By Sheree Bekker @shereebekker and Tracy Blake @tracyablake

“Women want to be leaders, we just put them off as we go along. I think in every program I have ever watched in my life the woman, the female doctor [unclear] is either hyper-sexualised…or she is not present….This is what young girls, what I, grew up with as the perception of what a female doctor was. This needs to change.” ~ Dr Carneiro, Swedish Football Association Conference 2014

What the Eva Carneiro case tells us about gender discrimination in sport

As the BJSM blog “Team doctors have the authority over managers to make medical decisions #PlayerSafety1st” pointed out, the Mourinho/Carneiro case has highlighted two critical issues: 1) gender discrimination in sport, and 2) a team doctor’s authority to make medical decisions, not the manager.

The second issue has rightly seen widespread outcry from the SEM community, and opened up much-needed conversation around scope of practice, and player safety. This included Lisa O’Neil’s excellent editorial “No way Jose! Clinicians have authority over patient care: The manager’s scope of practice does not cover medical decisions”.

Yet discrimination – specifically gender discrimination – the deeper underlying issue, has seen little to no commentary from within the SEM community. Whilst – as the recent BJSM blog post stated – “we applaud and celebrate all SEM practitioners who have a commitment to player welfare” – there has been limited outcry over the sexist treatment to which Dr Carneiro has been subjected, both in this case, and in the larger pattern of insidious and benevolent sexism which she has endured over her career.

The statement put out by Chelsea FC following the settlement of this case is perhaps the most telling sign of what it takes to be successful as a woman within SEM at the professional sports level:

“We wish to place on record that in running onto the pitch Dr Carneiro was following both the rules of the game and fulfilling her responsibility to the players as a doctor, putting their safety first. Dr Carneiro has always put the interests of the club’s players first.  Dr Carneiro is a highly competent and professional sports doctor. She was a valued member of the club’s medical team and we wish her every success in her future career.” ~ Chelsea Football Club Announcement, June 2016

For those in the SEM community, these statements may be self-evident. But we also need to address the perceptions of those with hiring power. The comments of Chelsea’s former manager explicitly questioned Dr Carneiro’s professional knowledge and her ability to fulfil her role field side at a professional event. These sentiments have the potential to not only follow the individual, but become attached to other women in SEM professions.

The under representation of women in professional SEM roles

Women in SEM roles in professional sport organizations are rare. A look at the 25 Canadian professional franchises in hockey, basketball, baseball, soccer, football and lacrosse, for example, shows that women comprise only 11 of the 219 listed sport medicine and sport science personnel. Negative comments that reference traits associated with being ‘female’ can implicitly or explicitly damage not only an individual’s future opportunities, but the opportunities for other women clinicians to work with the top professional athletes in the world. The impact of these comments hold even more weight in the modern era, where the globalization of information means that publicly-stated opinions can be accessed with the ease of opening a search engine. This has not been shown to be the case for men in the same situation, if for no other reason than there are simply too many men in these roles for such generalizations to be tenable. The inclusion of the club’s public statement as part of Dr Carneiro’s settlement clearly exonerates her professionally. However, until it is no longer required in order to justify the work of women SEM professionals, in the face of non-expert opinions, we collectively (men and women in the SEM community) have work to do.

In this way, women in this industry are shown time and time again – both intentionally and unintentionally, explicitly and implicitly – that they do not yet have an equal place in the sporting world. Men in SEM simply do not experience these same underlying messages.

Sport is often seen as ‘inherently good’ and put on a pedestal by our society. However, sport is not experienced as exclusively positive by those who are discriminated against. Discrimination exists at the intersection of gender, race, class, and economic disparities. This means that where gender issues are present, intersectional issues such as racism, and discrimination against people who identify as GLTBQIA – amongst others – exist. When these exist, even highly qualified and experienced women like Dr Carneiro are hindered or excluded from doing their jobs.

Where is our commitment to the safety of our women (and those who identify as women) and other underrepresented minority SEM practitioners, researchers, patients, and research participants? Just because discrimination is not recognised, does not mean that it does not exist. Agile moves around this issue, and careful sidestepping, only add to the unease that our community has with this very issue.

Let’s unpack this pattern with some recent examples from our research and context:

• Right here in BJSM an editorial pointed out that the female body is consistently underrepresented in SEM research.
• It was shown that sportsmen’s views on race, sex, masculinity, and sexual preference have meant the attrition of Indigenous players in the Australian Football League.
• Other recent instances of gendered discrimination and attack that come to mind are Raymond Moore’s sexist comments of women tennis players, Muirfield Golf club’s exclusion of women, and Brock Turner’s sexual assault of a woman (yes Turner’s sports participation is an important factor in his case).
• The gender pay gap persists – both in sport, and in academia.

Further, if we look at the people who make up our SEM practitioner and research community, there is a clear lack of diversity:

• Four out of the five keynotes at the upcoming International Olympic Committee World Conference on the Prevention of Injury and Illness in Sport are white men (the fifth keynote is yet to be announced – we call on the conference committee to seriously consider a woman, and perhaps even a woman of colour).
• All male panels are an all too common occurrence at our conferences.

Call to action, for broader inclusion in the SEM Community

To those who occupy discriminated spaces, and who are discriminated against, this is the threat to safety. What happened to Dr Carneiro is not merely a player safety issue, this is part of a broader SEM community safety issue that we have failed to recognise, acknowledge, and counteract.

It is not only women and underrepresented groups who are missing out when we discriminate against half of our population; everyone misses out. When we only hear the opinions of – or do the research of and on – one privileged group, we are missing the opportunity to be enriched by the knowledge, experiences, capabilities, and insights of women within the SEM community.

We owe it to our SEM community to: (i) as a start, open up this conversation, and; (ii) consider our individual roles and areas of influence and the ways in which we are both implicated in the issue, and can take small or large actions to be part of the solution.

We can, and should, do more.

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Sheree Bekker, Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Australia

Twitter: @shereebekker

Tracy Blake, Physiotherapist. PhD candidate, eSport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta

Twitter: @tracyablake