For starters, we can strive to identify the particular conditions that make women more susceptible to catastrophic knee injuries and develop training regimens that reduce that risk. According to Dr. Levine, preventative measures to protect against A.C.L.s remain "an elusive 'holy grail'."
Eliminating the eating disorders that are so common among female athletes might be unrealistic. Female athletes have figured out that sports can provide a fast track to getting thin. Girls' and women's social value remains tied to appearance, particularly body size, and Kate Upton on the cover of the Sports Illustrated swimsuit issue speaks a lot louder than the athletic trainer admonishing them to eat enough protein and carbs. Short of a massive cultural realignment (and we're not holding our breath), perhaps the best we can do is take aim at the most serious eating disorders--anorexia and bulimia—and continue to educate coaches and parents to encourage healthful eating and exercising.
A big part of reducing overuse injuries for girls and boys both will involve getting the word out about the perils of early sports specialization. For years, the American Academy of Pediatrics and top professional orthopedic organizations have cautioned against kids' specializing and overtraining, to little effect. Still, imposing enforceable restrictions on playing time won't work because of the vast and complicated array of sports and teams. If a child plays basketball for his school, church, and travel teams, who imposes the rules? "Parents have to be the advocates of their children, even if that means going against what the coach recommends," Dr. Brenner says. "It's about putting the child first."
Increasing the presence of women coaches will go a long way toward repairing Title IX's collateral damage. The Alliance of Women Coaches, founded last year as an outgrowth of the NCAA Women Coaches Academy, aims to boost the diversity and number of women in the profession and provide networking, career development, and support for women coaches in all sports at all levels. "One thing we're starting to look at is why aren't women being hired?" says Celia Slater, co-director of the Alliance and executive director of the NCAA Women's Coaches Academy. "Our job is to train and educate women on going through the job search, interviewing well, and accepting the job," she says, as well as to counsel them on balancing work-life issues. The Women's Basketball Coaches Association and the American Volleyball Coaches Association are also running programs and offering scholarships specifically designed to attract women coaches. More female coaches won't benefit just women, says VanDerveer: "In the same way that mothers and female teachers are so important, I think women coaches would be a great asset in bringing camaraderie and team-building to a group of men."
As for preventing the sexual abuse by coaches, says Finkelhor, coaches need to know what to do when they find themselves sexually attracted to young, physical athletes, just as psychotherapists are taught how to handle a possible sexual attraction to a patient. At the same time, student athletes need to be taught how to detect the coach who crosses too many boundaries—by showering them with extravagant gifts, or lots of one-on-one time—so they can prevent an ugly escalation. "Somebody needs to take this and write a good manual about it, in a complex way, without clichés," he says.
Finally, it's time for all coaches serving in the post-Title IX world to make the athletic experience more responsive to female sensibilities. That doesn't mean putting the brakes on the ambitions of the most athletic and competitive girls. But it does mean acknowledging in sports a reality that has gradually won acceptance in business, politics, and other areas of public life: that women and men differ in how they see and experience the world, and that respecting these differences benefits everyone.
Experienced coaches will tell you that boys and girls, by and large, bring different frames of mind and motivations to their sport. Tom Fleming, a two-time winner of the New York City marathon in the 1970s, has coached high school boys and girls since 1988. Boys are overconfident, he says, certain of victory in spite of their ill-preparedness, while girls underestimate their fitness. "As coaches, we need to spend more time talking to the young females about what they can be," he said.
Long-time high school coach Tim Lear reports that girls find more pleasure in the team bond than their male counterparts; the friendships built out of shared effort and common goals draw girls into sports and cement loyalties to the team. Katie McCafferty, a senior at Georgetown who runs Division 1 track and cross-country, put it this way: "The boys don't seem to have the same close, intimate bonds. They don't possess that same drive that our girl's team has to achieve that one goal together. And that's been the key to our success." That's true even at the elite level; Rebecca Lobo, the former WNBA star center and self-described "Title IX baby" says, "Camaraderie and team unity, creating a family atmosphere, is one place where you do have a difference between men and women. The women care about the 'we' and the guys care about the 'I.'"
For her part, Gouraige, once at college, quickly found herself dreading practices. "You always had to be on your game, study what was in your binder, know the plays, get out there and be your best, be the fastest, score the goals," she says. "It felt like a tryout at every practice."
Though she loved lacrosse, she didn't want to spend all her time playing it. She was eager to explore other things, and with a push from the coach, she left the team during her sophomore year. "When you go to college, it's all about how to win the national championship," says Gouraige, now 21. "Why can't sports just be fun?"