Women working as Sport and Exercise Medicine (SEM) practitioners in Australian elite sport are paid less and experience more gender harassment than their male colleagues, according to a recent study by Dr Sallie Cowan MACP and her colleagues (Cowan et al 2024), which was supported by an APA research grant and published late last year in the British Journal of Sports Medicine. 

The researchers investigated the experiences of male and female SEM practitioners, including both physiotherapists and doctors, who currently work or previously worked in Australian elite sport. 

‘We had been hearing anecdotally for some time about gender inequality and harassment in elite sport, both in Australia and overseas, but we wanted the evidence,’ Sallie says. 

The study consisted of a short survey focused on the experiences of female and male physiotherapists and sports doctors who were planning to work, were currently working or had previously worked in SEM in elite sport in Australia, with questions covering demographics, the sporting teams worked with, recruitment and experiences of working in elite sport. 

Participants also completed the Gender Experiences Questionnaire, which is used to measure gender harassment in the workplace. 

The majority (68 per cent) of the 223 participants were physiotherapists and more than 60 per cent were currently working as SEM practitioners. 

But while the numbers of women and men taking part in the study were similar, their experiences were not. 

Men worked 74 per cent more paid hours per week than their female colleagues and also had more paid weeks each year. Women worked slightly more unpaid hours each week and fewer paid hours; their proportion of unpaid to paid work was higher at 27 per cent compared to 13 per cent for men. 

Male SEM practitioners were more likely to travel, both domestically and internationally. The study results also showed that women were nearly seven times more likely than men to work with female athletes or mixed gender groups of athletes rather than with male-only athletes and were 3.6 times more likely to report that this affected their pay. 

‘Professional sport in Australia is still very male-dominated,’ says Sallie. ‘Men are more likely to work with male athletes and roles with men’s teams are considered to be more prestigious and better paid.’ 

She points to the AFL as an example—the well-established male teams in the AFL have year-round programs employing SEM practitioners, while in the far newer AFLW, SEM physiotherapists and doctors tend to work during the training and playing seasons only.

Women also felt that there was less female representation in their workplaces. 

Despite the negatives, though, more women currently working as SEM practitioners in elite sports reported positive experiences than those previously working in the field—both men and women reported feeling that they were part of the team, were satisfied with their work and felt valued. 

However, less than 50 per cent of both men and women felt that parents and carers were supported by their organisations.

Recruitment and opportunities to work in SEM for elite sports in Australia was another area that the researchers investigated. Women surveyed felt that they were being sidelined from opportunities to work in elite sports—twice as many women (65 per cent) as men felt that their gender influenced their opportunities. 

Adding to the problem is the fact that most roles in SEM are not formally advertised—instead, they are passed along via informal and internal networks, which favour men. 

‘Women get jobs through formal recruitment processes, while men get jobs through the network and “male sponsorship”,’ says Sallie. 

Women working as SEM practitioners also reported experiencing significantly more gender harassment including sexist remarks and sexually crude or offensive behaviour, infantilisation, work/family policing and gender policing than men, a pattern that the researchers noted was also seen in other areas of medicine, both in Australia and overseas. 

Overall, the study suggests that there is potential for a significant gender pay gap between women and men working in SEM at the elite level. 

This, plus the other barriers to women entering and continuing to work within SEM, such as the lack of opportunities offered to women and ongoing gender harassment, limit the number of women working in SEM, especially in leadership roles. ‘These are reasons why women leave the elite sport workplace,’ Sallie says. 

While the results did not come as a surprise to the researchers, they provide a foundation for change, says Sallie. ‘We wanted to set the scene so we can take the steps needed to change it,’ she says. 

‘It starts with men recognising that there is inequality and gender harassment in the elite sports workplace. We need to do better.’ 

The researchers have called for elite sporting organisations to take affirmative action to eliminate gender bias by recognising and addressing gender harassment in the workplace, setting targets for gender equality, saying no to gender pay inequity and establishing formal and transparent recruitment processes for equitable access to SEM careers in elite sport. 

Sallie says the research team will be meeting with key stakeholders including the APA and major sporting organisations in coming months to discuss the results of the study and how to go ahead with implementing the recommendations. 

In the meantime, they are close to completing a follow-up study consisting of in-depth interviews with a selection of the participants and expect to publish the results later this year.  

Reference: Cowan et al. You have to work twice as hard as a woman to show that you are competent. Experiences, opportunities and workplace gender harassment for Sport and Exercise Medicine practitioners working in elite sport in Australia. British Journal of Sports Medicine. 2024; 58: 1518–26.