Misuse of Florida student-athletes’ health information is very easy

Two months later last August Roe v. Wade Overturned by the Supreme Court, parents in Florida’s Palm Beach County School District began raising questions about a rule requiring state student athletes to submit detailed medical history forms to their schools before participating in sports.

For at least two decades, forms have included a set of optional questions about students’ menstrual cycles. But now, with many states criminalizing abortion, there are more concerns that menstrual data could be used as a weapon to identify or prosecute those who have terminated pregnancies. (In 2022, Florida passed a ban on abortion after 15 weeks, and its leadership has signaled interest in further restricting access to the procedure.)

And this school year, the Palm Beach County School District began offering students the option of submitting forms through a third-party software product, leading to particularly high levels of alarm about data privacy.

Some district parents wanted the period question gone. The episode raises the larger question of whether any medical data collected by these forms should be kept by any school or any district at all.

During several meetings, the Florida High School Athletic Association (FHSAA), which sets the rules for student involvement in school sports statewide, leaned toward a hard-line position on both questions.

In January, the organization’s sports medicine committee recommended making menstrual history questions mandatory And As the Palm Beach Post reports, students must turn in their responses to the school.

Florida isn’t the only state that asks student-athletes for their menstrual history. In fact, a minority of states – Only 10 — Clearly instruct student athletes to keep menstrual and other health information private.

Anyway, proposal need This information is extraordinarily difficult to justify: it poses a privacy risk and defies the recommendations of the National Medical Association, and it conflicts with the state’s prevailing educational trend, which has prioritized parental rights over almost everything else.

In a microcosm, the episode ushers in a new reality of the latter—Ro America: Period data should only be shared between patients and their healthcare providers.

Periods are a sign of health and people should talk about them — with their doctors

The menstrual cycle is such an important sign of health that many health care providers call periods the “fifth vital sign.” Especially in athletes, period changes may indicate that a person is not getting enough calories to offset high levels of activity.

So yes, athletes with periods should watch and take care of their cycle changes, says Judy Sims-Sendon, a Miami-based pediatric and adolescent gynecologist and president-elect of the North American Society for Pediatric and Adolescent Gynecology.

“But a physician’s or physician’s evaluation of menstrual history, and what it may or may not mean, is different than a school’s use of that information,” says Sims-Sendan. Practitioners are generally not health care providers, so they are not equipped to make medical assessments based on menstrual symptoms. But also — and importantly — schools and sports programs are not required to keep health information confidential under the federal HIPAA law (School is (Subject to other rules about sharing student data, but those rules allow access to data for broader reasons than HIPAA.)

The American Academy of Pediatrics (AAP) publishes separate forms for medical providers to complete when evaluating an athlete prior to participating in a sport. A form for the health care provider’s eyes only: A physical evaluation form with a warning that it may not be shared with schools or sports organizations. Then, there is a separate eligibility form for the physician to share with the school, with much less space for details.

The AAP keeps unnecessary medical details off the eligibility form for a reason, Sims-Sendon said. “It’s nobody’s business. You should not reveal it, because it has nothing to do with your sports activities,” he said.

Good Arguments (and No Arguments) Against Sharing Time Information Outside of a Physician’s Office

Parents’ fears about sharing their children’s health information with schools are well-founded. Without HIPAA protections, disclosure of health information can threaten individuals’ privacy rights.

Less discreet period-tracking apps also pose risks, as do some apps aimed at treating addictive disorders, depression and HIV. In 2019, the director of the Missouri Department of Health was caught using a period-tracking spreadsheet to identify patients who might have “failed” abortions; There is good reason to fear that an activist state government will try to use online tracked period information in service of the goal of criminalizing abortion.

That said, the FHSAA’s sports medicine committee isn’t entirely clear why Florida schools are so interested in collecting menstrual data from the state’s student athletes, or how they could use that data to discriminate against students.

Florida Gov. Ron DeSantis favors a near-total ban on abortion and, in 2021, signed a bill barring transgender girls from playing on girls’ teams in public schools. Could the questions be intended to identify and punish students who do not conform to the state’s gender politics?

It doesn’t seem possible. The questions — which ask about the date of menarche and the timing and frequency of periods — don’t provide data that would help adolescents seek abortion services, use contraception, or be evaluated for sexually transmitted infections. They would be poor screening questions to identify transgender students.

The state’s emphasis on including questions over parental objection is also strangely out of sync with Florida’s Parental Rights in Education bill, often called the “Don’t Say Gay” bill, Sims-Sendon said. “Our governor is incredibly supportive of parental control over student education,” and parents should have the right to control and protect their children’s health information, she said.

“I really don’t know what they’re trying to get at by asking for this information,” he said.

Overall, Sims-Sendon thinks it’s “really positive” that more people are talking openly about periods. But it’s one thing to educate students about menstrual health, and another thing entirely to assess and analyze someone’s personal menstrual history outside of a healthcare setting.

Young people need to be aware of the risks of losing control over that information, he said. “We call our reproductive health system ‘our personal’ for a reason.”