866 people sign up to urge FHSAA to take menstrual questions off athletics form

Update: The FHSAA called a special meeting to consider removing questions about menstrual history from the form altogether. You can read about it here.

High school athletics leaders in Florida are debating whether to mandate questions about student athletes' menstrual history in their annual physical forms signed off on by their doctor and turned into their schools.

Activists are gearing up to protest at the next board meeting of Florida's High School Athletics Association, and nearly 900 people have sent letters to board members to oppose the move.

While 35 other states require athletes to discuss their periods with their doctors and turn in the information, the issue has taken on new light in a post-Roe v. Wade world where students, parents and their physicians are reassessing reproductive privacy.

In October, The Palm Beach Post published an investigation that dug into why the female athletes are asked about their periods, where the newly digitized data is stored, and why it's sitting differently with athletes and their families.

Since then, the Florida High School Athletics Association has taken up the issue at least three times. But for reproductive privacy advocates, the association has taken a step backward. In January, the FHSAA's sports medicine committee agreed to recommend that the board of directors make the questions about menstrual history, currently optional on the athlete medical history form, mandatory.

Their recommendation goes further to say that athletes should be required to turn in their entire medical history to their schools, despite national recommendations that athletes' medical histories stay with only their doctors.

The FHSAA's board of directors will take up the issue at its next meeting on Feb. 26-27 in Gainesville.

Activists with Progress Florida, a St. Petersburg-based nonprofit, plan to attend the meeting in protest, said Amy Weintraub, the nonprofit's reproductive rights program director.

Weintraub added that the nonprofit has launched an online letter writing campaign, where people can add their names to a pre-written letter to FHSAA board members encouraging them not to require athletes to turn in their medical and menstrual histories to play. 

Letter writers can also edit the suggested copy, which says "Requiring students to divulge this information could carry grave consequences. Since the U.S. Supreme Court overturned the constitutional right to abortion, anti-abortion politicians are aiming to criminalize pregnancy outcomes in patients. Records, such as sports health forms, could become easy targets for aggressive local prosecutors to use against someone who has ended a pregnancy."

Weintraub said Friday that 866 people have sent letters so far.

Here's what to know about menstrual questions for student athletes in Florida: How we got here, where these questions came from and where we're headed next.

1. A brief timeline of Florida menstrual questions for student athletes

• June: Palm Beach County contracts with online student athlete registration platform, Aktivate. U.S. Supreme Court overturns Roe v. Wade.
• August: Parents raise concerns to The Post and school board about having to report student medical history, including menstrual history, using the online platform.
• October: The Post publishes its investigation into questions about athlete menstruation. The Palm Beach County School Board calls a meeting to discuss allowing parents to submit paper versions of the forms and asks FHSAA to review the annual pre-participation physical evaluation form for student athletes in Florida.
• November: The FHSAA's board of directors meets and decides against a move by one member to scrap the five questions about menstrual history altogether. The board sends the issue to its sports medicine committee for its recommendation.
• December: Florida state Sen. Lori Berman (D-Delray Beach) vows to bring legislation that would remove menstrual questions from the registration forms.
• January: FHSAA sports medicine committee meets to consider the issue. One member moves to recommend a four-page physical form where athletes are required to answer questions about their menstrual history, but don't have to turn those answers into their school. The committee decides instead to recommend requiring both the questions and that athletes turn in the information. The decision is upheld at a special meeting after FHSAA Executive Director Craig Damon apologizes for giving the committee false information about how many other states require the menstrual questions be answered and turned in to schools.
• February: The FHSAA's board of directors will meet Feb. 26-27 in Gainesville to consider the sports medicine committee's recommendation.

2. What is the FHSAA? Who gets to sit on the board?

The FHSAA is designated by state law as the governing nonprofit organization of high school athletics in Florida. 

Its board is made up of four elected public school representatives, four elected private school representatives, two elected school superintendents, two elected school board members, three representatives appointed by the commissioner of education and a representative of the commissioner, according to state law. Members are elected by FHSAA member school representatives. 

Fourteen men and two women currently comprise the board.

Student athletes do not turn in their medical history forms to the FHSAA or any state agency. In most counties, they are kept with the local school district, school athletic directors and coaches.

FHSAA's sports medicine advisory committee makes recommendations to that board and is made up of eight licensed physicians, one chiropractor, one podiatrist, one dentist, three athletic trainers and one current or retired head coach of a Florida high school. Members nominate and appoint new members.

The committee currently has 13 male representatives and five female representatives.

3. Why do doctors need to talk to student athletes about their periods?

Throughout the FHSAA's review the of the physical form, doctors have maintained that it's important to discuss menstrual irregularities with young athletes.

Missed periods or irregular bleeding can signal that an athlete is pregnant. 

But it can also be a symptom of a group of disorders called the female athlete triad. Low energy, eating disorders, irregular periods and anemia can signal low bone density — which puts an athlete at greater risk for bone fractures.

The questions about menstrual history have appeared on the form since at least 2002. The questions are part of a medical history section that patients fill out before entering the exam room and discussing their answers with their physician. While physicians underscore the importance of discussing menstrual history with athletes, several say that information should stay with the physician.

"If someone hasn’t had a menses for six months and they’re 15 years old, that can be totally totally normal, or it could be a sign of something," Palm Beach County pediatrician Dr. Thomas Schechtman said in September. "It’s not information that the school needs."

4. How many other states collect menstrual information from student athletes?

Research by The Post shows that Florida is not unique in asking athletes about their menstrual cycles during their annual sports physicals.

Thirty five states pose menstrual history questions to student athletes and require them to turn in the information to their schools to play. State athletic associations and school districts decide how those forms are stored.

Ten states, including California, Colorado, Maryland, Minnesota, North Dakota, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, instruct athletes not to turn in their medical history to their schools when they register to play.

But not all states ask athletes about their periods.

Five states, Idaho, Mississippi, New Hampshire, New York and Oklahoma as well as Washington, D.C. do not ask students about their menstrual histories on the forms. 

Louisiana asks only whether athletes have any menstrual irregularities, and athletes can check "yes" or "no."

5. Can this information be used to target transgender athletes?

In a post-Roe world, parents and transgender rights advocates have asked whether menstrual history reporting could be a way to identify transgender athletes.

For example, could a transgender female athlete be identified if she doesn't submit her menstrual history, or could a transgender male athlete be identified because he does submit his menstrual history?

Michael Haller, a Gainesville endocrinologist who works with transgender youth, isn't so sure.

Because Florida's current form doesn't require the menstruation questions or require the athlete to report their sex assigned at birth, it's unlikely to "out" trans athletes, he said.

"If they’re forcing the issue, then I would call it anti-trans," Haller said. "That’s probably the better question: 'Why do they have the questions in the first place?'"

Katherine Kokal is a journalist covering education at The Palm Beach Post. You can reach her at kkokal@pbpost.com. Help support our work,subscribe today!