Power, Performance, and Pressure: Sexual Harassment in Sports Medicine and Athletic Healthcare

Quid pro quo harassment generally involves a person in a position of authority conditioning an employment or other covered benefit or opportunity on submission to unwanted sexual conduct. In athletic environments, similar coercive dynamics can arise when a coach, supervisor, trainer, or other individual uses control over an athlete’s opportunities as leverage. The pressure does not always have to take the form of an explicit statement. Depending on the circumstances and applicable law, implied promises, threats, timing, and subsequent changes in treatment may also be relevant to determining whether sexual conduct was connected to an important benefit or opportunity. For athletes, the benefits at stake can be significant. A coach might promise additional playing time or a preferred team position in connection with sexual attention, or threaten a scholarship or place on the team after advances are rejected. A person in authority might also control access to competitions, travel, specialized training, recruitment opportunities, or recommendations to other programs or professional teams. Because athletes may spend years building their careers and reputations, the possibility of losing these opportunities can create tremendous pressure. The situation may become even more difficult when the person engaging in the misconduct is also the person to whom the athlete would ordinarily report workplace or program concerns. Similar problems can arise in sports medicine and athletic healthcare. An intern, athletic trainer, or other healthcare professional may depend on a supervisor for clinical assignments, evaluations, scheduling, recommendations, networking opportunities, or future employment. A sports medicine intern sexual harassment situation may involve a supervisor suggesting that professional advancement depends on accepting unwanted attention or, conversely, threatening career consequences after the conduct is rejected. Individuals who experience this type of coercion should consider preserving evidence they are legally permitted to retain, including emails, texts, direct messages, evaluations, schedules, scholarship communications, and records concerning assignments, playing time, or team placement. Evidence showing a connection between unwanted conduct and a promised or threatened opportunity may be particularly important. When appropriate, making complaints and important follow-up communications in writing can also help establish what was reported and when.

Fear of retaliation may prevent athletes and sports medicine professionals from reporting misconduct. Athletes may worry that speaking up will cost them playing time, a scholarship, a starting position, or a recommendation. They may also fear damage to their reputation within the athletic community or future recruitment and professional opportunities.

Sports medicine interns and other professionals may have similar concerns about evaluations, recommendations, assignments, and future jobs. Because athletic communities can be close-knit and highly connected, victims may feel that reporting one influential person could affect opportunities far beyond their current team or institution. Retaliation may be obvious, but it can also appear through a series of smaller changes. An athlete who rejects unwanted sexual advances may suddenly be benched or receive substantially less playing time. A previously established starter could lose their position without a clear explanation. Other warning signs may include exclusion from practices, competitions, meetings, or team travel; threatened scholarship opportunities; unexpected negative evaluations; increased scrutiny; or a sudden change in how coaches or administrators interact with the athlete. For interns or healthcare professionals, negative treatment might include removal from clinical assignments, reduced responsibilities, lost professional opportunities, or negative recommendations. Retaliation may also involve individuals other than the person accused of harassment if others within the organization respond negatively because an athlete or employee made a protected complaint. Not every unfavorable athletic or employment decision after a complaint constitutes unlawful retaliation. Coaches may legitimately change lineups, and employers may make valid performance or staffing decisions. This makes timing, past treatment, and the overall pattern especially important. An athlete who consistently received substantial playing time and positive feedback before reporting misconduct but was suddenly benched afterward presents different circumstances from an athlete whose playing time had already been declining for documented performance reasons. Likewise, a sports medicine intern with strong evaluations who suddenly receives unexplained criticism after reporting harassment may want to preserve both the earlier and later evaluations. Several seemingly minor actions may become more significant when considered together. Creating a timeline can help preserve this context. The timeline may identify the inappropriate behavior, when the conduct occurred, when it was reported, who received the complaint, how the institution responded, whether an investigation occurred, and what changed afterward. Records concerning playing time, assignments, scholarships, evaluations, schedules, team placement, and professional opportunities may also be relevant. Written documentation can make it easier to compare an individual’s treatment before and after a complaint and evaluate whether negative changes may have been connected to the report.

Sexual harassment in athletic and sports medicine environments can involve multiple individuals and institutions. Depending on the circumstances, potentially responsible parties may include coaches, assistant coaches, supervisors, athletic trainers, medical personnel, sports medicine professionals, athletic departments, schools, universities, employers, or other entities. An attorney can evaluate not only what the alleged harasser did but also whether an institution knew about prior misconduct, received earlier complaints, or failed to respond appropriately after concerns were raised. The abuse committed by former USA Gymnastics physician Larry Nassar illustrates the serious harm that can occur when misconduct is presented to athletes as legitimate medical treatment. In sports medicine environments, athletes may naturally place significant trust in physicians and trainers and may not immediately recognize when professional boundaries have been violated. Medical treatment may sometimes require physical contact, but that does not eliminate professional boundaries or excuse sexual misconduct. When conduct feels inappropriate or sexual, athletes should take those concerns seriously rather than assuming that a professional’s position automatically makes the behavior acceptable. An attorney can also help identify and preserve evidence relevant to a potential claim. This may include emails, text messages, performance evaluations, scholarship records, team communications, medical or internship records, and witness statements.

Witnesses may have observed inappropriate behavior, heard comments, experienced similar conduct, or noticed changes in how the victim was treated afterward. Preserving evidence of both the underlying harassment and subsequent retaliation can help provide a more complete picture of what occurred. Depending on the facts and applicable law, an attorney may evaluate potential claims involving sexual harassment, quid pro quo conduct, retaliation, or institutional responsibility. Legal standards may differ depending on whether the person affected is an employee, intern, student-athlete, or another participant in the program. Potential damages may also vary but can include emotional distress, counseling or medical expenses, lost scholarships, lost educational or career opportunities, other financial losses, and the impact the misconduct had on the individual’s ability to participate in and enjoy athletics. An attorney can also help an individual navigate internal reporting procedures while determining whether separate civil legal options may be available.

Coaches, trainers, supervisors, physicians, and other athletic professionals can hold tremendous influence over the people who depend on them. That authority should never be used to pressure someone into accepting unwanted sexual conduct in exchange for playing time, scholarships, team positions, jobs, recommendations, or other professional opportunities. Sexual harassment of female athletes and misconduct involving sports medicine interns can raise concerns not only about the underlying harassment but also about quid pro quo conduct and retaliation. Athletes and professionals who experience misconduct should consider preserving appropriate evidence of what happened, when it was reported, and whether their treatment changed after they rejected or reported the conduct.

Individuals who believe they have experienced sexual harassment or retaliation in an athletic or sports medicine environment may benefit from speaking with an attorney as soon as possible. An attorney can evaluate the circumstances, identify potentially responsible parties, help preserve evidence, and explain what legal options may be available.