Using the Larry Nassar Case to Create a Coach Education Module to Prompt Social Change

in Women in Sport and Physical Activity Journal

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Leslee A. FisherThe University of Tennessee

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The purpose of this paper is to demonstrate how case study methodology, an advocacy practice and policy model (APPM), and new directions in feminist theory can be utilized to educate coaches about sexual misconduct. Case studies are useful for both research and teaching purposes because they provide a potential framework for analyses of “real-world” problems. The APPM provides guidance on moving from analysis to action; in particular, advocacy is about education, negotiation, and persuasion. Feminist theorists push us to consider how the embodied experiences of female athletes and feminine subjectivities can unsettle and disrupt normative assumptions about the way that sport should be conducted. The case of Larry Nassar is utilized because of the amount of reporting available to analyze; this includes female athlete survivor voices. Having coaches wrestle with such questions as (a) Do I know the definitions of sexual misconduct? (b) Do I understand the warning signs a female athlete might be displaying if she is being abused by significant other in sport? (c) When do I have to report abuse to authorities? and (d) Do I know how to intervene on the athlete’s behalf? is important if we are to increase the likelihood of creating systemic change.

Kennedy (a pseudonym) is a USA National Governing Body President who is committed to female student-athlete welfare and advocacy. Kennedy recently contracted with Skyler (also a pseudonym)—a coach educator—to develop coach education modules to ensure that coaches in the organization are providing the highest quality of care for female student-athletes they work with. The unique part of Skyler’s background is that she positions her work in terms of advocacy, defined as “. . . engaging in purposeful actions that will help people advance their rights, opportunities, causes, and human dignity” (Monds-Watson, 2013, p. 58). Grounded in the code of professional ethics from the Association for Applied Sport Psychology (AASP) as well as the mission of the United States Center for Coaching Excellence (USCCE), Skyler creates coach education modules specifically with AASP’s (2020) Principle D: Respect for People’s Rights and Dignity in mind. This principle states:

AASP members are aware of cultural, individual, and role differences, including those due to age, gender [emphasis added], race, ethnicity, national origin, religion, sexual orientation, disability, language, and socioeconomic status. AASP members try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone unfair discriminatory practices (https://appliedsportpsych.org/about/ethics/ethics-code/).

In addition, Skylar is a member of the USCCE (2020) and believes in their mission of strengthening “. . . the quality of coach development systems through guided program development, training, and support for coach developers, and the accreditation of coach education and training provision all of which are based on cutting edge [emphasis added] sport coaching practices” (USCCE, 2020, https://www.uscoachexcellence.org/). Skylar is also committed to recent calls by Fisher and Anders (2019); Kerr and Stirling (2019); McMahon, Knight, and McGannon (2018); and Yukhymenko-Lescroart, Brown, and Paskus (2015), for example, who advocate for helping sport significant others understand how their own actions have strong and lasting effects on female athlete well-being. For the purpose of the current paper, the focus is on how this research can be used to educate coaches about both “. . . what to do (ethical leadership), as well as what not to do (abusive behaviors)” (Yukhymenko-Lescroart et al., 2015, p. 46).

One cutting-edge strategy that Skylar uses to educate coaches is the case study method (Yin, 2015). According to Yin (2015), a case study is “. . . an empirical inquiry that closely examines a contemporary phenomenon (the case) within its real-world context” (p. 194). The case study can contain single or multiple cases (Yin, 2015). The case study method is considered an in-depth, up-close exploration into a real-world, complex, and specific phenomenon (i.e., the case). Further, researchers can gather multiple documents over an extended period of time related to the same event (Yin, 2015); they can also highlight the contextual conditions of the case to add a deeper and more accurate depiction of the phenomenon under investigation.

There are differences between research case studies and teaching case studies (Yin, 2015). For example, the motive for research case studies (i.e., Yin, 2015) is to collect evidence—fairly and completely—and then generalize the findings to other cases. In contrast, the motive for teaching or pedagogical case studies (e.g., Boston University Center for Teaching and Learning, 2019; Dunne & Brooks, 2004; Pennsylvania State University, 2019; University of Buffalo, 2019) is pedagogical (Yin, 2015). A good example of pedagogical case studies related to sport coaching and pedagogy can be found in the work of Cronin and Armour (2019) who provide detailed narratives of selected caring coaching practice. While some scholars who construct and use pedagogical case studies may not be interested in generalizability, others are interested in generalizing the findings to other cases as well as to sport social justice advocacy (e.g., Fisher & Anders, 2019).

Advocacy using the case study method can be focused on only one case where change is required (i.e., case advocacy; Monds-Watson, 2013) or on multiple cases where systemic change is sought (i.e., cause advocacy; Monds-Watson, 2013). For example, case advocacy usually involves one person or an intact group, like when female student-athletes from one specific team report enduring sexual misconduct by their head coach. In contrast, cause advocacy focuses on tackling larger, systemic changes required including changing common procedures and practices, laws, and policies (Monds-Watson, 2013); this type of advocacy usually involves system, self-, legislative, or legal advocacy which centers on social action and ways to create social change (e.g., as a result of multiple reported cases of abuse in one sport organization, policy changes are made). Both types of advocacy require that the advocate to be determined, knowledgeable, and expend energy on clients who are often just trying to survive in their environments (Monds-Watson, 2013).

Skylar’s case and cause advocacy is informed by many theoretical insights, including an overarching model for dynamic advocacy called the advocacy practice and policy model created in the field of social work (APPM; Monds-Watson, 2013). The APPM has its theoretical foundations in systems theory (e.g., Bateson, 1972; Satir, 1988), empowerment theory (Staples, 1999), the strengths perspective (Saleebey, 2012), and the ecological perspective (Germain, 1978). For example, when thinking about making sport social change, it is important to remember that athletes and coaches are embedded in a variety of systems (e.g., Bateson, 1972; Satir, 1988) which include their families, teams, other coaches, club sport organizations, parent/boosters, administrators, athletic departments, universities, national and international governing bodies, and the legal system. Further, one of the main goals of the APPM is to empower clients (Staples, 1999); that is, the focus of the intervention is on “promoting the voice, perception, and ability of clients to influence a particular issue of importance to the client” (Monds-Watson, 2013, p. 65). In addition, each client not only brings with them the personal and systemic challenges they are facing but also great reserves of strength, passion, determination, skills, abilities, and resources to fight those challenges (e.g., Saleebey, 2012). And, finally, the total ecological environment (Germain, 1978) that the client works and lives in must be evaluated in order to create social change; issues related to housing, food, clothing, facilities, technology, etc. must all be included in an advocacy case study analysis if lasting change is to be made (Monds-Watson, 2013).

Skylar is also committed to engaging with recent feminist theorizing (Ahmed, 2017; Toffoletti, Thorpe, & Francombe-Webb, 2018), since the clients she works with the most are female athletes and the coaches who work with them. Following hooks (2000), Skylar believes that feminism is a movement to end sexist oppression; however, it is only a first step toward ending all oppression. She is also impacted by scholars like Ahmed (2017) who writes, “Feminism is a sensible reaction to the injustices of the world which we might register at first through our own experiences” (p. 21). Pulling concepts from Ahmed’s (2017) most recent book—a book that Ahmed wrote for a broader, non-academic audience—Skylar finds a new metaphor to help coaches think about female [athlete] embodied experience. Ahmed (2017) calls the metaphor a “sweaty concept”; we generate sweaty concepts when we try to describe something hard to comprehend in the present, something that’s extremely difficult that we’re going through. Put another way, while a concept represents something in a different way, perhaps turning it around or reorienting us to the world differently, a sweaty concept:

. . . is one that comes out of a description of a body that is not at home in the world…[coming] out of a bodily experience that is trying. The task is to stay with the difficulty, to keep exploring and exposing this difficulty. (Toffoletti et al., 2018, p. xii-xiii)

Informed, therefore, by both research (Yin, 2015) and pedagogical case studies (Cronin & Armour, 2019) as well as the APPM and intervention process (Monds-Watson, 2013) and new directions in feminist theorizing (e.g., Ahmed, 2017; Toffoletti et al., 2018), coach educator Skylar shows Kennedy how the Larry Nassar case can be worked through to help coaches think about their role in the institution of sport, the responsibilities they have to female athletes as a result, and the ways they can advocate on athletes’ behalf.

Step 1: Initial Definition of the Case

According to Yin (2015), the initial definition of the case should “. . . explicitly identify the people considered to be inside or outside of the group, with the consequences explained and justified as part of the case study design—even though such a preliminary bounding of the case can later be revisited” (p. 195). In the Nassar case, there is a large group of female gymnasts who interacted with—and had formalized relationships with—USA Gymnastics coaches and the team doctor (i.e., Nassar); in fact, 156 female athletes gave victim impact statements in court and 200 gymnasts are involved in a lawsuit against USA Gymnastics (see Graves, 2020, for example). Also included in the case are their parents and club gymnastics coaches (i.e., the Gedderts from Twistar Gym in Michigan; USA Today, 2019) who should be considered as part of the case because they affect the nature of the case study’s findings and questions (Yin, 2015).

Step 2: Developing a Case Study Protocol

Yin (2015) suggests that using a case study protocol helps to promote transparency. The case study protocol should cover the entire line of inquiry for the case, including topics and questions, probes, and clues for the analyst to use to assess her sources of evidence. Skylar developed a list of questions for herself to think about as she moved through first- and secondhand accounts of abuse of mostly female gymnasts by Nassar. In creating the list, she also thought about what would be most relevant for the coaches in the upcoming workshop she’s providing them for the USA National Governing Body. These questions included (a) Do coaches know the definitions of sexual misconduct? (b) Do they understand the warning signs a female athlete might be displaying if she is being abused by significant other in sport? (c) Do they know when they have to report abuse to authorities? and (d) Do they know how to intervene on the athlete’s behalf? (see Kerr & Stirling, 2019, for example).

Step 3: Collect and Analyze Evidence—The Nassar Case and 156 Female Athlete Survivor Stories

As Yin (2015) notes, case studies “. . . often call for the direct study of social processes in local settings—e.g., the operations inside an organization or school, or the workings of community or neighborhood groups” (p. 198). In other words, when doing fieldwork research, researchers include direct real-world observations about certain processes occurring inside the organization to determine why such processes are occurring; such observations can shed light on the complexity of real-world relationships (Yin, 2015). Skylar points out to Kennedy that while she hasn’t done direct observation of Nassar’s actions—in fact, only the survivors and a handful of others were present during the abuse—she does have public testimony and quotes from the gymnasts themselves (e.g., Denhollander, 2019) as well as from reporters (Graves, 2020; USA Today, 2019) to illustrate the embodied effect of abuse on survivors.

Skylar and Kennedy talk about developing a two-hour workshop for coaches focused on helping them recognize sexual misconduct in sport. After introductions and an icebreaker, Skylar would use case advocacy (Monds-Watson, 2013) to summarize the case for the coaches using USA Today’s (2019) coverage (informed by the Lansing State Journal and the IndyStar of the USA Today Network) as well as the Washington Post (Graves, 2020). Reporters from the USA Today Network (USA Today, 2019) pulled together a timeline demonstrating Nassar’s decades-long sport medicine career, his sexual assault convictions, and his prison sentences; they also included photos of the major individuals involved in this case. As Yin (2015) suggests, data collection procedures for case studies need to be transparent; this strengthens the reliability of the case. Note: Moving forward, readers are advised that there are some graphic descriptions of embodied sexual misconduct in survivors’ own words.

Abbreviated Background of Larry Nassar

Skylar could begin by telling the coaches that in 1985, Nassar graduated from the University of Michigan with a degree in kinesiology. He joined the USA Gymnastics national team medical staff as an athletic trainer one year later and, in 1988, he started his almost 30-year plus relationship with John and Kathryn Geddert who were the owners and operators of Gedderts’ Twistars USA Gymnastics Club in Dimondale, Michigan, just outside of Michigan State University (MSU). In 1989, he was accepted to medical school at MSU and completed his degree in osteopathic medicine in 1993. As early as 1994, the first reported sexual abuse of female gymnasts by Nassar began. An Olympic medalist alleged that he molested her around this time period for six years while a parent of a female gymnast at Twistars stated that they had also raised concerns about Nassar to John Geddert, but Geddert did not notify the police (USA Today, 2019).

In 1996, Nassar was appointed as the national medical coordinator for USA Gymnastics and from 1996 to 2008, he attended the 1996, 2000, 2004, and 2008 Olympic Games with the USA gymnastics teams. In 1998, he began abusing a daughter of a family friend who was six years old; she later told police Nassar penetrated her vagina with his fingers “every other week for five years” (USA Today, 2019). Two MSU student–athletes reported concerns to MSU trainers or coaches regarding Nassar’s behavior, but the university failed to take any action. Two other gymnasts receiving treatment for back pain from Nassar told their parents he was sexually abusing them; yet, nothing happened. In 2004, Nassar attempted to receive and/or received child pornographic images (USA Today, 2019).

From 2008–2016, Nassar continued to “treat” gymnasts and other athletes in the greater MSU area as well as in USA Gymnastics with his vaginal “procedure” to relieve back pain. In 2014, Nassar was cleared of any wrongdoing by MSU after there was another complaint of sexual assault during a medical exam from a recently graduated gymnast; he remained USA Women’s Artistic Gymnastics team doctor but retired from being USA Gymnastics Medical Coordinator. In 2016, he was released from his MSU patient and clinical duties after The Indianapolis Star published their long investigation into how USA Gymnastics handled sexual abuse complaints over many decades (USA Today, 2019).

In 2017, while under local, state, and federal investigation, Nassar’s medical license was revoked by the state of Michigan. In January of 2018, Nassar’s sentencing hearing began. As USA Today (2019) reported it, “The hearing was expected to last four days with 88 victim-impact statements. More women and girls came forward to speak, and in total 156 women and girls made statements over seven days.” In February of 2018, Judge Janice Cunningham sentenced Nassar to 40 to 125 years in prison—on the sexual assault charges—and he was transferred to an Arizona federal prison. In May of 2018, MSU agreed to settle for $500 million with hundreds of girls and women who alleged that Nassar sexually assaulted them (USA Today, 2019). And, on January 30, 2020, the Washington Post (Graves, 2020) published the story that USA Gymnastics was now offering sexual abuse survivors $215 million to settle their claims as part of a bankruptcy plan (Graves, 2020); however, as attorney John Manly—one of the attorneys for the 200 survivors—stated, “This proposed plan does not include the critical structural changes necessary to ensure the safety of girls moving forward, nor does it appropriately address the myriad physical and emotional challenges the victims face as a result of these crimes” (https://www.wtnh.com/sports/nassar-survivors-offered-215m-settlement-by-usa-gymnastics/, as cited in Graves, 2020).

Selected Survivor Impact Statements

To gain a more in-depth understanding of what survivors went through—and the systematic way that Nassar operated—Skyler gathered public quotes from reporters as well as survivors to present to the coaches. For example, she found a quote by Vaidyanathan and Hughes (2018), who wrote poignantly about the nature of the abuse that survivors suffered at the hands of Nassar. Skylar read Vaidyanathan and Hughes’ (2018) summation of the pattern of abuse—which uses survivors’ own words—to the coaches so that they can feel what it was like to be abused by Nassar:

Nassar had a strikingly similar pattern of how he abused young women, the vast majority of whom were gymnasts. They came to him often in pain, looking for help. At their most vulnerable moment, he tried to convince them what he was doing was normal—even talking about everyday life and joking as he touched them. By projecting a sense of normality from his position of authority, Nassar made his victims feel they were wrong to believe this was abuse, and that they would be in the wrong if they complained. “I remember having the option of keeping my spandex on, which I was very grateful for and chose,” said Jennifer Rood Bedford, a volleyball player at MSU between 2000 and 2003. “He had me lay down face down on the medical table. When he started treatment, I remember him saying his treatment relied upon applying pressure to areas around the pelvis and that this was normal. “So when he went down there, I just told myself it was normal, that he knows what he’s doing and don’t be a baby. . . . I remember laying there and thinking ‘Is this OK? This doesn’t seem right’.” Rachael Denhollander, a former gymnast from Michigan, was the first victim to speak up publicly in 2016. She told the BBC that Nassar abused her during every visit she made to his clinic over a year after she turned 15. Nassar would position Rachael’s mother at the head of the table so she was not able to see what he was doing. With one hand, he would carry out sports massage. With the other, covered by a towel, he would insert his fingers into Rachael’s vagina or anus. In one of their last sessions, he unhooked her bra and fondled her breast—the only time Rachael said she knew she was definitely being assaulted and not treated. Many of the women said their trust in male relatives, partners, doctors, strangers, friends, and teachers was destroyed as a result of Nassar’s actions. “My first reaction was to question myself, to blame myself,” said Jennifer Rood Bedford. “I wanted to believe the best in people, but no matter how much I rationalised—he’s a doctor, he’s treating you, he didn’t mean for that to happen—I couldn’t shake the voice in my head that something wasn’t right” (Vaidyanathan & Hughes, 2018).

Definitions of Sexual Exploitation, Sexual Abuse, and Emotional Abuse

From her previous training in both sport psychology and coach education, Skylar knew that the main problem/issue in the Nassar case is the sport abuse—particularly sexual exploitation, sexual abuse, and emotional abuse—that was perpetrated on female athletes by their team doctor. In the workshop she was designing, she wanted to be sure to give coaches a summary of the main facts from research that has been conducted related to sport abuse, including that while no sport abuse prevalence studies have been conducted in the United States to date (Kirby, 2014), sport researchers in the United Kingdom (UK) have reported that between 2% and 22% of all UK sport participants have experienced sport abuse (Brackenridge, Bishopp, Moussalli, & Tapp, 2008).

The research Skylar scoured to create the workshop included the following information: In the first prevalence study of its kind to be conducted in the UK related to organized youth sport participant abuse, 75% of 6,000 participants reported experiencing emotional abuse, 29% reported being sexually harassed, 24% reported being physically abused, 10% described engaging in self-harm, and 3% had experienced sexual abuse (Alexander, Stafford, & Lewis, 2011; Fisher & Anders, 2019). Therefore, operational definitions of sexual exploitation and sexual abuse (e.g., Brackenridge et al., 2008; Hartill & Lang, 2018; Hartill, 2013; Mountjoy et al., 2016) as well as emotional abuse (e.g., Kavanagh, Brown, & Jones, 2017; Kerr, Stirling, & MacPherson, 2017; Stirling, 2009) are something that coaches and administrators should consider. Scholars who have defined these behaviors also encourage sport professionals—including coaches and administrators—to think about and take on the role of agents for athlete protection and for sport social change (e.g., Fisher & Anders, 2019; Stirling & Kerr, 2008, 2010).

Sexual exploitation has been used to describe behaviors ranging on a continuum from sex discrimination and “chilly climate” at one end (i.e., the institutional level) to actual sexual assaults on the other (i.e., the individual level;Brackenridge, 2001; Bringer, Brackenridge, & Johnston, 2001). While a “chilly climate” at the institutional level would be difficult to hold one person like Nassar accountable for, certainly his perpetration of sexual exploitation, assault, and violence is something that sport communities could take up through not only the legal system, but also through research and in the training of current and former sport professionals (Fisher & Anders, 2019) who will serve female athletes. While abusive coaching behaviors have been perpetrated against athletes for years (e.g., see Brackenridge, 2017; Yukhymenko-Lescroart et al., 2015), they have just recently been highlighted at the institutional (vs. the individual) level and have been given the research attention they deserve (Kerr & Stirling, 2019), both in the UK and Canada as well as in the US (Fisher & Anders, 2019).

Sexual abuse has also been operationally defined by sport researchers. According to those working for the International Olympic Committee (IOC), for example, it is defined as “any conduct of a sexual nature, whether non-contact, contact, or penetrative, where consent is coerced/manipulated or is not or cannot be given” (Mountjoy, 2018, p. 1; also see Ljungqvist et al., 2008; McMahon et al., 2018). While sexual abuse and exploitation occur at all sport levels, these researchers have demonstrated that this behavior occurs in a particular way at the elite level (Brackenridge & Fasting, 2008; Fisher & Anders, 2019; McMahon et al., 2018). Further, sexual abuse encompasses many personal and contextual variables that—when taken together—constitute a complex phenomenon with many manifestations in behavior; that is, sport sexual abuse can be violent or pseudo-intimate, involve non-penetration or penetration, and/or be non-forced or forced upon the targeted individual (e.g., Fisher & Anders, 2019).

Sport perpetrators like Nassar typically engage in intentional precursors to the abuse. In fact, they often enact three distinct stages of behavior including deliberate planning, deliberate grooming, and then deliberate execution of the sexual abuse (Brackenridge et al., 2008). According to Brackenridge and colleagues (2008), the grooming process entails first “targeting a potential victim, building trust and friendship, developing isolation and control, building loyalty, initiating sexual abuse, and securing secrecy” (p. 390; also see Fisher & Anders, 2019). Of particular concern to coaches and others who work with female athletes is that both coaches and athletes often see these types of behaviors as “normal” to the coach–athlete relationship (Fisher & Anders, 2019).

Identifying and defining emotional abuse in sport has been challenging for sport researchers in part due to sport and cultural acceptance of psychological aggression (Stirling & Kerr, 2008). In addition, Stirling and Kerr (2008) suggest that emotional abuse has received little research attention due to (a) the perceived lack of urgency with respect to intervention, and (b) the frequent lack of malicious intent by the perpetrator (p. 173; see also Brassard & Donovan, 2006; Fisher & Anders, 2019). However, they posited that emotional abuse is an under-recognized yet extremely common form of child abuse; they define it as “a relationship between a child and caregiver that is characterized by patterns of nonphysical harmful interactions” (p. 173, based on Glaser, 2002; Fisher & Anders, 2019). According to this definition as well as survivor impact accounts related to the Nassar case (i.e., Carr, 2019; Denhollander, 2019), it cannot be denied that female athletes have experienced emotional abuse at the hands of Nassar.

Step 4: Put the Evidence into Theoretical Context

Armed with a summary of Nassar’s history—his systematic grooming and abuse of female athletes—as well as operational definitions of sexual harassment, sexual abuse, and emotional abuse from scholars whose work informs policy decisions for the IOC (e.g., Mountjoy, 2018), Skylar continued her analysis by revisiting the APPM (Monds-Watson, 2013) and recent feminist theorizing (Ahmed, 2017; Toffoletti et al., 2018). It is important to note that with few exceptions, Nassar targeted young female athletes and other young females whose sphere collided with his, particularly in club- and elite-level gymnastics. For those of us who work with female athletes, it is important to think about how a further exploration of the sport system where the abuse occurred could be deployed here to examine the Nassar case in more detail (Fisher & Anders, 2019). As stated previously, the APPM’s theoretical foundation is based on four major theories: systems theory (e.g., Bateson, 1972; Satir, 1988), empowerment theory (Staples, 1999), the strengths perspective (Saleebey, 2012), and the ecological perspective (Germain, 1978). Each theoretical component of the model is explored independently—and integrated with feminist theorizing—to help flesh out what went wrong in the Nassar case.

The System of Elite-Level US Gymnastics

As previously stated, athletes and coaches are embedded in a variety of systems (e.g., Bateson, 1972; Satir, 1988) which include their families, teams, other coaches, club sport organizations, parent/boosters, administrators, athletic departments, universities, national and international governing bodies, and the legal system. According to Mountjoy (2018), the reason that Nassar was able to perpetrate crimes against young female athletes for so long can be explained by three factors: (1) abuse of a power relationship, (2) a sport culture of deference and secrecy, and (3) failed sport leadership. Each of these factors is directly related to the ways the US elite-level gymnastics organizations were structured.

For example, the ways in which sport abuse was perpetrated by Nassar was particularly insidious in the USA Gymnastics Team environment (USA Today, 2019). Elements of that environment which contributed to Nassar’s abuse included (a) a toxic and corrosive versus respectful athlete environment, (b) sex-based discrimination and misogyny as the norm which normalized inappropriate conduct directed at female athletes by men in power, (c) those with the most power (i.e., coaches, sport medicine doctors) were the biggest abusers, (d) some were conferred with a “celebrity” status, and (e) perpetrators were emboldened by a “bystander” culture—female athletes were instructed not to talk to the outside world about what was happening in their training environment (Fisher & Anders, 2019; see also Brackenridge & Fasting, 2008; Garcia-Navarro, 2017). Also related to the culture of elite-level gymnastics is the fact that female athletes were used to being touched by their coaches and team doctors beginning at a very early age. Through the process of “spotting” by coaches who corrected their body mechanics as well as being physically manipulated by Nassar during his “treatments,” female gymnasts were trained to consider the touch by important others as “normal” (Fisher & Anders, 2019; see also Kerr, Stirling, Heron, MacPherson, & Banwell, 2015). As one reviewer of the current paper pointed out, the normalization of physical contact would almost certainly be seen as highly suspect or, at the very least, problematic in other contexts.

In addition, in US culture writ large, we don’t listen to women and girls (Fisher & Anders, 2019). What’s worse, as Ahmed (2017) writes, is the attitude, “Because you’re a girl, we can do [anything] to you” (p. 26). Nassar’s case serves as a stark reminder about how female athlete bodies and voices are situated within not only actual physical structures but cultural scripts about gender (Fisher & Anders, 2019). The personal is indeed structural (Ahmed, 2017).

As Fisher and Anders (2019) pointed out, this can be illustrated using a Detroit Free Press sports reporter comment. In the comment, Windsor (2018) explained why the Nassar case did not receive the type of coverage it deserved, even though many thought it was worse than the Penn State tragedy:

If this story had been about boys, the action would’ve come sooner. Much sooner. As it did with Penn State. And that’s a shame, yet hardly surprising. Because the truth is boys matter more than girls in this society. And if you don’t think that’s true, then ask yourself why satellite trucks haven’t encamped in East Lansing for the last 18 months, when the Indy Star originally broke the story. (p. 1)

Further, Windsor reflected that as an insider to MSU sports, he as well as others were complicit in Nassar being able to continue with his sexual exploitation of female gymnasts because he privileged masculinity and male stories (i.e., about MSU basketball and football) instead (Fisher & Anders, 2019). As Fisher and Anders (2019) pointed out, these [male] reporters “. . . accepted elite sports’ dominant cultural scripts . . . and the concomitant non-privileging and dismissal of female athlete stories” (p. 10).
Another disturbing fact in the Nassar case was that even if/when significant others were willing to listen to survivor accounts, they often countered with, “You don’t know what you’re talking about, little girl” (Fisher & Anders, 2019). Solnit (2014) captures this gendered phenomenon of being unheard as well as dismissed in her book Men Explain Things to Me. As she stated:

Men explain things to me, and other women, whether or not they know what they’re talking about. Some men. Every woman knows what I’m talking about. It’s the presumption that makes it hard, at times, for any woman in any field; that keeps women from speaking up and from being heard when they dare; that crushes young women into silence by indicating, the way harassment on the street does, that this is not their world. It trains us in self-doubt and self-limitation just as it exercises men’s unsupported overconfidence. (p. 4; see also Fisher & Anders, 2019, p. 11)

This phenomenon was on full display in a statement uttered by an MSU Title IX investigator. While interviewing a female athlete survivor, he told her: “You must have missed the nuance of the procedure”; the “procedure” he was referring to was Nassar’s actual sexual penetration of her vagina under the guise of a “medical procedure” (Windsor, 2018, p. 1; see also Fisher & Anders, 2019). When decision-makers like MSU Title IX investigators display purposeful disbelief and engage in discrediting female athletes and their allegations of sexual assault—actual bodily violation—this reinforces the gendered status quo and adds layer upon layer of visceral and psychic injury to these survivors (Fisher & Anders, 2019). As Ahmed (2017) reminds us:

Violence too is a mode of address. Being girl is a way of being taught what it is to have a body: you are being told; you will receive my advances; you are object; thing, nothing. To become a girl is to expect such advances, to modify your behavior in accordance; to become girl as becoming wary of being in public space; becoming wary of being at all. Indeed, if you do not modify your behavior in accordance, if you are not careful and cautious, you can be made responsible for the violence directed toward you. . . . (p. 26)

Considering this particular context as containing the elements of a systemic abusive sport culture, Skylar wanted to help coaches ask new feminist (e.g., Toffoletti et al., 2018) and human rights (Raj, 2002) questions related to all environments that female athletes train in (Fisher & Anders, 2019). If we want to change abusive sport cultures such as this—and practice coupling respect and dignity of female bodies with the right to security for those female bodies (Fisher & Anders, 2019)—we should be asking: Under what conditions are female athletes training? In what ways are their bodies being surveilled and disciplined by powerful others (Foucault, 2001; Markula & Pringle, 2006)? Are female athletes training in an environment that is toxic? Sexist? Misogynist? Are those in positions of power in the environment contributing to a culture of sex-based discrimination? Are athletes responding to men in power as celebrities and/or does their own celebrity status inhibit them from speaking out? Are female athletes suffering recognizable and heinous violations of dignity in those environments? Are men in power there harming and abusing female athletes emotionally, psychically, or physically? And, finally, are female athletes encouraged and validated for speaking up and speaking out when someone is harmed, or is their sport inclusion dependent upon silence, submission, and obedience? (Fisher & Anders, 2019). By practicing structural and intersectional analysis (e.g., the ways that systemic racism, sexism, etc. collide in female athlete lives; Crenshaw, 1991) as well as paying attention to factors that contribute to environments of sexual exploitation, Skylar hoped that coaches would become more aware of the conditions that female athletes are training in and their role and responsibility in making sure that it was safe.

The Lack of Agency and Power That Gymnasts Had

One of the main goals of the APPM is to empower clients (Staples, 1999). That is, the focus of the intervention is on “promoting the voice, perception, and ability of clients to influence a particular issue of importance to the client” (Monds-Watson, 2013, p. 65). When thinking about who Nassar’s female athlete survivors are, it is critical to remember that most of the “clients” in this case were children when they were abused. As Fisher and Anders (2019) stated, “Our female and male athletes who compete at elite levels at young ages are vulnerable in their very status as children and adolescents” (p. 13).

While child athletes oftentimes cannot verbalize the embodied experience of an abusive coach-athlete relationship, coaches can certainly be educated about such relationships. Using Crossett’s (1986) work, Brackenridge (2017) described a three-level classification system for abusive coaching relationships that would be helpful for coaches to consider in the Nassar case. Crosset’s (1986) classification system of coach behaviors to watch out for included:

  1. 1.Domination over training—in which sadistic methods are used, forcing athletes through the pain barrier and using exercise as punishment;
  2. 2.Domination over body—including sexual harassment, seduction, rape, exploitation of the athletes’ love of the coach, abusive use of a coaches power over an athlete (e.g., through food and nutrition regimes, enforcement of rules on weight, shape, hairstyles);
  3. 3.Domination over personhood—where the privacy of athletes is invaded by coaches controlling their parties, sex lives, sleep, dress codes, family activities and so on (as cited in Brackenridge, 2017, pp. 8-9).

Crosset’s (1986) research was derived from elite individual sports, such as gymnastics and swimming, so it seems particularly apropos to the Nassar case. In these sports, athlete/children start competing at a very early age; as a result, they often become isolated from “normal” significant others and tend to develop a dependency on their coach (Brackenridge, 2017). They also become dependent on medical personnel to patch them up and get them back into the gym as quickly as possible. At a minimum, therefore, those who are responsible for the welfare of female athletes in elite-level individual sports such as gymnastics should be ensuring that dominating coaching and medical practices such as the ones listed above are abolished.

In the current case, female athletes did not come forward, did not feel empowered to report their experiences of sexual exploitation in this environment for a variety of reasons. First, there was a consistent pattern of people in power not believing them when they did speak out; many survivors came forward to report sexual misconduct by Nassar over the last two decades and were not believed (Carr, 2019). Next, many were well aware of the potential cost of speaking out; this included the shattering of their dreams of becoming an Olympic champion and fear of retaliation—if they spoke out, their careers could have been derailed in an instant. As a result, many felt trapped because they knew that both Nassar and USA Gymnastics coaches were the people they had to go through to get to the next level (e.g., Chroni, 2015; Fisher & Anders, 2019). However, over 156 survivors came forward during Nassar’s trial and were brave enough to tell their stories.

Strengths the Gymnasts Displayed During and After Suffering Abuse

According to the theoretical underpinnings of the advocacy model that Skylar is informed by, each client in every case not only brings with them the personal and systemic challenges they are facing but also great reserves of strength, passion, determination, skills, abilities, and resources to fight those challenges (e.g., Saleebey, 2012). In fact, it wasn’t until the public heard the embodied voices of female athlete survivors that they were finally taken seriously (Fisher & Anders, 2019). When survivors got a chance to tell their stories publicly, their strength and courage was on full display. As Heldke and O’Connor (2003) point out, in order to redress harm to those who have been hurt/targeted in oppressive systems, it is important to hear from them about their experiences. This is because they have unique understanding and insights about psychological, social, and structural realities that those of us on the side of privilege cannot grasp.

Ahmed (2017) reminds us, too, that by facing what is, by noticing and exploring “. . . a world that reproduces violence by explaining it away” (p. 32), we can learn to notice our own and other women’s suffering. While Rachel Denhollander didn’t take legal action against Nassar when she was a child, she did write copious notes about her experience in her journal, which she kept for over a decade (Denhollander, 2019). Part of her survivor impact statement is excerpted below (CNN, 2018) as an illustration of her courage and strength. In it, she asked the court:

How much is a little girl worth? How much is a young woman worth?

Larry is a hardened and determined sexual predator. I know this first-hand. At age 15, when I suffered from chronic back pain, Larry sexually assaulted me repeatedly under the guise of medical treatment for nearly a year. He did this with my own mother in the room, carefully and perfectly obstructing her view so she would not know what he was doing. His ability to gain my trust and the trust of my parents, his grooming and carefully calculated brazen sexual assault was the result of deliberate, premeditated, intentional and methodological patterns of abuse—patterns that were rehearsed long before I walked through Larry’s exam room door and which continue to be perpetrated I believe on a daily basis for 16 more years, until I filed the police report.

Larry’s the most dangerous type of abuser. One who is capable of manipulating his victims through coldly calculated grooming methodologies, presenting the most wholesome, caring external persona as a deliberate means to insure a steady stream of children to assault. And while Larry is unlikely to live past his federal sentence, he is not the only predator out there and this sentence will send a message about how seriously abuse will be taken.

So, I ask, how much is a little girl worth? How much priority should be placed on communicating that the fullest weight of the law will be used to protect another innocent child from the soul shattering devastation that sexual assault brings? I submit to you that these children are worth everything. Worth every protection the law can offer. Worth the maximum sentence.

What is a girl worth? (CNN, 2018)

The Ecological Environment

The ecological environment that the client works and lives in must also be evaluated in order to create social change. This includes an analysis of issues related to housing, food, clothing, facilities, technology, etc. that the client is negotiating every day (Monds-Watson, 2013). Skylar felt as though she had a good grasp on the environment that the survivors of Nassar’s sexual abuse were embedded in. Therefore, she focused on the goal of reforming elite-level sport to make sure that female athletes are entitled to all fundamental freedoms and human rights as stated in Article 3 of the Declaration of the Elimination of Violence Against Women; these rights include security of the body as well as the right to liberty (Busia, 2002; see also Fisher & Anders, 2019, pp. 12–13). According to Busia (2002), bodily integrity is defined as “. . . the right to dignity and respect in one’s physical body and to be free from abuses and assaults, subtle and overt, including unwanted sexual exploitation in all forms. The violations of this principle worldwide are pervasive” (p. 6; see also Fisher & Anders, 2019).

Brackenridge’s (2001) work—specifically her model and continuum related to sexual exploitation in sport—could be helpful for key decision-makers to consider related to the Nassar case (Fisher & Anders, 2019). As a first step, those who are responsible for ensuring that female athletes have a safe sport experience need to unpack the discourse and larger power structures that female athletes are subjected to; this could begin with unpacking what we mean when we use the terms “bystander” and “complicity” in the sport context (Fisher & Anders, 2019).

For example, there were several bystanders in the Nassar case—as well as others who were complicit in not aiding female athletes—who could and should have come to their aid. The bystander effect occurs when:

. . . the presence of others discourages an individual from intervening in an emergency situation. The greater the number of bystanders, the less likely it is for any one of them to provide help to a person in distress. People are more likely to take action in a crisis when there are few or no other witnesses present. (Psychology Today, 2019)

At the local level, bystanders in the Nassar case included but were not limited to parents, MSU assistant coaches, faculty members, athletic administrators, etc. At the national level, bystanders included but were not limited to the NCAA and USA Gymnastics. There were also those who were complicit in not helping female athletes once they heard about their stories; these include but are not limited to sports reporters, coaches, the police, other female gymnasts, etc.

In addition, using Brackenridge’s model in her analysis, Skylar has come to understand that there are layers that can be used to investigate female athletes’ lived experience of Nassar’s—and other cases of—sexual violence. These include (a) the visceral level of experiencing Nassar’s violence; (b) the political/institutional level of disregard and denial of Nassar survivor voices that MSU, the NCAA, and USA Gymnastics displayed—this is another level of violence; (c) the larger cultural and societal discourses of sexism and heteropatriarchy at work in this case—another layer of violence; and (d) the lack of media coverage—another level of violence (Fisher & Anders, 2019, p. 12). All athletes have the right to compete in healthy training environments and not face the kind of systemic violence that Nassar’s survivors suffered (Fisher & Anders, 2019). As one of the reviewers of the current paper rightly pointed out, even though sport national governing bodies like USA Gymnastics have been forced to respond and change their policies—with the concomitant public scrutiny and organizational chaos that has ensued—they may not have done enough. Much more analysis is needed to explore whether the mandated changes that the United States Olympic & Paralympic Committee (USOPC) required US national governing bodies to undergo (Blackmun, 2018) have been made such as (a) changing the culture of sport, (b) changing the governance structure of the national governing bodies, (c) knowing who knew what and when, and (d) supporting safe sport victims and survivors. Skylar and others could employ the same analysis she used in the current paper to explore each of the four suggested USOPC changes above to develop case studies for future coach education and organizational trainings.

Conclusions

In summary, it is hoped that the case study provided in the current paper serves as an example—amongst others (e.g., McMahon et al., 2018)—of how an educational intervention like a pedagogical case study (e.g., Cronin & Armour, 2019) could be used to educate those who care about and work with female athletes about sport sexual misconduct. At the crux of this case were several facts that have been highlighted and investigated in more depth to help coaches further understand abusive sport structures and practices. For example, one fact is that [female] athletes are taught not to question the authority of coaches and doctors. Another fact is that sexual harassment and abuse have become normalized in certain [female] training environments as well as in society. A third fact is that even though institutional authorities like MSU and the USOPC received reports of sexual abuse committed by Nassar as early as the 1990s, no one opened a formal investigation until January 23, 2018, roughly 25 years later (Fisher & Anders, 2019). These institutions—and the people who run them—completely disregarded the experiences of abuse that elite female gymnasts suffered through for decades. Further, there are a lack of procedures for coaches, athletes, and their parents to follow when realizing that female athletes are suffering abuse at the hands of someone—like Nassar, their trusted team doctor—who was supposed to support them and help them reach their dreams.

The goal in the current paper, therefore, was to educate coaches about the definitions of sexual misconduct in sport, suggest ways to reform elite-level sport contexts, and address the lost female voice (e.g., Ahmed, 2017). Coaches should know how to define sexual misconduct, understand the warning signs a female athlete might be displaying if she is being abused by a significant other in sport, when to report abuse to authorities, and how to intervene on the athlete’s behalf (see Kerr & Stirling, 2019, for example). This is because the risks to female athletes’ senses of self, physical and emotional health and well-being, and enjoyment of sport are great when they are in subordinate relationship positions with significant others—who are trusted authority figures—who abuse and devalue them (Fisher & Anders, 2019). And, because of their responsibilities to athlete welfare, coaches need to take a good hard look at whether they themselves are perpetuating oppressive systems like sexism and patriarchy as well as potentially privileging elite athlete performance over elite athlete well-being and holistic development.

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Fisher (lfisher2@utk.edu) is Director of the Sport Psychology and Motor Behavior Graduate Program, Department of Kinesiology, Recreation, & Sport Studies, The University of Tennessee, Knoxville, TN.

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  • Ahmed, S. (2017). Living a feminist life. Durham, NC: Duke University Press.

  • Alexander, K., Stafford, A., & Lewis, R. (2011). The experiences of children participating in organized sport in the UK. London, UK: NSPCC.

    • Search Google Scholar
    • Export Citation
  • Association for Applied Sport Psychology. (2020). Association for Applied Sport Psychology Ethics code. Retrieved from https://appliedsportpsych.org/about/ethics/ethics-code/

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  • Bateson, G. (1972). Steps to an ecology of the mind. New York, NY: Ballentine Books.

  • Blackmun, S. (2018). Open letter to Team USA athletes regarding Nassar case. Retrieved from https://www.teamusa.org/News/2018/January/24/Open-Letters-To-Team-USA-Athletes-Regarding-Nassar-Case

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