Janice Turner reviews Abigail Shrier’s Irreversible Damage:

In both the US and Britain, Shrier shows, adolescent girls have record levels of anxiety and clinical depression, expressed in spiralling rates of self-harm, anorexia and suicidal thoughts. Overprotective modern parenting has rendered girls less resilient while the iPhone in their pocket tells them their bodies fail Instagram’s feminine ideals and shows them graphic pornography in which women are debased. No wonder the geeky or less “girlie” girls we once called tomboys, especially those who are becoming aware they are attracted to other girls, “flee womanhood”, as Shrier puts it, “like a house on fire, their minds fixed on escape, not on any particular destination”.

The girls she describes — like those I’ve met since I started reporting on this three years ago — show no discomfort in their female bodies until puberty. Then at secondary school, when gender roles turn starkly pink and blue, these non-conforming girls feel lost. Online they quickly find forums that diagnose their problem: their “gender identity” is really male. They are encouraged to assume he/him pronouns and boys’ names, which would matter no more than becoming, say, a goth, except for the insistent accompanying narrative that only after testosterone and surgery will they find happiness as their true male selves.

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Yet only ten years ago children with gender dysphoria were treated with “watchful waiting”, an approach pioneered in Canada by Dr Kenneth Zucker, who believed “a child or adolescent in distress is not reducible to one problem”. He found that over time this dysphoria faded for about 70 per cent of patients. But Zucker was hounded out of practice by activists and now transition is presented as a universal panacea. Even in more cautious Britain probing a child’s underlying trauma is classed by the memorandum of understanding that governs gender treatment as “conversion therapy”, akin to the barbaric practice of trying to brainwash a gay person straight. Except, argues Shrier, homosexuality is innate, prevalent in the most repressive countries. But “gender identity” is fluid, malleable by peer pressure or social contagion.

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None of this would matter if transition made these girls happy. But while initially testosterone makes them fearless and swaggering, the Tavistock GIDS (gender identity development services) clinic’s own report shows no long-term improvement in psychological wellbeing. This rare piece of research was published reluctantly only a few weeks ago, perhaps because it threatens an entire ethos. In clinics from Finland to Australia red flags are rising. “Detransitioners” are speaking out. Medical negligence class actions will begin.

Let’s hope grinning doctors posing with teenage breast tissue in pickle jars will be consigned alongside other collective medical madnesses such as false memory syndrome or 1950s lobotomies. And that girls’ bodies, as Shrier’s fearless book bleakly reveals, cease to be collateral in adult culture wars.

Let’s hope so indeed.