Michael Bailey, Lisa Marchiano, and Paul R. She critiques the gender-affirming model of care and profiles its critics: Kenneth Zucker, Ray Blanchard, J. She describes parents distressed by their children's transgender identification or transition. Shrier criticizes transgender-related curricula and policies in schools. She states that online trans influencers, on websites like Twitter, Tumblr and TikTok, frequently encourage questioning youth to identify as trans, experiment with breast binding and testosterone, and disown or lie to unsupportive family members. She discusses Lisa Littman's 2018 journal article on rapid onset gender dysphoria and the ensuing controversy and endorses Littman's findings. She profiles several teenagers who questioned their gender identities or came out as transgender while experiencing mental health or personal issues. She describes what she sees as difficulties facing teenagers who were assigned female at birth, whom she refers to as "girls": isolation, online social dynamics, restrictive gender and sexuality labels, unwelcome physical changes and sexual attention. Shrier states that she began to investigate adolescent-onset gender dysphoria after being contacted by the mother of a young adult with no apparent history of childhood gender dysphoria, who identified as transgender in college. There were several boycotts aimed at the book which characterized it as anti-trans and its use of "she" and "her" to refer to transmasculine and non-binary teenagers as misgendering. Positive reviews mostly endorsed Shrier's thesis, while much of the criticism focused on the book's use of anecdotes and other issues with its evidence. Shrier also criticizes gender-affirming psychiatric support, hormone replacement therapy and sex reassignment surgery (together often referred to as gender-affirming care) as treatment for gender dysphoria in young people. She attributes this to a social contagion among "high-anxiety, depressive (mostly white) girls who, in previous decades, fell prey to anorexia and bulimia or multiple personality disorder". Shrier states that there was a "sudden, severe spike in transgender identification among adolescent girls" in the 2010s, referring to teenagers assigned female at birth. ROGD is not recognized as a medical diagnosis by any major professional institution and is not backed by credible scientific evidence. Irreversible Damage: The Transgender Craze Seducing Our Daughters is a 2020 book by Abigail Shrier, published by Regnery Publishing, which endorses the contentious concept of rapid-onset gender dysphoria.
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