Meet the doctor tackling harassment, abuse, inequity in sports

Yetsa Adebodunde Tuakli-Wosornu, MD, MPH, was transformed by sports.

The associate professor at Stanford Medicine was sick and weak as a child growing up in Boston, having been born prematurely and enduring recurring health problems. But then as a teen, the girl born to Nigerian and Ghanaian parents was recruited to her school’s track team and something began to shift.

She grew stronger, physically and mentally. She learned how to succeed and fail graciously. She learned how to be a leader, a team member and a friend.

“I had that wonderful experience of how alive sport can make you feel,” Tuakli-Wosornu said. “I love track & field with every fiber of my being. I came into who I am on the track.”

As Tuakli-Wosornu pursued track in college at Yale and beyond, eventually competing on Ghana’s national team as a long jumper, she was shocked to learn how much athletic experiences could vary. The higher she rose in the ranks, the more toxic the environment became. She saw physical abuse, sexual assault and forced doping — all normalized and shrugged off as just how things were.

“Honestly, it was heartbreaking,” she said. “My first experience with sports was so overwhelmingly positive. Well-being and winning went squarely hand in hand; I didn’t understand how they could be separated.”

“My first experience with sports was so overwhelmingly positive. Well-being and winning went squarely hand in hand; I didn’t understand how they could be separated.”

Yetsa Tuakli-Wosornu

Luckily, Tuakli-Wosornu ended her sports career as she began it — with a welcoming culture and supportive coach in her professional track group in Florida. This experiential dichotomy, from amazing to amazingly toxic, informs Tuakli-Wosornu’s work today. She’s the founder of the Sports Equity Lab, an independent academic research group aimed at eliminating inequities in sports, and is developing a similar program at Stanford Medicine in the Division of Prevention Research in the Department of Medicine.

Recently, Tuakli-Wosornu was invited to lead a 15-person expert panel that created a consensus statement on harassment and abuse in sports for the International Olympic Committee. This is the third and most comprehensive review of the topic, and the statement was published on Nov. 25 in the British Journal of Sports Medicine.

We spoke with Tuakli-Wosornu to find out more about harassment and abuse in sports, something researchers term interpersonal violence. This conversation has been edited for length and clarity.

How did this statement come about?

The last consensus on this topic came out in 2016, so it was time for an update. We’re hearing more and more horrific stories, mostly of sexual violence. There is a rising concern within the sports and exercise medicine community — also from the press. The IOC reached out to me to chair the committee, I believe because I have a unique perspective on this topic: I’m a physician, a public health researcher and an athlete, so I can see this problem from multiple points of view. I’m proud to be the first Stanford professor to serve in the chair role.

How big of a problem is harassment and abuse in sports?

About one in three girls and women–33% — will experience some form of interpersonal violence in her lifetime. In sports, our best estimate is that between 44% and 86% of girls and women will have at least one such experience, and that can be psychological, physical, sexual or neglect. This is not a small problem, and it’s not limited to just one gender. I should mention that the vast majority of the literature we reviewed comes from North America and Europe, so these estimates are not globally balanced. This is a matter of urgent concern for everyone because sports are ubiquitous, touching countless lives. Making them safer has a direct, personal benefit for everyone involved.

Who is most likely to be a target?

We found that there are a number of characteristics that increase one’s vulnerability to interpersonal violence in sport, just like in society. People who are experiencing marginalization of any kind — those who are Black, Indigenous or people of color; women; and those with LGBTQ+ identities, disabilities or a low socioeconomic status — experience interpersonal violence at higher rates.

The late Celia Brackenridge, one of the founders of this field, found that there is a very high risk of interpersonal violence at the stage of imminent achievement — just before an athlete turns the corner and starts to perform well enough to, say, go to their first Olympics. For different sports, the age of imminent achievement is different. In gymnastics, for example, the athletes might still be in high school, but in track & field, they could be much older.

I have two kids who do sports. What do parents like me need to know?

Sports are supposed to be fun. It should be an amazing learning experience for your kids. If it’s done right, it will be uplifting and empowering. Look for environments where the coaches and staff intentionally cultivate the whole person, where they pay attention to the team culture and chemistry among the teammates. It can be challenging to pick up on abusive people or signs of abuse, but if a culture is geared toward holistic growth and child development, it’s a bit less likely. A culture of trust and open communication between the coaches and the parents, and among the parents, is also crucial.

Sports are supposed to be fun. It should be an amazing learning experience for your kids. If it’s done right, it will be uplifting and empowering.

Yetsa Tuakli-Wosornu

So, my parents’ WhatsApp groups are serving an important purpose.

Absolutely!

Are there characteristics of likely perpetrators?

It’s generally not the stereotypical big, bad, antisocial creep. And it’s not just coaches; it can be doctors, as we’ve seen in the news; lawyers; owners; parents; or other athletes. The way people feel in the space is important because the culture can uplift people and dissolve some of these problems, or it can push people in the direction of feeling so pressured to perform or get performance outputs that could affect their job, that they behave badly. Anyone can perpetrate, and anyone can be a victim. I wish I could give you a zinger — this kind of person is the one to look out for — but that’s not what the data show.

It’s not always going to be a Penn State situation where you have a Jerry Sandusky type.

Exactly. We also found that the media plays a big role in shaping the conversation. The committee made a recommendation for more balanced stories in the media that humanize and tell the truth, not just sensationalize.

What type of interventions could address the high rates of interpersonal violence in sports?

We know that structural features of an environment change behavior, so if we change the sports environment, we hope to see changes in individuals’ behavior. For example, many teams and organizations are focused solely on performance and profit. What if we change their incentive structures to also include well-being? That could go a long way. Safeguarding and well-being could even be written into coaches’ contracts and organization policies.

Many serially successful coaches, like Tara VanDerveer (former Stanford women’s basketball coach) and Dick Gould (former Stanford men’s tennis coach), attend to their athletes’ well-being and cultivate a team culture that uplifts everyone. If this positive model could be scaled beyond college sports to recreational and professional sports, some of the behaviors at those levels would likely change as well.