From Violation to Stigma: A Literature Review of Athletes’ Lived Experiences Following Anti-Doping Sanctions

The anti-doping system operates in a complex, morally charged, and high-stakes environment. Within this framework, the principle of strict liability and the tension between transparency, the protection of clean sport, and athletes’ rights amid intense public scrutiny can inflict harms that extend well beyond sporting ineligibility. Despite this, limited research has examined the lived experiences of athletes sanctioned for Anti-Doping Rule Violations (ADRVs) under the World Anti-Doping Code. This review identified 25 English-language studies between 2011 and 2025 involving sanctioned athletes, of which only 12 considered athletes’ experiences during and after the sanctioning process, reflecting the perspectives of 49 athletes found to have committed ADRVs. All but one received a sanction, and several claimed the violation was unintentional. The included studies were analyzed using descriptive and bibliometric techniques, narrative synthesis, and citational analysis to assess the composition, scholarly impact, and practical relevance of this emerging body of work. Through narrative synthesis, we identified five recurring themes across athletes’ accounts of the sanctioning process and its aftermath: (1) psychological and emotional distress; (2) social isolation and reputational damage; (3) perceived procedural injustice and institutional abandonment; (4) disruption to career trajectories and athletic identity; and (5) a sense of resolution or clarity despite adversity. However, the direct translation of this research into anti-doping policy remains limited. Difficulty in reaching and recruiting participants was common across the reviewed studies. Significant gaps persist in reporting standards, gender representation, and regional diversity, which hinder a comprehensive understanding of the personal consequences of ADRVs. Despite limitations, this review represents a critical step toward assessing the legitimacy of anti-doping enforcement from the perspective of those most affected. The findings underscore the urgent need for interdisciplinary research and policy development that consider athletes’ experiences and promotes more equitable and humane regulatory practices. Future work should be directed toward wellbeing and support needs of athletes facing ADRV sanctions, including those later acquitted, and structured pathways for transitioning out of, or returning to, sport post-sanction. Research should also expand to explore the perspectives of athletes impacted by doping within their environment for a comprehensive evidence-base for future anti-doping policies.