S3 EP 6 – Health and Gender Justice

This is the Sports and Society podcast where we go beyond scores, statistics and personalities to focus on issues and controversies in sports worlds. Your host, Jay Cochely, and Jeff Montesdeoca are sports sociologists and the authors of the book Sports and Society Issues and Controversies. The episodes in this podcast give you a behind the scenes look at the textbook, with stories from our lives, the scholars and athletes, as well as providing analysis of ongoing issues and controversies in contemporary sport worlds. We welcome hearing your thoughts and analysis, so please use this space to engage with us about the textbook or any of the topics we cover in this podcast. Hello and welcome to the Sports and Society podcast. Today's episode focuses on gender justice through the topic of women and girls' health. We have two experts on sports and health who can help us to understand why we should focus on the health of women and girls in sports, instead of just a general focus on sports and health. This episode directly addresses chapter 7 on gender and sexuality in sports, but also chapter 6 on violence and abuse. Our guest today are Jessica Kirby and Marissa Berronasquez. Dr. Jess Kirby is an associate professor of health promotion and sports psychology at the University of Colorado, Colorado Springs, and director of the Center for Critical Sports Studies. I guess that makes you my boss, Jess. Yeah, me too. Dr. Kirby's research focuses on exploring the sport and physical activity experiences of diverse individuals across the lifespan, as well as the impact of physical activity-based peer relationships on psychological well-being. Marissa Berronasquez is an assistant professor in the Human Physiology and Nutrition Department at the University of Colorado, Colorado Springs. Dr. Berronasquez is completed her PhD in human performance at Indiana University studying interventions to improve endurance performance in elite runners and cyclists. Her laboratory group at UCCS, 6% performance, focuses on researching the effects of different types of stressors on mental cycle health in female athletes and varying menstrual cycle characteristics effect exercise performance. Jess and Marissa, welcome to our podcast. Oh, thanks for having us. Okay, so let's jump in. We have two questions. We ask everybody. I don't know who wants to go first, but I would like to ask Jess if you want to go. Jess would go first. Sorry, not to put you on the spot. Jess has a majority, so she'll go first. Can you, Jess, can you talk about your sporting biography, your background in sports? Yeah, I grew up playing all different kinds of sports. volleyball is my sport of choice in high school and also grew up in a big sports family, so we were big sports fans, and I have a brother that's a retired professional athlete, so I've kind of been exposed to all levels and experiences of sports throughout my life and get the opportunity now as a professional to work primarily with college student athletes. So it's great. How about for you, Marissa? So I, unlike Jess, I was pretty bad at any ball sport or team sports, that led me directly to just running, so I ran cross country in high school and then in college at a division one program. So I probably have a slightly different experience than Jess. I kind of wish Jess was around when I was an athlete in college, but I had a pretty poor experience in college. I think it was the first time I really experienced not competing well and not doing well in a program, and I think that kind of pushed me to the point where I was injured frequently. We were in that culture of leanness, of thinness, and that was being pushed by our coaches and other sports staff to the point where it was pretty unhealthy and I had multiple stress fracture injuries and then eventually I stopped running in college after my third year just developed some more serious health complications, related to my cardiac health, developed some arrhythmias, and then I think over the years after that I've tried to rebuild my body, have a more healthy relationship with sport, with diet and body image and try to get to the point where I can compete now in a healthy way, both physically and mentally. Did that experience, because you're like one of the women in the literature, so did that experience then direct the kind of research you're doing now and the sorts of interventions that you're trying to make as a scholar? Yeah, absolutely. I think it took me a while to actually be able to study things like energy availability, relative energy deficiency, and sport, and those issues, because it was so close, I think close to home. For me, it's taken a lot of work, I think for me to get to the point where I can actually approach those questions and kind of use my lived experience, which I think it helps. It helps to have that experience to guide research questions that I feel relevant and passionate about. Your experience is real similar to the experience of Lauren Flushman, who wrote the book Good for a Girl, and for any of the students who really want to get into the things we're talking about today in detail, that's a good book to take a look at, because you're the classic case coming out of that book. Absolutely, yeah, Lauren Flushman's book Good for a Girl, I think it resonated so deeply with my lived experience, and yeah, I think the way she expresses herself in that experience is just the most eloquent that I've ever heard someone talk about, yeah. Yeah, I'd really recommend it for students that find this episode interesting. If you haven't read that book, that you take a look at it, it reads almost like a novel, but it's not a novel, it's her story, and she's done research, and so she's bringing in the sports science literature to address the experiences that she had and the observations that she makes. Your point, Marissa, about having that lived experience is incredibly valuable, I would say, as a scholar, and I think that one of the reasons why we ask these questions to everybody is because I think sports scholars, most of us, were competitive athletes at some level, and those experiences really are what drive our passions as scholars. Maybe you want to talk about your own experience, or how your own experience just has informed the scholarship you're doing now because you're parallel to what Marissa does, but you're also very different at the same time. Yeah, absolutely, and I think Marissa and I complement one another really well in our work. So I focused mostly on proactive, holistic athlete development from all the dimensions of wellness with the primary focus being on supporting and building athletes' mental health in order to improve their performance, enjoyment, and longevity in their sport. Marissa's experience and the book are a big experience of learning the book, and thousands of other girls and women in sport really drive my mission and my work to try to create tools and models and programs where I don't only go to one of the other ways and then to import, I don't have those experiences, they don't get out of the sport merely having just barely survived the experience, but they have tools to thrive and find joy in those experiences. Yeah, and Jess, you work with people who are so-called non-athletes, and including older people in the senior games, and so you get them involved in sport and we'll go. I want to ask you a couple questions about that as we move along, but if you could just mention the programs that you've developed at the University of Colorado, Colorado Springs to get students back involved in regular physical activity and how that relates to health, mental, and physical. Yeah, I've done a little bit of both in my early scholarly work, looked at those athletes that were maybe 50, 60 years and older, and then I did transition into developing physical activity programs for college students to improve their mental health. We developed the fitness buddies program at UCCS and did a few years of research on that, and then the past five years I've transitioned into working primarily with college athletes at the division one and two level, and helping them find tools to improve their experience. Yeah, the work that you do here on campus is amazing, and the support that you provide for our athletes is, you know, it's incredible. So, I want to move into more specifically the topics that we have for today, and I frame this episode on sports health in terms of gender justice. But in doing that, what we're suggesting is treating women and girls differently from men and boys. And this could seem really counterintuitive if we think of justice as treating everyone the same. Because the equal treatment is a hallmark of modern societies. But to understand this, I want to make a distinction between equality and equity. Equality says that fairness is treating everyone the same, even if it leads to unequal outcomes. Equity says that fairness means sometimes treating people differently so that there is equality of outcomes. And that's something we're going to see, I think, clearly as we talk about sports training and health. Okay, so let me get to my first question. So I just want to start thinking about sports as an institution. The context in which people are making decisions and engaging in specific practices that are consequential. What are some of the pressures and issues that sports as an institution creates for women and girls? Maybe you want to start first. Sure. Yeah, I think there aren't a lot of issues. Like with sports just as an institution, because I think sports themselves, I think before Title IX, especially in this country, were developed from a male paradigm, I think. And so I think the culture of sports, I can speak just from a physiology perspective, at least. The training that we implement for our female athletes is made for males. There is just not enough of a body of research out there yet to really have sex-specific training practices for our male and our female athletes. So we're still using, I think, these outdated research or these outdated training protocols to essentially train males and females the same, which I think can create a host of not only physical problems and injuries, but also, I think, just unrealistic mental pressures, which maybe just can speak to a little bit more of, with trying to keep up with that male standard. When you say was designed for men, what exactly does that mean? Sure. Yeah. So the body of research that we have in sport and exercise science is predominantly based on male bodies. So even as recently, I think the last review came out in about 10 years ago, 2015 or so, which suggested that we still, today, only have about a third of research participants in sports science and exercise research that are females. So that still means that today the majority are males. And so when we think about how coaching practices how training practices were developed, females were really only included in that research recently. And there's just not, there hasn't been enough time to really study and understand how female bodies are different. Yeah. And I think that's really important because all bodies are pretty pervasively policed within sport. And if you have someone who doesn't understand the female body, then you know, you're getting policed in the same way that male bodies are policed. And you know, the policing itself has problems in terms of control issues. But when it's applied to women in the same way that it's applied to men, it creates additional problems, both related to mental health and physical well-being. Yeah. I think that's an excellent point with the policing women's bodies. I'm kind of applying the same whether it's body image or performance standards that that males have on females where I think there's a question later on that I can go into more detail on, but with menstruation even, you know, it's been looked at as an issue that a lot of coaches where they don't understand, they look at it as well a problem for training and that they want women not to menstruate. And the coaches don't understand issues related to menstruation. And by the way, I've looked at the research and the research is pretty thin when it comes to high performance athletes. And it's generally ignored when it comes to the recreational level, unless you have somebody like Jess who is aware of some of those things. It's just not something that people will talk about, even though it affects their physical feelings and mental feelings at a particular time. Yeah, I've seen that and I teach a sex difference in physiology class at UCCS. And one of the first things that we do in class is have males and females in the class draw on the board what they think a menstrual cycle looks like. Oh, with a different hormone fluctuations like the time. And it's interesting that not normally do the male students not quite understand the, you know, what's actually going on in their female counterparts' bodies. And these are males who are going to go on into medical school, PT school, coaches, trainers. The females, a lot of times have no, like, similarly no idea what their actual hormones look like, what a menstrual cycle looks like. So then it is an issue that it's such a taboo topic. I think that we don't really allow ourselves to talk about, like, administration just seems like a topic that people try to avoid. I think like females in addition to males. You know, I'm still thinking about this. The thing you said earlier, Marissa, about the sports is designed for men. And so one of the things that you do as a coach is you have in your eye, your head, an idea of an ideal athlete, right? That's the model. And, you know, it's like their correct movements. I mean, just like, you know, I don't know if you were a sprinter, but like getting out of the blocks, it just seems like such an easy thing to do to run, to take the start. And yet the training is so specific in how you come out of the blocks. And I remember one time I was, when I was teaching a class and I wanted to make a point about this, and I had a bunch of runners in the class. And I showed them how I would come out of the blocks. And they just laughed at me. And I thought it was like, they thought I looked so silly. And I'm just like, wait, I'm just running. But so there is this idea in our heads of what an ideal athlete looks like. And part of the job of the coach is to train that athlete to approximate that ideal. And so then there's a kind of contradiction. If the ideal is a male, and it's a woman athlete or a girl athlete, then there's an inherent contradiction there. And that creates some tensions for the women athletes if they are by definition, not the ideal. Just can you talk about that a bit the way that when girls and women come into a sports space that is modeled around a male and a male body, how does that impact their experience? And what kinds of effects does that start to have on them? Yeah, I think it definitely impacts their ability to show up, get the same opportunities for training and coaching and improvement. Even from a really young age, we see girls are going to get less encouragement to be rough and tumble and use their bodies and play hard and jump off the playground and things like that. So they're getting less opportunity for quality motor development. They typically get less intense or specific motor skill coaching in sports. They get less strength and conditioning opportunities in sport, which sets them up for a slew of injuries as they progress through high school and college. And I think as well, like not critical time around like 12 or 13, we see a huge drop off in girls dropping out of sport because of those mixed messages. Like this is what it means in society or at school to be like cool or be a girl in a certain way, but this is how what I need to do to be an athlete. And sometimes those are conflicting messages that really wear away at a girl's confidence and sense of self-worth. Or when they hit puberty and their body starts changing, you know, then are they equally as valued on their team? Or do they start getting that feedback from coaches that I'm sure Marissa received a lot of like, you know, you need to stay lean or, you know, coaches really will coach girls to try to prevent or reduce menstruation so that they can stay lean and prevent some of those healthy changes in the body. And I think as girls progress to higher levels of sport, they definitely face a double edged sword of like conflicting expectations of athleticism and femininity and balancing the two. And I think there's an overall miss in sports. And we see this a lot on social media that, you know, the very best female athlete is just going to come, you know, just after like any man. Doesn't matter if they're an athlete or not. And there's slews of men in the internet that they, you know, yeah, I'm very confident I could beat, fill in the blank women, professional athlete, you know, I could beat Serena Williams in tennis. I could beat any player of the WMBA, you know, and then they try and they get totally smoked. But there's that idea that, you know, the girl's going to come in after the males and that's just not true in any activity, any sport. It's very mixed across the board. I love those when they're because that was a study done and it was like a majority of club level tennis players thought they could beat Serena Williams. Male tennis players thought they could beat Serena Williams in her prime. And I recently watched a video. It was the number one women's collegiate athletes. So she's not top-seated, and a group of male club players were asked to try to break her serve, and none of them could do it. And she's like, that woman is not going to be competitive in the WPA, let alone beat the top layer in the world. It's so unrealistic. So there's just one more question that I want to ask is, and maybe you can address this one also, Jess, which is one of the things that we, one of the problems we have is talking about male and, like, as you said, right? We tend to think of male and female athletes differently, and so we assume the men are going to be better regardless, and it's unrealistic, but at the same time, we want to treat every body the same, and struggle with talking about people's bodies and their needs as individuals differently. Can you talk about some of the things that kind of hold us back from talking about girls and girl and women athletes differently than men and boys? Yeah, I think it really starts early on in youth sport, and we put, I think, both boys and girls in youth sport at a disadvantage by separating them from, like, five years old, you know, from, like, youth through adolescents, like before those athlete tip puberty, there's not a lot of physiological differences, and so both boys and girls would sort of be served much better by playing together, competing together, pushing each other, and then as they reach those teenage years, then we could start to differentiate them by skill level. And I think across, I think we boys experience some of the same disservice of assumptions and expectations of, you know, maybe, you know, boys that are late developers who get cut early from sport because they haven't gotten big and fast in stront yet, and so taking a more developmental appropriate approach, I think, to training young athletes is really important. And then when it comes to, like, talking about bodies in sport, we need to not. And so that's, like, something that really damages boys and girls equally in sport is, you know, putting those expectations and value on, like, what your body should look like necessarily versus focusing on performance skills and function and ability and confidence and effort and hard work in those kind of things and makes a big difference. Yeah, and the women, the girls and women are much more apt to hear things about their bodies than men are and, or boy, than boys and men are. And so that puts additional pressure on them. And I think that was one of the things that Marissa experienced, you get this pressure. And then you start focusing on your eating and you end up in the, in the female triad, which maybe you could, you could explain that and we can think about that in connection with some of the male female issues related to a sport training. I think you know how we used to have the female athlete triad, but now we have relative energy deficiency and that's one of the gaps is that we for so long have made a lot of assumptions and targeted a lot of things about eating disorders and body image to women assuming that only girls care about how their body looks. And there is like a degree of that pressure in society, but I also think it totally ignores that boys experience the same pressure to have their body look strong and fit and like their sport. And there's a pretty strong group of male athletes coming out now who have experienced to be your eating disorders in sport and are like like we're just looking at women's physiology now we're kind of just looking at eating disorders and men now. Yeah, and I can explain that I just want to compliment what just said and kind of explain a little bit like the evolution I guess from the traditional female athlete triad, which refers to kind of this little triangle of issues that stem from low energy availability. So not having enough energy that you're taking it from your diet to meet your kind of metabolic needs to replenish things like muscle tissue, different organ system function, etc. Which leads to menstrual health disturbances and then bone health disturbances. And so there's a large consensus group I think just over the last decade or so that came together with researchers from all over the world that specialize in this area who kind of rethought the female athlete triad and broaden the scope a little bit more to now acknowledge like just saying that this isn't just a female issue it's one that affects males and this is actually an area if you look at there's on the NIH page which shows like what percentage of males and females are represented in NIH funded literature disorder reading is one of those issues is just pointed out that is understudied in males. So only like one percent of disorder reading research is done in males. So there's kind of been this push over the last decade with kind of recoining the female athlete triad to the relative energy deficiency in sport to including now male athletes and acknowledging that they may have a slow of like physiological health and performance issues from underfueling. But then the second thing that this kind of reframing of the female athlete triad did was kind of expand the different body systems and effects that low energy availability can have. So it's not just bone health, it's not just mental cycle health anymore it's things like cognition and brain health, emotional regulation and mood and a variety of other body systems that would affect not only performance but also health too. So this raises an interesting question for me at least I think it's interesting, I hope you do too. So health is so central to sports. Athletes are preoccupied with their health coaches are preoccupied with athletes health, you know sports is supposed to be healthy and we've had sports science since I don't know at least the mid 20th century that there has been all this focus on sports, the health of athletes and yet what you're talking about is these gaps in the study of athletes health, whether it was not looking at women's bodies differently from men, not focusing on diet and now it's assuming that all eating disorders, you know athletes with eating disorders as women and now we're just like realizing, oh yeah, yeah, yeah, men can have eating disorders as well and then recognizing there is all these other health negative health outcomes, what would you say is, like what has kept the literature, what has held the literature back for so long on things that seem so obvious, I mean for you, Marissa, you described the injuries that you had as a result of the training practices that there was again a lot of ignorance in the training that leads to these negative outcomes that are also limiting your performance. Yeah, and I think working with the elite of athletes and being a high performing athlete, I've learned that what is best and optimizes performance in a lot of sports at that top level is a lot of times conflicting for practices that best impact health. So for example, I think athletes are hyper focused on their strategies that will impact their performance with disregard for their health a lot of times where when you're at that level and you know whether your career depends on it or your scholarship or you know other things that you're motivated by, you're willing to do almost anything and sacrifice your health especially at that young age I think, you know when you're in high school college and you might not be thinking long term about the impact that this is having on your body and longevity in a career you're just thinking about the here and now and can I become a professional athlete, what can I do now to improve my performance? I didn't mean to interrupt but you know what you're talking about Marissa, what you're talking about right now is some of the things Jess is dealing with as she works with Division 1 and 2 athletes or athletes who want to be in Division 1 or 2. And I'm wondering Jess, how do you deal with these health issues when you're talking with those athletes? Yeah, I think we're working on the slow long game of culture change in sport, both Marissa and I from our different fields and angles and I will completely echo what Marissa said that I think the primary focus of sport science has been on optimizing performance which is oftentimes to the detriment of athletes health and longevity. And I think, but there's all of these like society biases and like stereotypes that we have in sport also have also been a piece that has driven the literature research. So the vast majority of sports science researchers have been men who carry a lot of these ideals and assumptions about athletes in sports. And so what I find in the multidisciplinary sport research is what are the questions that are not being asked because of those kind of biases and assumptions that exist. So in some of the sports I call you like in youth sports, sports I call you research. We see that it's reported often that girls want to participate in sport because they want to have fun with their friends and boys want to participate in sport because they want to be competitive in their new skills. And they both want to do both. So it's like, you know, or we see research in sports I call you on aggression is typically only done at male athletes like doing that thing that girls also have aggression in sport. So I think a lot of times it comes down to the questions that are not being asked. And so in my work now in like really creating non-clinical models for mental health in sport, it's really teaching athletes and coaches just how much mental health drives their performance which before we thought of it as a totally different system like we don't there's no crying in baseball like leave your feelings at home. It's not a part of sport. But now we know that the more you take care of your mental and emotional health and train those skills, the better you sleep, the better recovered, the more it strengthens your immune system and you actually will increase your feeling for performance. And so it's reteaching some of those ideas about how those systems are interconnected. Oh, you mentioned something about how the dominance of men as the researchers, Jason. But we also see that with coaching. You know, so prior to title 9, most of the coaches for women athletes were women. And then after title 9, which just opened up access for women and girls to participate in sport, there was a transition. And now we see, you know, men predominate in women's sports. You don't see many women coaches in men's sports. Can you talk about, maybe Marissa, you want to talk about this? Some of the tensions that women and girls experience when they have male authority figures, right? Coaches. And I don't know if that was a factor for you. If in fact, you did have a lot of male coaches, maybe you could draw on your own experience. And talk about how that impacted you as an athlete. Yeah, I mean, I think looking back, I did have exclusively male coaches and support staff. So there really was no female coaching influence, and nobody I could really go to for issues that felt very female-specific. And I think it's important, and I try to emphasize this to my students as well, in our sex differences and physiology class, that a lot of these topics, I wish and I encourage male, you know, whether it's a physician, you know, coach, support staff, et cetera, to actually be willing to approach these topics with their female athletes. Even though it feels uncomfortable and it feels taboo, I think as a coach, whether you're male or female, you should be comfortable talking about issues that impact performance and health. And that includes things like menstruation and being comfortable with understanding what that means and talking to female athletes about the symptoms that they're having, not just ignoring them and not just looking at things like menstruation or bleeding as hindrance to performance, but trying to work with your female athletes. And kind of just eroding that barrier to make it an open space for them to talk about those issues. And I think that's really important for just male and female coaches to understand, because I think my experience would have been a lot better if things like, you know, menstruation wasn't looked at as something that needed to be stopped. And you know, same thing with body image and fueling, I think, you know, male coaches have a responsibility to understand how female bodies are different and how their performance is different with a little bit more body fat or less muscle mass. Yeah. And what are the other issues that I think kind of tax on to what you're saying, Marissa, is that coaches, male coaches and female coaches, in some cases, deal with athletes in terms of the binary, the sex binary. And what that does is it places all of the women athletes into a particular category in the male coaches' mind. And a lot of those male coaches don't understand some of the differences that occur between women. And so we're talking about really learning, going in deeply to focusing on individuals and talking with them to find out how their bodies are working and the issues that they have. That's a great point, anything something we acknowledge and try to emphasize in our research and that when you look at a group of females and females who are physically active or athletes, the way in which their hormone fluctuations across the menstrual cycle affects their physiology, also mental health, emotion regulation, et cetera, it differs highly. Not only between two women or two females, but also between two menstrual cycles in the same individual. So I think your point, we really have to focus on the individual level. And I do try to teach my class that we really should in from a physiology perspective, look at sex, male, female, as a binary, where there are a lot of variations in these levels of reproductive hormones, of estrogen, progesterone, and females, and testosterone and males, and testosterone and females. And they're going to exist in differing levels in males and females. And that's going to affect how we look physically or phenotype, but also how we perform in our health as well. And this really raises some questions that I wasn't planning to ask, but now that you've brought it up, I think that we should talk about it, which is right now, bodies and hormones are highly politicized. I mean, we see that in the realm of sports. We're seeing that in the realm of the military, right, that, you know, men over 30 who have low testosterone are going to be eligible for, you know, testosterone boosting, as scholars that study bodies and health and these very specific issues, how do you view this politicization of hormones, of both male hormones and female hormones? I think it's a really dangerous road to go down. Like I mentioned, there's so much variation, so it gets, when you actually look at the hormone values, if we just take testosterone, for example, and you look at a group of males who are maybe, you know, 20, 30 years old, if you look at testosterone and females, same age range, there is, there's not a defining level. A level of testosterone that makes a female, biologically female or a male, biologically male. So I think we just don't, we really don't have enough research to understand, like what is the level of testosterone that would make somebody adequately fit for physical performance, I think. You know, there's so many other factors and I think, having people adjust the hormones, I think again is something that's really, it can be dangerous, where if let's say you're giving testosterone supplementation, sure, it'll increase your testosterone, but because it's a hormone and it operates, oh, we call systemically throughout your body, it's going to circulate in your bloodstream, it's going to affect all of your different organ systems. That could make those malindividuals, depending on the dose of testosterone that they're given, more susceptible to things like sudden cardiac death, for example, which is definitely an unwanted outcome for both health and performance, I would assume. So I think there's really no, not a lot of thought that's being given right now to these other physiological effects or the long-term effects. Yeah, and that's a real problem when it comes to things like sex testing and, you know, trying to stick with the binary when there's so much overlap is a challenge that can't be overcome at certain levels of sport involvement and that's an issue that we're going to be dealing with for a long time. Yeah, to your point, I mean, we look at testosterone levels throughout the day, like they're highest in the mid-morning and then they dip down and, you know, they have these daily fluctuations. Like you said, there are certain activities, like certain exercises that we can do, certain behavioral things, certain dietary stress, sleep that are going to affect those levels. And the same thing goes for females, too. I talk, work with a lot of females in the community where they've mentioned they've gone into their physician to get hormone testing done and always ask them, you know, how many times did you get that testing done? It's usually only once. And I think the same goes for males, if they go into testosterone clinic and it's only done at one time point, maybe not necessarily at the same time of day, I thought that it should be tested. And so we have no idea what what menstrual cycle phase they're in, we have no idea if those hormone levels are typical for that phase that they're in or if they're on a hormonal contraceptive, there's all sorts of different complicating issues that I think, again, when you politicize these issues, if you're not necessary. necessarily always involving the experts, you're not always evolving physicians or physiologists who might understand like the fluctuations in hormones like you mentioned. So I think that can be dangerous for the health and performance of our young men and women. I mean, I think part of why it's a valuable tool to be politicized is because there is some, it's so complicated and it is so confusing, but it's not just politicized, it's also commercialized. So Jess, as you know, I'm almost 60 years old. I'm still like active, but you know, I can't keep up with the young guys. When we're out biking, they're going to outcline me every time. Should I be running over to the low T center and plunking down some money to get some testosterone shots so that I can maintain my healthy performance as I'm an aging man. I would say there's a few things there like performance is definitely relative as of the age. It won't only necessarily be climbed, but it could feel like it's really declining compared to your younger counterparts. But with any of these decisions, it's like don't get your advice from Instagram or the Google, you know, like work with a trusted primary care physician to, like, a lot of things, rest of spoke about, like, way, you know, get tested over a year and kind of see where you're at. If you have a substantial deficiency, otherwise, you know, like, just tell those guys to respect their elders. I've never respect it. This is really interesting. I want to, I want to get back to what we were discussing before and there's an aspect of it that hasn't quite been addressed. And so we've brought up the fact several times that coaches will see thinness as a good thing. They'll, they'll see it's, you know, women athletes not menstruating as either benign or even a good thing. Contest, can you address that more specifically? Like why have we had these ideas that like all athletes should be super thin to perform best? Menstrual health is not really important. And what are the consequences of ignoring healthy diet, healthy menstrual cycles? Yeah. For a long time, there's been, you know, there's like, there's like research and sports science. And then there's like gym science. And so there's been a long time under misunderstanding and lack of education and coaching that more specifically for women, but across athletes in speed and endurance sports that smaller is better because they're going to be able to be faster. And what was really missed in that is if you just focus on losing weight, being lean, producing fuel, you sometimes have soccer vise your power because you've given up too much of your muscle mass and that muscle mass. And some body that is also very protective for chronic injuries. And so in the pursuit of like short-term speed gains, we took on long-term deterioration of health chronic injuries. A lot of athletes losing their athletic career early due to these things. And in my work on the psychosocial side, the consequences can be catastrophic because it's not just that maybe an athlete's career is shortened or that they experience substantial injuries, but the mental and emotional damage that they carry with them from developing disorder to eating, being body shamed, never feeling like they're good enough. That's something that athletes then are going to have to work through therapy, through mental healing, oftentimes for decades following their transition out of sports. So it's not just a short-term consequences. This typically a very long-term consequence. And there is a bit of hope. I find that some of the younger, more progressive coaches nowadays who are open to education and more interested in athlete longevity and health, they're starting to get that. They're starting to get how important fuel is and how you can lose an athlete for a year if you burn them out and under a few of them and overtrain them. And I've done a little bit of work in girls' wrestling, which is new. And their girls' wrestling is mostly being coached by old men who are previous wrestlers. And in that research, we saw that I think those men really understood the damages about severe weight cutting and wrestling specifically. And they were not encouraging their girls to do that. They were saying, "Pick a healthy weight that you can stay out pretty easily and get stronger in that weight class. Don't do these like crazy trash bags, fun or things." And to complicate things further, you know, the hormone levels, as you've pointed out, Marissa, are very during a time period. And they vary on a daily basis as well, depending on what you're doing. And so some activities will raise testosterone levels and sometimes, you know, if you're totally exhausted and you're resting, your testosterone levels may go down. And so, you know, it's really tough getting a good measure in the first place and then knowing what to do about what you found is another challenge. And so when the hormones become politicized, as Jeff is mentioning, we run down all sorts of wrong paths when it comes to understanding what's going on with bodies. Marissa, I don't know if you're comfortable talking about this, but if you are, it'd be great, you know, to address your experience of what Jess was describing of, you know, having been an elite athlete who then struggled with injuries and obviously that impacts your training. And then as you said, it forced you out early, so you had an early retirement. And then it took you years to rebuild. And you're still trying to get, if you could talk about your own, like sort of process of working through this stuff, that would be fascinating. Yeah, I mean, I think to Jess's point, coaches should be aware of like the lasting impact that this has, not just on performance, like in the short term and, you know, long term, but the mental and the mental burden of these issues. And I think, for me, myself, like I've tried over the last couple years to be more open and talking about my lived experience because it is, it's something I think I have waited talking about because it almost felt shameful that I'm, you know, in this career, I'm an exercise physiologist. I have a background in nutrition. I know what I should be doing. And I had to be honest with myself. I think a couple of years ago that I really hadn't healed for a lot of that trauma that I went through, you know, now almost two decades ago. And I recently went back and, you know, I, I'm working with a clinic right now for my own benefit. You know, I work with a therapist, I work with a registered dietitian, a psychiatrist. These are issues I've been managing. I can't for almost the last, like, you know, two decades of my life that I really haven't resolved. And it's impacted my relationship with like how I manage stress, like how I manage just my physical, like activity throughout the day. See, I don't know if I answered your question, but it's, it's something I think they need to be aware of that this, and I'm fortunate enough that I was able to get out of it at a time. I'm fortunate I didn't do my last year. They are where I can now do this healthy, where some of my teammates weren't as fortunate. And a lot, I think me talking about these issues that I've learned that this is a really common issue. Yeah. And, and Marissa, that's something that, that in our, in my reading of the literature, it shows that it's not only really common, but it's, it's really common with certain kinds of coaches, you know, who, who have an approach that pushes women into disordered eating and, and other issues that have long term health implications and, and both mental and physical. And, you know, some of those coaches have great reputations for turning out top athletes. And so we, we run into this conflict. You know, how do we deal with what we know is a coach who's destroying women on the one hand, you know, coaching women, but turning out a few top performers. Yeah. Yeah. I think one of the issues with coaching in sports and just the whole field, I think of sports science in, in general, is that you don't have to be credentialed necessarily, and have a background to understand some of these issues affecting physiology of nutrition, of, of, of health. And I think that's okay. I think experience can go a long way in being a good coach and there are good coaches out there who necessarily don't necessarily need to have a degree in, in exercise science or nutrition, et cetera. But I do think it's their responsibility to work with a team of experts if they really want to prioritize their athletes physical and mental health where you need to acknowledge where you don't have that information and, and really work with a multidisciplinary team of whether that's athletic trainers, register dietitians, sports psychologists, because I think that was one issue with my coach in college, he had a degree in geology. And some of the practices that he encouraged they weren't even just subtle that led us I think to disorder-deeting they were over and you know, I'm not gonna go through the specifics because it was very traumatic I think for some listeners who dealt with these issues, but It was abuse. I think and you know, I think And there was no protection I think from the athletes because you know He got fired from that job and went on to coach at two really big division one Universities and I'm sure have factored multiple other females in the same way And I think they're there just needs to be some oversight where You know, we need to I think encourage coaches to seek other like professional help with their coaching to really avoid these issues Yeah, and I think for the students who are listening especially the ones who are in sport management or interested in going into coaches All of what both you and Jess are saying Marissa is really important, you know, just your point As you talked coaches should be working with the team of people if a team is available Or they should be going to sources outside of an organization to get the information they need to deal with with athletes as individuals who have specific kinds of needs and And who you what you certainly don't want to create mental health problems for them or physical health So, you know, this is a management issue as much as it is just strictly a physiological one or a sociological one so The overlap here between disciplines is really important Yeah, I think that's a great point about management Where I think this is you know, maybe Jess can speak more and that's because she works closely with the NCAA it There's especially with I think Some of the changes of the NCAA is it's going through it now where we're paying our student athletes and it's I think it's putting a lot of pressure. It's professionalizing our student athletes at a younger and younger level And I think that that may and you don't have the research to back this up But in my mind it makes sense that that would increase these pressures Of unhealthy practices, you know, we're performance again optimal performances not go hand-in-hand with what's optimal for our student athlete health And I do worry that at a management issue things aren't being done From an administrative perspective to make sure that these safeguards are in place for athletes It just maybe you have to talk about because what in sociology right we're always looking at the institution and the individual and how they come together So maybe you have to talk a bit about how the instant sport as an institution of encourages unhealthy behaviors amongst athletes in the pursuit of both the pursuit of excellence, but also as as Marissa was talking about the amount of like myth and Ignorance involved in on the coaching side, but then also Is there something about the nature of athletes particularly high-performing athletes that makes them more likely to submit to unhealthy practices? Yeah, I think there is massive institutional concerns and institutional gaps across sports and systems across organizations and levels It's driven by money and you know, I think if we had to pick a tagline for everybody it would be like, but are we winning? And that kind of drives almost every moral values-based or ethical decision and we have yet to have I think really any Organizations stand in their values and ethics over winning and money in their sport The coaching is a great example. There is no Standardized regulation or accountability system or so to speak licensure for coaches So there truly is no accountability and as Marissa spoke about there is Thousands probably of cases a year where these just like awful abusive coaches Get the opportunity to resign because that looks better for the program It's less of a PR problem and they get to they get kicked down the road and this is across sports across level From you sport to to the Olympics and they get to go abuse their next set of athletes and you know They might go off the radar for like a year You know, and I think the book by Lauren Bushman like even the entire Nike ready Nike running machine as a good example of that Like there wasn't any like big accountability You've like they're just kind of like, you know, there was some like slaps on the hand and then they kind of kept on keeping on From for the most part it didn't massively change That program or how they do things are what they prioritize and my work in mental health is a good example of that because again It's something that it's typically not funded and prioritized Even though it would also help performance It's still not where we put our resources And you know, we don't put our our flag in the ground on that So yeah, there's no there's no regulation for coaches. There is a little to no accountability It's going to be on a case-by-case basis like in the NCAA I think it really usually comes down to who the athletic director is at a given program what Accountability may or may not look like but those are going to change and turn over frequently So we don't have any institutions who are holding lines that are are of what's acceptable and unacceptable Yeah, I think whenever we run into a problem in in sport What we say is well, we've got to fix the problem by fixing the individual athletes Not fixing the system within which those athletes are training and operating and And just you've you've Explained that nicely, you know the major problem in many cases is a structural problem and an institutional problem and their need to be fixes on that level Rather than just focusing on the athletes and saying oh, they're the ones who are screwed up. We've got to just fix them and But that's been the approach for as long as I can remember and I'm in my 80s So and and I started playing organized work when I was seven years old So, you know, it was always focusing on the individual athlete not on the system within which We were performing Seems like it's also important to recognize that Within this system athletes, there's a cat right we want it We don't want to think about athletes as individuals, but also as a cat just as individuals also as a category I mean these are the the person that becomes an elite athlete is highly motivated and is willing to make Tremendous amounts of sacrifice and becomes acclimated to discomfort and a variety of different kinds of discomfort and that is a person who's easy to manipulate Right and and the institution is set up in ways to take advantage of You know this the type of person that rises in that highly competitive environment I want to switch a little bit because we're running out of out of time here Um, and talk about what things that can be done So one of the things that you brought up earlier and I have some other like what can be done type questions is You know say coaches could be better at talking about talking to women athletes about their health menstrual health and what not and I think about You know, Marissa you discussed that exercise you do in your classroom where the students come up and they they they draw you know A period, you know the menstrual cycle on the board and and I think despite the fact that I've been married almost 30 years and lived with women before I was married Um, I don't think I would probably do any better than your students. I have a pretty I like I have a vague idea of what happens But I don't have a detailed understanding of what happens So say I'd become a coach and and I coach you sport but but say I was like a professional coach and coaching You know High level athletes or even high school athletes What are things I could be doing to get better at talking to my my women my girl and women athletes One to make them comfortable talking to me and then How could I be better informed and just better at discussing these issues with with athletes? Yeah, I think I mean, I think the first r is just that willingness to Approach those issues, which is which is huge. I think that's a big first step and there are resources available now Which I think a lot of maybe coaches and athletes may not be aware of we work with a company Um, it was founded by a researcher her name is George deeper in bells, but she developed this app called fit our woman And it's a it's a period cycle tracking app, but they have a coaching platform. It's it's highly used in the UK and European countries, but not as much I think over here It's been used by I think uh the women's um their the WNBA pretty heavily women's soccer Um, but I think it's something we can implement at the college level even where The coaches can have access to you know this app where their female athletes their team they it's a way Maybe to approach the conversation where you don't have to as a male coach where it might feel uncomfortable to go up to your female I think me like how's your period today or how are you sometimes like it's a very uncomfortable for probably both parties Um, this is allows a way where the coaches can you know with the athletes Incent of course um walk in and and they can see their team of athletes They're they're they're period tracking and it's a place where the women can log their symptoms So you can see what day is you know, maybe their female athletes might be most symptomatic have the most symptom burden, where, you know, maybe that's a way, that's kind of an entrance to approach those issues and kind of say, "Oh, hey, it looks like you're a little bit more symptomatic over the last couple days. How do you feel about taking it easy today?" And I think just approaching it as working with this is another training tool, just like we measure things like session-perceived exertion, heart rate, sleep, recovery, diet, like menstrual cycle symptoms. I think need to be part of the conversation, and if we approach it as a coaching tool rather than just something different about women's bodies, I think that might be a way to do it and kind of looking into you. There's other probably similar tools available as well. And maybe, Jess, you could answer this question. I'm thinking about an athlete who's maybe like a Lauren Fleshman who's, you know, maybe they're diet and training practices aren't as healthy as they could be, but they're doing a lot better than the people on their team. And they look around and they see that, you know, their teammates are getting injuries and they're losing training time and their performance is up and down and they're struggling a lot with their diet. What can a person on a team do? How can they intervene if they have a team culture that isn't as healthy as it could be, or if it should be, I should say? Yeah, that's going to be maybe something, maybe nothing. So it's going to be, you know, like depend on the team culture. So you know, like how authoritative is the coaching culture and how much psychological safety is present for everyone in that team or club to ask questions, to have hard conversations and to ask for help. So if there's, if it's entirely authoritative and there's no psychological safety, then that even conversations between teammates might not be welcome because they don't want to be that to get to the coach or them to be labeled as a problem. So it's really going to come down to the team culture as well as kind of the resources for help and support that are available readily to athletes through the organization. And I mean, certainly hopefully athletes feel safe to see resources outside of their team. Sometimes that feels safer. But again, like it's going to depend on that level of psychological safety and what has been instilled in them over probably a decade or more from previous team experiences. And what about you, you recognize this in yourself as the athlete and you're like, wow, I haven't had regular periods. And I have had these injuries and no one's explained to me why I'm having these injuries. But now, you know, I've listened to this podcast, I'm like, oh my God, I am that person. But they're getting a lot of pressure from their coaches, maybe their peers, maybe even their parents. You know, this could be a high school student. What are ways that athletes can advocate for themselves? How can they, like, what resources can they draw on? How can they strengthen themselves so that they can push back against these really powerful authority figures? Yeah, I think for a high school athlete, my hope would be that they could find some safe conversations with their athletic trainer if their high school has an athletic trainer, but they could possibly talk to the school counselor at school and ask if there's any availability of a dietitian that's connected to the school that they could speak with. That would be a great place to start, because as a kid, it's tough to navigate parents and coaches a little harder sometimes than it might be for a college athlete, but those would be great places to start. So this is all the time that we have for this episode. Marissa, Jess, thank you so much for coming on. This is such an important topic, and I won't lie, but this is pretty new to me, you know. And so I know that for a lot of the students who are listening, this must be really new to them as well, and that we, you know, as we've both said, we need a lot more research on this subject. So thank you so much for coming on and sharing your knowledge and expertise and your time with us. For folks listening, please keep an eye out for our next exciting, topical sports and society podcast. And then you can always join the discussion on our Discord server, and there is a link to the invite for the Discord in the description of this episode. Thank you so much, everyone, and enjoy the rest of your day. [MUSIC]