Katie Steele still gets sweaty when she talks about what happened to her nearly 20 years ago, when she was a track and cross country runner at the University of Oregon.
But it's one of the things she wants people to know about the mental health crisis in women's sports: trauma can affect athletes months or even years after the acute crisis.
“Just because you hang up your spikes and your suit doesn't mean it's over,” she told Runner's World in a phone interview.
Steele co-authored the upcoming book, “The Price She Pays,” (out June 18th) with Dr. Tiffany Brown and Erin Strout about the hidden mental health crisis in women's sports. Now a licensed marriage and family therapist, Steele was a highly-sought-after track and cross country athlete when she signed with the Oregon Ducks in the early 2000s. But her struggles as a collegiate athlete put her at risk from people she trusted to have her best interests at heart.
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In Eugene, Steele joined a program with unspoken rules about diet and a strict culture that centered around body size and appearance. One coach quit because of the toxic culture, but years later, that coach recounted how his boss, watching a game from the stands at Hayward Field, told Steele to “cut down on the fat pigs and fat cows.”
Alberto Salazar became informally involved with the program when a new coaching staff was installed in 2005. When Steele's performance began to decline (likely due to RED (relative energy deficiency in sports)), he stepped in and exploited Steele's weakness by referring him to Houston endocrinologist Dr. Jeffrey Brown, who diagnosed Steele at age 20 with hypothyroidism, which led to weight gain and fatigue.
Steele learned years later, through conversations with former coaches and teammates and tracing her own medical records, that she did not have hypothyroidism and did not need medication. Her own memory is hazy, and she still doesn't understand what happened. Even after outside doctors confirmed she did not have the condition at the time, and even years after she left the program, she continued to trust Salazar and Dr. Brown. Her body is now used to and dependent on the medication, and she must take it for the rest of her life.
These experiences led Steele to pursue a career in counseling, specifically to help young female athletes, “because that's what they needed at their age,” she writes in the book's introduction. Across sports, girls start suffering abuse at an early age, and sometimes the messages to win at all costs or be strong (but not too big) drive them to develop eating disorders or injury.
Oftentimes, sidelined or retired athletes struggle with depression, anxiety and other mental health crises. Sometimes the abuse is more blatant, as was the case with the now-disgraced and permanently banned Salazar, who Kara Gocher, Mary Cain and others say physically, verbally and sexually abused players.
“It's great to know I'm not alone,” Steele said, “but it's devastating that I'm not alone.”
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Knowing she's not alone is even more motivating. Steele is eager to make systemic change so that the mental health of female athletes is prioritized within the competitive system. “We have to make a change. We have to make sure athletes are protected,” she says. “There's just too much harm being caused by choosing comfort over change.”
To be clear, protecting athletes doesn't mean lowering expectations or making sports less intense. “We're not looking to water down sports or any of that stuff,” Steele reiterated. Rather than offering cookie-cutter solutions like “do yoga,” Steele said sports programs can actually quantify mental health issues like team retention and injury rates.
Courtesy: Little, Brown Spark
Though The Price She Pays details harrowing stories of female athletes who've dealt with everything from eating disorders, substance abuse, depression and suicidal thoughts to enduring abuse from coaches, other authority figures and peers, Steele said she ultimately feels hopeful for the future. Indeed, the “vastness and gravity” of the hundreds of stories she and her co-authors uncovered in researching the book was disturbing, but as Brown told Steele while writing the proposal, “Your story is so impactful, but the fact that your story isn't unique is what makes it so storylike.”
That’s why Steele has high hopes: “There are so many incredible women and girls and leagues out there trying to change things and do things differently. [by] “Focusing on women, trusting women, asking women, designing leagues for women,” she said. “The momentum for change is huge, and it's hopeful.”
Written for parents, coaches, and anyone who cares about women and girls in sports, the book goes beyond the usual playbook and highlights how nuanced and complex mental health issues are with tons of case studies and interviews. But sometimes the reaction from women in sports can be simplistic. Offering support requires nothing more than curiosity. “Ask about their experiences without trying to change the situation or solve the problem,” Steele writes in The Price She Pays.
Steele and his co-authors argue that just as there are protocols and checklists for dealing with concussions and other physical injuries, there should also be systems in place to address mental health concerns.
Such a change at the collegiate level would require new policies from governing bodies like the NCAA, which currently provides mental health care best practices for universities but only requires Division I schools to provide mental health services to athletes, without taking into account long wait times and a shortage of qualified staff.
In the meantime, Steele and Brown hope to grab the attention of well-meaning coaches, parents and administrators. Together, they've created the Athlete Mental Health Foundation, providing training and resources that go beyond books: equipping people with the tools they need to understand where they're at, accommodate different learning styles and better support their athletes.
“We wouldn't be doing this if we didn't believe in the power of sport and the power of sport, if we didn't have high hopes,” Steele said. “We [provide] Don't just name the problems, think of the solutions.”
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Abby Carney is a writer and journalist living in New York. A former D1 college runner and current amateur track athlete, she writes about the culture and people of running and outdoor sports for Runner's World, Like the Wind Magazine, The New York Times, and other publications. She also writes about non-running related topics and was the former editor of a food magazine.
