Gender- and/or sex-specific considerations for sport-related injury: a concept mapping approach for the Female, woman and/or girl Athlete Injury pRevention (FAIR) consensus.

Abstract

This study aimed to gather and represent experts' perspectives on the gender- and/or sex-specific factors relevant to injury risk for female/woman/girl athletes. Mixed-methods concept mapping study. Sixty-six experts including cisgendered (1) athlete/coach/carers, (2) clinicians, (3) sports science/high-performance professional, (4) administrators and (5) researchers brainstormed statements to a prompt ('What gender-specific and/or sex-specific factors do you think contribute to injury risk among female, woman and girl athletes?') before thematically sorting and rating the statements/factors for importance and modifiability (5-point Likert scales). Ten clusters were constructed from 101 unique statements/factors. The clusters (number of statements) include: (1) <i>Inequitable organisational funding and support</i> (n=17); (2) <i>Athletes' lack of, and access to, resources</i> (n=7); (3) <i>Lack of knowledge and expertise among support staff</i> (n=6); (4) <i>Lack of evidence for, and implementation of gender and sex-appropriate injury prevention</i> (n=20); (5) <i>Sex-related factor</i>s (n=14); (6) <i>Gendered health</i> (n=8); (7) <i>Gendered expectations to conform to athletic ideals and norms</i> (n=10); (8) <i>Gendered harassment (interpersonal violence) and social biases</i> (n=9); (9) <i>Gendered sport environment</i> (7); (10) <i>Gendered communication</i> (n=3). <i>Lack of knowledge and expertise among support staff</i> was deemed the most important and modifiable cluster to address gender- and/or sex-specific factors relevant to injury prevention for female/woman/girl athletes. Ten gender- and/or sex-specific clusters, ranging from organisational to biological considerations and societal influences, were defined that could impact female/woman/girl athlete injury risk factors. Advancing stronger evidence for gender and sex appropriate injury prevention is urgently needed.