On June 15, the House Government Reform Committee held the fourth in a series of hearings on anabolic steroids (AS). Previous hearings focused on male professional athletes and the impact of their steroid use on male high school and college students. On June 16, during consideration of a bill (H.R. 2829) to reauthorize the Office of National Drug Control Policy, the committee approved a provision that would require Major League Baseball, the National Football League, the National Basketball Association, and the National Hockey League to adopt drug testing policies meeting the same standards as the International Olympic Committee (IOC).
In his opening remarks, Chair Tom Davis (R-VA) explained that “studies have shown that growing numbers of young girls are beginning to use steroids. Some of this use is attributed to the desire to improve athletic performance. But some of it is because girls are looking for a way to get thinner, to reduce body fat to conform to an idea of beauty they feel pressured to emulate…Young women appear to be resorting to steroid use as a means of weight control and body-fat reduction that is, losing fat and gaining lean muscle. The use of steroids for this purpose often goes hand in hand with eating disorders not to mention the abuse of other drugs in order to stay thin.”
Pointing to news reports on steroid use among women, Ranking Member Henry Waxman (D-CA) stated, “These stories got our attention, in part because they suggest that the pressure to use these drugs illegally extends beyond the locker rooms and playing fields where we have been focusing our inquiry. Steroid use among female athletes is, unfortunately, nothing new. We’re all familiar with the images of East German female athletes from the 1970s and 1980s. But it seems to me that if young women today are taking steroids at high rates and taking them not just to improve their athletic performance, but to meet a socially expected standard of how they should look then perhaps the steroid problem is even bigger than we have thought.”
The committee first heard testimony from two female athletes: Kelli White, a former World Champion sprinter, and Mari Holden, a World Champion cyclist. Stating that she “was continuously being told by [her] advisors that usage of performance enhancing substances was necessary to be competitive because everyone else was doing it,” Ms. White told of how she used steroids after suffering repeated injuries in 2002: “In a relatively short time period, I had gone from being a very competitive sprinter to being the fastest woman in the world! In June 2003, I captured both the 100 and 200-meter United States Championships, and followed that by winning the same events in the World Championships in August.” After admitting to her steroid use before the United States Anti-Doping Agency (USADA), she received a two-year ban from competition and now assists USADA in educating other athletes. Ms. White thanked the committee for addressing the use of steroids among female athletes, stating, “This is a problem that is not gender specific, and affects people across all gender and racial lines. As an athlete, I am very aware of the opportunities which have advanced women in sports during my lifetime, and just hope the Committee takes note that the pressures and considerations pertain equally to men and women.”
Explaining that she had never used steroids or other performance enhancing drugs, Ms. Holden stated, “Looking back on my career I can smile knowing that I did it the right way. I have an Olympic medal and earning it was one of the greatest achievements in my life. The medal is only a symbol, but standing on the podium and hearing Anita De Frantz, a USOC [United States Olympic Committee] and IOC board member, tell me that my whole country was proud was the moment I had imagined since [childhood]. It was a feeling that I had overcome the odds and done it without compromising my values. There were so many opportunities to take the easy way, but I will never look back at my medal and feel anything but pride.”
Dr. Diane Elliot, a professor of medicine at the Oregon Health and Science University, cited a 2003 survey by the Centers for Disease Control and Prevention (CDC) that found that seven percent of ninth grade girls reported anabolic steroid use: “While seven percent is higher than other surveys, true rates may be difficult to determine. Women tend to use drugs alone and are better able to conceal drug use. The potential shame and stigma of steroid use may lead to a bias to underreport its use.” Addressing the factors for steroid use, she stated that “today, a lean more muscular appearance is a standard of both beauty and sports performance, and that combined pressure may place young female athletes at greater risk for disordered eating and the use of body-shaping drugs (e.g., diuretics, laxatives, diet pills, amphetamines and anabolic steroids). Eating disorders have become a major problem and are the third most common chronic illness among adolescent females. Disordered eating is present among all sports and is not confined to those encouraging a slender, immature body type or those that are judged and not refereed. Unfortunately, programs to prevent these body-shaping practices largely have been unsuccessful or paradoxically, may have increased these detrimental behaviors.”
Ms. Elliot and a colleague developed the Athletes Targeting Health, Exercise & Nutrition (ATHENA) program, which aims to deter drug use among female student athletes by incorporating educational programs into team practice activities. Highlighting the program’s success, she stated, “Following the program, girls in ATHENA had less new and ongoing diet pill use and less new use of athletic enhancing substances (anabolic steroids, amphetamines and sport supplements). They also reported less [instances of] riding in a car with a drinking driver, less sexual activity and fewer injuries. They ate better and could strength train more effectively. We continued to follow these young women and assessed them again one year after high school graduation. ATHENA graduates reported less alcohol and drug use. Those long-term findings show that directly focusing on risk factors and healthy decision-making skills truly has a lasting impact.”
A professor of health policy at the Pennsylvania State University, Dr. Charles Yesalis, addressed the physical consequence of anabolic steroid use: “In addition to affecting proportionally greater gains in muscle mass and strength in girls and women, these drugs predictably and sometimes permanently masculinize females. These virilizing effects include voice deepening, increased facial and body hair, loss of scalp hair, decreased breast size, clitoral enlargement, and menstrual irregularities. These effects can be in addition to many of the same adverse health effects that have been documented in males using AS, such as those affecting the heart, liver, and behavior.” Arguing that drug education programs have not been successful, Dr. Yesalis said that “we need to seriously consider increasing drug testing and penalties at the high school level. Furthermore, as a society we need to deliver a clear and strong message to our children that AS use will not be tolerated, even among elite athletes, who serve as role models.”
