The Price She Pays: Confronting the Hidden Mental Health Crisis in Women's Sports—from the Schoolyard to the Stadium

Two experts in mental health and sport lift the veil on the crisis in women’s athletics, offering parents and coaches urgently needed advice and support and showing how female athletes can find joy in whatever sport they choose, at whatever level they compete.

No matter the sport, the message to girls and women is the same: Be aggressive, but not too aggressive. Win at all costs, but be polite while doing it. Get strong, but not too big. Female athletes have long been conditioned to perform under these standards, gracefully and without complaints.

Yet, behind the scenes, female athletes are suffering from disordered eating and substance use; depression and anxiety; emotional and sexual abuse; racism and discrimination; self-harm, and even suicide ideation. When global tennis star Naomi Osaka and gymnastics world champion Simone Biles took breaks from competing to tend to their mental health, many were compelled to ask: What is causing this mental health crisis in women’s sports? In The Price She Pays, Katie Steele and Dr. Tiffany Brown illuminate where we are going wrong—and how we can correct course.

Through first-hand accounts, research, and reporting, they reveal the deep layers of trauma and mistreatment women experience in their pursuit of excellence in sport. They show parents, coaches, and athletes how to recognize the signs of mistreatment and mental health issues, and reveal how, by focusing on the wellbeing of the whole person—not just the athlete—we can provide women and girls with the support they need to thrive, in whatever sport they choose, at whatever level they compete.

About the Author

Katie Steele, LMFT is a former highly recruited D1 athlete who ran track and cross country for the famed University of Oregon team. After her running career intersected with the infamous coach Alberto Salazar, she was left with trauma for years to come. Deciding to dedicate her career to the integration of mental health care in athletics, she is now a Licensed Marriage and Family Therapist and co-founder of Thrive Mental Health, an outpatient mental health clinic in Bend, Oregon.  

Tiffany Brown, Ph.D., LMFT, is an award-winning, senior faculty member at the University of Oregon in the Couples and Family Therapy graduate program and a Licensed Marriage and Family Therapist who works with student athletes and provides mental health education for coaches and staff.

Journalist Erin Strout brings compelling storytelling and essential expertise to the project as well. Her work has appeared in Washington Post, ESPN, SELF, Outside, Runner’s World, Women’s Running, Triathlete, Women’s Health and more.