because once these insurers feel like they have to cover it, that’s it. You have just turned on the engine,” Abbruzzese said.

If an insurer covers testosterone to treat a man who was deficient, then, according to gender ideology’s cracked logic, the insurer would also need to cover testosterone for a woman identifying as a man. If a procedure to remove a man’s unwanted breast tissue was covered, then a similar procedure for a woman identifying as a man must also be covered. Denying those claims could subject insurers to federal enforcement action.

To mandate coverage for gender treatments, activists “snuck in gender identity without Congress ever voting for it,” Abbruzzese told me. Transgender rights groups filed lawsuits, to test whether judges agreed: Suddenly, a “woman” was anyone who claimed to be one, as far as provision of healthcare was concerned. Luxury cosmetic treatments became available even to minors covered by their parents’ insurance—at fire-sale prices.

Shrier discusses the odious and harmful organization The World Professional Association for Transgender Health (WPATH), which never saw an intervention towards transition it didn’t like, and even collaborated with the U.S. govenment (the Biden administration) to hide data suggesting that affirmative care and puberty blockers did not help young people with gender dysphoria. This hiding of data that the author Johanna Olson-Kennedy (and the Biden administration) didn’t like is one of the most disgusting incidents I know of involving withholding data:

[WPATH] suppressed publication of systematic reviews of puberty blockers, cross-sex hormones, and surgeries undertaken by Johns Hopkins University. That research would almost certainly have revealed, as so many systematic reviews have now done, that while the risk of sterility, cardiac event, osteoporosis, and bone fracture were high, any alleged mental health benefits of the WPATH-approved puberty blockers-to-cross sex hormones protocol remained unproven.

But the Biden administration pressed onward, suing any state that enacted bans on medical transition for minors. Assistant Secretary for Health Rachel Levine, a transgender adult, successfully pressured WPATH to drop minimum age requirements for gender medical treatments and surgeries in its September 2022 standards of care. Again and again, President Joe Biden and Vice President Kamala Harris used the bully pulpit to assure “transgender Americans . . . especially the young people” that “your president has your back,” as Biden declared in an April 2021 address to Congress.

In 2022, the Department of Health and Human Services published a fact sheet claiming that gender affirming treatments for youth were “crucial to overall health and well-being.” Any physician or therapist who might otherwise have been tempted to discourage trans-identified youth from immediate and irreversible medical transition sat up and took note.

The Obama and Biden administrations worked in tandem with activist organizations. Federal funds poured into tainted research. Gender physician Johanna Olson-Kennedy received nearly $10 million from the National Institutes of Health to study the effects of puberty blockers and cross-sex hormones on gender-confused adolescents ages 11 and up. (She later lowered the age to 8.) Olson-Kennedy and a team of colleagues recruited hundreds of transgender-identified minors. They gave one cohort of the children cross-sex hormones and another puberty blockers—to determine if either treatment produced improvements in mental health. (There was no control group.) After only one year on cross-sex hormones, two of her 315 subjects had committed suicide.

As for her nine-year study on puberty blockers, Olson-Kennedy didn’t like the results so, by her own admission, she shelved them. “She said the findings might fuel the kind of political attacks that have led to the bans of the youth gender treatments in more than 20 states,” according to The New York Times. She told the Times she intends to publish the data, but that getting her work to a place where it wouldn’t be “weaponized” required it to be “clear and concise. And that takes time.”

The public that had funded her research has never had the opportunity to review its results.

Surely the fact that Rachel Levine is a trans-identified man affected her harmful behavior as Assistant Secretary of Health, which underscores the dangers of appointing wolves to guard the henhouse, or at least reporting on the state of the hens.  Likewise, Chase Strangio, as the ACLU’s director of LGBTQ litigation, is another harmful wolf. He has corrupted the ACLU’s mission away from providing civil rights for all to prioritizing the rights of LGBTQ individuals.

As Shrier reports, Trump’s new Executive orders ameliorate the situations she’s warned about (yes, it is okay to admit that some of Trump’s orders are salubrious):

Trump’s executive order directs federally funded institutions to stop reliance on WPATH, calling its recommendations “junk science.” Cut off from what Abbruzzese calls WPATH’s “evidence laundering,” insurers will be forced to evaluate the gender medical evidence and issue policies on their own. Systematic reviews and investigations already undertaken in England, Finland, and Sweden indicate it’s not likely they will find the evidence for medically transitioning children to be terribly impressive. Activist researchers into gender medicine might soon see their federal grants dry up.

Every healthcare entity accepting federal dollars (nearly all of them, in Obamacare’s world) risks losing contracts with Medicare and Medicaid if they continue to provide pediatric gender transitions.

This executive order does not abolish pediatric gender medicine. Boutique practices that do not rely on federal funding can still offer “top surgery” to minors, for instance. There will surely be litigation to challenge the reach of Trump’s order.

But that order does break the spell—and the spell was always our biggest problem. Parents who allowed their children to transition are often caricatured as Hollywood eccentrics, the sort who bequeath their estates to teacup Chihuahuas. The parents I spoke to—even those who allowed their children to transition—are nothing like that.

Many are conscientious and loving and afraid, if a little naive. They believed medical science was above politics and beyond question. They had wandered into a Truman Show, an all-consuming simulacrum, designed to convince them to abandon their protective instincts. If the parents still weren’t convinced, therapists coerced them into allowing their daughters to undergo gender transition with this thinly veiled threat: “Would you rather a live son or a dead daughter?”

In the end, Shrier pats herself and her “allies” on the back for raising the alarm, but it’s a well-deserved pat, and if I ever meet her, I’ll add one of my own:

Disagreeable contrarians who resisted gender fever are the real oddballs. Some combination of personality quirk and conviction that occasionally makes us obnoxious employees and intolerable cocktail-party guests also inoculated us against gender madness. There is no reforming us.

But we served a vital function: Together, a ragtag crew of truculent journalists and outcast researchers stopped the entire herd from running off the cliff. None of us ever expected to be welcomed back into the same elite circles that, only recently, had cheered or looked away as a generation of tormented girls took themselves apart.