What's up with the new OSSAA pre-participation physicals???

 Jennifer Morris, MD, MBA

ABPN, ABPM-add, ABOM, ISSP




The Oklahoma Secondary School Activities Association (OSSAA) recently promoted updated physical examination and parental consent forms for student physicals, to much controversy (1, 2.)  The relevant portion is included below: 



Concerns centered on added questions regarding female reproductive health and sex assigned at birth. The questions were released in an environment laced with controversy regarding eligibility of participation in women's sports. It appears these questions may have been included to impact athletic eligibility for transgender athletes. Additionally, many parents, athletes, and administrators perceive the questions as being overly invasive. Indeed, my own daughter gave me the death stare that 11-15 year-olds hold dominion over when we reviewed the new questionnaire.

Transgender participation is addressed in the 70 Oklahoma Statute 27-106 biological sex affidavit passed in 2023, notating assigned sex at birth. There were no reproductive health questions in the 2021 pre-participation form. The 2024 form includes "sex at birth" as well as a menstrual health history for female athletes.

While the "sex at birth" question is unique to a handful of states, the reproductive history appears standard on 46/51 state forms I reviewed. These questions do not appear to materially impact transgender sports participation beyond 70 Oklahoma Statute 27-106, but they may serve to further embed challenges to transgender athletic participation, by normalizing certain sentiments and creating additional barriers to alter transgender sports participation legislation. 

The American Academy of Pediatrics and the American Academy of Sports Medicine have long been concerned with the health of young athletes in general, and specifically with the symptoms reflected in the female athlete triad (figure 2) and in the associated relative energy deficit syndrome (RED-S) (figure 3.) Likewise, the International Society of Sports Psychiatry aims to promote attention to RED-S, including the mental health concerns represented in this syndrome. 











The new forms also include expanded mental health and environmental safety questions.

At this time, the OSSAA is allowing utilization of either the 2021 or 2024 forms.

1. Oklahoma Secondary School Activities Association. Pre-Participation Physical and Parental Consent. https://www/ossaa/net/docs/2021-22/SportsMedicine/MF_2020-2021-PhysicalForm.pdf?id=512.  Accessed June 9, 2024.

2. Oklahoma Secondary School Activities Association. Pre-Participation Physical and Parental Consent. https://ossaaillustrated.com/wp-content/uploads/2024/04/MF_2023-24_Physicalform.pds. Accessed June 9, 2024. 


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