The picture that emerges is something much more complex than the familiar narrative of ‘born in the wrong body’. None of these girls appeared to be trans until their teenage years. Some are lesbians – but as one young woman explains to Shrier, being a lesbian is ‘just not very cool… it’s a porn category’, whereas being trans is celebrated. Others have eating disorders or issues with self-harm: for them, taking male hormones and having surgery to remove their breasts seems like another way to attack the body.
Shrier argues that this is being driven by social contagion. Trans identification spreads through schools, through friendship groups, through ‘influencer’ videos that offer a rose-tinted take on transition. But the medical pathway is not something to be taken lightly. Hormone treatments lead to lifelong infertility alongside other health problems. What’s euphemistically called ‘top surgery’ is actually an elective double mastectomy, while ‘bottom surgery’ to masculinise genitals is rarely undertaken and subject to heinous complications.