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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.
The pertinent question here is "What does the school (or state) plan to do with this information?" I ran a high adventure program for the Boy scouts for several years, and part of the job was reviewing the medical forms of participants. These were mostly filled out by a doctor following a physical, though some doctors would just attach copies of medical records. I was concerned with three things—first, I had to make sure that is was filled out and signed by a doctor and not the kid's parents. Second, I wanted to see if the doctor noted any restrictions on participation. Finally, I wanted to see if there were any conditions that could cause acute problems during the week, things like asthma, diabetes, allergies, etc. and whether the kid had a medication that needed to be taken. I'd also ask if there was anything else I needed to know about that wasn't on the form, like if they had surgery or broke a bone since the doctor cleared them (forms were good for a year). I specifically remember one girl's form mentioning menstrual problems, and I can tell you for a fact that I didn't ask any follow up questions because there was no way I could see it affecting her participation in the program.
So what is the school going to do with this information? Are they going to subject all sports physicals and questionnaires to an independent review by their own physicians who will have the ability to override the examining physician? Unlikely. Are they going to establish strict standard for menstrual problems that will be enough to override a student's participation? Doubt it. Will they follow up regularly to detect any changes and potentially refer the student for further diagnosis? You see where I'm going with this. Most likely this information is going to be looked at once by the coach and won't be referred to again unless the kid gets injured while playing, and even in that case this specific information will probably be ignored by anyone involved.
Does this mean that all of this is just an underhanded way of rooting out trans kids to prevent them from playing on girls teams? I doubt this is the case, but when you make a name for yourself for blatant culture war waging, and a change like this is introduced right around the time you've been pushing for a ban on transgender athletes in girls sports, you can't be surprised if people get a bit suspicious.
My guess is that it is a way to notice there might be a problem. As a teenage girl it would never have occurred to me to tell anyone if my period became irregular. How horrifying to raise the topic! Most teenage girls have not yet seen a gynecologist (btw, who ask on their intake forms the date of your last period, for this very reason.) Their individual coaches should be aware of this but I can see how specifically asking would seem intrusive and weird.
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