Girls Gone Steroids?

By Rick Collins, J.D.

Read the papers and you?d think that there?s a massive army of juiced-up prepubescent girls terrorizing the playgrounds of America. We can credit Associated Press (AP) reporter Linda A. Johnson for breaking the frightening news with an April article entitled, ?More Girls Try Taking Steroids to Tone Up.? In it, she proclaimed that ?[a]n alarming number of American girls, some as young as 9, are using bodybuilding steroids ? not necessarily to get an edge on the playing field, but to get the toned, sculpted look of models and movie stars.? Two days later, AP sports columnist Tim Dahlberg more tersely suggested that ?9-year-old girls are taking steroids just to look good.? The Baltimore Sun then ran a piece by Milton Kent declaring that ?up to 7 percent of middle school girls, age 9 to 14? have tried or are using anabolic steroids. More journalists jumped on the ?nine-year-old girls? story as sensationalistic shorthand for the dangers of steroid abuse. Politicians started using the image in their anti-steroid pandering to the voters back home. Even ubiquitous Canadian lawyer Dick Pound, ever eager to convince American tax payers to commit more money to his World Anti-Doping Agency, used it in a speech.

But is it true? Is there really statistical support for the horrifying proposition that somewhere in a school cafeteria there?s a jacked-up nine-year-old washing down handfuls of steroid tablets with sips from her juice box? Most reporters, unfortunately, have been suspiciously vague in their references to ?studies? on the subject. One reporter attributed the story to anonymous Youth Risk Behavior Surveillance System (YRBSS) questionnaires used by the Centers for Disease Control and Prevention (CDC). It?s true that a recent one supposedly showed that a whopping 7.3% of girls had used steroids. But it?s also true that the questionnaires have serious methodological flaws that account for the glaring discrepancy between these results and the results of better designed studies that show 1% or less. A high number of ?false positive? responses are likely from students who may confuse anabolic steroids with steroid-based cortisone creams, birth control pills, formerly legal adrenal steroids like ?andro,? or performance-enhancing dietary supplements like creatine, amino acids or whey protein. And here?s the kicker: the YRBSS surveys aren?t given to middle-school kids! Only high school students are administered these surveys.

So, what stats exist for middle-schoolers? According to sources at the CDC, a very small number of states and cities conduct a Youth Risk Behavior Survey (YRBS) at the middle-school level. The one question about steroid use on these surveys is even more vague than the national survey question, and some localities have chosen to omit the question altogether. If the question is posed, the middle-school survey simply asks, ?Have you ever used steroids?? and the student merely circles ?Yes? or ?No.? False positives are highly probable because the term ?steroid? is not defined and words like ?anabolic? and ?illegal? are omitted. Even so, state-specific surveys don?t suggest a significant number of middle-school girls taking steroids. For example, the 2003 Maine YRBS reported that the ?current level of steroid use represents a statistically significant decrease in steroid use since 1997.?

How about national survey data for middle-schoolers? Although still subject to potential false positive responses, the University of Michigan?s annual Monitoring the Future study isn?t as ambiguous as the YRBS because it gives a brief explanation of what?s meant by the term ?steroid.? Not surprisingly, the 2004 study finds much lower rates of usage: only 1.9% of all 8th graders, male and female, admitted ever using steroids. While any adolescent steroid abuse is obviously a problem, does the study support claims of a burgeoning epidemic? Not at all ? in fact, the rate is exactly the same as it was back in 1991. Further, only 1% of the 8th grade girls admitted steroid use in the past year. ?I would certainly not say that there is an epidemic of use among females,? stated Dr. Lloyd Johnston, the study?s head researcher. ?The story was hyped in an AP story earlier this year, and it just keeps playing on.?

Even Dr. Harrison Pope, the Harvard psychiatrist and steroid researcher largely responsible for the public perception of a ??roid rage? epidemic, has flat out stated that ?steroid use by girls is extremely rare. There have been some large, anonymous studies [in which] there were surprisingly high figures [for girls]. You have to allow that many of the responses may be false positives. A girl may say, ?Oh, the dermatologist gave me steroids to treat poison ivy? where she is confusing corticosteroids with anabolic steroids, which are two entirely different substances.? In his most recent appearance before Congress, he debunked the idea that girls are injecting liquid steroids or downing oral tablets like candy corn, stating that ?even the 1% rate is still probably a substantial overestimate? and that a 0.2% rate is the most reliable estimate. ?I would strongly question the assertion that there is currently a widespread public health problem of anabolic steroid use by teenage girls or young women in the United States.?

If the experts on steroids aren?t buying the story, maybe the experts on kids might. I asked the social worker at a New York middle school ? a professional who works closely with ?at risk? children and is privy to their darkest secrets ? for a reliable opinion on the validity of the story. She shared the confidential results from a recent district-wide survey that showed that the percentages of 8th and 10th grade girls who?d ever tried steroids were less than 1 percent. Her view: the story was a joke.

So, have our middle-school daughters ditched Coach bags and bejeweled cell phones for Deca and D-bol? Are our little fourth graders forking over their milk money to brace-faced little dealers after chorus class? The truth is alarming indeed, but not because there?s an epidemic of bearded, balding, acne-scarred tweens tearing up the local Limited Too. There isn?t, and we should all have known that. What?s scary is how easily lazy reporters and self-serving opportunists can foment a wave of national hysteria in the absence of facts, evidence and common sense.