It used to be understood that gender dysphoria is vanishingly rare, typically afflicts boys, and almost always begins to manifest when a child is extremely young. In recent years, however, there’s been an epidemic in many Western countries of older girls who suddenly claim to be in the wrong body. This “rapid onset gender dysphoria,” as Abigail Shrier argues in her important 2020 book Irreversible Damage: The Transgender Craze Seducing Our Daughters (which I reviewed), is a fad rooted in a number of contemporary social factors.

Many have expressed concern about this trend. Yet transgender activists, eager to increase their visibility and clout, have embraced these girls as real cases of gender dysphoria and have pushed for them to be “transitioned,” pronto. Such transition usually starts with the administration of puberty blockers, continues with massive doses of testosterone, and concludes with “gender-affirmation surgery”—known to today’s self-identified trans teenagers, rather innocuously, as “top surgery” (mastectomy) and “bottom surgery” (metoidioplasty and phalloplasty, which transform the clitoris into something resembling a penis).

A decade ago, subjecting minors to these protocols would have been seen as malpractice and child abuse. But in the last few years, the practice has won widespread political, cultural, media, and judicial support. Never mind that puberty blockers, while presented as harmlessly allowing young teens a “pause,” so that they can ponder their options, can in fact be quite harmful and are almost always followed by hormone therapy; that testosterone, which can cause sterilization, osteoporosis, heart disease, and stunted growth, invariably results in such irreversible symptoms as sterility, facial hair, and a deeper voice; and that “gender-affirming surgery,” of course, destroys healthy body parts that can never be restored.