Book Review: Bad Therapy by Abigail Shrier

Abigail Shrier, a former conservative opinion columnist, released a new book, Bad Therapy, which was predictably met with the dysregulated rage we’ve come to know from a certain corner of the internet. I came across the book because of the distributed temper tantrum, read its description, and ordered it immediately. It would fit neatly on the shelf with other critical looks at parenting advice, like Cribsheet and Expecting Better that my wife had ordered.

Still licking their wounds from her previous book, Irreversable Damage, detractors piled on with their usual set of ad hominems, tu quoques, and other childish arguments. I haven’t read Irreversable Damage (yet), but am told it roughly postulated that the 4000% increase in teens identifying as trans wasn’t purely a case of diagnostic substitution, but may have been influenced by things like financial incentives, patient satisfaction scores, or the never-ending quest for the almighty internet point. History suggests this is not only a reasonable hypothesis, but should probaby be our baseline assumption about new therapies and diagnoses.

Like others, I read it in almost a single sitting. Almost, because it was 4:30am and I thought I still had a couple of chapters. I woke up and finished the last chapter, then noticed the rest of the book was endnotes and citations. I haven’t combed through those yet, but I certainly will.

Among detractors who have actually read the book, many seem quite disappointed that they got an opinion piece instead of a peer-reviewed meta-analysis. Fortunately, I was privileged enough to be able to manage my expectations when ordering a book from a former opinion columnist in the Political Commentary section of Amazon.

So, it’s very much commentary (not “Science”), but it appears well-researched and virtually every emperical claim is backed by an endnote. As books (and not science journals) tend to do, she illustrated her point with a number of personal anecdotes and interviews with a variety of professionals.

Detractors are quick to point out that it’s “one-sided” and doesn’t tell their side of the story. No shit. This is how political commentary works; it doesn’t pretend to be a neutral, scientific study. Secondly, we’re all very familiar with the “other side”, which is the current state of affairs that’s been expatiated on by Slate and so many others.

In other words, this is the other half of the story.

She points out a number of alarming trends that make the situation out to be much worse than I initially thought. I’m not sure I can accurately assess the true extent of it from my vantage point, but she confirms a number of casual observations I’ve made over the past few years. It might not qualify as Science™, and perhaps she’s exaggerating (or is working with a non-representitive sample), but it tracks.

I’ve not seen any valid arguments against any of the points she’s making. Most of them fall into the same, predictable categories many of us have come to expect from the usual suspects:

• “That never happens!”
• “That’s a Republican talking point!”
• “She wrote an anti-trans book!”
• “She’s just an opinion columnist, not an ‘Expert’!”

The internet is extremely efficient at gathering, organizing, and presenting evidence. That Reddit hasn’t already filled its pages with The Science that disproves her points is suggestive that such evidence does not exist, and she might even be right. It certainly feels right - and that’s all that matters, amirite?

Every parent, teacher, counselor, and social worker should read this book, not because it presents a novel scientific truth, but because it expresses something that so many people have been thinking and feeling for years. The dysregulated response among the True Believers should be cause enough to order it - one-sided arguments are Bad, after all.

I don’t fret anxiously over “dangerous opinions” because I’m a big boy who can use Google, who can consider multiple viewpoints and conflicting evidence, and synthesize my own opinions. I understand that the kids affected by the phenomena she discusses in her book may not be able to do this, but that shouldn’t (and doesn’t) limit the rest of us.

The opprobium to the fundamental notion that treatment can cause harm betrays the ignorance of the people tasked with overseeing peoples’ mental and emotional well-being. It suggests that, at a minimum, these people are operating beyond their remit, insufficiently prepared for the task at hand. It follows that poor outcomes should be expected - and therefore, sought out and remedied.

If the secret to fixing the kids is fixing the parents, perhaps the secret to fixing the parents is fixing the therapists.

10/10, no ragrets.