How Title IX Hurts Female Athletes

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The groundbreaking legislation, which was supposed to help women thrive in sports, has had several unintended, negative consequences.

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Sophia Gouraige grew up playing soccer and lacrosse in the verdant suburbs of New Jersey. Her parents were part of the Volvo-driving army standing on the sidelines with Starbucks cups on Saturday mornings, cheering as their agile, pony-tailed daughters ran up and down the field. In middle school she began to focus primarily on lacrosse and became such a standout player at Kent Place School in Summit that she was recruited to play for Boston College.

Like most female athletes of her generation, Gouraige owes her athletic career in large part to Title IX, the 1972 federal legislation mandating equal access for women in education, including sports. The youth leagues she played in as a child trickled down from Title IX, and the legislation likely played a role in Boston College establishing a women's lacrosse team in 1992.

Title IX has clearly triumphed in its mission to equalize the playing field for young women. Its impact can be felt at every level of competition, from the fourth-graders strapping on their batting helmets as Little League gears up, to the thousands of high-school girls who surrender their spring breaks for pre-season training in track or lacrosse.

The numbers bear it out. Since the advent of Title IX, according to the National Federation of State High School Associations, the number of girls playing high school sports has grown more than tenfold, from 294,000 in 1971 to nearly 3.2 million last year.

But this welcome transformation has come at a serious cost for many female athletes. Title IX has inflicted significant collateral damage, including increased health risks for the players, a drop in the number of women coaches, and increased exposure to sexual abuse.

Like their male counterparts, girls have started to specialize early in their careers, working on just one sport year-round, often as a way to capture the attention of college coaches. With more scholarship money available than ever, girls feel pressured to specialize at a young age in the hopes of winning a spot on an elite team or gaining an edge in the increasingly competitive college admissions game. Despite persistent warnings from orthopedic surgeons and trainers, young athletes bent on specialization continue to suffer from preventable overuse injuries, like stress fractures and stress reactions, according to the American College of Sports Medicine. "More than 50 percent of what we see in sports medicine are overuse injuries, which are entirely preventable," said Dr. Joel Brenner, chairman of the American Academy of Pediatrics and the Council on Sports Medicine and Fitness.

Of special concern for girls is damage to their anterior cruciate ligament, or A.C.L., the tiny ligament in the knee that connects the two halves of the leg. Female athletes are four or five times more likely than male athletes to have A.C.L tears, says Dr. William Levine, the director of sports medicine at Columbia University and the head physician for its varsity teams.

As Dr. Levine explains, once girls begin to menstruate, they become more "quadricep-dependent" than males, and that thick slug of muscle in the middle of the thigh then works against the A.C.L., sometimes causing tears. "Female athletes jump and land in a more erect posture, which puts increased stress on their A.C.L," he says.

Girls who participate in endurance sports like distance running, which emphasize leanness, also contend with a debilitating syndrome called the "female athlete triad." By eating too little or exercising too much, or some combination of the two, they start to develop three-interrelated problems: eating disorders, bone loss, and the cessation of their menstrual cycles. While 1.2 to 4.3 percent of all women athletes have the full "terrible triad," as Dr. Levine calls it, 70 percent are thought to have one component of it. Six top sports associations, including the American Academy of Family Physicians and the American College of Sports Medicine, assert that "fifteen to 62 percent of college female athletes report a history of disordered eating"—ranging from bulimia to restricted calorie intake to fad diets—which is higher than the presumably more sedentary general population.

In sports played by both boys and girls, female athletes also suffer from concussions at significantly higher rates. Studies carried out at Ohio State University and at Nationwide Children's Hospital suggest that girls who play basketball are three times more likely to report concussion symptoms—dizziness, blurred vision, memory loss—than boys. Female soccer players are sidelined for concussions 68 percent more often than their male counterparts.

The growing prominence of women's sports has also changed the dynamic in the locker room. Though Title IX has increased opportunities for female players, the number of female coaches has actually declined, even as the total number of jobs has expanded dramatically. "The most significant unintended consequence of Title IX is the dearth of women in leadership positions," says Mary Jo Kane, Director of the Tucker Center for Research on Girls and Women in Sports at the University of Minnesota.

When women's sports programs started gaining prestige and funding in the 1970s, they began to attract male coaches. Prior to Title IX's passage, women comprised more than 90 percent of the head coaches of women's college teams. Shortly thereafter, their share of the available positions dropped by half and has remained at about that level ever since, according to the 33-year longitudinal study, "Women in Intercollegiate Sports, 1977-2010," conducted by the Acosta and Carpenter. In 2010, the proportion of women coaching women's teams stood at the second lowest in history, 42.6 percent, with 21 fewer female coaches than two years prior. "Title IX has been a boon to male employment opportunities," says Kane.

For Stanford women's basketball coach Tara VanDerveer, recently inducted into the Basketball Hall of Fame, this gap represents Title IX's greatest failure. She calls the lack of opportunities for women coaches a "disturbing trend" that says to girls, "It's okay for you to play, but you don't have what it takes to coach."

For female players, the gravest consequence of having male coaches has been an increased risk of sexual abuse. Pediatrician Ken Feldman, the recently retired medical director of the Children's Protection Program at Seattle Children's Hospital, says that although there is no formal tracking of sexual abuse by coaches per se, "girls will be more victimized than boys." Dr. David Finkelhor, Director of the Crimes Against Children Research Center at the University of New Hampshire believes that the physical nature of sports can make them sexually charged. "There's tremendous intimacy in coaching situations, between men and girls," he says. "Young people are sexually attractive, and they don't turn that off in their interactions with adults." Since 1999, 36 coaches from the U.S. national swim team—including the former director—have resigned or been banned from the sport following allegations of sexual misconduct or inappropriate sexual behavior. In November, USA Gymnastics named Don Peters, coach of the 1984 U.S. Olympic women's team, "permanently ineligible" for membership after two of his former gymnasts reported having sexual intercourse with him when they were 17 and 18 years old.

As Title IX prepares to celebrate its 40th anniversary this year, we believe that many women of our generation are ready to move beyond the comforting fiction that equality of opportunity, and rough parity with boys, is enough for female athletes. It's time to stop celebrating the raw numbers and to start figuring out how to improve the quality of women's athletic experiences.

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Linda Flanagan & Susan H. Greenberg

Linda Flanagan is a cross-country coach who writes regularly for The Huffington Post. Susan H. Greenberg, a freelance writer and former Newsweek editor, blogs at unvarnishedmom.com.

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