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Form that asks female student-athletes in Florida about their menstrual histories sparks calls for change

Some physicians and parents say collecting and digitally storing the information puts students at risk in the post-Roe era. One district has inquired about having the questions removed.
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A Florida school district is seeking to change a state medical form that asks female student-athletes about their menstrual histories following criticism from some physicians and parents who say it's unnecessary for schools to collect and digitally store such information and that doing so puts students at risk in the post-Roe v. Wade era.

The Palm Beach County School District has asked the Florida High School Athletic Association to alter its physical evaluation form for student-athletes so it no longer includes five optional questions asking about menstrual history, a spokesperson for the school district said.

“Although the question regarding menstruation is optional, our district has recently inquired about having this question removed,” the spokesperson said.

The paper form has been used and stored by all state school districts for "several years," said the spokesperson, who added that the district keeps records for seven years before it destroys them.

The Palm Beach Post reported that the backlash started after the district announced it would offer student-athletes the option this school year to digitally submit the form to the sports management software company Aktivate, which could be required to turn data over to legal authorities and other officials, according to both its privacy policy and federal law.

The concerns also come on the heels of Florida’s 15-week abortion ban, as well as broader worries among abortion rights activists and experts about how digitally stored information about menstruation could be used in light of the increase in abortion restrictions nationwide.

'To have this digitized makes it a bigger concern'

The optional questions ask students when they had both their first periods and their most recent ones, as well as how long their cycles usually are, how long their longest cycle was and how many periods they had within the year.

The Aktivate website says “a valid subpoena would be required” for the company to share information with law enforcement. It also notes that because the company works directly with schools, it is required to comply with the federal Family Educational Rights and Privacy Act, which protects the privacy of students’ educational records — but includes disclosure exceptions for subpoenas, state and local authorities and “appropriate officials in cases of health and safety emergencies.”

An Aktivate spokesperson said the company "adheres to the data privacy standards set by each school district," in addition to "all state and federal laws relating to the confidentiality of student records."

The platform provides coaches with information that could be relevant in a student-athlete's health emergency, and Aktivate "can accommodate profile removal requests," the spokesperson said.

"Upon request and approval by the school district, the company is able to remove parent login information, as well as any associated athlete profiles," the spokesperson said.

Craig Damon, the executive director of the Florida High School Athletic Association, said state law requires it to mandate that prospective student-athletes complete evaluations incorporating their medical histories. Florida students and parents also must sign forms providing consent for to release medical histories "should treatment for illness or injury be necessary," he added. 

A spokesperson for the association did not respond to specific inquiries about the Palm Beach County school district’s request to remove the information about menstrual history from the physical evaluation form.  

Dr. Thresia Gambon, a pediatrician and the president of the Florida Chapter of the American Academy of Pediatrics, said a student-athlete's menstrual history can provide important insight for doctors, noting that irregular menstruation is one component — along with disordered eating and osteoporosis — of the female athlete triad, a disorder that can lead to reproductive, bone and cardiovascular issues. But she said she does not see why schools need that information.

"Having menstrual history is very important — whether it’s very important that it's included in that form is a different question," she said.

Gambon pointed to the American Academy of Pediatrics’ guidelines for physical evaluation forms for student-athletes, which explicitly state that forms related to medical histories and physical examinations should not be shared with schools.

And "to have this digitized makes it a bigger concern, because it is private medical information," she added.

The only form the academy recommends making available to schools is a medical eligibility form, which explains whether students are medically eligible to compete and provides space to list emergency contacts, allergies and medications.

Dr. Rebecca Carl, a sports medicine physician and a member of the executive committee of the American Academy of Pediatrics' Council on Sports Medicine and Fitness, said the academy's guidance "allows confidential, HIPAA-protected information to remain part of a child's medical record while providing schools with the information needed to determine whether the child is medically eligible for sports."

A representative for the Florida High School Athletic Association did not respond to an inquiry about the academy’s guidance.

'I'm worried about her future'

Yvette Avila, whose daughter attends a Palm Beach County middle school and plays softball, said she and her daughter prefer not to record the girl's menstrual data with the district.

“Nobody wants period information on any kind of document when you’re in middle school,” she said.

Avila is considering home-schooling her daughter.

“I’m worried about her future, of course, in regards to, like, what are they doing with that?” she added.

Aktivate, which launched last fall and was co-founded by former AOL CEO Jon Miller, signed a three-year licensing agreement with the Palm Beach County School District in June, according to a document obtained by The Palm Beach Post.

At an August school board meeting in Palm Beach County, Aktivate CEO Hesky Kutscher said: “We very much respect parents’ privacy rights, and in fact we provide high security and high privacy for all the information that is put into our system — far bigger security, by the way, than paper.”

In addition to inquiring about removing questions about students' menstrual histories, the Palm Beach County School District's spokesperson said officials “will continue to explore other options, such as lobbying for revisions to this form and/or limiting the information provided to schools to solely the physician’s approval or disapproval of the student-athlete’s medical clearance.”