The discourse on this issue is way overfocused on elite athletes, imo. Elite athletes have different reasons for pursuing their sport and are up against the upper limits of what their bodies are capable of. The real value of sports for the vast majority of people is in the exercise and community, and their performance is largely dependent on skill, not their genetics. Most people don't pursue a sport, but we would all probably benefit a lot from one.
Unfortunately, the discussion re: elite athletes is causing restrictions on trans athletes to be introduced at amateur levels and even among child athletes, where the competitive concerns are completely irrelevant. Given how important sports and games can be for motor learning, creating situations where kids are excluded or otherwise made to feel uncomfortable in athletic spaces is doing them a lot of harm.
This is a post about how medical professionals should approach this with their patients. So good for you, but medical professionals can and should respond differently and that's the whole point.
Also, if you consider what responses are actually likely to encourage behavioral change, shaming is a lot closer to enabling than a judgement-free discussion of the risks and making a plan for gradual desistance with buy-in from the patient. As someone who works in health, I can tell you this is a core skill of the job and something we are doing constantly. This situation should be no different.
Shaming really only serves the emotional needs of the person dealing it out - it signals a disavowal of responsibility on your part should the unhealthy behavior continue. ("I fucking warned you" etc) This is not appropriate for a medical professional, as that patient is still your responsibility whether or not they follow your advice.
it really depends on the athlete - for an endurance athlete in particular, you don't need a crazy amount of protein. Dancers/gymnasts too or really any sport more reliant on cardiovascular endurance or coordination than maximal strength or power.
bodybuilders/powerlifters are on the far other end of that spectrum, they probably have the highest demand for protein intake out of any athlete. The general consensus is the muscle-building benefits of more protein flatten out around 0.8g protein per 1lb body weight. so about 120g of protein for someone who weighs 150lb. You can definitely eat more or less without issue, that's just roughly the threshold where more protein doesn't seem to help you athletically.
The nutritional guidelines under RFK's administration were changed to recommend 1.2-1.6g protein/lb of body weight for EVERY American, which is fucking ridiculous. It is fine to eat the high end of that range, but you have to be very careful to get enough carbs and fats without introducing too much caloric surplus. There is a valid argument that protein tends to keep you satiated longer and eating a lot of it might be good if you're looking to lose weight. I don't think it's a great idea for everyone though, and most Americans get enough protein for their basic needs anyhow.
but you know what's even better at keeping you satiated that most Americans are actually super deficient in? that's right fuckin FIBER baby. Protein is just in fashion right now, especially among conservatives, many of whom are meeting this through red meat probably because they think lentils are icky and woke. and we're god awful at health education so various nutrients get touted as THE THING YOUR BODY DESPERATELY CRAVES or THE THING THAT IS LITERALLY KILLING YOU on a rotating basis. e.g. electrolytes, carbs respectively.
(I can get more specific academic references for the earlier points, but I encountered much of it in Eric Helms' The Muscle and Strength Pyramid books, which line up with opinions of other credible trainers I've encountered. those books are also just a great read on this topic)
There are many, many more options than "scold and shame" and "dismiss accountability altogether" and as a medical professional it is part of the job to find the route to holding someone accountable while also ensuring that they will continue to trust you enough to discuss these things going forward.
Like okay, on just a person-to-person basis, if someone drinking during pregnancy pisses you off and you get upset with them, I kinda get it even if that's not an ideal response. It is an emotional response to possible harm. But a medical professional has to keep their emotions detached enough to choose the path that leads to the best outcomes. Last thing you want is your patient getting frustrated with you and going to the grifter who tells them all the drinking they want is OK so long as they take a bullshit supplement. Shaming does not motivate behavioral change in the way that laypeople tend to believe it does, especially in public health. You have to meet people where they're at and guide them toward reasonable steps, otherwise you're doing more harm than good.
glass beach - glass beach (from "the first glass beach album")
from the chorus:
In here, you'll be okay
And when your heart breaks, I'll be beside you
So please stay here with me
Breathe in like waves on a glass beach
fuckin incredible song, album, and band. glass beach has sadly disbanded but their vocalist has a new project called "you are an angel" with another self titled song that I can recommend too.
Yeah that's a possibility, I also suspect he believed that trans women would need/want as high a dose as possible and didn't seem to believe a lower dose would have any effect.
There are possibly more relevant examples than Hades, it was just the first that came to mind. It is not a complete departure from typical male character design, don't get me wrong, but I do think there's a greater variety than most games - Hypnos, Sisyphus, Orpheus, Icarus, Apollo, Hephaestus, and Narcissus are who I'm thinking of more specifically. The general character style does still lean on muscular definition (and they're generally still pretty unrealistic bodies for irl humans) but there's more room for a variety of builds and not everyone is portrayed as particularly strong or lean. You are correct that a lot of it comes down to outfit design, but that is still part of the overall character design and it does still feel like a step outside the norm.
the difference is that the bodybuilder aesthetic isn't usually what women are into. Nothing inherently wrong with it of course but it's still built for the male gaze. If you ask a gym buff IRL about it they'll tell you most people who notice their physique are men. The shredded video game dude can instead be thought of as a signifier of masculinity and sometimes as a fantasy for men to project themselves into while playing.
I don't think the washboard abs and boulder shoulders would disappear entirely if male characters were designed more for the female gaze, but we'd probably see some more dad bods and smaller dudes too. Hades comes to mind as an example.
oh my God I'm sorry that happened to you :( HRT management is so fucking simple, I'm honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I'd been taking with some occasional hormone panels.
for a while it was "too early" to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that's what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like "the online trans community" focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn't really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying "so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it's fine!" Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn't even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn't even think we changed my dose?
So then I looked through my records and it turned out he's been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn't discuss a dose increase at all so I didn't really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I'd been feeling and ask for an explanation. He just told me it sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
This is a context where what works for different people tends to vary a lot, so experiment with a few different strategies and find what you like best! As long as you're pushing yourself close to muscular failure for a couple sets, you probably will see an increase in strength regardless of the particular loading strategy.
Usually it's best for warmup sets to not be fatiguing at all - you want to save your energy for the heavy working sets close to failure that will provide the most stimulus. So I'd go for 6-8 reps at about half the weight you want to do in your first working set. Warmups are just to get comfortable with the movement and make any adjustments before you do your working sets.
You may like "wave loading" - progressively lowering the reps and increasing the weight over the course of your sets. All sets are performed within a rep or two of failure, but e.g. the first set is failure after 8-10 reps, second set is failure after 6-8 reps, third is failure after 4-6 reps, or something similar. You can use a 1RM calculator to estimate what difference in weight would bring you down from one rep range to another.
It may or may not also be helpful to bring yourself completely to failure in the first set to ensure you're stopping only when you cannot possibly do more reps, and not due to sensation of weakness, slowing of the movement, or moderate reduction in range. To do this, you'll want to keep doing reps until the cable absolutely will not move - you might have a few more reps in the tank on your first set than you realize. Raising the rep range a bit can also help with this.
(also, re: another question from the original post, you can do less than 6-7 reps of a movement and get stronger if you're getting close to muscular failure. I do a lot of sets in the 3-5 rep range, not all the time, but especially for big compound movements it can be great.)
Might just be the flare of the pant legs, but it looks like her knees are hyper extended way beyond fully straight to me lol. The stretch itself doesn't have to be too hard on your knees though!
those ilium wings are like two dinner plates good lord
The discourse on this issue is way overfocused on elite athletes, imo. Elite athletes have different reasons for pursuing their sport and are up against the upper limits of what their bodies are capable of. The real value of sports for the vast majority of people is in the exercise and community, and their performance is largely dependent on skill, not their genetics. Most people don't pursue a sport, but we would all probably benefit a lot from one.
Unfortunately, the discussion re: elite athletes is causing restrictions on trans athletes to be introduced at amateur levels and even among child athletes, where the competitive concerns are completely irrelevant. Given how important sports and games can be for motor learning, creating situations where kids are excluded or otherwise made to feel uncomfortable in athletic spaces is doing them a lot of harm.
Oh no, shoes shaped like feet! Won't someone think of the children??
Was just about to say the same. It's a great source of unwelcomed conversations alongside queerness and toe shoes.
Lightning Bolt - Blow to the Head
a lot of songs by this band could work, they're so chaotic and violent!
This is a post about how medical professionals should approach this with their patients. So good for you, but medical professionals can and should respond differently and that's the whole point.
Also, if you consider what responses are actually likely to encourage behavioral change, shaming is a lot closer to enabling than a judgement-free discussion of the risks and making a plan for gradual desistance with buy-in from the patient. As someone who works in health, I can tell you this is a core skill of the job and something we are doing constantly. This situation should be no different.
Shaming really only serves the emotional needs of the person dealing it out - it signals a disavowal of responsibility on your part should the unhealthy behavior continue. ("I fucking warned you" etc) This is not appropriate for a medical professional, as that patient is still your responsibility whether or not they follow your advice.
it really depends on the athlete - for an endurance athlete in particular, you don't need a crazy amount of protein. Dancers/gymnasts too or really any sport more reliant on cardiovascular endurance or coordination than maximal strength or power.
bodybuilders/powerlifters are on the far other end of that spectrum, they probably have the highest demand for protein intake out of any athlete. The general consensus is the muscle-building benefits of more protein flatten out around 0.8g protein per 1lb body weight. so about 120g of protein for someone who weighs 150lb. You can definitely eat more or less without issue, that's just roughly the threshold where more protein doesn't seem to help you athletically.
The nutritional guidelines under RFK's administration were changed to recommend 1.2-1.6g protein/lb of body weight for EVERY American, which is fucking ridiculous. It is fine to eat the high end of that range, but you have to be very careful to get enough carbs and fats without introducing too much caloric surplus. There is a valid argument that protein tends to keep you satiated longer and eating a lot of it might be good if you're looking to lose weight. I don't think it's a great idea for everyone though, and most Americans get enough protein for their basic needs anyhow.
but you know what's even better at keeping you satiated that most Americans are actually super deficient in? that's right fuckin FIBER baby. Protein is just in fashion right now, especially among conservatives, many of whom are meeting this through red meat probably because they think lentils are icky and woke. and we're god awful at health education so various nutrients get touted as THE THING YOUR BODY DESPERATELY CRAVES or THE THING THAT IS LITERALLY KILLING YOU on a rotating basis. e.g. electrolytes, carbs respectively.
(I can get more specific academic references for the earlier points, but I encountered much of it in Eric Helms' The Muscle and Strength Pyramid books, which line up with opinions of other credible trainers I've encountered. those books are also just a great read on this topic)
There are many, many more options than "scold and shame" and "dismiss accountability altogether" and as a medical professional it is part of the job to find the route to holding someone accountable while also ensuring that they will continue to trust you enough to discuss these things going forward.
Like okay, on just a person-to-person basis, if someone drinking during pregnancy pisses you off and you get upset with them, I kinda get it even if that's not an ideal response. It is an emotional response to possible harm. But a medical professional has to keep their emotions detached enough to choose the path that leads to the best outcomes. Last thing you want is your patient getting frustrated with you and going to the grifter who tells them all the drinking they want is OK so long as they take a bullshit supplement. Shaming does not motivate behavioral change in the way that laypeople tend to believe it does, especially in public health. You have to meet people where they're at and guide them toward reasonable steps, otherwise you're doing more harm than good.
glass beach - glass beach (from "the first glass beach album")
from the chorus:
fuckin incredible song, album, and band. glass beach has sadly disbanded but their vocalist has a new project called "you are an angel" with another self titled song that I can recommend too.
Please?
Yeah that's a possibility, I also suspect he believed that trans women would need/want as high a dose as possible and didn't seem to believe a lower dose would have any effect.
There are possibly more relevant examples than Hades, it was just the first that came to mind. It is not a complete departure from typical male character design, don't get me wrong, but I do think there's a greater variety than most games - Hypnos, Sisyphus, Orpheus, Icarus, Apollo, Hephaestus, and Narcissus are who I'm thinking of more specifically. The general character style does still lean on muscular definition (and they're generally still pretty unrealistic bodies for irl humans) but there's more room for a variety of builds and not everyone is portrayed as particularly strong or lean. You are correct that a lot of it comes down to outfit design, but that is still part of the overall character design and it does still feel like a step outside the norm.
the difference is that the bodybuilder aesthetic isn't usually what women are into. Nothing inherently wrong with it of course but it's still built for the male gaze. If you ask a gym buff IRL about it they'll tell you most people who notice their physique are men. The shredded video game dude can instead be thought of as a signifier of masculinity and sometimes as a fantasy for men to project themselves into while playing.
I don't think the washboard abs and boulder shoulders would disappear entirely if male characters were designed more for the female gaze, but we'd probably see some more dad bods and smaller dudes too. Hades comes to mind as an example.
hugs back! I'm sorry you had a similar shitty experience, thanks for sharing it here so I could get mine off my chest :)
oh my God I'm sorry that happened to you :( HRT management is so fucking simple, I'm honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I'd been taking with some occasional hormone panels.
for a while it was "too early" to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that's what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like "the online trans community" focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn't really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying "so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it's fine!" Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn't even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn't even think we changed my dose?
So then I looked through my records and it turned out he's been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn't discuss a dose increase at all so I didn't really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I'd been feeling and ask for an explanation. He just told me it sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
This is a context where what works for different people tends to vary a lot, so experiment with a few different strategies and find what you like best! As long as you're pushing yourself close to muscular failure for a couple sets, you probably will see an increase in strength regardless of the particular loading strategy.
Usually it's best for warmup sets to not be fatiguing at all - you want to save your energy for the heavy working sets close to failure that will provide the most stimulus. So I'd go for 6-8 reps at about half the weight you want to do in your first working set. Warmups are just to get comfortable with the movement and make any adjustments before you do your working sets.
You may like "wave loading" - progressively lowering the reps and increasing the weight over the course of your sets. All sets are performed within a rep or two of failure, but e.g. the first set is failure after 8-10 reps, second set is failure after 6-8 reps, third is failure after 4-6 reps, or something similar. You can use a 1RM calculator to estimate what difference in weight would bring you down from one rep range to another.
It may or may not also be helpful to bring yourself completely to failure in the first set to ensure you're stopping only when you cannot possibly do more reps, and not due to sensation of weakness, slowing of the movement, or moderate reduction in range. To do this, you'll want to keep doing reps until the cable absolutely will not move - you might have a few more reps in the tank on your first set than you realize. Raising the rep range a bit can also help with this.
(also, re: another question from the original post, you can do less than 6-7 reps of a movement and get stronger if you're getting close to muscular failure. I do a lot of sets in the 3-5 rep range, not all the time, but especially for big compound movements it can be great.)
Might just be the flare of the pant legs, but it looks like her knees are hyper extended way beyond fully straight to me lol. The stretch itself doesn't have to be too hard on your knees though!
knee crunching noises