2024-08-07T13:43:08-05:00

I’d like to talk about sporting categories generally, and then look at a couple of specific situations for people with XY disorders of sexual development.


Update 8/4/24: See here for “Toward a Robust Definition of Sport Sex” by David J. Handelsman in Endocrine Reviews. Table 2 lays out all the variations in genetic and physiologic status for the purpose of determining how to categorize an athlete for elite sport.  (To my knowledge everything I say below in simpler terms is consistent with this article.)


What are sports categories for?

Sporting categories exist in order to create opportunities for fair, enjoyable play for whoever the category was created for.

We create categories based on age, based on interest (recreational vs. highly competitive), based on budget (local vs. travel teams), based on resources (D1 vs. D3 schools), based on skill (C1 vs. C4 cycling), based on size (featherweight vs. heavyweight), based on physical ability, and also quite often (but not always) based on sex.

You can no doubt think of other categorization systems as well.

Aren’t the categorization rules sometimes unfair?

A frustrating reality of categorization systems is that they are imperfect. The child whose birthday falls just inside the maximum age-limit for a team has an advantage over the year-younger child who is also lumped in the same bracket.

Likewise, given the limited availability of teams, a newer, less skilled, or less physically adept child may struggle to find opportunities to play a given sport, due to restrictions on age or sex categories.

Shouldn’t categories be flexible to allow for these exceptions?

It all depends. Fortunately some less-competitive leagues will allow category exceptions, specifically in acknowledgement that a given player is of a fitting size and skill level for the team, despite not matching the general categorization.

Likewise, given a limited pool of athletes, there might be some mixing and matching of rules. For example, a youth team might be co-ed, but with older girls allowed to play in a younger boys’ age bracket, or younger boys allowed to play only if they move up to an older girls’ bracket.

Another example: I’ve been playing this summer in a co-ed hockey league that is for either 45+ or beginners, and the categorization is “you would like to play a chill, lower-contact, slower-paced game.”

In some situations, though, flexing category rules doesn’t work well.

Are there are important social reasons for the categorization?

Single-sex teams (and other groups) may have been created specifically for providing the unique mentoring and community-building that boys-only or girls-only groups provide.

Alternately, a team or league might be strictly-single sex due to religious or philosophical concerns about modesty or appropriate male-female interactions.

Changing it up: A team might be strictly co-ed because its physical, aesthetic, or social purpose centers on male-female pairs.

And moving on to other social purposes entirely . . . A team or group might be strictly lgbtq+ (or a subset), strictly for those in addiction recovery, strictly for children in foster care, etc., because it exists to create support and community for persons with experiences under some portion of the stated umbrella.

Is the category too hypercompetitive?

I wish I could say this is only a problem at the elite level, but there’s something about sports that brings out insanely, manically competitive behavior in otherwise seemingly normal people.

Thus unfortunately your local kiddie t-ball team or adult rec softball league might have to start checking birth certificates and enforcing strict eligibility requirements because the grown-ups have gotten so emotionally warped that they are determined to win at all costs, or at least go down trying.

When the stakes are higher — when scholarships, prize money, endorsements, fame, and advancement to the premier level come into play, then things can get extraordinarily nasty, fast. The only way to be as fair and sane as possible is to set clear categorization rules and stick to them.

How do the Olympics fit into all this?

The Olympics runs competitions for a limited number of sports, so there’s already a paring down of which athletes will ever have their accomplishments acknowledged at the Olympic Games.

Within that framework though, the Olympics has decided (rightly) to create sex-based categories, in addition to a few size-based categories such as for boxing.  The Paralympics also uses ability-based classifications specific to each sport.

I think we can reasonably say that the sex-based categorization of Olympic sports is not for a purely social reason. It’s not to help young men and women to build community and social support with others of their own sex. The two categories exist because the goal of the Olympics is to see who is the very best in the world at a given athletic feat.

For nearly all Olympic sports, if there were not sex-based categorization, only men would qualify.  The physical performance potential between males and females is massive, because human female bodies are designed to accomplish tasks that male bodies cannot do; in the survival tradeoffs, female athleticism takes a backseat to childbearing capacity.

And thus it becomes of interest: What can the very best-trained female athlete do?  Just how far can a woman’s body go in pursuing a given athletic task?

Note very well: We don’t have to have elite women’s sports. We could decide that from birth through adulthood, girls and women will simply play in the co-ed league that matches their ability level, and that will mean the best females will do quite well at the recreational level, end of movie.

If that is your stance, say so.

Those of us who support the existence of female-only sports beyond the recreational level believe that it is good and worthwhile for women to be able to see just how far a female body can go. This requires strict sex-segregation.

An aside on safety and bodyweight:

–> In some sports there may also be safety hazards at play, as there is a significant gap between the size and power of the largest and strongest men compared to the largest and strongest women.

Likewise, in sports with bodyweight categories, a male of the same weight as a female opponent will have greater physical power, and at the very least should play up to a higher bodyweight category to offset the male physical advantage in strength-to-weight ratios.

I mention these two factors because they are equally pertinent to the examples that follow, and would also apply to athletic organizations that aren’t pursuing a goal of promoting female sport, and therefore allow males into “female” categories, but may nonetheless decide that not injuring the smaller, weaker athletes is a worthwhile secondary social goal.

How does all this affect intersex, non-binary, and transgender persons?

Keep in mind that sporting categories can exist for any number of reasons. If your goals are primarily social, then your local sporting category rules can be adapted to meet whatever the social goal might be.

We know that the Olympics and most (but not all) other elite sporting events don’t have a primarily social focus in sex-categorization because of the many female athletes who socially identify as transgender or non-binary but who compete, rightly, in the female category. They have female bodies, and do not engage in testosterone doping (if they wish to be eligible for the female category), and therefore they are correctly striving to see how just well their female bodies can perform at their chosen sport.

One of the difficult cases, however, is for individuals who test as XY genetically, but who due to a disorder of sexual development were assumed at birth to be female.  Let’s look at two examples.

Should every XY athlete compete in the “male” category?

In 1999, the IOC stopped performing the routine genetic screening (via a cotton swab on the inside of the athlete’s cheek) to confirm that all female athletes were in fact female. This has created the scenario in the present Olympics where athletes disqualified for testing as XY by their own sporting bodies have gone on to compete as females at the Olympic games.

In the interest of fairness (and safety), a return to screening would be a simple, low-hassle way of quickly confirming that female athletes are eligible for their category.  Such screenings are faster and less invasive than the many anti-doping screenings that are routine in elite sporting due to the widespread problem of cheating.

However, a strong case can be made that some XY athletes flagged during a routine genetic screening should be allowed to appeal and play in the female category. Others belong in the “male” category, even if socially they have chosen to maintain a feminine personal identity.

In Swyer Syndrome, the affected person has XY chromosomes but develops female genitalia and does not undergo puberty unless hormone replacement therapy is provided.

It would be reasonable that a woman with Swyer syndrome, receiving female hormonal therapy and who has by definition never been exposed to male hormones, let alone male puberty, be allowed to appeal for the right to compete in the “female” category after an initial cheek swab genetic screening raises a flag.

It’s no doubt a frustrating situation having to take that extra step after screening, but also by the time a woman is actually competing at the elite level, she’s probably already been to the doctor for her amenorrhea and has the case notes ready to go. If the cheek swab results are in fact a surprise to her, it’s a fortunate catch, since untreated Swyer Syndrome causes osteoporosis due to the lack of estrogen, as well as an increased risk of certain tumors.

In justice, sporting authorities should have an accelerated pipeline for referral, diagnosis, and treatment in these rare but real cases, so that the young woman doesn’t miss out on important competitions due to bureaucratic delay.

While one could make the argument that all XY athletes should automatically be required to compete in the male category, Swyer Syndrome seems to be a legitimate exception — not because the affected persons “identify” as female, but rather because in terms of the goal of seeing just how far a female body can perform, physically this is the matching group.  The usual course of treatment does not confer male physical athletic advantage.

–> Obviously if a person with Swyer Syndrome has made the decision on diagnosis to pursue male hormone therapy (a valid personal medical decision), thereby undergoing the masculinizing affects that confer male physical advantage, then the “male” category would be the better match.

Now let’s look at a different disorder that leads to a different result.

5-alpha reductase deficiency causes an XY male to have underdeveloped male gonads to undergo male puberty:

Doctors diagnose 5ARD when a baby with female-like or nonbinary genitalia has tests that show 46,XY chromosomes and specific hormone levels (high testosterone and low DHT). In older kids or teens, doctors might notice the condition when someone who looked more female at birth starts to develop changes typical for males during puberty. Tests will show the same hormone pattern as in younger children.

Although men with this disorder may experience impaired fertility, they are indeed able to father children.

While this is obviously a very psychologically and socially challenging situation, there is no doubt that for elite competitions (even at the high school level or as soon as the disorder is identified), the athlete should compete in the “male” category.

We could go through every disorder of sexual development and make similar assessments, but we’ll stop there. For more reading:

In all cases, there is no reason to assume that an athlete with a disorder of sexual development is intentionally trying to game the system; a fair and consistent application of the category rules based on the physical facts of the individual case can put to rest any such suspicions.

Joe Thomas (football) and Simone Biles (gymnastics) high-five at a celebrity softball game.

Photo by Erik Drost: Joe Thomas (American football) and Simone Biles high-five during a celebrity softball game, via Wikimedia, CC 2.0. One of the other beauties of sex-based categories for elite sports is seeing how sports such as gymnastics differ in style because of the ways that male and female bodies are each magnificent in their own distinct ways.

Checking in to apologize for the radio silence and assure you a new beginning is in sight!

Marriage has been much on my mind, and I’m hoping to write more on interrelated topics soon, but meanwhile let me say that the past several months have been the most work* I’ve ever put into preparing for a single sacrament.


Usually my advice to young couples is to keep the wedding small and hold onto as much of your savings as possible for getting your marriage off on solid financial footing. I stand by this generally. I remain absolutely firm on avoiding all wedding-induced debt, and likewise leaving the emergency savings untouched, even if it means just a tiny wedding with only the very closest family.

And yet sometimes parenting takes us to new places.  Unexpected plot twists that have come to us thus far in the journey:

  • We became rabbit lovers!
  • We became sports parents!!
  • We became big-wedding people???!!!

These things happen. Your vocation should lead you to new places, and here we are.


In prayerfully discerning whether to accept the very generous contributions of some loved ones to basically double our budget so this wedding could be a much more elaborate affair than previously planned, what I found myself coming back to in prayer was The Wedding at Cana.

Here is this young couple embarking wholeheartedly on a marriage that is exactly what our world needs — cherishing each other, centering their lives around Jesus, eager to embark on their lifelong mission together as husband and wife for certain, and as father and mother when the time comes.

Our other children and their peers can attest that it can be very hard to find a future spouse, even when you are both intentional in your dating and open to letting God surprise you.

There are no guarantees in life, but if ever I had confidence that an engaged couple had chosen well and were likely to succeed, with the Lord’s help, at the long and challenging vocation ahead of them, this is that moment.

So yes, this is indeed something to celebrate.


Well, you don’t go big and stay within even generously-loosened financial constraints unless you put a load of work into it. At every turn my daughter has been finding the most frugal way to get the thing done, putting hours of work into researching, handcrafting, and carefully selecting where to outsource help and what to do in-house.

I’ve been the co-conspirator all along, letting her lead but putting in the manpower when there is something I’m uniquely suited to either by talent or dint of free time.

It’s going to be good. So beautifully good.

But I don’t anticipate any serious writing happening through the rest of June, because I’ll be deep in extended family time before and after.


In good news: Come August our youngest goes off to college, and the SuperHusband and I will be empty nesters!  So after a summer that will stay pretty busy even after the last of the wedding guests heads home, it is our plan that I’ll focus in the year head on more writing stuff.

We all know how plans tend to go, but my hope is to pick back up with a novel project that, while entirely, 100%, heavens to Betsy this is fiction fiction fiction, will certainly having me doing a lot of thinking about the kinds of topics I write about here and at the ‘stack.

That’s the hope.

Anyway, rejoice with me as my daughter and future son-in-law prepare for the biggest moment in their young lives, and thanks for being here.

Wedding at Cana, late 16th century, lavishly painted feast scene

Artwork: Wedding at Cana, public domain, click through for details and a full-resolution image.  Yes, this is basically what my life feels like right now, but in a good way!

*Okay if we count gestating and delivering the recipient, then I’ve put waaaay more work into four baptism preps. Although, then we think about two decades and change spent rearing the Fitz-half of the couple, and there we are.


PS: 100% I got my daughter a copy of The Sinner’s Guide to NFP.  You know it.

My daughter and soon-to-be son-in-law are facing some major school and career decisions today, and here’s what I’ve been telling her this spring: Marriage is meant to change you.

Who you each are, separately, as single, unmarried persons is supposed to be different than who the two of you become when you are intimately joined in a lifelong, life-giving union.  The whole point is to become something different!  If you wanted your life to be exactly how it was before, you wouldn’t be getting married!

So it is with the priesthood, with religious life, with parenting . . . with undertaking any serious vocation, religious or secular.


So often we hear moms — it’s usually the mom — saying “I’ve lost my identity now that I have a baby.”

When you dig underneath, there are different kinds of common identity concerns:

  • Her identity was tied up in her career, but now she’s staying home and feels herself slipping away from her profession and her financial self-sufficiency.
  • Previously she found her identity in hobbies and pastimes that just don’t mesh with caring for a baby, so now what?
  • Her body has completely changed and it’s never going back to how it was, and she really loved identifying with how it used to be.

–> Pause here to note that moms who continue pursuing their careers after having kids often report struggling with a different identity crisis.

Too often work-at-work moms are expected to bring no hint of the impact of their new family life with them into the office, lest they sabotage their employment opportunities, and furthermore they are somehow supposed to also pull off everything some fictional, hyper-idealized stay-at-home-mom reputedly does with her kids.

Meanwhile the loss of free time and the struggles with body image apply equally or more so.


Sometimes the “identity” crisis isn’t about identity at all, though, but about a serious and potentially even life-threatening situation:

  • She is overworked, exhausted, not getting enough sleep, and struggling with basic physical needs, and no surprise this is wearing her into a state of despair.
  • She is under-appreciated and taken for granted in her new life as a caregiver, and can’t get the emotional and practical support that she needs.
  • She is criticized and demeaned for “not doing enough” or being “incompetent” because she has taken on an endless, enormously difficult task that will never, ever be done to perfection because hello caring for a baby is not, at all, like finishing some project at the office.

This is not the way. None of this is.

When I talk below about finding your identity in your new vocation, that does not mean “finding yourself” in neglect, abuse, or casual indifference from the people who are supposed to love and care for you.

It’s normal to find parenting and other serious vocations to be highly demanding and challenging pursuits. It is not normal or healthy to be driven to feeling hopeless, worthless, isolated, burnt-out, or unable to cope.

If that last list is you, claw your way to a place and physical and emotional safety and start figuring out what changes you can make to get out and stay out of the black hole.


I had a pastor once who really liked going to the gym in a regular t-shirt and shorts, or going around town on his day off in a generic polo and khakis, and being taken for just some random guy.  He loved being a priest, and truly relished giving of himself in priestly service to others, but sometimes he needed the emotional space that comes with no one coming up to you for priest-stuff.

That’s cool.

No matter how much you love your kids, it’s pretty likely you need some breathing space to not be needed for a little bit, while the kids are safely being tended by some other person.

No matter how much you love your profession, and how much the world desperately needs the work that you do,  sometimes you need to turn off the phone and let someone else deal with the thing while you take well-earned vacation.

No matter how vital and soul-saving your ministry is, you can only give yourself away to others if there is something of you left to give.

None of this is about “identity” — it’s just common sense.


So what is identity about?

I had a great aunt who shared with me something my generation didn’t fully understand: When the wedding announcements or society pages in the local paper back in the day referred to the bride by the husband’s name, “Mrs. John Smith” or what have you, it was a moment the girls longed for and cherished.

They loved taking their husbands’ names, in full, not because they were losing themselves, but rather because to them it was about arriving: I am so proud of who he and I are becoming, now that we are one. We are undertaking a mission together, and I am proud of the man I have chosen to be my partner in this life we are going to forge.

That proper sense of joy and self-identification with a mission and vocation wasn’t then and isn’t now about naming conventions, or who watches the baby, or what kind of professional career you do or don’t pursue.

Rather, it’s this: A great vocation changes us. It changes who and what we are.


One of the ladies I play hockey with will often explain some quirk about her day or her choices or her interests by saying, “Well, I mean, it’s probably because I’m a nurse.”

It’s changed her.  She poured her life into an irreplaceable and invaluable vocation, and she is therefore a different person than she was so many years ago, before she gave her life to caring for an unending line of patients who desperately needed the help she had studied for and practiced to be able to give.


Sometimes, though, our vocations call us into a new and unwanted identity.

It is hard, so hard, when you find your life being pared down to a set of constraints you didn’t choose.

It’s hard enough when you walk into a vocation — a marriage, a religious vocation, a career, a ministry, a new child — and face in full the normal and expected sacrifices but which bite more keenly than you’d imagined.

Even harder is when the sacrifices you must make in life come from things no one expects or deserves: Unjust financial or legal problems, betrayal by someone in a position of trust, illness or injury, bereavement, disaster, or just some miserable combination of bad luck and weirdly converging lousy circumstances.

But even here, we have an opportunity for a horrible vocation to become a great vocation. I didn’t choose this suffering, but I will allow myself to be changed as a result into something and someone new and different and good. 

I will do all I can to leave a legacy of virtue even as everything I once held dear diminishes and wafts away on the breeze.


So I am going to tell a story about these kids I mentioned up top. My daughter and her fiancé have just wrapped up undergrad, and as they get married this summer they are also entering a transitional period of figuring out graduate school and jobs and next steps.

All spring I’ve been telling my daughter: It’s okay if your major life choices as a wife are different than what you would choose if you were single. It’s not bad or wasteful or letting anyone down if you make job and school decisions for your marriage that are different than what you’d do otherwise.  That’s normal and healthy and all part of it.

But here is what happened: She got offered this thing (and she has to decide on it today) that is her dream opportunity in so many ways, but the logistics are a mess.  To accept the position would be to ask her husband to make an enormous sacrifice just weeks into their marriage.

So he said to her, “But if I had this opportunity, I wouldn’t be able to pass it up. So if you want to take it, I will figure something out.”

And whatever that something turns out to be, we will know that marriage has changed who and what he is.  Instead of being a guy who does his own preferred things, he’s now a guy who steps up and sacrifices out of love for his wife.

Hands of husband and wife with their gold wedding bands prominent.

Photo by RF Vila, via Wikimedia, CC 4.0, showing the hands and wedding bands of a couple married forty years.

What does the Catholic Church have to say about the recent Alabama Supreme Court ruling on embryos and wrongful death of minors lawsuits? Today I want to run through several aspects of the case that touch on the Catholic faith, from legal questions to very personal family planning decisions.

Every aspect of this case is highly emotionally charged, and my goal here is to sort out truth from hyperbole.  You may not be comfortable with the Church’s stance on a given aspect of the case (even if you’re Catholic), but the only way to know where you agree and disagree is to start by understanding correctly what the Church actually teaches.

What are the key aspects of this ruling?

The two cases being considered involve three families whose frozen embryos were destroyed due to negligence by their IVF clinic. The parents have attempted to get compensation for their loss under the Alabama Wrongful Death of a Minor Act.

Click here for the link to the full text of the decision, which is fairly readable.  Here’s a summary of Justice Mitchell’s key points:

  1. The Supreme Court of Alabama can only rule on questions or concepts that it has been specifically asked to treat.
  2. The Supreme Court is limited in its decisions to interpreting what the law of the State of Alabama actually is, according to the plain meaning of the legislative texts.
  3. Even if the justices themselves might prefer the law to say something other than what it does, they can’t create interpretations to conform to their wishes; it’s the job of the legislature to reform the law.
  4. The plain meaning of Alabama law as currently written includes stored embryos in the definition of “minor children” for the purposes of the specific civil law statute in question in this pair of cases.

This last point is important, because the decision specifically explores the differences between civil and criminal law, and explains why it’s often (rightly) possible to get compensation for damages in a civil case even if the situation doesn’t rise to the level of bringing about a conviction for related criminal charges.

This makes sense! There are many situations where we might accidentally or carelessly bring about some harm that in justice we should try to make amends and restore our neighbor as much as possible, but in which a criminal charge would be going too far — it would be an injustice to send someone to jail (or worse) given the circumstances and/or level of evidence.

This distinction is very important in wading through reactions. This ruling treats civil law, so anyone saying that “IVF has been criminalized!” is just not being honest.  This ruling does say that the law as written allows parents of frozen embryos to sue for civil compensation under the Alabama Wrongful Death of a Minor Act.

Who is affected by this ruling?

This ruling concerns Alabama state law. Other states may have similar laws but which either explicitly carve out exceptions for IVF, or which create exceptions indirectly.

And, narrowing it down further, what this ruling did was send the case back down to a lower court for trial.  Justice Mitchell’s opinion laid out multiple aspects of the case that the Supreme Court was unable to rule on because it was not asked by either party to do so.  Thus while the Alabama Supreme Court ruled that the Wrongful Death of a Minor Act could apply in this case, it did not make any decision about whether the IVF clinic actually owed damages.

Justice Mitchell’s decisions pointed out one very important aspect of the case that, in the new trial, may have a strong bearing on whether new precedents will be set concerning civil liability for IVF clinics:

During oral argument in these cases, the defendants suggested that the plaintiffs may be either contractually or equitably barred from pursuing wrongful-death claims.

In particular, the defendants pointed out that all the plaintiffs signed contracts with the Center in which their embryonic children were, in many respects, treated as nonhuman property: the Fondes elected in their contract to automatically “destroy” any embryos that had remained frozen longer than five years; the LePages chose to donate similar embryos to medical researchers whose projects would “result in the destruction of the embryos”; and the Aysennes agreed to allow any “abnormal embryos” created through IVF to be experimented on for “research” purposes and then “discarded.”

The defendants contended at oral argument that these provisions are fundamentally incompatible with the plaintiffs’ wrongful-death claims.  . . .  The trial court remains free to consider these and any other outstanding issues on remand.

In what ways is this ruling “Catholic”?

Here are two aspects of Catholic teaching that are consistent with this ruling:

Subsidiarity.  In sticking strictly within the bounds of what the state Supreme Court has the right to decide, this ruling respects the principle of not overreaching in authority.

Dignity of human life from conception. As it happens (whether the judges agree with the law or not — their job isn’t to approve the law but to rule according to the law as written), Alabama state law is in many ways in accord with Catholic teaching on the reality that human life is sacred, that our lives begin at conception, and that our worth as a person isn’t determined by our age, ability, or usefulness.

–> To better understand the philosophical underpinnings of this belief, whether from a religious or secular point of view, the book you want is Embryo: A Defense of Human Life by Robert P. George and Christopher Tollefsen.

All that said, there are details of this case that bring to light some areas where Catholic teaching is quite distinctive. Let’s look at that next.

What is the Catholic position on embryonic human life?

The Catholic position is rooted in biological fact: The defining moment when a human being comes into existence is at conception. That would be fertilization of the ovum (not a human being) by the sperm cell (also not a human being).

The Church takes an interest in this scientific question because the implications are so far-reaching. Unlike a utilitarian philosophy, which judges the worth of a person based on his or her usefulness, Catholicism holds that all human beings have equal rights and dignity.

Thus, for example, genetically screening embryos to select a child who doesn’t have an undesired trait, and in the process killing those who don’t meet spec, is morally abhorrent.

This position is in no way unique to Catholicism — many religions, as well as many non-religious people — agree that we shouldn’t kill people just because they have a particular illness or disability.

Likewise, it is absolutely unacceptable to participate in any way in discarding frozen embryos just because they are no longer wanted, nor to use stored embryos for scientific research or technological developments that knowingly, intentionally involve killing the embryo.

–> In contrast, we could imagine a scenario where an embryo from an ectopic pregnancy, which is certain to die if it remains implanted in the mother, might morally be transferred to an experimental artificial womb, if the hope is that the child will survive — perhaps to be experimentally re-implanted into the mother’s uterus. Even though there’s high likelihood the procedure would not succeed, the intention is not to kill the child; it is an attempt, however long the odds, to save the child’s life.

And remember that in all cases, it is morally acceptable to remove the embryo or fetus from the mother’s body if indeed necessary to save the mother’s life. We can’t actively kill the baby as in abortion, but surgical or vaginal delivery of the intact child is morally acceptable, even if the baby is far too young (such as in ectopic pregnancy) to survive outside the womb.

Is IVF okay as long as no embryos are destroyed?

This is a completely different question, and one on which Catholicism has far less company.  Many Christians (and others) who recognize the embryo’s inherent dignity as a human being do, nonetheless, allow IVF as long as a sincere attempt is made to implant and bring to term all embryos conceived in this way.

Here’s the Catholic position on IVF in a nutshell:

Most important: Every child conceived by IVF is a gift of God, precious and equal in dignity to all other humans.

More difficult to understand: Nonetheless, the sexual act itself has a sacredness that needs to be respected.  Conception should occur within an act of intercourse between faithfully, lovingly married husband and wife.

This second point is a hard teaching. We can point to many cases where IVF is attempted by loving, faithfully married husband and wife who are only trying to solve their fertility problem.

These cases are fundamentally different from surrogacy or donor cases where the right of the child to know and be reared by its own parents is intentionally denied by design, and which in some cases even amount to full-on trafficking. We need to acknowledge that.

We need to recognize that not every instance of IVF has the same level of moral problems.

Nonetheless, Catholicism does teach that couples should not use IVF.

We should also recognize that even though in many cases couples will be able to conceive by seeking alternate forms of fertility treatment, that won’t always be true.

Isn’t the strict rule against IVF counter to the pro-life ethic?

To be pro-life is to respect the dignity of all human beings.  Often (not always) our respect for the sacredness of the gift of human life leads married couples to have another child, even when doing so involves a certain amount of sacrifice or hardship.

(And there is no denying that IVF involves sacrifice and hardship!)

Likewise, respect for human life means that when a child is conceived in a way that isn’t ideal, such as an out-of-wedlock pregnancy, or even in a way that is overwhelmingly and entirely evil, such as rape, we nonetheless treasure the child. The child might be the only good thing in the whole horrible situation, but the child is good.

We seek to help the mother through the serious hardships her pregnancy involves, and we seek to support her in whatever choice she makes about whether to rear the child herself or to seek a good adoptive family for her child.

When appropriate (such as an ordinary out-of-wedlock pregnancy), we seek to help the father to also foster a right relationship with his child. The best way to do that will depend on the unique circumstances of the situation.

All that said, being pro-life is not about maximizing human population via any means available. For couples suffering from infertility, the pro-life choices are to:

  1. Help them conceive using morally acceptable means if possible. If that is not possible then to . . .
  2. Provide support and accompaniment as they find other ways to live out their God-given vocation, whether that be through adoption, fostering, or some completely different ministry.

What if a Catholic has used IVF anyway?

Well, that’s in the past.  You can’t change the past.

Furthermore, even though few people can understand the pain of infertility, any honest Catholic will admit that frankly we’ve been tempted by far less, and have frequently fallen short of the mark.

That doesn’t mean IVF is no big deal. What it means is that you move on.  Your past makes its mark on your life, but it doesn’t define who you are now, nor who you will become.

If you knew it was wrong when you did it? Take it to Confession. You chose to do something you knew not to do, and you’re sorry, and you want to live differently going forward. Receive God’s forgiveness and healing.

If you didn’t even know it was wrong when you did it? Then you didn’t know. In order to be culpable of a sin you have to know it’s a sin! Now you do know, and your life will be different as a result.

If you aren’t clear in your mind about where you were, mentally, at the time? Just bring it up in Confession.  God knows your heart, and He is ready to embrace you, and love you, and welcome you into a relationship of peace and joy.

God bless.

2024-01-31T20:43:07-05:00

Question that’s been generating some unnecessary panic: Is it okay for a Catholic to celebrate Valentine’s day, birthdays, anniversaries, or other special events that happen to fall on Ash Wednesday or Good Friday?

Short answer: In the United States, at present yes in fact you can, though with some restrictions.

Here are the details.

Period promo poster for "The Ashes of My Heart" starring Barbara Castleton, 1917.
Poster: Top result on Wikimedia when I searched for “heart with ashes.” I had no idea they were making films about opioid addiction back in 1917. (Image is public domain.)

 

#1 It’s always better to fast as fully as possible.

If your health and state in life allow it? Nothing but prayer, water, and works of mercy for you. (And the Eucharist of course!)  That’s not a requirement, but it’s an ideal worth approaching.  For some of you with a history of eating disorders or perfectionism-related mental health issues, your correct approach is to simply follow the rules set forth by your bishops’ conference and offer up your genuine sorrow that a stricter fast simply is not the prudent course.

#2 Your state in life makes a difference.

If you are clergy or religious, you have an obligation to immerse yourself in the liturgical life of the Church with a totality prescribed by whatever rule of life you are bound to follow.

If you are a lay person, your vocation is lived out in the context of family and community life, and you have wider room for discernment on what exactly that should look like on a holy day.  There may be good, serious reasons that a celebration on-the-day is in fact a work of mercy on your part.

#3 Is it possible to reschedule?

Still, the goal is not to play “What can I get away with here?”  If you can move an important life or work event to another day, do that.

As much as possible, we want to set aside Ash Wednesday and Good Friday as the sacred days that they are, leaving behind as many of our worldly attachments as we can.  The kids will be *just fine* if you hand out the pink cupcakes a day early. Talk about a perfect teaching moment!

Likewise, in most dating and marriage relationships, your simply expressing a preference to move the celebration to a slightly different date will be a non-issue. The mere fact that you request it is all your loved one needs to hear, just like you are always quick to accommodate the preferences of those around you whenever possible.

#4 Can you do the thing without doing the thing?

If it’s just a little bit of a cake being passed around the office, you can hover during the brief festivities sipping water from your Yeti cup, and then gratefully accept your slice of cake and carefully wrap it up and put it in the fridge to save for later.

Not every celebration requires actually eating and drinking the celebratory foods.  It’s fine to just watch and make merry on an empty stomach.

#5 What’s my real intention?

Nonetheless, we can think of situations where you might rightly discern that going along with a given celebration is the right thing to do. Examples:

  • Your spouse is very uncomfortable with your deepening practice of the faith, and would be saddened and alarmed if you moved Valentine’s dinner, which you two have always celebrated on the 14th for reasons that go way back to some important traditions and memories in your marriage.  Out of love for your spouse and a desire to not create a stumbling block to the faith, you resolve to celebrate your special day together cheerfully and without hang-ups.
  • You forgot to check the calendar last fall before setting the date for your Baptist great-grandma’s 99th birthday party.  There is no way on earth you’d cancel on the biggest event the senior center is going to see all year.
  • Your employees have been through a rough time lately, and everyone is (genuinely!) looking forward to that big thing the facilities team put together to honor some colleagues who really went the extra mile. You didn’t pick the date, and you wouldn’t dream of letting these guys down after everything they put into it.

You can think of other situations. The decision to go ahead with the celebration isn’t about you wanting to slack off on your spiritual discipline, it’s about respecting the real emotional needs of others around you.

If we lived in a totally-Catholic society this wouldn’t be a factor. But we don’t. Perhaps the fact of our nation’s cultural and religious pluralism is one reason the US bishops have set their fasting guidelines as they have.

#6 There are still limits.

Your celebratory meal needs to meet two requirements:

  • No overeating.
  • No meat.

That’s it.  By the US bishop’s guidelines for fasting, you are permitted one full (normal) meal on the fast day. Alternately, if you are joining your loved ones for just that slice of cake or a few chocolates, it can be part of one (or both) of your two allowed snacks that together make less than a complete second meal.

Yes, you could have dessert, if you eat less of the dinner so that you aren’t over-stuffing yourself.  Yes you could drink that glass of wine or mocktail, ditto. If you go to one of those restaurants where the portions are huge, you need to either leave the extra on your plate or else request a to-go box and eat the remainder tomorrow.

And yes, you need to skip the meat and go with the fish or the vegetarian option. At Great-Grandma’s barbecue birthday luncheon, you will need to discretely manage to eat only the rice and the vegetables, no pork or chicken or brisket, and yeah even pick out the obvious lumps of bacon in those collards, so maybe it would be smart to call the caterers and get a tray of catfish added to the menu.

And you don’t get to pout about it, either. Man up, eat your greens without drawing attention to yourself, and silently thank God that at least the bishops haven’t outlawed banana pudding.

On the other hand, you do not need to scruple over sauces or soup stock made from animal products, but which aren’t meat themselves.  It’s legal.  (Hash, my friends, is not legal. Sorry. But you knew that.)

Finally, it is essential to remember that it is still a day of prayer and fasting.  Be joyful and fully present to those you love during your time together, but during those hours of the day that are yours to do with as you please, dedicate your holy day to prayer and penance.

#7 You set your own rules for your personal Lenten penance.

So does all this mean you can have cake and chocolate candy and brownies on Ash Wednesday and Good Friday? What??

Well, that’s up to you.  It’s your job to discern what specific penances you wish to take on above and beyond what is strictly required, and it is your job to decide if you should make exceptions to those penances.

It’s quite possible you shouldn’t have cake ever, because you know that it’s terrible for your (personal) health, and the people who love you wish you wouldn’t.  Nothing celebrates 99 years, or the lifelong marital commitment, or appreciation for the people who spend large parts of their lives working alongside you, like doing your best to be there, healthy as possible, for those you love.

It’s also possible that everyone’s just happy you could come, and nobody cares whether you have the cake. So skip it.

Likewise, consider that people around you might be genuinely inspired by your example if you are able to share their joy while also (without drawing attention) denying yourself in accordance with the spirit of the sacred season.  Your act of self-denial may evangelize people you had no idea were noticing.

But if that chocolate candy or that cake are in fact not a problem for you physically, and it would be really meaningful to your loved ones to share that moment of celebration with you? Yes, you are in charge.

You decide what your personal Lenten penances will be, and then you decide when it’s best to stay the course without exception, and when, in contrast, setting aside your planned penance is in fact a work of mercy.

 

Related:

 

2024-01-03T12:02:25-05:00

Is “Calories In Calories Out” the reality about weight loss and obesity? I caught a few glimpses of the recent Twitter food fight over that question, and here are the two main, credible arguments in favor:

  • It is a mathematical fact.
  • We understand that many people find the math hard, so they use other rules that are simpler to follow, and that’s fine, but it’s still CICO.

I’d like to weigh in with a reality check: CICO is sometimes the problem, but it isn’t always the problem.

I know real live people who used calorie counting, either directly or through a simple set of portion-control practices, to lose weight and keep it off. Some included exercise in their approach, others did not.  Most experienced a little bit of hunger while losing weight, but overall found it to be a manageable experience with no negative side affects (no depression, anxiety, anger, fatigue, frequent infections,  hormonal disorders, etc.)  After reaching their goal weight, they had no further difficulty with maintaining their new, lower weight via continuing with the same dietary approach that got them there.

These people exist. They are by no means the majority of dieters, but they are real human beings in actual human bodies, and they are the examples the public health industry points to when saying that Eat Less Exercise More is all it “really” takes.

And yet, clinical practice has shown that while CICO is sometimes an effective approach to weight loss, most of the time CICO alone is not sufficient.

What’s going on?

Let’s pause for some metaphors.


If you google “Causes of Foundation Failure” overloading is often (not always) on the list.  The structure is too heavy for its foundation, done. That’s the problem.

Dam failure? Maybe there is simply too much water pushing against the dam. You need to either reduce the amount of water being retained, or you need to strengthen the dam, or both.

Power grid going down? Maybe there is too much demand for electricity and the system can’t handle it.

Blew a circuit in your house? Maybe you’ve plugged too many appliances into that outlet.

These are real things that happen, and they are analogous to Calories In Calories Out. Your foundation really will fail if you overload it. Your circuit really will blow if you overload it. It’s not pretend.

And yet I promise you: Do not hire an engineer whose only solution is, “I guess three bedrooms is too much house for you,” or “Have you considered that maybe you’re just not meant to have lights in that room?”


Sometimes the problem is simple, obvious, easy to diagnose and fix.

I know to unplug the portable heater in the bathroom before running the hair dryer and we’re set. The circuit can only take so much. No big deal. Nothing deeper going on.

Likewise, I have a friend who lost all his excess weight just by cutting out his ice cream snack at bedtime and going for a pleasant walk every day. Simple, painless, and while we could point out that dropping the sugary item and increasing the exercise both have a favorable effect on insulin levels, which is essential to metabolic health, we can at least grant that it’s entirely possible simple calorie balance was the problem.

But no amount of “don’t overload the foundation” will fix the fact that your house is on a sinkhole. No amount of “eat less exercise more” will fix your weight problem if you have an underlying issue above and beyond simple overeating.


There is a reason that for many people, net-calorie reduction alone is not an effective weight loss strategy.

This happens either because:

  • They were already eating a healthy quantity of food, and their overweight was driven by some other problem than simple energy balance.
  • Their body responded to the calorie reduction by going into a powerful “starvation” mode — decreasing calories-in caused an uncontrollable drop in calories-out as the body fought against the perceived famine.

In both cases, calorie reduction is not a healthy weight loss strategy.  

People in these situations need to figure out a different approach to being as healthy as possible, given the body that they have.


A lot of people who can’t lose weight through simple net-calorie reduction can lose weight successfully either through a fasting protocol or through changing the composition of their meals — even if in all three approaches they are eating the same total number of calories.

This is because though the number of calories may be identical, how you feel and how your body responds can be remarkably different.  A successful diet has to both:

  • Be mentally sustainable. If it leaves you light-headed, fatigued, or experiencing serious psychological side effects, it’s not sustainable.
  • Induce a healthy metabolic response.

Thus there’s a reason that some people try a diet that works great for their spouse, and the diet fails. Either it causes too many unhealthy side effects, or the diet itself is entirely manageable, but no weight loss ensues.  I’ve known people who simply had to try a different diet than their spouse, and the different diet worked miracles!

It’s like husband and wife had different bodies! They were not the same! They had different biological problems.


I have a daughter who is considering becoming a poop donor. Results of research into fecal transplants as an obesity treatment have been mixed — sometimes it leads to weight reduction, other times it doesn’t.  This anecdote of a fecal transplant (for other reasons) apparently causing obesity is quite telling.

I think based on the research to date we can reasonably conclude that sometimes gut microbiota is the primary factor in obesity or leanness . . . and other times it isn’t.


So, in conclusion:

Is it true that eating too many calories will cause weight gain.

It is not true that all weight gain is caused by too many calories.

It is also not true that everyone is able to gain weight by eating more! Some people have serious medical problems causing their low body weight. Other people have not-necessarily-pathological reasons that they simply can’t eat enough to gain weight because the sheer amount of food it would take is not tenable.

Thus I conclude: Of course you should consider whether you are simply eating too much.  But also the human body is complex and there are many factors that drive body weight.

If you’ve resolved to “finally lose that weight” this year, or if you’ve given up on losing that weight because your resolution has failed so many times in the past, consider that you might need to do a lot of research to figure out what’s going on.

Crepes and cider at a restaurant near Notre Dame, Paris.

Photo (by me): Pretty good crepes and cider at a restaurant near Notre Dame Cathedral, Paris, France, 2018. This is not an effective weight loss protocol for me.

2023-10-05T14:13:56-05:00

My friend Emily DeArdo and I have a fitness club. It meets via text message, and it involves reporting in how we’re doing and how our day went, and congratulating each other for making good decisions where our health is concerned.

And here’s the thing: Emily is the girl who has kept me going on exercise, and not giving up, when it was extremely difficult to believe that it mattered.

When you have a chronic illness, exercising is really hard. There are lots of obstacles, situations where you just can’t, and you don’t get the amazing results that other people get. Last autumn I needed to hear from Emily: “Yes, my training at the gym is working. I am gaining strength and endurance.”

I needed to hear it because if Emily DeArdo can get improvements at the gym? You probably can too.

I held onto that all this fall when I was laid out flat with the latest exacerbation of my (much different) illness. I wanted to be working out, and I just couldn’t. The best I could do (see below) is identify a sustainable step count and aim for that (with just essentials of self-care and time with the family), and accept that it would take a lot of rest and strategizing even to function at the minimal sustainable level.

But it paid off! Eventually the exacerbation cleared up, and that discipline I’d developed let me hit the ground running (literally, within a few weeks, though it was mostly walking at first, see below about that, too) and get back on the training plan.

So today I want to talk about the reality of exercise when you have a chronic illness that significantly hampers your ability to exercise.

Grim Reaper reaching out for you
This is the Memento Mori t-shirt I commissioned off my daughter last fall. I talk about it here. Artwork by A. Fitz, photo by me.

Updated: A word about ME before we continue . . .

I’m reminded on World ME Awareness Day that for the disorders in the myalgic encephalomyelitis / chronic fatigue syndrome constellation, including the form of post-COVID syndrome that falls into that grouping, post-exertional malaise is the extremely serious, defining pathology, and it directly inhibits your ability to increase your amount of exercise, because it is specifically a disorder of exercise-recovery. 

So when I warn about “don’t wreck yourself” below? If you have ME/CFS, that warning is a flaming volcano and you need next-level caution, because the downside is much, much greater than average, even in sick-people world. 

–> I would advise here that if you have a new-onset illness characterized primarily by fatigue, act as if it’s ME until you are certain it’s not. Don’t do the ramping up. Do the part where you dial back and rest enough. If it’s not ME/CFS, it’ll become clear with time. (And, you’re going to your doctor and running all the test to see if it’s something easy to diagnose or urgent to treat, right?)

And for everyone, seriously: You need to learn about the unique features of your disease and know what the specific hazards are that you have to caution against. What follows are some general concepts, but liver disease is different from heart disease is different from lung disease . . . and so on. Your have to add in your personal factors and adapt accordingly.

Now carrying on with the previously-published post . . .


Exercise matters.

Dr. Howard Luks is on my priority-follows list on Twitter, one of the handful of people I’ve picked to be my positive brain-break when I just want to chill and be inspired. (Emily’s there, so is John Herreid with all his great art posts . . . it’s a variety of interesting people who make my day better with what they say.)

I don’t know Dr. Luks and I haven’t read his book. What I know is that his blog and his tweets contain lots of good, important information about why exercise matters:

I need these reminders, so I keep a flow of them in my life. If you are not working hard to build and maintain muscle mass, mobility, and aerobic conditioning? You’re in trouble.

But if you have a serious chronic illness, you probably feel like all this is impossible. You’re not alone.

The fitness world doesn’t know what to do with sick people.

That includes doctors.  Here’s Dr. Luks at a loss about people like us. At the end of the tweet I’m about to link, he writes:

And yes, I do realize there are many people who are ill, disabled, disadvantaged, and otherwise cannot exercise, afford fresh produce etc… but I still think it’s worth sharing this info with the rest of the population that this is worthy of consideration.

But what he writes is still true even if you have an illness that hampers your ability to exercise:

https://twitter.com/hjluks/status/1654825573439492096

It is still true that exercise is beneficial and necessary even though most fitness writers are athletes, and most exercise scientists are focused on peak human performance.

It is still true even though the usual standards for what you “ought to be able to do” are absurdly out of reach for many people with chronic illness.

Fitter is still better, even when your “fitter” is barely on the fitness radar.

My favorite fitness bloggers and podcasters tend to be like “Okay, for this problem, what you need to do is these many pull-ups, and . . .” Um, okay. What if I have that problem, but I can’t do a pull-up?

Well you know what, sick people? There are other exercises you can do if you can’t do a pull-up. And you can do them fewer times, or with less resistance, or whatever it takes so that you are exercising the amount that you can.

That’s all you can do. But you will be healthier than you otherwise would be if you build that muscle mass, even if what you build is invisible to these fitness gurus.

So I’m here to tell you: Come join the club of sick people who reap the benefits of exercise, even if no one else in the world thinks it’s really happening.

And that’s the rest of this post: How to get yourself into the mental space where you can do that, and how to approach your training plan when you can’t just follow some recommended workout created for regular people.

Let’s start with the mental game.

You have to prioritize stewardship of your health.

This is really hard, because everybody around you wants stuff out of you. Even if you were a regular person, you could not give everybody that piece of you they’re trying to take.

When you are a sick person, you have to be much more intense about setting boundaries.  Everyone’s going to be playing the game of “If she can do that, why can’t she _______?”

The answer is: She can’t do the lower priority item because she chose to do the more important thing.

So you have to get to a place where you recognize: Taking care of my body is more important than other stuff people want from me, because if I don’t take care of it right now as a high priority, I’m going to be even sicker or deader down the road, and then who are they gonna whine to?

It really sucks having to make these trade-offs.

It’s a lose-lose life you’re living. No matter what you prioritize, you will have to give up some extremely important things.

Regular people are like, “I prioritize things like family, friends, quiet moments savoring the sunset . . . you just have to focus on what really matters in life.”

Sick people are like: “Yeah, I have to choose whether to talk to my kid for five minutes today or brush my teeth. Maybe I can do two minutes with the kid and some mouthwash.”

Even if you’re not that sick right now? You have to get very far into regular-people territory for a long time before you’re going to be able to do all the basic things that matter most.

Until then, you’re going to constantly be having to thicken your skin and accept that the life you actually have is one where you have to say no to things — people, mostly — that you truly treasure.

This is why it is so hard to exercise enough when you have a chronic illness.

It takes ruthless determination to not make that phone call to someone you love so that you can go to the gym instead. But you, unfortunately, have to choose. And if you don’t choose the gym today, there will be no phone call tomorrow.

We’re not talking about you putting your Olympic dreams above close family and friends. We are talking about the fact that if you don’t get very, very serious about your physical training you will be dead sooner. And then the people who joke about how you’re so hard to get on the phone will really know what “hard to reach” is like.

When you can, train as hard as you can reasonably, safely sustain.

Different illnesses take on different contours. My friend Emily, a double-lung transplant recipient with cystic fibrosis, has a fairly stable situation overall, punctuated by bouts with infections or other setbacks that require rest and recovery.

In contrast, I have a relapsing-and-remitting illness. When I am seriously sick, Emily’s normal runs circles around me. But when I’m not in a sick phase, I can do way more than she can.  Your situation is probably yet different from either of us.

Regardless, there are likely times when you can do relatively more, and times when you really can’t.

During those times when can do more, physically, there are going to be many, many things you are going to want to catch up on. During those times, though, you need to be banking physical fitness.

Fitness-banking is a thing.

You need as much muscle mass as you can get. You need as much aerobic conditioning as you can get. You need as much strength, balance, and mobility as you can get.

When you are more-sick, some deconditioning is going to occur. You can’t help that or change that.

What you can control is your starting point. If you lose 10% of your muscle mass while you’re down with a bad bout of the thing, yeah that sucks — but it sucks way more if you didn’t have much to begin with.  Which means that when you can*, you need to hyper-focus on strength training, even though it means missing out on other stuff.

*You can’t always.

Everyone dies in the end.

It is really discouraging when you have to put so much work and discipline and self-denial into fitness training, and you still look and feel like a lump.  It’s not fair that other people get to keep their fitness gains, because they don’t have bouts of some stupid illness. It’s not fair that other people can train more intensely with bigger results and far less sacrifice, because they have normal bodies that can do that.

Well, okay. You know what else is not fair? You cheating yourself out of being as healthy as you can be.

Exercise is always, for everybody, a temporary game. No one escapes death forever. No one stays perfectly healthy forever, no matter how amazing their health-and-wellness game.  But guys, everyone gets the same amount of eternity.

What you’re deciding with how you exercise isn’t whether you will one day be sicker and later be deader. What you are deciding is: Will I be as healthy right now as I can be? And will I be as healthy as I can be for as long as I can be?

Exercising isn’t selfish.

This is a huge mental shift you have to make.

You think, “Oh I’m so humble with putting others first, and not being vain about my appearance, and being so accepting of my difficult lot in life.” Okay that’s fine as far as it goes.

But also, if you don’t do what you reasonably can to take care of the body that has been given to you — even if it’s a bit of a clunker — then you are being selfish. You are making the decision to have less time and less ability to be with others and to serve others.

The point of serious fitness training for sick people isn’t that we’re going to impress anyone. We aren’t. Sorry. The point is to be there for others as well as you can.  And fitness makes a huge difference in the course of your disease (yes, it does!).

There are no guarantees, of course. If you knew exactly when and how you would die, you could carefully steward all but the last ten days, and then binge on Krispy Kreme with your besties and go out in style.

That is not reality. Reality is that you need to invest in your physical health as if you aren’t going to get hit by a bus tomorrow morning. Your responsibility isn’t to control what you can’t control and can’t know. Your responsibility is to consider the fact that you might not get hit by a bus tomorrow, and prepare for that.

Okay, so what does that look like?

Let’s start with reality when you’re super sick and honestly you can’t do much at all.

When you can only do very, very little, prioritize:

Non-negotiable medical care. Let’s be real: Little things like taking your medicine you’ll get seriously sick (or sicker) without, checking your blood sugar if you have diabetes, monitoring your blood pressure if you have hypertension . . . these require physical energy. Depending on your health condition, you probably have some true do-or-die interventions. Do those.

Put lower on the list things that might-be-nice but honestly aren’t personally major risk factors for you.

True do-or-die chores. Maybe the garbage really has to go out today, because otherwise you have a serious sanitary situation on your hands. Okay, take it out. Or maybe you can tie up that bag and set it aside and someone else can take it out later, and that’s not your first choice but it’s FINE.

Your energy goes first to the things that really, truly must be done. If it can wait, it gets downvoted on the priority list.

Rehabbing your biggest vulnerabilities. Those exercises that help your bad knee, or balance training because honestly you need it, or stretches to keep the back pain down to a minimum . . . whatever it is. You know what your things are. If you can only do twenty-five seconds of exercise today, do the exercise that will shore up, even just a tiny bit, the thing that otherwise is gonna wreck you.

Prioritize this over low-urgency chores. You’re gonna have a lot harder time getting laundry done if you let your back go out again.

Sticking to a sustainable daily level of exertion. Maybe “sustainable” is:

  • “I am going to eat today and also go to the toilet and frankly if I do those two we’re calling it a victory.”
  • Or: “I can do up to 2,000 steps a day, and if I obsessively stay under that ceiling, I can reliably do it again tomorrow and the day after.”
  • Or: “I will do the top thing on my list (um, those meds?), and then rest. When I feel energetic again, I will do my #2 priority (food? toilet?).” And you slowly turtle your way through the day, and it works for you.

And that’s it. Stick to sustainable.

The thing you are missing is that regular people are not living at their maximum capacity.

Even professional athletes aren’t pushing themselves so hard that they literally, really truly could not brush their teeth at the end of the day if they added one more thing. They just go run the Ironman and then they’re like, “Yeah I can also brush my teeth today I have so much extra energy even after doing that.”

Sick people are on a different plan. Your daily sustainable energy output is intensive training.  The discipline of sticking to what you can sustain will pay back so, so much.

Err on the Side of Being a Little Too Careful

So you think you can probably do 2000 steps a day? Yeah let’s see 1500 for a week and then we’ll talk.

Exercise guide suggests starting with five pound weights? We’re starting with zero weights, and if that works we’ll up it to a pound.  Three sets of ten? Nope, one set of three. 90 degree angle on that new stretch? Okay well we’re starting with 45 and we will see from there.

See, the thing is: You can always add moreYou cannot undo an injury.

If you wreck yourself, it is going to cost you much, much more than it will cost a regular person.

When everything goes fine with your initial, super-cautious approach? Great. Increase the intensity a tiny bit and see how it goes. If it’s still fine, sure, inch it up another notch.

If you do this, eventually you will safely get to your sustainable max. Sure, it is slower progress than if you had somehow magically known exactly what you could do before you even tried. But this isn’t fairyland, and also you know what slows down your progress? Getting injured.

Intensify when you can, and don’t dilly dally about it.

When you are feeling relatively better, here is what you are going to want to do:

  • Get out and tackle that huge, physically intense project that really needs to be done, even though you are deconditioned from being so sick and it’s probably going to wreck you.
  • Tackle a million little things that you are so behind on that if you did nothing but chores for the next six years, maybe you could catch up.
  • Spend time with people and get back to all your old activities.
  • Eat donuts. Hurray, you’re better!

Here is what you have to do instead:

  • Slowly, carefully, ramp back up your conditioning program, and wait on physically intense chores until you have built back up the strength to do them safely.
  • Work through only the highest priority backlog of chores first. Yes, you need to get the IRS off your back. Immediately. No, you don’t have to clean out right now that closet that frankly someone else can deal with if it comes to it, it’ll keep until later.
  • Continue thinking carefully about your priorities. Who are the people who truly have a claim on you above all others? What are the activities that contribute most to your mental health, even if they seem gratuitous or “wasteful” to other people who are not you?
  • Slowly but seriously ramp back up on your conditioning program.

–> I’ll note, however, that chores are exercise.  They just aren’t always the right kinds of exercise in the right proportions. The key is they need to be the exercise that fits into your conditioning plan. Don’t sort the odd sock basket instead of completing the strength training workout you would otherwise be ready to do. But if your fitness plan legit calls for a short, light walk, it’s okay if your house is cleaner at the end of that walk.

And then here is what you need to do next, if you keep being pretty healthy overall, for you:

  • Continue slowly but seriously ramping up on the conditioning program, even if you are back to where you were before.

Even if you get to where you’re in pretty good shape for someone your age? Even if you are fitter than you’ve ever been? Keep going.

You are not a regular person.  You have to bank your fitness while you can, and bank as much as you can, because when you get sicker again, you are going to need that reserve.

Keep exploring until you find the kind of exercise that works with the body you have today.

What I do for exercise is constantly changing because my body is constantly changing.

I love the outdoors. I like yardwork, hiking, camping, biking . . . all kinds of outside activities. Also, I live in the Deep South. Before I developed an illness that is made worse by heat exposure? I was the queen of heat adaptation.  A little insufferable about it, ask anyone.

I was good at exercising in the heat. I was dying laughing back during the Atlanta Olympics when there were all these articles about athletes having to deal with heat and humidity, oh my. Poor babies.

Well, that was before. And I do still work the heat-adapting as much as I can? But also I finally realized I needed to find options for exercise during the hot-season that were compatible with the body I have today.

Maybe one day, because I do keep working on the heat-adapting within my capacity for that, I’ll be able to get more summer outside-time. For now, ice skating it is. You could do a lot worse.

You have to become the expert in adapting recommendations.

The other day Emily was talking about the value of wall sits, and I balked. They don’t go well for me. And somewhere in that conversation came the aha-moment: I don’t have to go into a deep wall sit. There is still strength-training happening even if I’m sitting at a much shallower angle.

The thing is: Only I can know what that angle is.

A physical therapist can’t feel my knee creaking, even if she’s watching carefully for all the right body mechanics. A fitness guru on the internet can’t write up a special version of his go-to workout Just for Jennifer. A doctor making general recommendations about “getting more exercise” is not living my daily life.

So I have to be the leader. I have to be the one who pays careful attention to my body and makes smart decisions about what I can and can’t do.

And the same goes for you. Become the leader in making the final judgement call on what you can do and how much you can do.

When you do that, exercise becomes good.

 


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