Writer Abigail Shrier goes in depth into the serious harm being caused to American pre-teen and teenage girls in her book Irreversible Damage: The Transgender Craze Seducing Our Daughters. Numerous interviews of girls who desire to transition reveal some of the causes are not just uncertainty with their gender, which is experienced by many and soon outgrown.

The other primary causes she lists are:

• Low self-esteem because of impossible beauty standards.
• Depression and anxiety.
• The postings of cool social media influencers who advocates passionately for kids to choose to transgender at any sign of ambivalence.
• General media pro-transgender advocacy.

Surprisingly, a large part of the problem is excessively coddling parents who give their young daughters no reason or opportunity to rebel. She wonders:

Whether this transgender craze isn't partially the result of over-parented, coddled kids desperate to stake out territory for rebellion. Whether it is no coincidence that so many of these kids come from upper middle-class white families, seeking cover in a minority identity? Or is it the fact that they overwhelmingly come from progressive families - raised with few walls, they hunt for barriers to knock down.

The teen years are naturally tumultuous. Teens get emotional as they learn and mature. Parents are supposed to set limits. If you have a fight with your teenager, she might be angry with you, but she'll feel the presence of a guardrail. Sometimes, just knowing it's there may be enough. Your teenager may tell you she hates you; she may even believe it. But on a deeper level, some of her need for individuation and rebellion may be satisfied. If you eliminate all conflict through endless agreement and support, it may only encourage her to kick things up a notch.