Low Testosterone: To T or Not to T

Dear Mr. Dad: My 13-year old son doesn’t seem to be maturing as quickly as his peers. His voice has barely changed, he’s not sprouting much facial or body hair, and he’s below average in height. He’s also overweight and seems tired a lot of the time. Lately he’s become obsessed with the idea that his problem is Low-T. He’s been bringing me magazine ads, pointing to TV commercials and Internet ads, and is trying to convince me that he needs testosterone supplements. Could he be right? I though low testosterone was only something that affects older men.

A: The answer to your question is Yes and No. Yes, he could indeed have low testosterone (frequently–and annoyingly–referred to as Low-T). But No (no, no, no) he should absolutely not start taking supplements or doing anything to “treat” the problem until he’s been properly diagnosed by a professional. And by professional, I mean a trained healthcare provider who will run blood tests (the only accurate way to measure testosterone levels) and who is committed to identifying the underlying issues and how to overcome them, rather than to selling you a bunch of pills. Stay far, far away from anyone (including advice columnists) who claims to be able to diagnose and treat low testosterone or other medical conditions without actually seeing the patient.
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Sleep Woes: How Much Is Too Much?

Dear Mr. Dad: My husband and I have a three-year-old daughter and we’re a concerned about her sleeping patterns. Most people we know who have kids the same age worry that their children aren’t getting enough sleep. We’ve got the opposite problem—including naps, she sleeps about 14 hours a day! Is there such a thing as getting too much sleep?

A: Sleep is one of the things that parents of infants and toddlers struggle with the most—and, as you said, the problem is usually too little of it, not too much. Nevertheless, it’s perfectly natural to worry about anything child-related that’s out of the ordinary, even if it’s something that would make a lot of other parents envious. The general consensus among experts is that children your daughter’s age should be getting 12-14 hours per day of shuteye, including naps, so you’re within the range of what’s “normal.”

Children do a lot of their developing—both physical and mental—when they’re asleep, so there’s no question that sleep is important. But as we all know, kids develop at different rates, so it’s no surprise that what may be plenty of sleep for one toddler could be nowhere near enough for another. Bottom line, we all need as much sleep as we need—and those needs change over time. At six, your daughter probably won’t need any more than 12 hours per night. And by the time she heads off to middle school, she’ll be down to 10 or 11. When she hits the teen years, her sleep needs will increase (but since worrying about her will keep you awake at night, your family’s total average sleep time will stay about the same).

The thing to focus on here is the quality of your daughter’s sleep, not the quantity. And one way to assess that is to simply pay attention to her behavior when she’s awake. If she’s generally happy, energetic, playful, engages with you, and seems to be having a good time, all is well. But if she’s sluggish, tired, irritable, or behaves differently (worse) than usual, there could be a problem. It could be something as simple as iron deficiency, but it’s worth making a call to your daughter’s pediatrician.

A note on last week’s column on the Obama Administration’s exaggerated claims of the prevalence of sexual assaults on college campuses. I received a huge number of responses from men and women around the country. Most were quite supportive and some shared their very poignant experiences of having been falsely accused of assault and how difficult (or, in some cases, impossible) it has been to recover. A smaller number of people disagreed with my take on the issue and shared their equally poignant stories of instances where legitimate cases of rape or assault had been ignored and, again, how difficult or impossible it has been for the victim to recover. But whether they agreed or not, these emails had one thing in common: they were written by people who had an interest in a respectful, healthy debate of an important issue.

Unfortunately, there were a few outliers—people (all of whom disguised their identities in some way) who felt the need to call names, make accusations and threats, and even suggest ways I should kill myself. I truly enjoy interacting with readers of this column and am happy to discuss pretty much anything with anyone, but if your email is inappropriate (you’ll know it if it is), don’t expect an answer.

Sexual Assault on Campus: A Case of Battered Statistics Syndrome

Dear Mr. Dad: I’ve been reading about the recent White House study showing that one in five women will be the victim of rape at some point in her life. As a mother of twins (a boy and a girl) who are graduating high school, I’m scared for my daughter’s safety and I’m worried that my might do something unspeakable. What can I do to protect both of my children?

A: The first thing to do is calm down. For as much media coverage as the White House study got, it is one of the most flawed, inflammatory, and just plain incorrect pieces of “research” I’ve ever seen.

Let’s start with the numbers. To come up with its 1-in-5 statistic, the White House task force relied on a 2011 study conducted by the Centers for Disease Control (CDC) which used a very broad definition of “sexual violence,” Besides forced genital and oral sex (whether by violence, drugs, or threats—the kinds of things that most people would consider rape), the CDC included “forced kissing” and “rubbing up against you in a sexual way, even if it is over your clothes.” That behavior shouldn’t be tolerated. But dirty dancing is not rape. To suggest that it is just plain wrong.

The CDC study also includes as victims of “sexual assault” women who answered Yes when asked whether they had ever had sex with someone who had pressured them by “telling you lies” or by making “false promises about the future they knew were untrue,” or “by showing they were unhappy.” Again, not nice, but regretting a sexual encounter after the fact doesn’t make it rape.

Besides relying on the results of ambiguous questions, the White House also claimed that just 12% of campus sexual assaults are reported—meaning that 88% aren’t. Mark Perry, a professor of economics at the University of Michigan—a guy who know a thing or two about statistics—carefully looked at the data and came up with a very different story. Between 2009 and 2012, there were 137 sexual offenses reported at the University of Wisconsin-Madison. If that’s 12%, the other 88% would be 1,004, bringing the total to 1,141. Dividing that by the 22,330 female students and the University (51.6% of 43,275), reveals that a female student’s actual chance of being sexually assaulted is 5.1%–a quarter of what the what the White House is claiming—and that’s still counting dirty dancing and being lied to as rape.

The report has a number of other flaws. For example, it completely overlooks a growing body of solid research finding that sexual assault on campuses is hardly a one-way street. In fact, young men and young women are equally likely to admit to having pressured someone else into having sex.

But a more serious problem is the report’s recommendations to essentially strip accused male students of their legal rights. The report states that “[t]he parties should not be allowed to personally cross-examine each other.” Um, the Constitution’s 6th Amendment, however, grants anyone accused of any crime anywhere that exact right.
Obviously, this is a much bigger issue than I can tackle here. But the bottom line is this: talk with your son and your daughter about unwanted sexual advances and about the statistical distortions the White House is peddling. As a parent, I’m sure you don’t want your daughter thinking of herself as a victim—and I know you don’t want your son to become a victim of overzealous college administrators who see every young man as a rapist waiting to happen.
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Infertility: Not for Women Only

Dear Mr. Dad: My wife and I have been trying to have a baby for two years. Both of us have undergone lots of testing but the doctors still don’t know what the problem is. Throughout all of this, dozens of people—mostly friends and family, but also doctors, nurses, lab techs, and others—have come up to me and either offered some kind of advice, asked how my wife is doing, or told me what I need to do to support her. This whole process has been extremely stressful, and both my wife and I are emotionally devastated, but not a single person has asked how I’m doing. I’m getting really angry about being ignored and I’m trying to keep from biting someone’s head off. How should I respond?
A: Just a few decades ago, infertility was considered to be the woman’s “fault.” But today, experts know that it’s more evenly split. About 40% of the time, the cause can be traced to the woman; 40% of the time it’s traced to the man; and the remaining 20% is “unexplained.” Still, because the pregnancy would happen inside the woman’s body, society assumes that women are the only ones affected by infertility. The fact that men experience stress or grief or might be “emotionally devastated” by the shattering of their hopes and dreams rarely occurs to anyone.
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Watch Out, Baby!

Dear Mr. Dad: My husband and I both work and we have our 2-year old daughter in a lovely home daycare. We really like the provider—she makes organic food for all the kids she takes care of, and does a lot of fun activities with them. But we recently found out that she also has the kids in front of the TV or playing video games for several hours every day. It’s so hard to find good-quality, affordable childcare these days, plus our baby really loves her caregiver. How bad is it for toddlers to watch a little TV?

A: Unfortunately, the whole issue of babies and TV is far from being black and white. The official position of the American Academy of Pediatrics is that kids under two should have as close to zero time in front of screens as possible, and kids older than two should limit screen entertainment to an hour or two per day (not including time on computers that are being used for homework, of course). The point is that children should spend a lot more of their time interacting with other people than with electronics.

In an ideal world—where most of us don’t happen to live—that’s definitely the right approach. But we all have situations that call for a little rule bending, and an hour of TV while you’re taking a shower or making a phone call probably won’t cause any long-term damage. And neither will the parental magic trick most of us perform when trying to tame loud or restless kids: pulling out the tablet or smartphone and putting it gently into those little hands.
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Exploring the Culinary Arts

Dear Mr. Dad: I’m not a whiz in the kitchen but I learned enough as a kid to make it through college without having to subsist solely on peanut butter sandwiches and Ramen noodles. My wife and I both cook meals but we can’t seem to get our son (age 11) remotely interested in cooking. How do we get him interested in learning how to cook for himself?

A: You’re absolutely right—everyone should be able to cook enough to feed themselves. Most of us will never become great chefs, but it is possible to get your son to join you in the “not-a-whiz-in-the-kitchen” category. At the very least, knowing how to cook a few things will improve your son’s diet–kids who can cook are less likely to rely on fast food and more likely to eat healthier foods. There are a number of other advantages, which I’ll get to in a minute. But your first step should be to try to figure out what your son has against getting in front of the stove.
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