A book on transitioning girls is denounced as transphobic

A TEENAGE GIRL who decides to alter her body so that it resembles a boy’s commits herself to a lifetime of medical treatments. “Top surgery”—a double mastectomy—is a major operation. She must take regular, large doses of testosterone. This may increase her chance of developing heart problems. It also causes the uterus to atrophy, often painfully, which may necessitate a hysterectomy.

Some of the changes to her body will be irreversible, and likely to cause distress if she changes her mind. If she has taken puberty-blockers as well as testosterone she may well be infertile. Only a few months of testosterone may have altered her voice and given her a lifelong five o’clock shadow. Fortunately for such girls, “bottom surgery”—a phalloplasty—is so often problematic that few request it.

All this, coupled with the fact that adolescence is confusing at the best of times, might suggest that teenagers should, by and large, be discouraged from embarking on biomedical gender reassignment. That is the argument running through “Irreversible Damage,” a book by Abigail Shrier, a journalist. It is not one that holds much sway in America. As the number of transgender clinics has grown from one in 2007 to at least 50 today, so has the number of young patients in them. Once they were mostly boys; today they are girls. Ms Shrier argues...

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