AMA Delegates Tackle Protections for LGBTQIA+ Athletes

Participation of LGBTQIA+ athletes in sports earned a mixed response during the American Medical Association (AMA) House of Delegates interim meeting in Orlando, Florida on Saturday.

The LGBTQ+ Section introduced a policy statement calling for the AMA to support reducing barriers to sports for the LGBTQIA+ community by educating physicians about the “benefits and barriers” to their participation in sports, and by backing legislation and regulations that would ensure this population can participate in sports “inclusive of LGBTQIA+ persons.”

Isabel Ball, a medical student and “proud lesbian,” who spoke on behalf of the LGBTQ+ Section, highlighted a benefit, explaining that playing sports gave her the confidence and leadership skills to pursue a career in medicine.

She also dealt with the barrier of discrimination: As a high school senior, when she first “came out,” she nearly quit soccer after the parents of a teammate suggested that “queer women should not be allowed in locker rooms with their daughter,” she explained. Ball said her coach and the teammate quickly “shut down” the disparaging comments.

As a first-year college student, she overheard a teammate use a homophobic slur. Once again, she considered calling it quits, but a supportive coach and her teammates kept her in the game.

Zarah Iqbal, MD, MPH, speaking on behalf of the American Academy of Pediatrics, shared her support for the policy statement, noting that “sports have such an incredible impact on kids, ranging from mental health, obesity prevention, feeling like you’re part of the community, and that’s what this resolution is about.”

“So we really need to think about the benefit to all of the kids, even starting, with 3-year-old sports teams, and all the way up from there… and how we’re excluding a group of people from having those benefits,” she added.

But what about the “fairness” of biological females playing with biological males, and “the safety of that?,” stated Martha McConnell, DO, a psychiatry resident from Indiana University School of Medicine in Indianapolis. McConnell, who spoke for herself, said she agreed with many of the positive comments about the resolution.

Rhonda Sharp, MD, from Indiana, pointed out that there are a lot of sports where anyone can play. “We’ve had girls on male football teams in Indiana before,” said Sharp, who spoke on her own behalf. But she argued that was different from a biological male competing against a biological female in swimming, for example.

“We’ve got to be fair to everybody,” Sharp said.

Kavita Arora, MD, MBE, a delegate for the American College of Obstetricians and Gynecologists, stressed that the resolution isn’t centered on “fairness” but on “access and participation” in sports.

“So it’s firstly about health. It’s about exercise. It’s about community. It’s about belonging. We should want that for all of our patients,” Arora said. She noted that studies have shown that some LGBT people have a higher risk for overweight or obesity.

Vanessa Stan, MD, an alternate delegate for the American Association of Geriatric Psychiatry, spoke as an individual and as the mother of a nonbinary child. She said that in men’s professional sports, there are no stated gender-based limits to participation. For instance, the National Basketball Association (NBA) does not have a rule that explicitly prevents women from playing in the league. Men are not allowed to play in the Women’s NBA, although the WNBA has had openly nonbinary players.

It’s only in women’s sports, where there is controversy, and people worry about “mixing people,” she said, although these concerns are not really about safety, she argued, but about “fear-mongering. These are vulnerable folks.”

Carl G. Streed Jr., MD, MPH, a delegate for the LGBTQ+ section, also underscored that the intent of the resolution is access.

“We are acknowledging that there are governing bodies … that have medical professionals who are providing input on how best to make sure that people are being included at the most elite level appropriately, and therefore we’re not countering that,” Streed said. “We’re really trying to make sure everybody’s included, and that we are doing this based on the evidence, the science, and the best thing for our patients.”