Florida sports association to reconsider menstrual questions for high school athletes

Palm Beach Post | By Katherine Kokal | October 13, 2022

The Florida High School Athletic Association will reconsider questions about menstrual history on its physical form for student athletes after a Palm Beach Post story prompted intense reaction from athletes, parents and physicians. 

At a special-called Palm Beach County School Board meeting Wednesday, visiting FHSAA board member and former Republican state Rep. Ralph Arza said he is going to add an agenda item to the Nov. 6 and 7 meeting of the association’s board of directors to permanently amend the form. 

His recommendation will be to remove the optional questions about menstruation and update the form to ensure that only the final physician sign-off sheet is turned into schools.

“This is egregious,” Arza said in an interview. “There is no reason that we need to be collecting this information and there is no reason that schools need this. It’s another example of the FHSAA not representing the people it’s supposed to serve.”

Right now, the FHSAA is responsible for developing and distributing the three-page physical form across the state. Student athletes are required to turn in all three pages of the form to their schools before they can practice and play. The forms, including athletes’ medical history, can be accessed by coaches and athletic directors.

Arza asked the Palm Beach County School Board for a letter of support to present to the board. He added that he’d like to get letters of support from other urban school districts across Florida, specifically Broward and Miami-Dade. Arza represented parts of both counties from 2004 to 2006 in the state House.

Local school board members also voiced their outrage over the five questions about when athletes got their last period and how many weeks they typically go between periods, among others.

“This is information that should be between a doctor and a patient,” board member Alexandria Ayala said. 

They appeared to agree that they support Arza’s amendment. 

“This needs to be changed. I’m just thrilled you’re going to represent us,” board member Marcia Andrews told Arza. “We need to get this removed.”

Outrage is shared across the state in Sarasota. 

Jane Goodwin, chair of the Sarasota County School Board, said the questions were “very invasive” and should be removed from the forms.

“Putting women under the microscope as opposed to men. I mean, really? Do we need more of that?” Goodwin said. “I think this is an antiquated issue that shouldn’t be on any form, and it has nothing to do with participation in sports.”

The issue is not on the Sarasota County School Board’s agenda for its upcoming meeting Tuesday, and Goodwin said she hasn’t heard from anyone in the community on the issue. It could come up at a future board workshop, but because of Hurricane Ian, it hasn’t been on the board’s radar, she said.

What are the questions about menstrual periods on Florida athlete registration forms?

The five questions about menstruation, marked “for female athletes only,” have been on the FHSAA’s annual registration form since at least 2002.

They are: 

• When was your first menstrual period?
• When was your most recent menstrual period?
• How much time do you usually have from the start of one period to the start of another?
• How many periods have you had in the last year?
• What was the longest time between periods in the last year?

A series of events have changed how people think about their reproductive privacy — including the June overturning of Roe v. Wade and stricter abortion laws taking effect in many states that can lead to prosecution.

These events, and personal beliefs about data privacy, have in some cases reframed families’ sensitivity to reporting a person’s reproductive history.

And many people weren’t aware the questions were on the forms.

In Palm Beach County, parents have pressured the school district to make an online registration platform optional after they raised concerns about where their students’ data can end up.

Aktivate, an online platform designed to make athlete information easier to track, requires a value, such as “N/A,” to be entered for every question on the athlete’s participation physical whether the question is optional or not.

School district officials and school board members have said their phones have been ringing “off the hook” about the questions.

Why doctors ask athletes about their menstrual periods

It’s important for a young person to discuss their menstrual history with their doctor, because irregular periods can be signs of what is known as the female athlete triad, a disorder that can affect an athlete’s ability to play without getting injured. 

The three-page FHSAA physical form includes a two-page medical history where athletes are asked to report seizures, surgeries and allergies and the like along with their menstrual history. The final page is a clearance form that asks the doctor to list any limitations for the athlete to practice and play. 

But physicians, many of whom regularly fill out pre-participation physical forms, say that medical information that doesn’t directly affect an athlete’s emergency care should not be shared with their school. 

In Florida, the FHSAA’s form states that an athlete’s entire medical history should be turned into the school along with the one-page clearance signed by their doctor. 

That runs contrary to the guidance on the national physical form, developed by the American Academy of Pediatrics, which says only the one-page clearance should be submitted to schools. 

 “I don’t think it was our intent for this information to be shared with anyone else,” said Dr. Chris Koutures, a pediatrician based in Anaheim, Calif., who served on the committee that wrote the national physical form.

FHSAA is required by state to handle athlete registration

The FHSAA’s sports medicine committee, which includes 16 physicians, athletic trainers and coaches, reviews the pre-participation physical form each year.

At the committee’s most recent meeting on Aug. 16, the committee briefly discussed updating the form to comply with national guidelines.

But neither the agenda nor the minutes specified what those updates were. No members of the committee returned requests for comment on the form or its updates. 

State law requires the FHSAA to create and distribute a pre-participation physical form.

It also says the result of medical evaluations should be given to the schools but does not specify what parts of the physical evaluation form should be submitted.

Palm Beach County School Board Chair Frank Barbieri lambasted the form’s questions and the fact that schools must collect all the pages. 

He also said he’s worried the school district could be held liable if the coach is aware of a medical issue but a physician clears an athlete to play and a medical emergency occurs. 

He used the example of reporting an athlete’s high blood pressure on the form. 

“If that box is checked and we have it, and the coach lets a kid go out and play and he has a stroke, I mean even though the doctor cleared him, I’m sure the school board will get sued because it’s on the form,” he said. “We don’t need to see this stuff.”