Amazon overrules employees’ calls to stop selling book questioning mainstream treatment for transgender youth

Amazon has refused to stop selling a book that doctors and transgender advocates have said advances a narrative of transgender identity as a disease after employees asked the company to yank the title from its digital shelves.

Dozens of Amazon employees backed an internal complaint lodged in April arguing the book, “Irreversible Damage: The Transgender Craze Seducing Our Daughters,” by journalist Abigail Shrier, violates Amazon’s policy against selling books “that frame LGBTQ+ identity as a mental illness,” according to images of the complaint and responses viewed by The Seattle Times. Leaders of Amazon’s affinity group for LGBTQ+ employees, Glamazon, also asked the company to drop the book, according to Slack messages viewed by The Seattle Times.

“As a proud Amazonian and a queer person, I invite Amazon to do the right thing and remove this book from our offerings globally,” wrote the employee in the initial complaint.

In an interview Monday, Shrier said that her book “does not in any way come out against [gender] transition, certainly not for adults.” Instead, she said, she opposed what she called the “fast-tracking of youth” into surgical or hormonal therapies, which medical professionals have said does not happen.

On April 23, Amazon’s director of book content risk and quality posted on an internal message board that Amazon would not stop selling “Irreversible Damage.” “Amazon has an internal process for evaluating the appropriateness of books and we have shared your feedback,” the director wrote. “In this case, the process included gathering feedback from Glamazon board members and the Books Diversity, Equity, and Inclusion team. After examining the content of the book in detail and calibrating with senior leadership, we have confirmed that it does not violate our content policy.”

Employees affiliated with Glamazon, though, said they were dissatisfied with the company’s decision to keep selling “Irreversible Damage.” “We’ve been fighting this for months,” a Glamazon board member told other employees last week, according to images of Slack messages viewed by The Seattle Times. “We were consulted. We told them it’s transphobic and needs to be removed.”

Amazon did not respond to questions for this article.

Amazon’s decision comes amid both increased scrutiny of how tech platforms vet the content on their platforms, and a rising tide of anti-transgender legislation.

Earlier this year, Amazon stopped selling the 2018 book “When Harry Became Sally: Responding to the Transgender Moment,” announcing that it would no longer allow books framing transgender and other sexual identities as mental illnesses on its platform.

“Irreversible Damage” falls into that category, said many of the Amazon employees calling for its removal. The book, which opens with a chapter titled “Contagion,” aims to examine what it calls “the current trans epidemic plaguing teenage girls.” (Shrier said it was unfair to examine “words taken at random from my book” and that she was using the medical terminology figuratively.)

Shrier argues that young girls are pressured to undergo surgical and hormonal interventions that they may later regret. “A generation of girls is at risk,” according to the book’s Amazon.com summary. “Abigail Shrier’s essential book will help you understand what the trans craze is and how you can inoculate your child against it — or how to retrieve her from this dangerous path.”

Target pulled “Irreversible Damage” from its online bookstore twice, first in November. The retailer briefly reinstated the book after Shrier and other conservative commentators decried the removal as “spineless,” then yanked it again in February. Target did not immediately respond to questions about its decision to stop selling the book.

Medical experts have said “Irreversible Damage” is a work of misinformation with potentially harmful consequences for the health of an already vulnerable group.

“The book promotes the idea that gender diversity is pathological and should be ‘cured,’ “ said Dr. Jack Turban, a fellow in child and adolescent psychiatry at Stanford University School of Medicine researching the mental health of transgender youth.

Research indicates it is rare for teens who have come out as transgender to later realize they are cisgender, meaning they identify with the gender they were assigned at birth.

Some medical professionals question whether it’s worth agonizing about whether someone is “really” transgender, advocating instead for an approach that helps patients navigate how their gender identities change or solidify over time.

The book feeds into a growing swell of conservative action to restrict young people’s access to gender-transition therapies, said Dr. Diane Ehrensaft, a psychologist at the University of California, San Francisco, who works with transgender children and teens.

State legislatures have introduced more than 20 bills this year to limit medical care for transgender youth, an approach the American Academy of Pediatrics has warned will threaten their health and well-being.

“The risks for trans kids — the risk for suicide, anxiety, depression, sexual acting out, disordered eating, school dropout, drug abuse — go up when they can’t get the care they need,” Ehrensaft said. Meanwhile, research from the University of Washington has found that transgender children who are supported in their authentic gender by their parents and communities are just as mentally and emotionally healthy as their cisgender peers.

“I’m not into book banning,” Ehrensaft said. “But I can say that if I were Amazon, I would not want to represent this book.” (Shrier said doctors like Ehrensaft who follow guidance from the American Academy of Pediatrics and other national physicians’ associations on best practices to treat transgender youth, which include referring teenagers for hormonal and surgical interventions if necessary, “make money off transitioning kids” and are therefore biased.)

“Irreversible Damage” is currently the No. 1 bestseller in Amazon’s “Transgender Studies” and “LGBTQ+ Demographic Studies” sections. Those categorizations risk conferring credibility on a book that has not earned it, said queer, nonbinary author and media critic Dianna Anderson, whose book about nonbinary gender identities is forthcoming from publisher Broadleaf.

“Irreversible Damage” is helping sustain a ginned-up moral panic over “outside forces ‘transing’ teenage daughters,” Anderson said, likening Shrier’s book to previous frenzies over debunked phenomena like Satanists working in child-care centers.