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Have you heard of the Female Athlete Triad (FAT)?
If you are a female athlete, or closely associate with female athletes, there's a very good chance that you've heard of the FAT, which has possibly the single most fantastically inapposite acronym in the history of acronyms. On the other hand, if you are neither a female athlete nor closely associated with female athletes, there's a good chance you've never heard of the FAT. The short version is, female athletes often show up at physician's offices experiencing menstrual dysfunction, low energy availability, and decreased bone mineral density. Sometimes this is also associated with that most famous of social contagions, the eating disorder--but often not!
The FAT is an important part of understanding female athletic health. Coaches and trainers (if they're worth anything at all) know to watch for certain warning signs, especially amenorrhea, anemia, and low body weight. Athletes exhibiting even one of these symptoms should, to the best of my understanding, be placed on lighter workout regimes or even excluded from practice altogether; athletes exhibiting all three should be excluded from athletic participation until more detailed medical examination can be done.
The FAT may be somewhat controversial in that attention to it arguably holds women back--a woman who cares more about a gold medal than about having children someday is rather unlikely to care much about amenorrhea (and may even see it as a blessing). But there are other consequences, too--like stress fractures, osteoporosis, bradycardia, and so forth. So people in charge of caring for female athletes--parents, yes, but also coaches and trainers--have for decades been generally regarded as under obligation to monitor women and girls for amenorrhea, anemia, and body weight/eating issues.
Why should you care? Well, recently there has been some culture war brouhaha over Florida (surprised?) weighing certain laws or regulations regarding the monitoring of menstrual health in teen athletes (really, just some standard questions on a standard form). Despite the AP's surprisingly helpful writeup, the Florida High School Athletic Association held an emergency meeting to "reconsider" their forms immediately, rather than waiting for their scheduled meeting later this month.
Certain folks in my social feeds have been going nuts about how monitoring menstrual health is a sneaky way of excluding trans athletes, or secretly learning who has gotten an illegal (?) abortion, and of course--it's all on Ron DeSantis, somehow. Time magazine, for example, seems happy to selectively report on the matter, as does Florida Politics. Advocate asks "why!?" Apparently, people have been asking "why!?" for months.
They've also been getting the same answer for months: "this is to make sure athletics is not endangering these girls' health." This is nothing new, and is something many states check. Should states check this sort of thing? I can imagine a certain sort of libertarian declaring that, no, this is unnecessary. But by and large it is the not the libertarians asking these questions--it seems to primarily be the people looking for something, anything to prevent Ron DeSantis from becoming President in 2024.
And they're even, apparently, willing to ignore and/or unwind a thirty-year-old staple of youth sports medicine to get the rhetoric they're after.
Even among libertarians, I think that's going to be a pretty fringe position, at least if they're applying the same sort of standards to female athlete reproductive safety and health as is typically done for other types of athletics safety and health. When an athlete is concussed, it is not simply up to them to decide whether they'd like to keep playing. If a male track athlete wants to run through a stress fracture, any decent and well-meaning coach will tell them that they can't do that, for their own health. For anyone who's been near competitive sports, you know that this is part of the overall deal - when you sign up, you pre-commit to doing what you're told by coaches and medical staff, and it's important that you pre-commit to it because everyone in these sports will push themselves too hard and too far if allowed to do so. We should acknowledge that bad choices made by highly competitive people in the spirit of competition aren't the same thing as coolheaded, voluntary choices and that it really is best to delegate this to someone that has the athlete's best interests at heart.
Is there anyone that wants to do a sneaky ban on trans athletes competing with girls? I'd be pretty irritated by a political process that tried to just make it inconvenient rather than openly saying that males should not be allowed to participate in girl's sports.
Openly saying that is easy. Actually instituting a policy that has any chance of being effective is difficult. The most straightforward way would be to simply implement mandatory sports physicals performed by a school doctor that included a genital examination. Of course, that would never happen, as the backlash among normal parents would be greater than any concern about a few trans athletes slipping through. Another way would be to establish a reporting system, where those suspected of being male can be reported to the body governing scholastic athletics, and that body can conduct its own investigation. This eliminates the problem of effectively punishing everyone for the sins of the few, but creates a system that might even be worse—any well-built female athlete could be reported to the commission and forced to undergo a humiliating investigation where her womanhood is called into question and could still possibly end up with a doctor conducting a genital exam. An obvious, straightforward way would be to simply require a copy of a birth certificate with the registration. The only problem here is that Florida has already made it relatively easy to get an amended birth certificate with a different sex, and undoing that system do to concerns about high school athletics would open a whole new can of worms.
Or you can create a bunch of half-assed policies that aren't fundamentally related to the issue but could help catch it indirectly. So if you start asking questions about menstruation you can flag all of the ones that say they've never menstruated; most school sports start at seventh grade and most girls have hit puberty by then and the ones that haven't probably aren't setting any records. But when a 16 year old who has never menstruated wins regionals and is obviously pretty athletic, you have some basis to conduct an investigation that isn't based on rumor and innuendo. I don't think that this is what's going on here, but it's at least a plausible strategy.
Somehow sports bodies are able to determine if a person has a minutely increased levels of some perfomance enchancing drug (some athletes find present such measures a significant obligation), but determining if they posses functioning testicles is to big of an ask.
We're not talking about international governing sports bodies here, we're talking about state and local scholastic sports bodies. It's understood that more is at stake when competing at the highest levels, or even at the collegiate level, than competing at the high school level. There you're talking about athletes who have already shown a significant dedication to their sport and they're more likely to jump through hoops to continue playing. The same can't be said about the girl who wants to run track because all her friends are doing it, or the girl who gets recruited from youth league to play soccer at a small high school that will take practically anybody just so they can field a team.
Anyway, the real question here is for whom is this too big of an ask? If any of these protocols were put into place the biggest objections wouldn't come from disinterested observers like you or me, or even from liberal or trans rights activists. They would be from the parents of the children affected, many of whom are conservative and would otherwise support the transgender athlete ban. Just not when enforcing it subjects their children to invasive examinations.
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