We Thought You’d Never Ask: Insights From the Health of Elite Retired Australian Female Athletes Survey

CONTEXT: Historical underrepresentation of female athletes in sports medicine and rehabilitation research has limited the understanding of long-term postretirement health outcomes and the development of female-specific athlete care systems. This study aimed to (1) describe the mental health, brain health, cardiovascular health, musculoskeletal health, and general well-being of elite retired Australian female athletes; (2) compare these characteristics with the Australian general population where possible; and (3) explore retired athletes' perception of how sport has impacted their health and well-being. METHODS: Data were collected through a larger online cross-sectional survey co-created with female athletes and disseminated to Australian retired elite (international- and national-level) female athletes aged ≥18 years old and retired from elite competition ≥2 years. RESULTS: One hundred and ninety-nine retired athletes (mean [SD]: age 44 [10] y; retired for 16 [9] y; competed for 10 [5] y) across 31 different sports responded to the 147 questions. Athletes had lower odds of depression than the general population (odds ratio = 0.65; 95% CI, 0.49 to 0.86). Nearly all athletes (94%) reported witnessing or experiencing harassment/abuse during their career. A greater proportion of athletes (8%) reported atrial fibrillation/flutter than the general population (2%). Eighty-one athletes (41%) reported retiring due to injury-most commonly involving the knee, the most common source of ongoing pain. Despite the impact of injuries, most athletes (81%) would compete at the same level again if given the choice. They recommended current developing athletes prioritize individual health needs and foster a sense of self beyond sport. CONCLUSION: We identified a high prevalence of harassment and abuse, atrial fibrillation/flutter, and knee injuries. These findings highlight the need for sex- and gender-specific tailored mental health and injury prevention systems-moving beyond reliance on male-centric data-to protect all athletes' long-term health and well-being.