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Let’s Bust Some Myths!

It’s too late after puberty, hormones won’t change xyz

While yes, many adult trans people dearly wish they’d been able to medically transition before going through the “wrong” puberty, the truth is that a lot of changes will still occur later… even to “unchangeable” things like the skeleton.

The body is remaking itself throughout life, and hormones tell it how to do that. Some parts are just quicker or slower than others. Also: the skeleton is pulled-on constantly by our muscles, and in a battle of muscle vs bone, muscle will always win over time.

Examples of this include:

  • trans men building bigger bones to support their bigger muscles
  • trans women getting smaller, with wider hips and a pelvic tilt

Trans people have sporting advantages

Assuming at least a year’s cross-sex hormonal treatment, there is no useful advantage to being trans when engaging in a sport. There are small advantages and disadvantages (which goes for any person’s body, really). For example:

  • Trans women will tend to be taller than cis women on average…
    • …but that larger frame is now being powered by smaller muscles, because they shrink much quicker than the skeleton.
  • Trans men taking T are the only athletes allowed to take testosterone…
    • …but they will still often be smaller than their fellow male competitors, for example.

Read: Do Trans Women Athletes Have Advantages? (A rather balanced expert overview, which does also cover trans men)

There’s a trans population explosion; it’s a social contagion epidemic!

Source for figures: The Overall Rate Of Left-Handedness (Researchgate)

Left-handed people used to make up around 3% of the population… Until the 1920s, when that figure jumped sharply upwards, before plateauing at around 12% in around 1960, where it’s stayed since. What happened?! Simple, schools stopped forcing children to use their right hand.

Today, people ask for trans healthcare because they know it exists! Decades ago, it wasn’t such common knowledge.

The same explanation can be applied to other “population explosions” such as for autism and ADHD.

Fun fact: Mt. Everest was “discovered” in 1852, but scientists suspect it probably existed long before then! People whose ancestors were living on it long before 1852 also agree. Sometimes something exists for a long time, and only comes to wider public awareness later.

Transgender healthcare is too readily available, especially to children!

To believe some press outlets, you’d think:

  • HRT is available from school vending machines,
  • kids can get a walk-in top surgery at recess,
  • and there’s an after-school sterilization club.

In reality, while availability varies from place to place, trans healthcare is heavily gatekept. Even adults have trouble getting it, often having to wait years and/or pay large sums of money… and get permission from a flock of doctors, psychologists, and the like. For those under the age of 18, it’s almost impossible in many places, even with parental support.

Puberty-blockers shouldn’t be given to teenagers, as the effects are irreversible

Quick question: who do you think should be given puberty-blockers? For whom do you think they were developed? Not adults, for sure! They were not developed for trans teens either, but for cis pre-teens with precocious puberty, to keep puberty at bay, to do it correctly later. Nobody argues they’re unsafe for much younger cis children, and only object when it’s trans teens.

They’re not only safe and reversible, but also self-reversing. Stop taking them, and the normally scheduled puberty promptly ensues by itself. For trans kids, the desired effect is to buy the kid time to make an informed and well-considered decision. After all, the effects of the wrong puberty are really difficult to undo!

A lot of people rush medical transition and regret it!

Trans people wish it could be rushed! It’s a lot harder to get gender-affirming care as a trans person, than it is to get the same (or comparable) care as a cis person. Yes, cis people get gender-affirming care, from hormones to surgeries, and have done for a long time.

As for regret… Medical transition has around a 1% regret rate. For comparison, hip replacement has a 4.8% regret rate and knee replacement has a 17.1% regret rate.

A medical procedure with a 99% success rate would generally be considered a miracle cure!

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    Prioritize Your Mental Health Like Your Physical Health! Remember, mental health is just as important. Take care of yourself and seek help when needed.

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  • Not quite an introvert or an extrovert? Maybe you’re an ambivert

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    Our personalities are generally thought to consist of five primary factors: openness to experience, conscientiousness, extroversion, agreeableness and neuroticism, with each of us ranking low to high for each.

    Graphic
    Extroversion is one of the Big Five personality traits. Big 5 personality traits graphic

    Those who rank high in extroversion, known as extroverts, typically focus on their external world. They tend to be more optimistic, recharge by socialising and enjoy social interaction.

    On the other end of the spectrum, introverts are more likely to be quiet, deep thinkers, who recharge by being alone and learn by observing (but aren’t necessarily shy).

    But what if you’re neither an introvert or extrovert – or you’re a bit of both? Another category might fit better: ambiverts. They’re the middle of the spectrum and are also called “social introverts”.

    What exactly is an ambivert?

    The term ambivert emerged in 1923. While it was not initially embraced as part of the introvert-extrovert spectrum, more recent research suggests ambiverts are a distinct category.

    Ambiverts exhibit traits of both extroverts and introverts, adapting their behaviour based on the situation. It may be that they socialise well but need solitude and rest to recharge, and they intuitively know when to do this.

    Ambiverts seems to have the following characteristics:

    • good communication skills, as a listener and speaker
    • ability to be a peacemaker if conflict occurs
    • leadership and negotiation skills, especially in teams
    • compassion and understanding for others.

    Some research suggests ambiverts make up a significant portion of the population, with about two-thirds of people falling into this category.

    What makes someone an ambivert?

    Personality is thought to be 50% inherited, with the remaining being influenced by environmental factors and individual experiences.

    Emerging research has found physical locations of genes on chromosomes closely aligned with extroversion-introversion traits.

    So, chances are, if you are a blend of the two styles as an ambivert, one of your parents may be too.

    What do ambiverts tend to be good at?

    Man selling book to woman
    Ambiverts are flexible with talking and also listening. Cotton Bro Studios/Pexels

    One area of research focus in recent decades has been personality type and job satisfaction. One study examined 340 introverts, extroverts and ambiverts in sales careers.

    It has always been thought extroverts were more successful with sales. However, the author found ambiverts were more influential and successful.

    They may have a sales advantage because of their ability to read the situation and modify their behaviour if they notice a customer is not interested, as they’re able to reflect and adapt.

    Ambiverts stress less than introverts

    Generally, people lower in extroversion have higher stress levels. One study found introverts experience more stress than both ambiverts and extroverts.

    It may be that highly sensitive or introverted individuals are more susceptible to worry and stress due to being more perfectionistic.

    Ambiverts are adept at knowing when to be outgoing and when to be reflective, showcasing a high degree of situational awareness. This may contribute to their overall wellbeing because of how they handle stress.

    What do ambiverts tend to struggle with?

    Ambiverts may overextend themselves attempting to conform or fit in with many social settings. This is termed “overadaptation” and may force ambiverts to feel uncomfortable and strained, ultimately resulting in stress or burnout.

    Woman talks on the phone
    Ambiverts tend to handle stress well but feel strained when overadapting. Cottonbro Studios/Pexels

    But personality traits aren’t fixed

    Regardless of where you sit on the scale of introversion through to extroversion, the reality is it may not be fixed. Different situations may be more comfortable for introverts to be social, and extroverts may be content with quieter moments.

    And there are also four other key personality traits – openness to experience, conscientiousness, agreeableness and neuroticism – which we all possess in varying levels, and are expressed in different ways, alongside our levels of extroversion.

    There is also evidence our personality traits can change throughout our life spans are indeed open to change.

    Peta Stapleton, Associate Professor in Psychology, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Here’s To Getting Assuredly Good Health

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    An unusual amount of excitement in the health news world this week, with health insurance in the spotlight:

    Deny, Delay, Depose?

    Insurance company UnitedHealthcare, which used AI with a 90% error rate to deny insurance claims (of which, disproportionately denying insurance claims of the elderly), has come under extra public scrutiny this week for its recent-years business practices:

    ❝Nearly 1 in 5 insured adults experienced claim denials during a 12-month period.

    Those with job-based insurance or Affordable Care Act policies ran into this problem about twice as often as those covered by Medicare or Medicaid❞

    …although, the company has dramatically increased its care denials for Medicare Advantage enrollees, doubling the rate of denials as it implemented its new, automated denials process.

    Anesthesiologist Dr. Brain Schmutzler noted:

    ❝We have a bigger issue with the insurance companies in general, who, essentially, it’s their job to make money, not to actually pay for health care❞

    And in those cases where healthcare is not denied, it is often dangerously delayed, as insurance companies can stall for time to decide whether they’re going to pay or not.

    One useful take-away from all of this is that if your insurance claim is denied, consider fighting it, as often they can be overturned.

    Specifically, it can be good to insist on knowing who (named persons) was involved in the denial process, and their qualifications. Once upon a time, this was mostly unqualified interns, which prompted insurance companies to reverse the denial rather than admit that; nowadays it’s mostly AI, which many companies can hope will shield them from culpability—either way, fighting for one’s rights can often be successful.

    Read in full: Killing of UnitedHealthcare CEO prompts flurry of stories on social media over denied insurance claims

    Related: With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help

    Rest Easy

    Health insurer Elevance Health (formerly Anthem Blue Cross Blue Shield), had last month announced plans to limit its coverage for anesthesia used in operations, whereby they would pay for only a certain amount of anesthetic, and if the procedure was still ongoing when that amount had been used, then well, you were on your own.

    However, on Thursday afternoon and allegedly completely coincidentally in the wake of the Wednesday assassination of the CEO who oversaw the denial of so many health insurance claims, this decision to limit paying for anesthesia was reversed, retracted, and they are now doing their best to downplay what the proposal would have meant for anesthesiologists and patients:

    Read in full: Insurance company halts plan to put time limits on coverage for anesthesia during surgery

    Related: The Insider’s Guide To Making Hospital As Comfortable As Possible ← an anesthesiologist’s tips

    Getting a good grip of your health

    What’s the best indicator of good health when it comes to age-related health issues? It’s not BMI! Could it be blood pressure? It could, but the news presently is about grip strength.

    While training to have an amazing grip (and neglecting all else) will not necessarily increase your general healthspan, having a weak or strong grip is strongly associated with, respectively, having weak or strong general health in later years.

    This is because unless someone has been training very unnaturally, grip strength is a good general measure of overall muscle strength, which in turn is a good indicator of metabolic health, as well as bodily robustness.

    Read in full: Handgrip strength is a reliable predictor for age-related disease and disability, finds study

    Related: Resistance Is Useful! (Especially As We Get Older)

    Take care!

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  • Rebounding Into The Best Of Health

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    “Trampoline” is a brand-name that’s been popularized as a generic name, and “rebounding”, the name used in this video, is the same thing as “trampolining”. With that in mind, let us bounce swiftly onwards:

    Surprising benefits

    It’s easy to think “isn’t that cheating?” to the point that such “cheating” could be useless, since surely the device is doing most of the work?

    The thing is, while indeed it’s doing a lot of the work for you, your muscles are still doing a lot—mostly stabilization work, which is of course a critical thing for our muscles to be able to do. While it’s rare that we need to do a somersault in everyday life, it’s common that we have to keep ourselves from falling over, after all.

    It also represents a kind of gentle resistance exercise, and as such, improves bone density—something first discovered during NASA research for astronauts. Other related benefits pertain to the body’s ability to deal with acceleration and deceleration; it also benefits the lymphatic system, which unlike the blood’s circulatory system, has no pump of its own. Rebounding does also benefit the cardiovascular system, though, as now the heart gets confused (in the healthy way, a little like it gets confused with high-intensity interval training).

    Those are the main evidence-based benefits; anecdotally (but credibly, since these things can be said of most exercise) it’s also claimed that it benefits posture, improves sleep and mood, promotes weight loss and better digestion, reduces bloating, improves skin (the latter being due to improved circulation), and alleviates arthritis (most moderate exercise improves immune response, and thus reduces chronic inflammation, so again, this is reasonable, even if anecdotal).

    For more details on all of these and more, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Green Tea Allergies and Capsules

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Hey Sheila – As always, your articles are superb !! So, I have a topic that I’d love you guys to discuss: green tea. I used to try + drink it years ago but I always got an allergic reaction to it. So the question I’d like answered is: Will I still get the same allergic reaction if I take the capsules ? Also, because it’s caffeinated, will taking it interfere with iron pills, other vitamins + meds ? I read that the health benefits of the decaffeinated tea/capsules are not as great as the caffeinated. Any info would be greatly appreciated !! Thanks much !!❞

    Hi! I’m not Sheila, but I’ll answer this one in the first person as I’ve had a similar issue:

    I found long ago that taking any kind of tea (not herbal infusions, but true teas, e.g. green tea, black tea, red tea, etc) on an empty stomach made me want to throw up. The feeling would subside within about half an hour, but I learned it was far better to circumvent it by just not taking tea on an empty stomach.

    However! I take an l-theanine supplement when I wake up, to complement my morning coffee, and have never had a problem with that. Of course, my physiology is not your physiology, and this “shouldn’t” be happening to either of us in the first place, so it’s not something there’s a lot of scientific literature about, and we just have to figure out what works for us.

    This last Monday I wrote (inspired in part by your query) about l-theanine supplementation, and how it doesn’t require caffeine to unlock its benefits after all, by the way. So that’s that part in order.

    I can’t speak for interactions with your other supplements or medications without knowing what they are, but I’m not aware of any known issue, beyond that l-theanine will tend to give a gentler curve to the expression of some neurotransmitters. So, if for example you’re talking anything that affects that (e.g. antidepressants, antipsychotics, ADHD meds, sleepy/wakefulness meds, etc) then checking with your doctor is best.

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  • How long does back pain last? And how can learning about pain increase the chance of recovery?

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    Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.

    Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.

    If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:

    • acute – those with back pain that started less than six weeks ago
    • subacute – where it started between six and 12 weeks ago
    • chronic – where it started between three months and one year ago.

    We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.

    Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.

    More pain doesn’t mean a more serious injury

    Most acute back pain episodes are not caused by serious injury or disease.

    There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.

    Factory worker deep-breathes with a sore back
    Your doctor or physio can rule out serious damage.
    DG fotostock/Shutterstock

    Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.

    The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.

    The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.

    Reduce your chance of lasting pain

    Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:

    • understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
    • reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.

    How to reduce your pain sensitivity and learn about pain

    Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.

    Physio helps patient use an exercise strap
    Some programs combine education with gradual increases in movement.
    Halfpoint/Shutterstock

    These programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.

    But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.

    When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.

    Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.

    But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.The Conversation

    Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Why Adult ADHD Often Leads To Anxiety & Depression

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    ADHD’s Knock-On Effects On Mental Health

    We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:

    ADHD… As An Adult?

    In women in particular, it can get missed and/or misdiagnosed:

    Miss Diagnosis: Anxiety, ADHD, & Women

    …but what we’re really here to talk about today is:

    It’s the comorbidities that get you

    When it comes to physical health conditions:

    • if you have one serious condition, it will (usually) be taken seriously
    • if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
    • if you have three, people will think you are making at least one of them up for attention now
    • if you have more than three, you are considered a hypochondriac and pathological liar

    Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.

    Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.

    If this is you, by the way, we hope at least something in the following might ease things for you a bit:

    It’s the same for mental health

    In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.

    (Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).

    Why?

    Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.

    • “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
    • “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
    • “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.

    Overwhelm and breakdown are almost inevitable.

    And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.

    Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).

    What to do about it

    How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.

    Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.

    Here’s a good starting point for that kind of thing:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:

    Behavioral Activation Against Depression & Anxiety

    If things are already bad, then you might also consider:

    And if things are truly at the worst they can possibly be, then:

    How To Stay Alive (When You Really Don’t Want To)

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

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