This was an amazing book. The author, who is pro-trans and uses the preferred pronouns of the adult trans individuals she interviewed, discusses at length the social contagion aspect of what researcher Dr Littman termed Rapid Onset Gender Dysphoria (ROGD). In brief, traditional gender dysphoria starts from a VERY young age (2-4 years old), is extremely consistent, and affects biological males at least three to four times as frequently as biological females. This author supports gender transition for such individuals. However, ROGD affects primarily post-pubertal biological females who have always considered themselves female but recently found themselves in friend groups with multiple trans individuals, especially with significant and sudden exposure to trans-related social media, and their self-identity as the opposite gender (again, biological females identifying as males at least three times as often as the reverse) comes on very suddenly. A high proportion of these girls change back to female in a few years, especially if their social media groups and friend groups are changed for whatever reason. This clearly indicates a social contagion aspect, and many of the adult trans individuals this author interviewed expressed concern about the issue.
The author raises many questions, most important in my opinion being: Is there any way to develop a more objective means of determining whether someone really is trans? As a nurse practitioner, I administer objective measures of the severity of a patient's depression or anxiety in order to guide initial prescription and dose changes, usually PHQ-9 and GAD-7. It seems funny to call them "objective" given that they rely on the patient answering questions about him/herself (for those who don't know, anything the patient says is considered "subjective" and anything the healthcare provider assesses or measures, such as listening to your heart or looking at your lab results, is called "objective"), but they're extremely helpful because patients often can't tell they're doing better or worse because their depression or anxiety makes them myopic, but these scales show that there have been changes (for better or for worse) and can guide treatment even when the patient is unable to verbalize (or unable to verbalize CORRECTLY) what has changed, if anything. Objective depression/anxiety scales such as these have been thoroughly tested via research on actual patients. I've successfully used objective scales to guide patients on whether they do or don't actually need to use medication--for example, accurately predicting that my moderately or severely depressed patient who doesn't want medication actually will be very much improved if they take it, or accurately predicting that my very mildly anxious patient won't improve on anxiety medication. Unfortunately, with gender dysphoria, the determination is often made with questions that should really apply to all adolescents, such as, "Do you feel uncomfortable with your body?" and, "Do you ever wonder what it would be like to be the opposite sex?" There are no objective scales and therefore no way to accurately predict whether the patient who thinks they don't want to transition actually might benefit from transitioning or, alternatively, the patient who thinks their problems will be solved by transitioning actually won't benefit at all. When we're talking about taking a very inexpensive, mild anxiety medication for 6 weeks before realizing it made no difference, it's not a big deal if my patient doesn't listen to me when I predict, on the basis of an objective anxiety scale, that the medication won't help her. But when we're talking about transitioning to a new gender, and every failure to improve is blamed on having only partially transitioned, and so the only way to know whether further transitioning will help is to go all the way through permanent removal of healthy breasts, uterus, penis, or testicles and further surgery to create a faux vagina or penis and scrotum, there's a MUCH greater risk involved in going ahead with the recommended treatment, particularly when there's no thoroughly tested objective scale to use to predict the likely outcome. It's all based on the very subjective claims made by individuals who may very well merely be caught up in a social contagion. Many girls with ROGD are being pushed to transition further and further, and any failure to improve is blamed on not having fully transitioned, and so girls who likely would have resolved their gender dysphoria and returned to identifying as female instead end up making permanent changes such as mastectomy, which they later regret.
One final note: The author mentions that girls with ROGD are disproportionately more likely than the average population to be autistic, but comments that she can't really go into that in more detail in large part because there isn't much research on it. But she comments that, similar to Dr Littman's findings, a lot of the girls with ROGD whom she interviewed or whose parents she interviewed were autistic. It would be interesting to see some more research on that very specific issue.
Disclosure: I am writing this review long after having read the book, so I've probably misremembered some things and failed to mention others that were very important.
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From the Publisher
About the author
Must read if parent or mentor of young girls
I highly recommend you read this book. The book is based on interviews of parents, doctors, therapists, educators and trans influencers.There are statements an ideologies I don’t agree with in the book but my overall take is she is addressing a phenomenon happening with young girls and teens that is akin to the 90a anorexia movement with teenagers where groups of teens are coming out trans in numbers that don’t make sense. If you’re objecting to the book based on the author or because of the title of the books, then so be it. But you know the old saying, don’t judge a book by its cover. 🙂 As a mother of three girls, I found this gave me some understanding of what I have personally seen occurring and things to be aware of as a parent and mentor to girls. In no way did I ever feel like she was being disrespectful or dishonoring to the trans community. I find it interesting the push back to this book from people who have never read it.
Top reviews from the United States
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- Reviewed in the United States on July 9, 2020
Top reviews from other countries
- H SReviewed in Australia on August 10, 2024
Absolutely essential reading, especially for anyone with a pre-teen or teenager!
- dario marcatoReviewed in Italy on February 11, 2025
Great book, all those against it are just frightened that their bubble might collapse.
-
BambiReviewed in Mexico on March 10, 2022
Excelente lectura, interesante e informativa.
