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Jason greeted me in the waiting room with a warm, generous smile. He was a sturdy 11-year-old boy, confident and connected. As he walked into my office, I couldn’t help but notice how stiff and lumbering his gait was, almost like an old man. Through the course of our time together, he sat up several times and twisted his torso to “crack” his spine.
Jason’s parents were bringing him to see me, a psychologist, for help with a modern parenting dilemma: their son was intent on playing football. The school he attended fielded a team starting in the sixth grade, and he was already running plays with his older brother in the backyard. He was also eating extra meals to gain weight. Over the next year, he would add 20 pounds and come to look more like a smaller version of the position he had his eye on: offensive linesman.
Jason was already fearless in the two sports he played. He excelled as a defender on his soccer team, even though he was not so quick, and was a success from the moment he stepped out on the wrestling mat. He had also already taken numerous trips to the ER. His drive to top his brother’s bike jumps and other feats of derring-do inevitably led to crashes. But as fearless as Jason was by day, at night his true age came to the fore. He experienced persistent nightmares and was an intermittent bed-wetter. Though he tried bravely to cope with his parents’ divorce and wrenching shared-custody, he was unsettled.
What might have been an easy problem for his parents to resolve ⏤ they agreed football did not make much sense for a boy so young, especially one who had already suffered one concussion ⏤ was complicated by larger issues. The family was steeped in football culture. An uncle whom Jason closely identified with was an NFL trainer and his sons, older cousins Jason looked up to, both played on youth teams. In a nutshell, football had become Jason’s identity. Since he was a young boy he had admired the team-oriented, rough-and-tumble nature of football culture. He hoped his parents would support his “dream.”
Jason’s parents had managed to put their son off until age 12 by sharing research on the ill effects of head trauma on developing brains. They had both read study after alarming study detailing what happens when young brains are banged around in contact sports. When a team of neuroradiologists at Wake Forest School of Medicine followed a cohort of 8- to 13-year-old boys for a full football season, comparing before and after images of their brains, a scientific consensus began to emerge in 2016: even boys who are not diagnosed with concussions can manifest “changes associated with traumatic brain injury.” The more impacts a boy experiences, the more damage researchers observe in the white matter of their brains.
A subsequent study from a Boston University research team approached the question from another angle: they autopsied the brains of former NFL players. On the basis of post-mortem studies of men who had begun playing before age 12, they recommended that young boys should not play football. Separately, researchers from the same Chronic Traumatic Encephalopathy Center compared players who began playing before age 12 with those who started after 12. They found a significantly increased risk for behavioral dysregulation, depression, and impaired executive functioning associated with play at younger ages.
Even though participation rates in youth football have dropped since 2008 ⏤ 3.5 million (mostly) boys currently play youth football in the U.S ⏤ the number of diagnosed, sport-related concussions still doubled between 2005 and 2015. More troubling, concussions are probably underreported. In response to new scrutiny, many boys try to hide their symptoms for fear of being sidelined. In a 2013 report by the Institute of Medicine, “Youth profess that the game and the team are more important than their individual health and that they may play through a concussion to avoid letting down their teammates, coaches, schools, and parents.”
Parents of boys like Jason are on the horns of a historic dilemma. The very qualities that encourage their sons to take unhealthy risks are still widely valorized. In fact, masculine stereotypes have been reinvigorated, reinforced, and even exaggerated. According to psychologist Ray Lemberg, television and video game characters have lost fat and added muscle over the last decade or two, setting an impossible standard for boys’ bodies: “Only one or two percent actually have that body type. We’re presenting men in a way that is unnatural.” In a 2012 study, more than a third of middle and high school males used protein powders or shakes to build muscle. A smaller percentage, between 3 to 12 percent, admit to using steroids. Pediatricians have proposed the term, Adonis Complex, to describe this male body image problem.
The good news is that the disconnect between boys’ health and sporting traditions like “playing through pain” has become harder to ignore. In pursuit of the cultural ideal as “the stronger sex” ⏤ robust, tough and self-reliant ⏤ boys adopt attitudes and behaviors that have a negative impact on their health. According to a group of pediatricians, “Compared with females, adolescent males have higher mortality, less engagement with primary care, and high levels of unmet needs.” The age group with the greatest gender health gap is 15- to 24-year-old. Younger males are three times more likely than females to die from injuries occurring in motor vehicles or bicycles, in sports, in falls, or as a result of spinal cord and traumatic brain injuries.
What Jason’s parents felt, even if they didn’t see it clearly, was that their son drank the cultural brew and had become intoxicated. He was all too willing to sacrifice himself for the higher purpose offered by historic masculine values ⏤ even though routine casualties have always been an inconvenient truth about boyhood. Even after his parents shared information about Second Impact Syndrome, he was unfazed. To play football was his raison d’etre. He had the fever.
Parents like Jason’s are beginning to figure this out. The sport of football is, according to a recent article by Tim Froh in The Guardian, “in crisis.” Propelled by growing concerns of parents, medical providers, and researchers, states like California are considering legislation like the Safe Youth Football Act, which would prohibit kids under the age of 12 from playing organized tackle football and is viewed by many of the sport’s proponents as an “existential threat.” New tackling guidelines, rule changes, and more limited contact practices are some of the other measures being implemented by coaches and youth associations around the country. Meanwhile, Chris Nowinski, CEO of the Concussion Legacy Foundation, continues to argue that any risk is unreasonable, that no tackle is safe for a developing brain.
Even though the risks are real and their sons blind to them, I do not recommend helicopter-style rescues in my work with parents. Both as a man and as a father of two athletic sons, one who played into college, I understand the thrill of sports. In both roles, for sure, I sometimes even went too far. But the point is not to protect boys from all risk. Exercising freedom, creativity, and judgment in a pinch creates such a feeling of being alive! Parents should never take that away from their children.
The more Jason’s parents step in to regulate his choices, the more likely he is to feel misunderstood and to nurse an aggrieved version of his personal dream. The goal, I reminded them, is their son’s self-regulation: that he is guided by a commitment to his own well-being and the integrity of his body.
On a national level, I am not sure nanny state regulation is the solution to the adverse health issues facing boys, either. The problems with male health are endemic to the culture. From the time they are very young, boys are subjected to masculine norms that are hardly budging despite several decades of advocacy for gender equality. How, I asked Jason’s parents, had he become so susceptible to the seductions of a popular culture that football is such a powerful dream, even despite recent head injury concerns?
It seems what’s needed, for families of boys like Jason and for young males generally, is for the truth of boys’ humanity ⏤ including their biological needs and vulnerabilities ⏤ to be taken more fully into account. Simply put, the cultural construction of boyhood itself must change. In the blur of their contentious divorce, when the parents were just trying to survive and to provide a semblance of continuity for their sons, they had been unable to notice or do anything about how Jason struggled. Throughout their lives, boys’ emotional needs are commonly triaged.
In the end, Jason’s parents worked out a compromise with him. They met with the football coach and were reassured that he was up to date on the risks of head injury and had moved his team to no-contact practices. The league in which the team played its games had also adopted new rules limiting contact. Under these conditions and with a green light from their pediatrician, they agreed that Jason could try playing the following year. But they insisted that if there were any further head trauma, Jason would walk away from the sport. Meanwhile, they got him involved in another sport ⏤ lacrosse ⏤ that he loved, providing him with a satisfying fallback.
What these parents accomplished, though it wasn’t easy, drove home this important point to their son: taking care of himself was the top priority.
Boys who are vigorous, fully alive, and thriving are our best bet for becoming good men.
Michael C. Reichert is a psychologist, executive director of the Center for the Study of Boys’ and Girls’ Lives, and author of theYahoo Lifestyle column, #MeToo Guide to Raising Boys as well as the forthcoming, How To Raise A Boy: The Power of Connection to Build Good Men.