Health barriers for girls and women in sport

This is a House of Commons Committee report, with recommendations to government. The Government has two months to respond.

Third Report of Session 2023–24

Author: Women and Equalities Committee

Related inquiry: Sexism and inequalities in sport

Date Published: 5 March 2024

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Contents

1 Introduction

1. There have been some remarkable breakthrough moments for UK women’s sport in recent years, including huge progress at elite international and domestic levels. A surge in public interest in women’s sport is borne out by record live attendances and television audiences.1 The Women’s UEFA EURO22 football tournament, memorably won by England’s Lionesses at Wembley Stadium in July 2022, broke records for interest in the women’s game, including:

  • a new high attendance figure of 87,192 for a women’s international football match in Europe, the largest attendance ever at a women’s or men’s EURO championships final;
  • a new aggregate attendance record across the tournament of 574,875, which was more than double the previous record set five years previously in The Netherlands;2 and
  • a peak UK television audience of more than 17 million people, making it the most-watched women’s football match ever in the UK, and, at the seven-month point in the year, the most-watched television event of 2022.3

In August 2023, the FIFA Women’s World Cup final between England and Spain in Sydney attracted a peak UK television audience of nearly 12 million people, with almost four million additional views on BBC Sport and the iPlayer. It was the second most-watched BBC television event of the year, behind only the coronation of King Charles III in May.4

2. There is persuasive evidence that breakthrough events such as EURO22 and the 2023 World Cup Final are translating into sustained changes in public interest and viewing habits.5 The additional public interest has driven substantially higher Women’s Super League, and other elite European league, match attendances and TV audiences.6

3. The increasing popularity of women’s sport is not limited to football. Research published last year by the Women’s Sport Trust (WST) shows increased television audiences for women’s Six Nations rugby and international and domestic cricket, notably the women’s Ashes series and the new short form of the game, The Hundred; progress WST Chief Executive, Tammy Parlour, described as “unstoppable”.7

Female health and physiology in sport

4. This increased attention has also served to shine light on the health and physiological challenges that women and girls face in sport. We heard oral evidence in late 2022 and early 2023 on girls’ and women’s experiences of sexism and inequality in football. We then focused our inquiry on female health-related needs in wider sport, motivated in part by evidence on the disproportionate prevalence of anterior cruciate ligament (ACL) knee injuries in women’s football. We wanted to know whether the ACL issue was indicative of a broader problem: whether girls and women in sport more widely were being affected by a relative lack of understanding and attention given to female health and physiology-related needs.

5. From June to November 2023, we heard oral evidence from a panel of current or recently retired elite sportswomen, with experiences in cycling, netball, rowing and rugby, followed by organisations advocating for women in sport, a women’s health and fitness coach, and a GP specialising in menopause; the national governing bodies of three individual sports - England Hockey, England Netball and the Lawn Tennis Association; and finally, from UK or England-wide organisations responsible for sports’ funding, governance, coaching, and sports science: UK Sport, Sport England, UK Coaching, and the UK Sports Institute respectively. A full list of oral witnesses is published at the end of this Report.

6. We requested written evidence from the Government, which was submitted by Rt Hon Stuart Andrew MP, Parliamentary Under Secretary of State for Sport, Gambling and Civil Society, and Minister for Equalities in the Cabinet Office’s Equality Hub, and Rt Hon Damian Hinds MP, Minister of State for Schools at the Department for Education.8 We are very grateful to everyone who contributed to our work.

7. In the course of our inquiry, we became aware of excellent programmes to encourage more girls and women to participate in and reap the benefits of sport and exercise. There are numerous campaigns, action plans and initiatives intended to redress the balance in an often male-dominated sector. Health-related issues for women in sport, particularly around the menstrual cycle and periods and pregnancy and maternity, are increasingly coming to the fore and our inquiry identified pockets of significant progress in addressing them. While this should be celebrated, the key aim of this Report is to help precipitate a more effective and better coordinated, cross-departmental, sector-wide approach, to the benefit of girls and women throughout their life paths, from early years, through puberty and motherhood, to midlife and beyond.

2 Barriers to girls’ participation

8. Girls face particular challenges to participation in sport. These arise from a combination of gender stereotypes that promote the very outdated notion that sport is a predominately male sphere, and health and wellbeing issues experienced only or predominately by girls. Below we examine some of these distinct barriers and the adequacy of steps being taken to address them.

The early years “gender play gap”

9. Barriers to girls’ participation in sport and exercise begin from a very early age, driven by a combination of hormonal differences and the application of gender stereotypes around physical activity. Lisa West, Head of Policy, Partnerships and Public Affairs at the advocacy charity Women in Sport, told us there was evidence that “we are doing a lot of damage early on”, and that many girls are “lost” to sport and exercise before they start primary school. She emphasised that gender disparities in physical activity start from six months, when baby boys first experience a surge in testosterone levels. She described the effects of this, combined with gender stereotypes around what are too often perceived to be suitable types of play for boys and girls:

From that point, boys are 6% stronger and faster than girls. Therefore […] the way we then play with them and the physicality they generate means that, when they come into primary school, there is a real gap in fundamental skills between boys and girls.9

10. Baz Moffat, a women’s health and fitness coach and co-founder and CEO of The Well HQ, which is leading ground-breaking work across this area, described an observable “gender play gap” among children at the age of five, by which point:

Girls move a lot less than boys. All of us can observe that when we are out in the parks and the playgrounds. The boys are doing rough and tumble and playing around. They are learning how to move their bodies, but girls are just not moving as much.10

Participation and enjoyment at school

11. Research has consistently shown gender disparities in participation in, and enjoyment of, physical activity and physical education (PE) at school. Youth Sports Trust’s (YST) series, Girls Active, has surveyed levels of physical activity among boys and girls since 2016. The most recent data show that girls are on average physically active for 60 minutes or more on fewer days per week than boys (3.3 days for girls, compared to 3.9 days for boys in 2022–23). Sport England survey data on the percentage of girls and boys taking part in physical activity for an average of at least 60 minutes per day also show a significant gendered disparity (45% of girls, compared to 50% of boys in 2021–22).11

12. The gender gap in enjoyment of school PE is much more pronounced and has widened since 2016. The proportion of girls saying they enjoy PE has fallen (from 74% in 2016 to 63% in 2023), while boys’ enjoyment has remained stable at 86%. The “enjoyment gap” is most stark at Key Stage 4 (KS4), encompassing Years 10 and 11 of secondary school, when children are aged 14 to 16 years. The 2022–23 figures fell to 59% of girls in this age group enjoying PE, compared to 84% of boys.12 Ali Oliver, YST’s Chief Executive, said this should “ring alarm bells”, both for girls’ physical and mental health and for future activity levels and wellbeing among women.13

Dropout rates during puberty

13. Part of the reason for the pronounced enjoyment gap at KS4 lies in the very different ways in which boys and girls experience puberty, creating distinct barriers for girls. While pubescent hormonal changes associated with boys typically make them “faster, fitter, more aggressive and well suited to playing sport”, girls’ enthusiasm for sport, and their athletic confidence, can be negatively affected in several interconnected ways.14 Baz Moffat explained that girls:

[…] hit puberty and their bodies do not feel great. The girls who love sport will carry on doing sport, but there is a massive group for whom the barrier to dropping out of sport is very low. Their breasts grow; they get periods; they cannot move their bodies; they are not given opportunities in sports that they want to do; they are asked to wear skirts and all of that.15

14. Furthermore, parents are more likely to encourage their sons in sport and exercise than they are their daughters. YST reported that “only 31% of girls feel encouraged and supported to be active by their dads, compared to 50% of boys.”16 There is also evidence that internalised gender stereotypes and peer pressure pose barriers to teenaged girls’ participation. For example, research shows that girls at this life stage do not see sport as “cool” or “feminine” and that they often prioritise more stereotypically female activities such as socialising.17

Concerns about PE and sports kit

15. Girls’ anxieties and body confidence issues associated with PE kit and sportswear was a very strong theme in evidence to us and is strongly supported by recent research findings.18 England Hockey player, Tess Howard, published research for her postgraduate degree last year. She found that a range of body image concerns about PE kit, including sexualisation, fear of “masculinisation” and “butch/lesbian” perceptions, play a “major role” in girls’ high dropout rates.19 She emphasised the importance of choice of sportswear for girls, telling BBC Sport:

Women’s sport is on the rise. We are so proud of our successful female sporting teams; but think of all the girls we have lost to kit problems. It’s not a girl issue, it’s systemic in society and it’s a simple fix: choice. The data shows simply expanding sports kit flexibility and choice increases comfort in sport and the likelihood of long-term participation.20

YST found from its 2022–23 Girls Active survey that, when asked about PE and sports kit, 29% of girls did not “like the look” of current options; 30% wanted to wear their own choice of sportswear; and a majority (56%) wanted “more options to choose from”.21

16. Kelly Gordon, Director of Development for England Netball, emphasised the importance of educating girls about the benefits of sports bras, given that breast-related issues were often cited as a barrier to girls’ participation. She told us there was currently “no education” about this in schools. She said:

We hear […] of girls not even knowing that they should wear a sports bra or doubling up. We hear a lot about finishing the school day and just putting another bra on top of it. Breast issues are […] a highly stated reason not to take part in PE. It is about that simple education of, “It is really important to wear a sports bra, and you can go and get one from your high street store, as long as you know the correct size” […].22

17. National governing bodies we heard from had taken steps to increase choice of kit. Jo Ward of the Lawn Tennis Association (LTA) described how tennis at the grassroots level “does not mandate what people wear”. She told us the LTA had a campaign called Play Your Way:

[…] where we send the message loud and clear that anybody anywhere can play tennis, wearing what they want, and play how they want and so on. Those messages are really important to the wider tennis population.23

18. Nick Pink, CEO of England Hockey, told us that hockey’s dress regulations had been amended at the beginning of 2023, “backed up” by Tess Howard’s research.24 Hockey players on the same team may now individually choose between a skirt, a skort (skirt with shorts sewn in underneath), or shorts. Previously all players on the same team were required to wear the same, and only had the choice of skirt or skort. In June 2023, this change was also made at the international level, following pressure from England Hockey.25

Period-related concerns

19. YST’s research shows that issues around periods are the most commonly cited barrier to participation among secondary school girls, with 38% of those surveyed raising periods as an issue. Of those who raised periods as a barrier to PE, 68% said they were concerned about being in pain or discomfort; 60% worried about leaking; and 57% said low mood while on their period was their main concern.26

20. Witnesses reported a lack of education for girls around managing the menstrual cycle and periods in the context of school sport and exercise.27 Kelly Gordon of England Netball told us that, while a number of elite sportswomen had recently broken the “taboo” of periods in sport, the issue was still “less talked about in schools”.28 She believed there was “a huge way to go in terms of education for girls […]”. She told us research England Netball had conducted with Swansea University showed that “only 51% of schools in England have the menstrual cycle as part of the curriculum, even though it is mandatory.” She reported that where the menstrual cycle is taught, it is typically once per year, “part of a biology lesson” in secondary school, and typically delivered after most girls had started their period at age 11 or 12 years.29 Baz Moffat of The Well HQ emphasised that “PE teachers have no education about girls going through puberty”, which she believed was a “massive” issue.30

21. Kelly Gordon described how Swansea University had developed “a four-week lesson plan to help teachers deliver menstrual cycle education”, which there were plans to pilot in schools.31 Her view was that education about the menstrual cycle, periods and physical activity should be delivered at a “much younger age”, noting that there was currently “very limited education” at primary school.32 On average girls have their first period aged 12 years and many start their period at eight or younger.33 Kate Seary, co-founder and Director of Kyniska Advocacy, argued:

[…] we need to get everyone on a level playing field so that, whatever sport you go into, whatever school you go into and wherever you are having your PE lessons, there is the same support and knowledge there about the menstrual cycle and performance in sport.34

Strategies, action plans, campaigns, and initiatives

22. In July 2023, the Department for Education (DfE) published an updated School Sport and Activity Action Plan, which sets out a two-year plan to improve equal access to, and the quality of, PE and sport in schools. It notes that in 2021–22 girls were significantly less likely than boys to have opportunities to play a range of sports in school PE lessons, including football, basketball, cricket, and rugby. In contrast, girls had more access than boys to rounders, netball, badminton, dance, gymnastics, and volleyball. Overall, a greater proportion of boys (77%) reported having access to team sports at school than girls (69%).35

23. A key objective of the DfE’s action plan is to “encourage equal access to sport for girls and boys”, with the DfE’s “expectation” that “the starting point for schools should be to give girls and boys access to the same sports where they are wanted.”36 Another key element of the plan is to “support teachers and schools to deliver 2 hours of high-quality PE [per school week] and provide competitive and extra-curricular opportunities to both girls and boys.”37

24. The plan emphasises that, from September 2023, gender equality criteria were “phased into” the School Games Mark, a government-funded award scheme administered and assessed by YST, to reward schools that demonstrate commitment to the development of school sport. Launched in 2012, the voluntary scheme aims to improve PE and sport provision by assessing participating schools, against a range of quality criteria, for bronze, silver, gold, and platinum awards. From September 2024, the assessment criteria will formally include “prioritising gender issues in [the] planning and delivery of PE and school sport”.38 The Minister also noted that the DfE had committed “almost £980k” to an initiative called Your Time, which “provides leadership and competitive opportunities for girls aged 8–16”, and is intended to:

[…] address barriers to girls’ participation, which includes body consciousness. We are working with Learning Skills Foundation to capture the learning from this programme and further understand how schools approach issues like body consciousness to support girls to access PE and sport.39

25. Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Society in the Department for Culture, Media and Sport (DCMS), noted “some fantastic initiatives” intended to encourage girls and women to participate in sport. These include Sport England’s This Girl Can campaign, which launched in 2015 and has “already inspired millions of women and girls to get active regardless of shape, size and ability”, and an online Sport England-funded video platform called Studio You, which is designed to help PE teachers engage girls aged 11 to 16 years through a broader range of physical activities they may enjoy at school, from yoga to boxing.40

26. Jeanette Bain-Burnett, Executive Director of Policy and Integrity at Sport England, told us that Studio You had been used in 50% of schools and had reached 100,000 girls. The physical activities and sports available via the platform had been “co-designed” with girls and were intended to address their barriers to participation, including body confidence.41

27. Both Ministers noted the broader, DCMS-led Get Active strategy for the future of sport and physical activity, published in August 2023. This aims to increase participation among underactive groups, including girls and women. Its headline aim is to support 2.5 million more adults and 1 million more children in England to meet the definition of active (at least 150 minutes of physical activity per week for adults; 60 minutes per day for children) by 2030.42

28. Ministers also emphasised the establishment in September 2023 of a National Physical Activity Taskforce (NPAT), chaired by the Secretary of State for Culture, Media and Sport or the Minister for Sport, alongside former England rugby international Ugo Monye. NPAT meets quarterly and includes representatives from across the sector and a wide range of government departments.43 The Minister for Sport told us NPAT’s December meeting would focus on “action needed to improve children and young people’s activity rates, especially amongst under-represented groups (including girls).”44

29. While expert witnesses welcomed the Government’s and Sport England’s strategies, action plans and campaigns, particularly the new Get Active strategy and This Girl Can, we were told there was still insufficient focus on key health and physiology-related barriers for girls, particularly at school. We heard that the DfE’s updated school sport plan was inadequate in this regard and that schools needed more specialist PE teachers.45 Witnesses argued for better training in girls’ health and physiology for all teachers delivering PE lessons, and more support for them to have conversations with girls about their needs in the context of PE and school sport.46

30. YST called for a national campaign to accompany Get Active, which it argued should “aim to replicate the success of previous campaigns such as ‘5 a day,’ with an ambition to dramatically raise awareness of the importance of being physically active”. It also called for clear measurement of progress and accountability in relation to the strategy’s key targets.47

31. YST welcomed the creation of NPAT; however, it argued that success would require “political leadership” and “specific engagement with under-participating and under-represented groups to help inform delivery”. YST told us:

Providing a platform for young people to share their voices offers an effective way to understand barriers and opportunities, and to use these to shape provision and deliver high-quality, engaging experiences based on their needs. This is also important to help identify key transition points during childhood at which participation rates can drop-off–such as entering secondary school, and the onset of puberty–in order to tailor specific support and interventions as required.48

32. Girls face a number of distinctive health and physiology-related barriers to participation in, and enjoyment of, sport and physical activity, from early years to post-puberty. Existing programmes and interventions from the Government and other bodies, while welcome, do not yet go far enough in addressing these barriers and are yet to reverse alarming downward trends in girls’ enjoyment of PE. They also lack specific age group-related targets for participation in and enjoyment of PE and school sport.

33. Key anxieties for girls include concerns around periods, yet education on the menstrual cycle, despite being mandatory, is only being delivered in half of schools. It is shocking that around 50% of schools are disregarding a vital, and mandatory, element of the curriculum. Where it is being delivered, in most cases, it is part of a biology lesson and years after most girls will have started their period. As we have found in our other work, this is typical of current teaching on reproductive health, which is inadequate, irrelevant to girls’ needs, and delivered too late in girls’ development. These failings are having obvious consequences for girls’ confidence and, in terms of participation in and enjoyment of PE and sport, leading to withdrawal from necessary, healthy activity.

34. The Department for Education must urgently review the quality and timeliness of education on girls’ health and physiology, including the effects of puberty, the menstrual cycle, and periods in the context of PE and school sport. Whether part of PE or PSHE, or ideally both, this education needs to be delivered more effectively and much earlier. Teachers need to be better trained to deliver it, including around how to have effective conversations with girls and support them during this significant life stage. Education on reproductive health is a positive, not a barrier to overcome. Our recommendations reflect what girls are asking for and are straightforward to implement. The DfE must make clear to all schools that not delivering education on the menstrual cycle is unacceptable and set out in response to this Report the steps it will take to ensure 100% compliance with the current requirements, with a clear timeframe to achieve this. We further recommend the DfE supports pilots of new approaches, such as the enhanced, four-week lesson plan being developed by Swansea University, and commits to rolling out an improved offer across all primary and secondary schools within the next 12 months.

35. The evidence on girls’ anxieties around PE kit is overwhelming. We recommend the Department for Education and National Physical Activity Taskforce review guidance for schools on school PE kit, with the aim of ensuring all schools permit the widest possible choice for girls. That guidance should include advice to schools on use of sports bras by girls taking part in PE and school sports.

36. We recommend Sport England launch a new strand of the “This Girl Can” campaign aimed at parents, tackling early years gender stereotypes around physical activity and sport. This should include a specific focus on the positive role fathers can play in encouraging girls in sport and exercise. Sport England should also work with the Department for Education to roll out the “Studio You” platform across all secondary schools, with the aim of reaching all girls meeting the Government’s definition of inactive in Key Stages 3 and 4. The DfE should further update its School Sport and Physical Activity Action Plan to include measurable targets for closing the “enjoyment gap” in PE between boys and girls.

37. Given the very distinctive issues for girls, and to ensure their needs are not overlooked, we recommend the Minister for Women and Equality Hub officials attend the National Physical Activity Taskforce, alongside organisations with data and expertise in this area, including Youth Sport Trust and The Well HQ. The Taskforce must consider as a priority the best available evidence, including from the Youth Sport Trust’s “Girls Active” survey series, on which to base interventions designed to address girls’ health and physiology-related barriers.

3 Midlife and menopause

38. Around a third of women aged 41 to 60 years are not getting the amount of physical exercise recommended by the Chief Medical Officer. We know that exercise is particularly important for this group, with substantial physical and mental wellbeing benefits. However, women in midlife and beyond face a number of specific barriers to participation, including perimenopausal and menopausal symptoms, gendered caring responsibilities for children and elderly relatives, and the time pressures of work when many women are at the peak of their careers.49

Key barriers for women in midlife

39. Lisa West of the advocacy charity Women in Sport emphasised the cumulative impacts for women in midlife of earlier barriers to participation, for example those experienced during early years, primary school and during puberty, as discussed in chapter 2. She said that many women will have had a “hideous time” in school PE and dropped out of sport and exercise many years earlier. These cumulative barriers were often compounded by further issues experienced by women in midlife, not least a lack of time. Lisa West told us:

We know that a lot of women in that stage have less than 35 minutes a day of time to themselves, by the time they have been to work and looked after everyone they are looking after. If we look at the Government recommendation for physical activity for health, they barely have enough time to get that in in that time. They are incredibly time poor.50

Her view was that “sport, fitness and leisure is still not good enough at understanding women in this life stage and what they need.”51

40. Ms West observed that the messaging around encouraging activity among women at this life stage did not properly take account of their circumstances. She explained that:

We are taking people who have had a bad experience of sport and physical activity, and then we are saying, “It is really good for you. Off you go. You are going through the menopause; go and be active”. We are just not giving them the messages that they need to hear. We are telling them why they should do it as opposed to talking to them in a way that says, “I understand the experiences you have had and why physical activity is not inherent in your daily life. How do we therefore create something that works for you?”52

41. Baz Moffat from The Well HQ told us about work it had been doing with personal trainers and instructors in the fitness industry, most of whom were men. She emphasised the importance of trainers and instructors understanding the health-related needs of women in midlife, for example:

[…] they might have bodies that have not moved, bodies that are overweight or pelvic floors that are leaking. Then they have coaches who do not know how to train them with that body, so they are more likely to get injured or just be embarrassed by being asked to do something that they cannot necessarily do.53

She argued that it was crucial to educate people in the fitness industry to understand women’s distinct needs and train them in the correct ways to achieve “strong resilient bodies.”54

This Girl Can campaign and the Get Active strategy

42. We heard that campaigns to boost participation rates in sport and physical exercise tended to be heavily focused on young people.55 Women in Sport’s research has found that women in midlife and beyond “feel largely ignored, invisible and irrelevant, and this is particularly true when it comes to sport and exercise.”56 However, the This Girl Can campaign has previously had a focus on women in the 40 to 60 year-old age range. The second phase of the campaign, in 2017, included examples of real women in this age group taking part in a diverse range of slower-paced physical activities.57

43. The DCMS Get Active strategy for the future of sport and physical activity, discussed earlier in this Report in relation to girls’ participation, identifies women as an underactive group but contains no detailed analysis of the barriers at different life stages, including midlife. It welcomes “significant strides” made by the This Girl Can campaign by “understanding and addressing the barriers to being active that women and girls report” but does not quantify progress or set measurable targets by age group. Neither does the strategy set out any specifically tailored interventions designed to increase women’s participation by age group. The document itself does not include a single mention of the words “midlife” or “menopause”.58

44. Women in midlife face specific health-related barriers to participation, including but not limited to the symptoms of perimenopause and menopause. These occur after many have experienced barriers at earlier life stages, including in early years and at school during puberty. Many women at this life stage will have dropped out of sport and physical exercise many years previously. These barriers are compounded by the convergence of gendered social factors, including caring responsibilities for children and ageing parents, leaving them particularly time poor. Encouraging and facilitating women in midlife to become more active is therefore a challenge that requires a thorough understanding of their needs and specifically designed interventions. Current efforts, including the Government’s “Get Active” strategy, are inadequate for this group. The strategy lacks detailed analysis of the issues, measurable targets, and specially tailored interventions. This must be rectified.

45. We recommend Sport England prioritise another phase of the “This Girl Can” campaign focused on women in midlife, showing real life examples of women in the 40- to 60-year-old age group participating in a wide range of sports and physical activities, to inspire others.

46. We recommend the DCMS update its “Get Active” strategy for the future of sport and physical activity in relation to women in midlife. It should work with organisations including Women in Sport and The Well HQ to include an analysis of the key barriers faced by women in this age group, measurable targets to increase their levels of activity, and specifically tailored interventions.

4 Sports and exercise research

47. An apparent lack of understanding of the causes of disproportionate rates of anterior cruciate ligament (ACL) knee injuries in elite women’s football led us to examine whether this was indicative of a systemic issue. While women’s health issues in sport, from managing the menstrual cycle and periods, to support for athletes returning after having a baby, and the needs of perimenopausal and menopausal women, are receiving increased attention, there was a strong sense among witnesses that there is still a way to go to reach gender equality in sports and exercise research.59

48. Many of the leading sports in the UK were codified well over 100 years ago, and as such were designed by men, for men in a highly patriarchal era.60 We heard how some of the issues sportswomen face today are a consequence of how sport evolved as a male-dominated sphere.61 Baz Moffat of The Well HQ observed:

We have designed a male-shaped system because the men were there first and there were only men involved with it. If you look at the professional sports such as rugby, cricket, or football, we have now just put women into that system. We are only recently having the conversation about girls and women being different from men.62

49. Professional rugby player Shaunagh Brown reported that throughout her career female players had often been treated like “small men” by coaches and medical staff, rather than as women with different needs.63 Baz Moffat told us that for decades the demand from women in sport had been to be treated the same as men — for example, the ongoing fight for equal access, equal respect, equal media coverage, and equal pay — but there was now a growing demand for women’s differences to be acknowledged, better understood and more effectively supported.64 In this chapter we examine the extent to which sports and exercise research is beginning to better understand and support the distinctive health needs of women.

ACL injuries

50. Female footballers are between three and six times more likely to suffer an ACL knee injury than their male counterparts.65 The injury is one of the most serious that can affect footballers and others taking part in fast-paced sports that require sharp, start-stop movements and changes in direction. A serious ACL tear or rupture typically requires surgery and many months of recovery. While treatments have improved in recent years, it can still be career-limiting or career-ending in the worst cases.66

51. The issue of ACLs in women’s football gained widespread attention when five of the World’s top 20 (Ballon D’Or-nominated) female players suffered the injury in 2022.67 In oral evidence in November 2022, the football journalist and author Suzy Wrack described ACL injuries in the women’s game as an “epidemic”.68 Many current Women’s Super League players, including stars such as Chelsea’s Australian international Sam Kerr, are currently recovering from ACL damage.69

Relative lack of research and action

52. In the view of Suzy Wrack and others, there has been much less research into, and clear action taken to understand and mitigate, ACL injuries in women’s football than would have been the case had there been a problem of similar magnitude affecting elite male players.70

53. Witnesses explained that the causes of women’s ACL injuries were likely to be multifaceted, with a longer list of risk factors for women than men, including the specific mechanics of female knee movements, overloading or inconsistent loading of women’s knee joints, poor training methods, and the condition of pitches used by women.71 Baz Moffat of The Well HQ told us that anatomical and physiological risk factors for women intersected with issues of sexism. She noted that:

There are no football boots designed for the female foot. Women are often put on secondary playing surfaces. Coaches are often of a lesser quality in the women’s game, and they are not as experienced. In the men’s game, if boys are in the football academies or sports teams, they would have been exposed to strength and conditioning coaches and nutritionists from a very young age. You have to be pretty elite and advanced to get any exposure to that as a woman. That is also massively contributing to the increase in injury rates in women.72

54. Suzy Wrack reported that individual studies are now being undertaken to investigate some of the potential causes of ACL injuries in women’s football. For example, Roehampton University is researching the mechanics of knee movements, while separate studies are looking into the effects of footwear (see our work on football boots, below). However, she told us that the research “all feels quite disparate”:

[…] there is a piece of research that needs to be done collectively, that brings together the voices of women who have had these injuries, and ensures they play a part in being involved in this research, which needs collective investment. It should not be the case that one club goes off and does their own little bit of research and then is protective of their secret recipe for preventing ACL injuries. There needs to be Football Association, league or even premier league-wide support for this kind of research, because it is a huge issue.73

Football boot design and retailing

55. We were surprised to hear evidence that, despite the soaring popularity of women’s football and increasing rates of girls’ participation, there are very few football boots designed specifically to meet the needs of girls and women.74 In May last year, Dr Emma Ross, a sports scientist and co-founder of The Well HQ, told football news website 90 Min:

It amazes me that there’s no women’s boots. Brands will advertise their boots as women’s boots but only because they go down to a size three and men’s boots don’t. Women’s and men’s feet are different, and women’s and men’s bodies are different. […] You make studs and the sole to withstand the capacity of the average man, and then you put an average woman in them and as fast and as quick as they are, they’re not as strong or as powerful as men. So those boots are now designed to grip a heavy, strong, man into the ground but you’ve got a lighter woman in them and they’re getting anchored to the ground by them. When they need to turn, the grip is too big. […] It is bonkers that we don’t have big brands making a selection of women’s boots.75

56. In addition to the potential link to ACL injuries, there is evidence that football boots are causing broader problems for many female players. In June 2023, a survey coordinated by the European Club Association of around 350 elite female footballers from around Europe found that 82% experienced discomfort from their football boots.76

57. In oral evidence in June 2023, Baz Moffat noted some limited progress, in that a leading brand had released a new football boot, which was genuinely “unisex” rather than simply being “shrunk down” from a male boot. Its design had “taken into account the female biomechanics”. She noted, however, that it was at the upper end of the price range for football boots, at around £200. She believed that the development of this boot was a signal that the sportswear sector was “getting there”. However, she emphasised that there was currently only one brand in the world, IDA Sports, dedicated to producing boots designed specifically for women’s feet. While she believed IDA’s boots were “brilliant” for girls and women, they were also sold at a relatively high price point and were not “a mass-market product”.77

58. We wrote to IDA Sports and some of the leading mass-market sportswear brands, to better understand the situation and to push for gender equality in the design and retailing of football boots.78 Laura Youngson, founder and CEO of IDA Sports, told us that when she started researching the product in 2017 “there was no data at all on female football boots […]”. She had subsequently conducted research with podiatrists, physiotherapists and players into the “specific differences in biomechanics, anatomy and physiology between women and men”. IDA’s boots, which first came to the market in 2020, are built around a last (the mould around which footwear is made) constructed using scans of more than 700 women’s feet. Echoing a phrase used by witnesses to our inquiry, she emphasised that “women are not small men”. She told us there were several fundamental differences between men’s and women’s feet, and therefore shrinking down a boot constructed around a male last was “sub-optimal”. She also believed that “unisex” boots being developed by some of the leading brands were also “not enough” to meet women’s distinct needs. She told us that IDA’s female-specific boots were designed to provide greater comfort and reduce pain and fatigue, thereby reducing women’s risk of injury.79

59. In relation to boot design as a potential factor in ACL injuries, Ms Youngson acknowledged that the causes were multifactorial but stated there were:

[…] major improvements that can be made within the surface to boot connection (i.e., what type of shoe you wear for what pitch type or conditions) that could reduce the risks associated with injury. We have been researching traction specifically as it relates to female athletes and what stud configuration and depth are optimal for female power to weight ratios and biodynamics.80

60. We also received and published responses from leading sportswear brands Adidas, Nike, and Puma. All stated a broad commitment to gender equality in football and sport more widely. Each was taking a different approach in relation to girls’ and women’s football boots. Adidas told us it took a “gender neutral” approach. Contrary to the evidence we received from Baz Moffat and IDA Sports, Adidas claimed that it was not “simply creating smaller sizes of men’s footwear”. Rather, it had a “creation feedback loop” from male and female footballers. They told us:

We conduct rigorous testing of our football boots across a gender-equal cohort; this means that every football boot in the current adidas range of products is tested in groups of 50% men and 50% women, from grassroots players to those at the very top of their game.81

61. Puma acknowledged that until 2020, girls and women had been “compelled to play in ‘unisex’ boots” but that feedback from female players had led the brand to develop “a new generation of football boots specifically made for female players.”82 More broadly, Puma told us that:

As an industry, we are only just starting to understand there are multiple differences between the male and female footballer: the age they begin playing and training, biomechanical needs, variations in bone density, the impact on the body of the female monthly cycle, nutrition, running action, leverage issues created by female biomechanics, contact impacts, speed of play, recovery rates, to name but a few.83

62. Nike, the brand behind the recently released unisex boot mentioned by Baz Moffat that had “taken into account the female biomechanics” (the Phantom Luna), told us it was currently investing heavily in female-specific innovations in sports footwear and that 70% of participants in research at its sports laboratory were now female.84

63. We had concerns about how football boots were being retailed in stores and online, noting that online searches for women’s boots brought up a range of, often brightly coloured, shrunk down or unisex options, with little or no indication of the extent to which they had been designed for or tested on female feet, and very few genuinely female-specific boots available in the stores of leading retailers.

64. IDA Sports told us it had “yet to break into” UK stores. Laura Youngson explained:

This could be for many reasons, but we suspect it is partly related to the fact that the majority of buyers are male and not yet aware of the differences that IDA addresses (it is interesting to us that the buyers in major US retailers have been far more open and accessible). As you can imagine, the difficulty in entering retailers stymies the opportunity to create the space for the dialogue.85

65. We approached the owners of the leading sports retailer Sports Direct, Frasers Group Plc, to find out what efforts it was making to stock as wide a range as possible of boots designed to meet girls’ and women’s needs and to label and describe these options accurately in store and online. Frasers Group told us Sports Direct’s current approach was to categorise boots “by performance for adults and kids, as opposed to gender”, but that it was “looking for ways to improve our consumer experience and elevate our digital and physical categorisation to make for a more seamless consumer journey.” It emphasised that Sports Direct was “proud” to retail a range of boots that took into account in their design the “physiological and anatomical needs of girls and women”, including several Puma options and the Nike Phantom Luna.86 We noted that many Sports Direct outlets routinely advertise many Nike boots as being either for “men” or “junior boys”, while other brands were not gendered. We approached both companies about the gendering of Nike footwear; neither committed to taking any action to address it.87

66. We wanted to know what the Football Association (FA) was doing to push for gender equality in this area, including progress towards an equal range of options for girls and women at the same range of price points. The reply from Baroness Sue Campbell, the FA’s then Director of Women’s Football, was disappointing. She stated that, while the FA works closely with England kit supplier Nike, more broadly “sportswear companies define their own products based on their own research and insights, business models, and demand.”88

Karen Carney’s review of women’s football

67. In her independent review of women’s football, which was presented to the Government and published in July 2023, former Chelsea and England player Karen Carney concluded that the ACL issue was indicative of a much wider problem. She reported on remarkable gender inequality in sports science and exercise research, citing a recent academic article, which found that only 6% of research studies were conducted by women using all female participants. In contrast, 31% of studies were conducted entirely by men using all male participants. Across all 5,261 research papers analysed for the article, 66% of study participants were male.89

68. Karen Carney also emphasised an urgent need for the wider sports and exercise sector to better understand and support health and physiology-related barriers for females through the life course, noting that: 88% of women say that symptoms associated with the menstrual cycle limit their performance in sport and exercise; 30% say these symptoms “significantly impact their quality of life”; 50% of post-natal women experience pelvic floor dysfunction, which is a substantial barrier to returning to sport and exercise; and 64% of girls have dropped out of sport by the time they finish puberty.90

69. While Karen Carney reported recent progress in understanding and supporting women’s needs in some sports, notably England Netball’s partnership with The Well HQ and development of the NETBALLHer programme (see chapter 5), more broadly her review identified “a lack of active, formalised cross-sport sharing of best practices and innovation around issues that impact elite female athletes.” She recommended the Government convene a cross-sector group, which should “establish links with academia and have a shared mission of resetting the bar for the professional environment of female athletes in this country.”91

70. In December 2023, the Government responded to the Carney review, accepting, and committing to action, all 10 of its strategic recommendations for women’s football, including the establishment of a new independent governing body for women’s professional football, separate from the FA. Responding to the recommendation to convene a cross-sector group, the Government committed to “convene a roundtable discussion with industry leaders across all women’s sports in early 2024.”92

71. In a letter to us in October 2023, Baroness Campbell told us the FA was “conducting its own research on elite female athletes, with a specific focus on female health” and that it was working with the University of Nottingham on a new research project on ACL injuries. The intention was that the newly created governing body for women’s football would “create a dedicated central research unit focused on player health, injury prevention and management.”93

Women and women’s issues in research

72. We asked the DCMS and the DfE what they were doing to encourage more women into the field of sports and exercise research and encourage more work on health and physiology issues affecting females. The Minister for Sport told us that the Government:

[…] fully supports the sector as it moves to become more inclusive and welcoming of its spectators, participants and people in its workforce. We want to see more women in all positions across sport - whether playing, coaching, in medical and support roles, or at board level. As set out in the sport strategy, we want sport to be an exemplar in championing equality of opportunity.

He did not, however, set out any specific actions being taken to boost female representation or attention to women’s health issues in sports and exercise research.94

73. The Minister for Schools noted some positive signs for female representation in the sector. For example, qualification entry data show recent progress in the proportion of women taking biological and sports science at degree level (almost 50% of entrants in 2021–22), and a 9% increase between 2019 and 2022, from 5,240 in 2019 to 5,710, in the number of women accepted onto full-time undergraduate sport and exercise sciences courses.95

74. The UK Sports Institute (UKSI) is the UK Sport grant-funded organisation providing sports science and medicine support to elite, principally Olympic and Paralympic, athletes.96 Dr Craig Ranson, UKSI’s Director of Athlete Health, told us that, while UKSI was not itself a research institute, it had a good recent track record of partnering with researchers on issues for women in sport. For example, prior to the 2020 Tokyo Olympic and Paralympic Games, a UKSI partnership with the University of Portsmouth and a sportswear company investigated the health and performance effects of sports bras. This led to around half of GB’s female athletes using a new health and performance-enhancing product at the Games, and it is now available for all women to buy.97

75. Dr Ranson acknowledged the lack of all-female sports and exercise research but pointed to signs of progress in the field. He told us that:

[…] 50% of our staff are female. A lot of them are sports scientists; they come from a sports science background. They are now young practitioners who regularly lecture; they are involved as alumni and as researchers. […] I think we are at a watershed moment where that shift is taking place.98

76. There has been a slow and disparate response to disproportionately high rates of ACL injury in women’s football. We have no doubt that a health issue of similar magnitude affecting elite male footballers would have received a faster, more thorough, and better coordinated response. We agree with Karen Carney that the issue is indicative of systemic gender inequality in sports and exercise research, which is still overwhelmingly conducted by men, looking at issues affecting men.

77. While there are positive signs of change in the sports and exercise research sector, a more concerted and coordinated, cross-sector approach is required to achieve equality of attention to health and physiology-related issues affecting sportswomen, including those arising from kit and equipment. We note the Government’s acceptance of Karen Carney’s recommendation for it to convene a cross-sector group to consider these issues, but its response needs to go much further than its current commitment to a single round table meeting.

78. It is symptomatic of gender inequality and sexism in the sports sector that the first football boot in the world designed around female feet came to the market less than four years ago. Since then, limited progress has been made by the largest sports brands, who between them have produced only a handful of football boots designed specifically for the needs of girls and women. Some of those that are available are at a price many people cannot afford. It is also disappointing that Sports Direct, the UK’s largest sports retailer, appears unwilling to promote football boots to women and girls in store and does not stock a wide a range of boots designed specifically for women. Girls and women at all levels of sport deserve kit and equipment properly researched and designed for their health, wellbeing, and performance needs. At a time of soaring interest in women’s sport, the sector must do better. The aim must be to provide an equal range of sports kit and equipment designed to meet girls’ and women’s needs, at a comparable range of price points, as is available to boys and men.

79. We recommend the DCMS and DfE establish a taskforce, including UK Sport, the UK Sports Institute, women’s health and fitness experts including The Well HQ, sport and exercise research institutes, and the UK divisions of leading sportswear and sporting goods brands, to develop a long-term strategy to tackle sportswomen’s health and physiology-related issues. The strategy should set out key priorities for research; actions to increase availability of suitable, female-specific sportswear and kit (and given the associations with discomfort and injury, football boots must be a priority); and steps to achieve equal representation of women, as authors and study participants, in the field of sports and exercise research. We recommend this strategy be published within six months.

5 Coaching

80. In this chapter, we consider the extent to which sportswomen are being adequately supported by their coaches in relation to health and physiology-related needs. We heard a range of experiences across several sports, including cycling, netball, rugby, and rowing, and heard evidence about coaches’ varying levels of knowledge, understanding and support. We also examined instances of unacceptable coaching cultures and practices that may disproportionately affect girls and women, including deeply concerning examples of body-shaming and inappropriate approaches to weighing of athletes.

Sportswomen’s varied experiences

81. Evidence from sportswomen suggested that the level of understanding and support varied greatly depending on the nature of the sport and its predominant coaching culture, as well as the knowledge and attitudes of individual coaches. Mathilda Hodgkins Byrne, a Team GB rower, told us that the culture in rowing, for male and female athletes, was to “train until you break”. She said she was “pretty certain” that no elite rower “would feel that they could back out of a session because of a period, no matter how uncomfortable they were.”99

82. Mathilda reported that a condition called Relative Energy Deficiency in Sport (RED-S) was “very common” in rowing.100 RED-S can affect athletes when they take in insufficient energy from food to sustain the body’s needs during rigorous exercise. It can lead to a range of serious medical issues, including bone and tendon injuries, respiratory conditions, and, in serious cases, fertility problems. It occurs predominantly in endurance and aesthetic sports, in which athletes are more likely to under-eat, whether intentionally or unintentionally, to maintain a lean physique.101 Prior to 2014, it was known as “the female athlete triad” because of its association with menstrual dysfunction alongside low energy and decreased bone mineral density in women.102 Mathilda told us that throughout her career as a rower, it “seemed more abnormal if you had a regular period” than if not. She told us she had encountered the attitude that “you are not training hard enough if you maintain having one.”103

83. Janet Birkmyre, a competitive track racing cyclist, considered that she was fortunate to be in an individual amateur sport, which meant she could choose, and pay for, a coach based on their knowledge of issues such as RED-S and nutrition. She acknowledged that the experiences of women in teams, training together as a squad, may be very different.104

84. Shaunagh Brown reported mixed experiences during her rugby career. She said it was “only in the last year” that the taboo of talking about the menstrual cycle and periods in rugby had begun to be broken. It was becoming “more and more normal” to build sufficient trust with coaches to talk about the performance impacts of female health, for example being able to say to a coach:

“I am not in a good place for this type of session today and maybe I need to step away. Maybe I need to dial back”. It has taken a long time to get to that. It would have previously been automatically assumed, “You are just lazy” or “You just cannot be bothered today”.105

85. However, Shaunagh told us that male coaches working in women’s rugby were “generally not interested”:

[…] to the point where we had sessions as a squad about training around your period, maximising when you can and what to not do when you are at highest risk of injury, and the male coaches were not in the room. There were very poor excuses that they could not be there and yet they are at every single other session.

Shaunagh reported that there were “very good men out there”, who were “good at listening and actively wanting to know more”, but, she said, there were “not enough”.106

86. Eboni Usoro-Brown, who won 117 caps for England Netball before retiring in 2022, said she was “disheartened” to hear some of the experiences of other sportswomen. She described “individually tailored programmes” for members of the England netball squad. Every year for at least the last ten years, England netballers had undergone “prehab programmes” designed to prevent injuries, including ACL knee injuries, to which netballers can be prone. Individual prehab programmes were developed after “fitness testing, strength and conditioning testing” and monitored throughout the year by a strength and conditioning coach. Ms Usoro-Brown told us netballers and their coaches used the Performance Data Management System, an app developed in 2015 by UKSI to monitor athletes’ key health information and allow coaches to tailor training programmes. We heard it was widely used in netball to monitor players’ health data, including menstrual cycles and indicators of RED-S, and used to help tailor individual training programmes.107

87. Others had much less positive experiences. Shaunagh told us that elite female rugby players had used PDMS for several years, but the practice had ended around two years ago after feedback from players that “nothing was done” with the information entered into the app.108 Mathilda said rowers entered data into the PDMS app, but she did not know whether the information was widely used by coaches or medical staff.109

Coach education and qualifications

88. We wanted to know what was being done to better educate sports coaches on female health needs. Janet Birkmyre told us she had completed a British Cycling level 2 coaching course, which includes 16 hours of face-to-face and six hours of online learning, to enable people to create and deliver their own cycling courses. She said the course included “all sorts of wonderful modules […] but absolutely nothing about female health or the menstrual cycle.”110

89. Representatives of the national governing bodies for hockey, netball and tennis reported that they were taking steps to improve their coaches’ knowledge of female health issues, including through coaching qualifications. Jo Ward of the Lawn Tennis Association said that all LTA-accredited coaches had been required to complete a female health workshop since 2017.111 Both the LTA and England Hockey reported that female health was now a core component of coach qualifications and in continuing professional development.112

90. Kelly Gordon of England Netball described aspects of the NetballHER programme, being developed with The Well HQ. She said the programme was “all about supporting the female body and trying to break the taboos that girls and women experience at all life stages”. She told us female health in coach education was a “big area” for the programme, which had just launched a specific “learning offer”. The intention was that female health would be included in all netball coaching qualifications within a year.113

91. Emily Handyside, Coach Programme and Pathway Manager at UK Coaching, a charity dedicated to supporting and educating coaches across all levels and sports, argued that the lack of attention given to female health in coach qualifications was another symptom of sport having been developed “by men, for men”. Female health had therefore often been “overlooked”. Her view was that it should become a mandatory element of coach qualifications, so that “it just cannot be overlooked any longer.”114 Nick Pink of England Netball suggested that the Chartered Institute for the Management of Sport and Physical Activity (CIMSPA), the professional development body for the sector, which accredits courses and qualifications, would need to be involved in any cross-sports initiatives in this area.115

92. The level of knowledge and support for sportswomen’s health needs varies greatly between individual coaches and coaching teams. There are also wide variations in the adequacy of support across different sports. The national governing bodies we heard from were each taking their own steps to address this. While we support these actions, women’s sport would benefit from greater coordination and sharing of best practice across the sports and exercise sector to ensure that all girls and women receive adequate support from appropriately qualified coaches.

93. We recommend that UK Sport, Sport England, UK Coaching, the Chartered Institute for the Management of Sport and Physical Activity and the national governing bodies come together to convene a female health in coach education working group. It should draw on emerging best practice from programmes such as NETBALLHer to develop a strategy to better educate coaches at all levels in female health, including, where appropriate, through mandatory qualifications, alongside an action plan setting out how this will be achieved. The strategy and action plan should be published within six months.

Tackling harmful coaching cultures

94. We examined some very concerning examples of inappropriate coaching cultures, in which athletes, often girls and young women, have been pushed to the point where they have suffered mental health and wellbeing impacts. These issues are at the intersection between health-related issues for girls, bullying, and abuse. While we have taken a keen interest throughout this Parliament in tackling various forms of violence against women and girls, allegations of abuse were not within the scope of our inquiry.116 Instead, this inquiry focused on the impact of poor coaching practice on health issues that can disproportionately affect girls, such as body image and disordered eating.

Swim England

95. We were particularly concerned about reports that began to emerge last year about the coaching culture in swimming. A large number of swimmers disclosed that they had been subjected by their coaches to humiliating weigh-ins, “fat-shaming” and consequent wellbeing impacts, including body image issues, disordered eating, irregular periods, and mental ill health. Phoebe Lenderyou, a former Commonwealth youth gold medalist who had “been tipped for world success” at senior level told the BBC she had suffered with bulimia for years because of swimming’s “toxic coaching culture”. The BBC reported it had been “inundated with reports of malpractice” at all levels of the sport, including:

  • swimmers losing so much weight their periods stopped.
  • one teenager being told to keep exercising with a broken rib so she could continue “fat-burning sessions”.
  • one club forcing children to train for hours without water on weigh-in days so fluid retention would not affect the scales.
  • children sworn and shouted at for poor performance often linked to exhaustion and lack of nutrition.117

96. The sport’s national governing body, Swim England, issued an apology to affected swimmers, commissioned an independent review and report by barrister Louis Weston into these and other issues relating to practices at three swimming clubs, and promised to take steps to improve its coaching culture, and its complaints and safeguarding mechanisms.118

97. We wrote to the then CEO of Swim England Jane Nickerson, asking for more information about the number of girls and women who had been affected, and more details about steps being taken to investigate the prevalence of issues including inappropriate use of weighing, discipline and re-educate coaches, and improve swimming’s coaching culture.119

98. Jane Nickerson could not tell us how many female swimmers had been affected by issues around weighing and body-shaming because Swim England’s “old case management system isn’t able to report in this level of detail”. She confirmed there were “no open, or recently closed cases from the last twelve months that have involved allegations of an inappropriate approach to weighing.” She set out the actions the governing body had taken or was planning to take to address the issues, including:

  • A new mandatory weighing policy from June 2023, in which only over 18s or under 18s on the elite talent pathway can be weighed, and in any case only with “clearly documented reasoning, specific to that athlete, and with the athlete’s optimal long-term development in mind”.
  • Strengthening its welfare and safeguarding team, including the appointment of Talent Welfare Officers.
  • Delivering workshops on disordered eating for swimmers, parents, and coaches.
  • A wide-ranging safeguarding, welfare and culture change plan, Heart of Aquatics, which has commissioned “independent experts to undertake a comprehensive listening exercise […] to give all members of the aquatics community the opportunity to share their views and experiences.”
  • Appointment of a new Oversight Committee, including independent members, to manage and oversee the new safeguarding, welfare, and culture plan.
  • A new Swim England Coaching Plan to be delivered over three years to “cultivate a coaching culture and behaviours that ensure our participants enjoy a safe and fulfilling sporting experience.”120

99. We questioned Sport England, the arms-length body of government which funds Swim England, about its assessment of Swim England’s response. Jeanette Bain-Burnett, Sport England’s Executive Director of Policy and Integrity, told us it was taking the situation “very seriously”. She described some of the instances of inappropriate coaching practice in swimming as “shocking” and “unacceptable”. She said the organisation was working closely with Swim England to “make sure their coaching practices are improved”. It had imposed “very strong conditions” on Swim England’s continued funding and moved it from multi-year funding to one-year conditional funding. While removal of funding was “not always the best answer” because national governing bodies such as Swim England had important community links, funding would only be extended “if they live up to the standards that are set out in our conditions”.121

Tackling bullying

100. On the broader issue of inappropriate coaching practices, bullying and abuse in wider sector, Ms Bain-Burnett told us Sport England was “absolutely committed to improving welfare and safeguarding practices across sport.” She assured us it was “something that is front and centre on our agenda”.122 She noted that the DCMS had published a call for evidence on integrity in sport alongside its Get Active strategy for the future of sport and physical activity, published in August 2023.123 The Department highlighted that issues of coach misconduct had come to light across several sports in recent years, including cricket, gymnastics and football, as well as swimming.124 It noted that investigations into complaints “suggest ingrained cultural issues that have developed over many years.” It stated in the strategy:

We must not shy away from the difficult challenges that the sector is facing. We owe it to those who have shared their painful experiences to listen and improve for future generations. Indeed, it is vitally important that people feel able to come forward with their concerns.125

Its intention for the call for evidence was to identify actions required to “improve substantially how concerns and grievances are dealt with in the sector”, including, if necessary, for the Government to establish a new independent complaints body or Ombudsman.126 The call for evidence ran from August until the end of October 2023.127

101. Emily Handyside told us UK Coaching “would like to see an independent body where complaints can be raised by participants or coaches” because:

We are hearing on the ground from coaches who are observing practices that they may be a little bit uncomfortable about, or where things are a little bit grey, that they do not know where to go or perhaps do not feel comfortable going and reporting to their sport, for fear of not being believed or it being detrimental to their position or progression within the sport.128

102. Dame Katherine Grainger, Chair of UK Sport, the DCMS-sponsored governing and funding body for Olympic and Paralympic sport, reported that it was halfway into a three-year pilot of an independent complaints body called Sport Integrity. The intention was to pilot an approach with case managers, investigative powers and independent investigators. All national governing bodies were being asked to sign up to the pilot, and all were expected to have done so by the end of 2023. She told us, in November 2023, that Sport Integrity had received its first complaints. She believed Sport Integrity was “a really positive step” and “something that, I hope, when it rolls out, will be better for the whole system.”129 UK Sport confirmed in December 2023 that the Sport Integrity pilot had concluded 8 cases.130

103. Public weighing and body-shaming of girls and young women is wholly unacceptable. That this should have occurred in a sports environment, in which girls already face barriers to participation, is deplorable. Swim England must restore trust in swimming’s coaching practices and culture, and Sport England must oversee the change process until this is achieved. Sport England must, in response to this Report in no later than two months, update us on its assessment of Swim England’s response to the issues and the steps it is taking to oversee the situation.

104. Issues of bullying, harassment, abuse, and discrimination are not limited to swimming, with issues emerging across several sports in recent years. We welcome the DCMS’s call for evidence on integrity in sport, which closed three months ago, and expect to see tangible actions as a result. In response to this Report, the DCMS should set out in detail:

  • insights from the call for evidence on integrity in sport;
  • the proposed the next steps in improving how concerns and grievances are dealt with in the sector;
  • its evaluation of the effectiveness of the Sport Integrity pilot; and
  • a timetable for further change in the sports sector.

6 Pregnancy and maternity

105. The perception that motherhood means the end of a woman’s career in top level sport is increasingly being challenged.131 A growing list of high-profile examples demonstrates that mothers can not only return to their sporting careers but also reach new heights of success. Below we consider the support available to women looking to return to high level sport after having children and the adequacy of pregnancy and maternity policies and practices across a range of sports.

Recent high profile sporting mothers

106. There have been several recent high-profile examples of mothers successfully returning to elite sport. The Ukrainian tennis player Elina Svitolina defeated No. 1 seed Iga Swiatek to reach the Wimbledon semi-finals last year, only months after having a baby.132 Professional road racing cyclist Lizzie Deignan was back competing in the sport’s grand tours less than seven months after giving birth.133 Several star players at the 2023 women’s football World Cup were mothers, including three members of the USA squad, Crystal Dunn, Julie Ertz and Alex Morgan.134 Last year, Sky Sports published an article suggesting that while 2022 was seen as a key breakthrough year for women’s sport, with record attendances and TV viewing figures, 2023 was:

[…] shaping up to be the one where elite sportswomen, in full flight of their careers, are changing the notion of waiting until the final embers of their profession or retirement before starting a family.

It noted that in 2023 several of the biggest names in women’s sport had announced their pregnancies at the peak of their careers, including four-time tennis grand slam winner Naomi Osaka; England women’s rugby World Cup finalist Abbey Ward; and German golfer Sophia Popov, winner of the 2020 Women’s Open Championship.135

107. The UK Sports Institute noted that from a medical science perspective, new mothers faced a number of challenges to sporting performance in the first six to nine months post-partum, including potential muscle weakness associated with a break from training during pregnancy or resulting from childbirth, risk of pelvic dysfunction, and challenges around nutrition, particularly if they are breast-feeding their baby. Social and cultural barriers also persist, in particular gendered issues around caring for a baby, such as disrupted sleep and emotional adjustments associated with being a mother. However, it also noted childbirth’s potential benefits to sporting performance, including increases in circulating blood volume, red blood cell volume, and haemoglobin mass and concentration, leading to increased delivery of oxygen to the muscles, which can “improve endurance and aerobic capacity.”136

Sportswomen’s varied experiences

108. We heard starkly contrasting evidence about support for mothers returning to sport. Much depended on culture and the attitudes of individual coaches and support staff. In our first evidence session on sexism and inequality in football, Fern Whelan, former Everton and Brighton and Hove Albion player and Equality Diversity and Inclusion Executive at the Professional Footballers’ Association (PFA), told us that many women still had poor experiences, depending on which club they played for. She said at some clubs the culture still prevented players from even talking about wanting to have a baby. Her view was that the importance of an open culture around pregnancy and maternity and “not feeling as though you have to hide it from anyone is massive.”137

109. Former England netball player Eboni Usoro-Brown returned to elite level netball with Team Bath aged 33, six months after having a baby. Again, netball appeared to be establishing best practice. She told The Times that the support she had received was “pioneering” and could be used as a model of good practice for all sportswomen.138 Ms Usoro-Brown told us she felt “lucky” in the support she received. She noted that her coach had recently given birth herself and was “very passionate about women’s health and welfare.” She described her return process as “very positive”:

I was asked to come to every single training session to be involved and have input. […] It was really important at that time that the coach [ … ] ensured that I had a pelvic floor health consultant, who I saw prenatally and postnatally. Prenatally, they developed a programme so I could still do some strength and conditioning training under supervision and under guidance from the pelvic floor health consultant, but very much at my own pace. Nothing was pushed. There was no expectation from the club as to when I was expected to return […]. I was not allowed to return to training or to the court until the pelvic floor health consultant had signed me off. I was not allowed to run until, I think, 12 weeks after I had given birth. It was very gradual.139

110. Mathilda Hodgkins Byrne reported a less positive experience in trying to return to elite level international rowing. She told us that, while support from GB rowing while she was pregnant had been “brilliant”, she had become very frustrated about the support to return to top level competition. She told us, “I was straight away removed from the main programme. That would be my biggest criticism.” She said that while members of her pregnancy and maternity support team at GB rowing had been very good, this had not included all of her coaches. She said that “unless [coaches] are on board and supporting, it is very easy to feel alienated and pushed to the side […].”140

Sports’ maternity policies

Recent progress in professional sports

111. There has been notable recent progress in sports’ pregnancy and maternity policies. In March last year, Everton player Toni Duggan gave birth to a daughter and became the first professional Women’s Super League (WSL) footballer to receive maternity leave and pay. New rules were introduced at the start of the 2022–23 WSL season, allowing 14 weeks maternity leave on full pay.141 While ground-breaking for professional football, this compares poorly to other sports. For example, in February 2023, the Rugby Football Union introduced 26 weeks leave on full pay in a new maternity policy for professionally contracted England players.142

112. Fern Whelan of the PFA described the WSL’s new maternity provision as “a really good start”. However, she felt that women’s football still had “a long way to go” in relation to supporting mothers with family-friendly policies:

For example, if I am a mother and I am breastfeeding, but I want to go back to playing, can I bring my child in? Is there somewhere I can breastfeed privately? Can I express? As a club you really have to think about all those things.

She also argued that more investment was needed in specialist medical and coaching support for mothers returning to football.143

UK Sport policy for funded athletes

113. UK Sport first published pregnancy guidance for national governing bodies and funded athletes in November 2021. It applies to Olympic and Paralympic athletes but can be used as a model for other sports. The guidance was published to support UK Sport’s view that “raising a family and being an elite athlete should not be mutually exclusive.” It contains a wide range of advice, for example on perinatal and postnatal mental health; use of supplements by pregnant sportswomen; breastfeeding; and advice on coping with stillbirth and miscarriage.144

114. The November 2021 guidance set out that funded pregnant sportswomen will remain fully funded during pregnancy and for up to nine months after their baby’s birth. It stated that pregnant sportswoman’s intention to return to elite competition should be discussed and confirmed no later than six months into the pregnancy, at which point a plan for her return should be mutually agreed and the sportswoman’s commitment to the plan continually monitored, reviewed, and finally assessed and confirmed at nine months post birth.145

115. In oral evidence in June 2023, Mathilda Hodgkins Byrne broadly welcomed the new guidance. She told us she had deliberately delayed announcing her pregnancy until after it was published. However, she expressed some concerns about its likely effectiveness for rowers trying to return to elite level international competition. She said that while nine months funding post-partum may be sufficient in many sports, it set a potentially unrealistic performance expectation for some mothers returning to rowing.146

116. Discussing the new guidance, Dame Katherine Grainger of UK Sport acknowledged that it was “slightly crazy” that in the 21st century sport had only just begun to address the maternity leave needs of sportswomen. She emphasised that UK Sport guidance had been published after an 18-month in-depth consultation with athletes, coaches, and performance directors, and had been “received really well”. However, she acknowledged that it was still in its early days and emphasised that the organisation had committed to learning from the first iteration and to keep it under review.147

117. We asked Dame Katherine whether UK Sport was willing to review the funding period in the light of Mathilda’s evidence. She told us that “the decision on nine months was a big discussion point through the consultation”. She believed that having the discussion with athletes about their intentions and potential to return to elite international competition at six months post-partum was the right timeframe, and that in the consultation phase, “everyone felt that that would be comfortable.” She emphasised that the assessment was:

[…] not about asking, “Nine months post-birth, what is the level of performance from that athlete?” It is working with the coaching, medical and support teams to assess the potential for that athlete. If they want to come back and are up for this, and the potential looks good, that is when a decision can be made around the investment. It is not a hard and fast “Nine months, boom, you’re done.” It is “Where are we now? Can we look at potential?”148

She also noted that nine months’ post-partum funding was in line with statutory maternity pay.149

118. UK Sport updated its guidance in December 2023. It makes clear that the timeframe within which an athlete is expected to return to the same levels of performance as pre-pregnancy “must be considered on a case-by-case basis, because no two cases will be the same.” While an athlete must confirm her intention to return at six months, an assessment of her performance potential should be made at nine months post-partum. This assessment “should indicate […] future medal potential and not necessarily performance outcomes” at that time.150

119. We asked Dame Katherine for her assessment of progress in pregnancy and maternity policy and practice across wider sport, in the context of the much less generous entitlements in professional sports such as football. While she “would not comment on the specifics” and acknowledged the challenges in women’s professional sport, notably the huge, gendered imbalances in funding and pay, she said:

When it comes to pregnancy and women’s health issues […] the really important thing is that we are sharing knowledge across all the spheres. We in the Olympic and Paralympic world find it really helpful to know what the non-Olympic sports are doing, what the home countries are doing and what the professional sports are doing. We hope it goes both ways.151

120. A long-overdue culture change is taking shape in sport around pregnancy and maternity. While policies and practices being adopted in funded Olympic and Paralympic sports and, to a lesser extent, in some professional women’s sports are welcome, there is still a long road to travel, both in maternity pay and leave and the wider culture of supporting pregnant women and mothers. These issues are key to women’s equality in sport, as they are across society, and, as such, we believe the Government should take a role in supporting best practice.

121. We recommend the DCMS, UK Sport, Sport England and the sports’ national governing bodies establish a permanent working group on best practice in pregnancy and maternity policy, including maternity leave and pay and wider policies to support pregnant sportswomen and returning mothers. This working group must consider a road map to equal access to leave and funding/pay in line with statutory maternity rights, across all international sports.

Conclusions and recommendations

Barriers to girls’ participation

1. Girls face a number of distinctive health and physiology-related barriers to participation in, and enjoyment of, sport and physical activity, from early years to post-puberty. Existing programmes and interventions from the Government and other bodies, while welcome, do not yet go far enough in addressing these barriers and are yet to reverse alarming downward trends in girls’ enjoyment of PE. They also lack specific age group-related targets for participation in and enjoyment of PE and school sport. (Paragraph 32)

2. Key anxieties for girls include concerns around periods, yet education on the menstrual cycle, despite being mandatory, is only being delivered in half of schools. It is shocking that around 50% of schools are disregarding a vital, and mandatory, element of the curriculum. Where it is being delivered, in most cases, it is part of a biology lesson and years after most girls will have started their period. As we have found in our other work, this is typical of current teaching on reproductive health, which is inadequate, irrelevant to girls’ needs, and delivered too late in girls’ development. These failings are having obvious consequences for girls’ confidence and, in terms of participation in and enjoyment of PE and sport, leading to withdrawal from necessary, healthy activity. (Paragraph 33)

3. The Department for Education must urgently review the quality and timeliness of education on girls’ health and physiology, including the effects of puberty, the menstrual cycle, and periods in the context of PE and school sport. Whether part of PE or PSHE, or ideally both, this education needs to be delivered more effectively and much earlier. Teachers need to be better trained to deliver it, including around how to have effective conversations with girls and support them during this significant life stage. Education on reproductive health is a positive, not a barrier to overcome. Our recommendations reflect what girls are asking for and are straightforward to implement. The DfE must make clear to all schools that not delivering education on the menstrual cycle is unacceptable and set out in response to this Report the steps it will take to ensure 100% compliance with the current requirements, with a clear timeframe to achieve this. We further recommend the DfE supports pilots of new approaches, such as the enhanced, four-week lesson plan being developed by Swansea University, and commits to rolling out an improved offer across all primary and secondary schools within the next 12 months. (Paragraph 34)

4. The evidence on girls’ anxieties around PE kit is overwhelming. We recommend the Department for Education and National Physical Activity Taskforce review guidance for schools on school PE kit, with the aim of ensuring all schools permit the widest possible choice for girls. That guidance should include advice to schools on use of sports bras by girls taking part in PE and school sports. (Paragraph 35)

5. We recommend Sport England launch a new strand of the “This Girl Can” campaign aimed at parents, tackling early years gender stereotypes around physical activity and sport. This should include a specific focus on the positive role fathers can play in encouraging girls in sport and exercise. Sport England should also work with the Department for Education to roll out the “Studio You” platform across all secondary schools, with the aim of reaching all girls meeting the Government’s definition of inactive in Key Stages 3 and 4. The DfE should further update its School Sport and Physical Activity Action Plan to include measurable targets for closing the “enjoyment gap” in PE between boys and girls. (Paragraph 36)

6. Given the very distinctive issues for girls, and to ensure their needs are not overlooked, we recommend the Minister for Women and Equality Hub officials attend the National Physical Activity Taskforce, alongside organisations with data and expertise in this area, including Youth Sport Trust and The Well HQ. The Taskforce must consider as a priority the best available evidence, including from the Youth Sport Trust’s “Girls Active” survey series, on which to base interventions designed to address girls’ health and physiology-related barriers. (Paragraph 37)

Midlife and menopause

7. Women in midlife face specific health-related barriers to participation, including but not limited to the symptoms of perimenopause and menopause. These occur after many have experienced barriers at earlier life stages, including in early years and at school during puberty. Many women at this life stage will have dropped out of sport and physical exercise many years previously. These barriers are compounded by the convergence of gendered social factors, including caring responsibilities for children and ageing parents, leaving them particularly time poor. Encouraging and facilitating women in midlife to become more active is therefore a challenge that requires a thorough understanding of their needs and specifically designed interventions. Current efforts, including the Government’s “Get Active” strategy, are inadequate for this group. The strategy lacks detailed analysis of the issues, measurable targets, and specially tailored interventions. This must be rectified. (Paragraph 44)

8. We recommend Sport England prioritise another phase of the “This Girl Can” campaign focused on women in midlife, showing real life examples of women in the 40- to 60-year-old age group participating in a wide range of sports and physical activities, to inspire others. (Paragraph 45)

9. We recommend the DCMS update its “Get Active” strategy for the future of sport and physical activity in relation to women in midlife. It should work with organisations including Women in Sport and The Well HQ to include an analysis of the key barriers faced by women in this age group, measurable targets to increase their levels of activity, and specifically tailored interventions. (Paragraph 46)

Sports and exercise research

10. There has been a slow and disparate response to disproportionately high rates of ACL injury in women’s football. We have no doubt that a health issue of similar magnitude affecting elite male footballers would have received a faster, more thorough, and better coordinated response. We agree with Karen Carney that the issue is indicative of systemic gender inequality in sports and exercise research, which is still overwhelmingly conducted by men, looking at issues affecting men. (Paragraph 76)

11. While there are positive signs of change in the sports and exercise research sector, a more concerted and coordinated, cross-sector approach is required to achieve equality of attention to health and physiology-related issues affecting sportswomen, including those arising from kit and equipment. We note the Government’s acceptance of Karen Carney’s recommendation for it to convene a cross-sector group to consider these issues, but its response needs to go much further than its current commitment to a single round table meeting. (Paragraph 77)

12. It is symptomatic of gender inequality and sexism in the sports sector that the first football boot in the world designed around female feet came to the market less than four years ago. Since then, limited progress has been made by the largest sports brands, who between them have produced only a handful of football boots designed specifically for the needs of girls and women. Some of those that are available are at a price many people cannot afford. It is also disappointing that Sports Direct, the UK’s largest sports retailer, appears unwilling to promote football boots to women and girls in store and does not stock a wide a range of boots designed specifically for women. Girls and women at all levels of sport deserve kit and equipment properly researched and designed for their health, wellbeing, and performance needs. At a time of soaring interest in women’s sport, the sector must do better. The aim must be to provide an equal range of sports kit and equipment designed to meet girls’ and women’s needs, at a comparable range of price points, as is available to boys and men. (Paragraph 78)

13. We recommend the DCMS and DfE establish a taskforce, including UK Sport, the UK Sports Institute, women’s health and fitness experts including The Well HQ, sport and exercise research institutes, and the UK divisions of leading sportswear and sporting goods brands, to develop a long-term strategy to tackle sportswomen’s health and physiology-related issues. The strategy should set out key priorities for research; actions to increase availability of suitable, female-specific sportswear and kit (and given the associations with discomfort and injury, football boots must be a priority); and steps to achieve equal representation of women, as authors and study participants, in the field of sports and exercise research. We recommend this strategy be published within six months. (Paragraph 79)

Coaching

14. The level of knowledge and support for sportswomen’s health needs varies greatly between individual coaches and coaching teams. There are also wide variations in the adequacy of support across different sports. The national governing bodies we heard from were each taking their own steps to address this. While we support these actions, women’s sport would benefit from greater coordination and sharing of best practice across the sports and exercise sector to ensure that all girls and women receive adequate support from appropriately qualified coaches. (Paragraph 92)

15. We recommend that UK Sport, Sport England, UK Coaching, the Chartered Institute for the Management of Sport and Physical Activity and the national governing bodies come together to convene a female health in coach education working group. It should draw on emerging best practice from programmes such as NETBALLHer to develop a strategy to better educate coaches at all levels in female health, including, where appropriate, through mandatory qualifications, alongside an action plan setting out how this will be achieved. The strategy and action plan should be published within six months. (Paragraph 93)

16. Public weighing and body-shaming of girls and young women is wholly unacceptable. That this should have occurred in a sports environment, in which girls already face barriers to participation, is deplorable. Swim England must restore trust in swimming’s coaching practices and culture, and Sport England must oversee the change process until this is achieved. Sport England must, in response to this Report in no later than two months, update us on its assessment of Swim England’s response to the issues and the steps it is taking to oversee the situation. (Paragraph 103)

17. Issues of bullying, harassment, abuse, and discrimination are not limited to swimming, with issues emerging across several sports in recent years. We welcome the DCMS’s call for evidence on integrity in sport, which closed three months ago, and expect to see tangible actions as a result. In response to this Report, the DCMS should set out in detail:

  • insights from the call for evidence on integrity in sport;
  • the proposed the next steps in improving how concerns and grievances are dealt with in the sector;
  • its evaluation of the effectiveness of the Sport Integrity pilot; and
  • a timetable for further change in the sports sector. (Paragraph 104)

Pregnancy and maternity

18. A long-overdue culture change is taking shape in sport around pregnancy and maternity. While policies and practices being adopted in funded Olympic and Paralympic sports and, to a lesser extent, in some professional women’s sports are welcome, there is still a long road to travel, both in maternity pay and leave and the wider culture of supporting pregnant women and mothers. These issues are key to women’s equality in sport, as they are across society, and, as such, we believe the Government should take a role in supporting best practice. (Paragraph 120)

19. We recommend the DCMS, UK Sport, Sport England and the sports’ national governing bodies establish a permanent working group on best practice in pregnancy and maternity policy, including maternity leave and pay and wider policies to support pregnant sportswomen and returning mothers. This working group must consider a road map to equal access to leave and funding/pay in line with statutory maternity rights, across all international sports. (Paragraph 121)

Formal minutes

Members present

Caroline Nokes, in the Chair

Dr Lisa Cameron

Kim Johnson

Lia Nici

Kirsten Oswald

Sexism and inequalities in sport

Draft Report (Health barriers for girls and women in sport), proposed by the Chair, brought up and read.

Ordered, That the Report be read a second time, paragraph by paragraph. Paragraphs 1 to 121 read and agreed to.

Summary agreed to.

Resolved, That the Report be the Third Report of the Committee to the House.

Ordered, That the Chair make the Report to the House.

Ordered, That embargoed copies of the Report be made available, in accordance with the provisions of Standing Order No. 134.

Adjournment

Adjourned till Wednesday 6 March at 9.30am.


Witnesses

The following witnesses gave evidence. Transcripts can be viewed on the inquiry publications page of the Committee’s website.

Wednesday 14 June 2023

Janet Birkmyre, Track Racing Cyclist; Shaunagh Brown, Recently Retired Professional Rugby Player; Eboni Usoro-Brown, Recently Retired England Netball Player; Mathilda Hodgkins Byrne, GB RowerQ1–33

Baz Moffat, Chief Executive, The Well HQ; Dr Louise Newson, GP and founder, The Menopause Charity; Lisa West, Head of Policy, Partnerships and Public Affairs, Women in Sport; Kate Seary, Director, Kyniska AdvocacyQ34–52

Wednesday 06 September 2023

Nick Pink, Chief Executive Officer, England Hockey; Kelly Gordon, Director of Development and Executive Lead for NETBALLHer, England Netball; Jo Ward, Head of Coach Education and Qualifications, Lawn Tennis AssociationQ53–103

Wednesday 22 November 2023

Emily Handyside, Coach Programme and Pathway Manager, UK Coaching; Dr Craig Ranson, Director of Athlete Health and Performance Data, UK Sports Institute; Jeanette Bain-Burnett, Executive Director of Policy and Integrity, Sport England; Dame Katherine Grainger DBE, Chair, UK SportQ104–160


List of Reports from the Committee during the current Parliament

All publications from the Committee are available on the publications page of the Committee’s website.

Session 2023–24

Number

Title

Reference

1st

The National Disability Strategy

HC 34

2nd

Misogyny in music

HC 129

1st Special

Attitudes towards women and girls in educational settings: Government, Ofsted and Office for Students responses to the Committee’s Fifth Report of Session 2022–23

HC 258

Session 2022–23

Number

Title

Reference

1st

Menopause and the Workplace

HC 91

2nd

The rights of cohabiting partners

HC 92

3rd

Black maternal health

HC 94

4th

Equality and the UK asylum process

HC 998

5th

Attitudes towards women and girls in educational settings

HC 331

6th

So-called honour-based abuse

HC 831

1st Special

Ethnicity pay gap reporting: Government response to the Committee’s fourth report of session 2021–22

HC 110

2nd Special

Equality in the heart of democracy: A gender sensitive House of Commons: responses to the Committee’s fifth report of session 2021–22

HC 417

3rd Special

The rights of cohabiting partners: Government response to the Committee’s second report

HC 766

4th Special

Menopause and the workplace: Government response to the Committee’s first report

HC 1060

5th Special

Black maternal health: Government Response to the Committee’s Third Report

HC 1611

6th Special

So-called honour-based abuse: Government response to the Committee’s Sixth Report

HC 1821

7th Special

Equality and the UK asylum process: Government response to the Committee’s Fourth Report

HC 1825

Session 2021–22

Number

Title

Reference

1st

Levelling Up and equality: a new framework for change

HC 702

2nd

Appointment of the Chair of the Social Mobility Commission: Katharine Birbalsingh CBE

HC 782

3rd

Reform of the Gender Recognition Act

HC 977

4th

Ethnicity pay gap reporting

HC 998

5th

Equality in the heart of democracy: A gender sensitive House of Commons

HC 131

Session 2019–21

Number

Title

Reference

1st

Unequal impact? Coronavirus, disability and access to services: interim Report on temporary provisions in the Coronavirus Act

HC 386

2nd

Appointment of the Chair of the Equality and Human Rights Commission

HC 966

3rd

Unequal impact? Coronavirus and BAME people

HC 384

4th

Unequal impact? Coronavirus, disability and access to services: full Report

HC 1050

5th

Unequal impact? Coronavirus and the gendered economic impact

HC 385

6th

Changing the perfect picture: an inquiry into body image

HC 274


Footnotes

1 See, for example, UEFA, ‘Women’s EURO 2022: All the records set in England’ (1 August 2022), accessed 18 December 2023; “Unprecedented audiences watch women’s sport as major properties break TV viewing figure records at start of 2023”, Women’s Sport Trust press release, 18 May 2023; “The Hundred shatters attendance records and increases TV viewing figures across men’s and women’s competition”, Sky Sports, 27 August 2023

2 UEFA, ‘Women’s EURO 2022: All the records set in England’ (1 August 2022), accessed 18 December 2023

3England’s Euros triumph draws record TV audience of 17m”, The Guardian, 1 August 2022

4 Women’s World Cup: 14.46m tune in to Lionesses final defeat on BBC and ITV, SportsPro, 21 August 2023

5Attendances key to turning moments into habits in women’s sport”, Women’s Sport Trust press release, 28 March 2023

6UEFA Women’s EURO 2022 one year on: impact study shows major boost across Europe”, UEFA press release, 6 July 2023

7Unprecedented audiences watch women’s sport as major properties break TV viewing figure records at start of 2023”, Women’s Sport Trust press release, 18 May 2023; see also, “The Hundred shatters attendance records and increases TV viewing figures across men’s and women’s competition”, Sky Sports, 27 August 2023

8 Letter from Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Service, Department for Culture, Media and Sport, to the Chair of the Committee, dated 7 December 2023; Letter from Rt Hon Damian Hinds MP, Minister for Schools, Department for Education, to the Chair of the Committee, dated 19 December 2023

9 Q37

10 Q34

11 Written evidence submitted by Youth Sport Trust, November 2023

12 Ibid.

13 Youth Sport Trust, ‘New research finds PE ‘enjoyment gap’ for girls is widening’, accessed 19 December 2023

14 See, for example, The Open University, Supporting female performance in sport and fitness, September 2022, p42

15 Q34

16 Written evidence submitted by Youth Sport Trust, November 2023

17 The Open University, Supporting female performance in sport and fitness, September 2022, p42

18 See, for example, Q57 [Jo Ward]; Q70 [Nick Pink; Kelly Gordon]; see also, Tess Howard, “Practical, professional or patriarchal? An investigation into the socio-cultural impacts of gendered school sports uniform and the role uniform plays in shaping female experiences of school sport”, Sport, Education and Society, April 2023

19 Tess Howard, “Practical, professional or patriarchal? An investigation into the socio-cultural impacts of gendered school sports uniform and the role uniform plays in shaping female experiences of school sport”, Sport, Education and Society, April 2023; see also,

20Kit and body image affects girls’ participation in sports, new study says”, BBC Sport, 7 April 2023

21 Written evidence submitted by Youth Sport Trust, November 2023

22 Q70

23 Q67

24 Q69

25 Q58; See also, “Female hockey players can wear skirts, skorts and shorts in same team after rule change”, BBC Sport, 7 June 2023

26 Reports available to download from Youth Sport Trust, ‘Girls Active National Reports’, accessed 2 January 2024

27 See, for example, Q16 [Janet Birkmyre]; Q34 [Baz Moffat]

28 Q56; see also, for example, “Eilish McColgan column: ‘Why is menstruation still a taboo subject?’”, BBC Sport, 19 August 2022; “Let’s start talking openly about periods and call time on this taboo”, The Telegraph, 15 June 2023

29 Q56

30 Q34

31 Q82

32 Q83

33 See, for example, NHS inform, ‘Periods (menstruation)’, accessed 21 February 2024

34 Q37

35 DfE, School Sport and Activity Action Plan: Update, July 2023, p19

36 Ibid., p20

37 Ibid., p9; see also, “New plan to deliver high quality PE and sport for all pupils”, DfE press release, 19 July 2023

38 DfE, School Sport and Activity Action Plan: Update, July 2023, pp19–21; Letter dated 19 December 2023 to the Chair of the Committee from Rt Hon Damian Hinds MP, Minister for Schools, DfE

39 Letter dated 19 December 2023 to the Chair of the Committee from Rt Hon Damian Hinds MP, Minister for Schools, DfE

40 Letter from Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Society, Department for Culture, Media and Sport, and Minister for Equalities to the Chair of the Committee dated 7 December 2023; see also, ‘Studio You’, accessed 8 January 2023; See also Sport England, ‘This Girl Can: Our story so far’, accessed 8 January 2023

41 Q106

42 Department for Culture, Media and Sport, Get Active: A strategy for the future of sport and physical activity, August 2023

43 Letter from Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Society, Department for Culture, Media and Sport, and Minister for Equalities to the Chair of the Committee dated 7 December 2023; Letter dated 19 December 2023 to the Chair of the Committee from Rt Hon Damian Hinds MP, Minister for Schools, DfE; the Departments included in the NPAT are DCMS; DfE; Department of Health and Social Care, Department for Transport, Department for Environment, Food and Rural Affairs and Department for Levelling Up, Housing and Communities.

44 Letter from Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Society, Department for Culture, Media and Sport, and Minister for Equalities to the Chair of the Committee dated 7 December 2023

45 Q86

46 Q86 [Kelly Gordon and Nick Pink]; Q87 [Jo Ward]

47 Written evidence submitted by Youth Sport Trust, November 2023

48 Written evidence submitted by Youth Sport Trust, November 2023

49 See, for example, Women in Sport, Menopause, me, and physical activity, May 2018; Women in Sport, Inspiring women to be active during midlife and menopause, May 2021

50 Q47

51 Q47

52 Q48

53 Q48

54 Q48

55 Q48 [Lisa West]

56 See, Women in Sport, ‘Inspiring Women to be Active During Midlife and Menopause’, accessed 19 January 2024

57 Sport England, ‘This Girl Can: Our story so far’, accessed 19 January 2024

58 DCMS, ‘Get Active: a strategy for the future of sport and physical activity’ (section 2), accessed 19 January 2023

59 See, for example, Q40 [Baz Moffat]; Qq49–50 [Dr Newson]

60 Q70 [Nick Pink]

61 See, for example, Q70 [Nick Pink]; Q136 [Emily Handyside]

62 Q40

63 Q5; Q14

64 Q40

65 See, for example, “Sam Kerr setback highlights impact of ACL injuries in women’s game”, The Guardian, 7 January 2024

66 See, for example, Blackberry Clinic, ‘ACL injury in football – causes and treatment’ (December 2022), accessed 17 January 2023

67 See, for example, “Spoty winner Beth Mead calls for more research into women’s ACL injuries”, The Guardian, 22 December 2022

68 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12

69Sam Kerr setback highlights impact of ACL injuries in women’s game”, The Guardian, 7 January 2024

70 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12 [Suzanne Wrack and Fern Whelan]; see also, “Spoty winner Beth Mead calls for more research into women’s ACL injuries”, The Guardian, 22 December 2022

71 Q40 [Baz Moffat]; Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12 [Suzanne Wrack]

72 Q40

73 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12 [Suzanne Wrack]

74 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12 [Suzanne Wrack]; Q41 [Baz Moffat]

75Why are there so many ACL injuries in women’s football?”, 90Min, 4 May 2023

76Survey finds 82% of female players experience pain wearing football boots”, The Guardian, 27 June 2023

77 Q41

78 Letter dated 3 July 2023 from the Chair of the Committee to senior executives at Adidas, Nike, Puma and Umbro

79 Sports brands responses to our Chair’s letter of 3 July 2023

80 Ibid.

81 Ibid.

82 Ibid.; see also, Puma, Women’s football boots, accessed 16 January 2023

83 Sports brands responses to our Chair’s letter of 3 July 2023

84 Ibid.

85 Ibid.

86 Letter from Frasers Group Plc to the Chair of the Committee, dated 31 October 2023

87 Letter from Frasers Group Plc to the Chair of the Committee, dated 31 October 2023; Letter from Nike, October 2023

88 Letter from Baroness Sue Campbell, Director of Women’s Football, The Football Association, to the Chair of the Committee, dated 20 October 2023

89 Karen Carney, Raising the Bar: Reframing the opportunity in women’s football, July 2023, para 111

90 Ibid., p 44; see, Cowley, S., Olenick, A.A., McNulty, K., and Ross., E., “’Invisible Sportswomen’: The Sex Data Gap in Sport and Exercise Science Research”, Women in Sport and Physical Activity Journal, vol 29 (2) (2021), pp 146–151

91 Ibid., para 115

92 Department for Culture, Media and Sport, ‘Government response to independent review: reframing the opportunity in women’s football’ (December 2023), accessed 15 January 2023

93 Letter from Baroness Sue Campbell, Director of Women’s Football, The Football Association, to the Chair of the Committee, dated 20 October 2023

94 Letter from Rt Hon Stuart Andrew MP, Minister for Sport, Gambling and Civil Service, Department for Culture, Media and Sport, to the Chair of the Committee, dated 7 December 2023

95 Letter from Rt Hon Damian Hinds MP, Minister for Schools, Department for Education, to the Chair of the Committee, dated 19 December 2023

96 Prior to April 2023 UKSI was known as the English Institute of Sport

97 Q123

98 Q123

99 Q9

100 Q7

101 See, for example, Project RED-S, ‘What is RED-S?’, accessed 17 January 2023

102 Todd, E., Elliot, N., and Keay, N., “Relative energy deficiency in sport (RED-S)”, British Journal of General Practice, vol 72 (2022), pp 295–7

103 Q7

104 Q7

105 Q9

106 Q14

107 Q4

108 Q7

109 Q7

110 Q16

111 Q79

112 Q80 [Jo Ward]; Q81 [Nick Pink]

113 Qq56–7

114 Q136

115 Q83

116 See our work on: pornography and its impact on violence against women and girls; the escalation of violence against women and girls; attitudes towards women and girls in educational settings; so-called honour-based abuse; and misogyny in music.

117Swimmers ‘ruined’ by culture of fat-shaming and bullying”, BBC News, 24 February 2023

118Swim England ‘truly sorry’ over abuse and bullying claims”, BBC News, 8 March 2023; see also,

119 Letter from the Chair of the Committee, CEO of Swim England, dated 25 September 2023

120 Letter to the Chair of the Committee from Jane Nickerson, CEO of Swim England, October 2023

121 Qq141–2

122 Q141

123 Q143; see DCMS, ‘Sport integrity - call for evidence’, accessed 18 January 2023

124 See, for example, “Jahid Ahmed: ‘Racism and bullying never leave you,’ says ex-Essex player”, BBC Sport, 11 December 2023; “Interim report reveals 400 submissions over UK gymnastics abuse”, The Guardian, 9 March 2021;

125 DCMS, Get Active: a strategy for the future of sport and physical activity (section 2), accessed 18 January 2023

126 DCMS, Get Active: a strategy for the future of sport and physical activity (section 2), accessed 18 January 2023

127 DCMS, ‘Sport integrity - call for evidence’, accessed 18 January 2023

128 Q145

129 Q146

130 Sport integrity statistics received from UK Sport, December 2023

131 See, for example, Q22 [Eboni Usoro-Brown]; “The success of mothers at the World Cup will force football to change”, Financial Review, 2 August 2023

132Wimbledon 2023: ‘Super Mom’ Elina Svitolina upsets No.1 seed Iga Swiatek to reach semifinals’, WION, 11 July 2023

133Lizzie Deignan’s 5 biggest steps in her journey back to racing”, Trek, 19 May 2023

134The success of mothers at the World Cup will force football to change”, Financial Review, 2 August 2023

135How top-level athletes are rewriting pregnancy in sport narrative and forcing governing bodies into action”, Sky Sports, 8 March 2023

136 Written evidence from UKSI, December 2023

137 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12 [Fern Whelan]

138‘Pioneering’ fitness plan from Team Bath helps Eboni Usoro-Brown return after giving birth”, The Times, 14 March 2021

139 Q19

140 Q23

141 Football Association, ‘FA and PFA agree new benefits’, accessed 19 January 2024; “England and Everton star Toni Duggan, 31, to become first British footballer to receive full pay while raising her baby”, Daily Mail, 14 November 2022

142 Rugby Football Union, ‘RFU maternity pregnant parent and adoption leave policy provides 26 weeks of full pay’, accessed 19 January 2024

143 Oral evidence heard on sexism and inequality in football, 16 November 2022 (HC 830), Q12

144 UK Sport, Pregnancy Guidance and Support for UK Sport Funded Athletes and Pregnancy Guidance and Support for Sports Governing Bodies Funded by UK Sport, November 2021, available to download from UK Sport, ‘Pregnancy guidance’, accessed 29 August 2023

145 Ibid.

146 Q23

147 Q154

148 Q156

149 Q156

150 UK Sport, Pregnancy Guidance and Support for UK Sport Funded Athletes and Pregnancy Guidance and Support for Sports Governing Bodies Funded by UK Sport, November 2021, available to download from UK Sport, ‘Pregnancy guidance’, accessed 19 January 2024

151 Q158