Heather Anderson was a healthy, active young woman who played team sports since she was 5.
She was known for wearing a bright pink helmet so her mother could spot her on the field, where she excelled at professional rugby and Australian rules football.
But Anderson died by suicide last November at 28.
“It’s a tough way to see your child die, it’s tough to see your child die anyway,” her father Brian Anderson told the Australian Broadcasting Corporation.
“But suicide causes you to re-examine everything, to look at every interaction,” he added.
An autopsy revealed that his daughter suffered from chronic traumatic encephalopathy, or CTE, making her the first female athlete known to have the concussion-related brain disease.
“While we’ve been finding CTE in males for quite some time, I think this is really the tip of the iceberg,” Michael Buckland, founder of the Australian Sports Brain Bank, told the ABC.
“It’s a real red flag that now women are participating [in contact sports] just as men are, that we are going to start seeing more and more CTE cases in women.”
Buckland, who is also an associate professor of neuropathology at the University of Sydney, co-authored a report on Anderson’s CTE for the journal Acta Neuropathologica.
Women and girls worldwide are increasingly encouraged to participate in contact sports: In 2022, almost 1 million women and girls played some kind of contact sport in Australia, researchers wrote in the Conversation.
But female athletes are more likely to suffer from concussions and to have more severe symptoms, according to researchers.
“Female athletes appear to sustain more severe concussions than male athletes, due in part to a lower biomechanical threshold tolerance for head impacts,” wrote the authors of a 2020 study in the Orthopaedic Journal of Sports Medicine.
“Additionally, concussions may … [result] in worse symptoms and amenorrhea [absence of a menstrual period]. Although females are more likely to report concussions than males, underreporting still exists and may result in concussions going untreated,” the authors wrote.
CTE is a brain disease found in people with a history of repetitive head impacts that can occur in contact sports, military service, employment as a first responder or other activities that involve repeated head impacts, according to the Boston University CTE Center.
These can include concussions that cause symptoms as well as “subconcussive” hits that don’t cause symptoms, such as heading the ball in soccer. A hundred years ago, boxers with CTE were referred to as “punch drunk.”
According to a recent report from the BU CTE Center that examined 376 former NFL players, 345 of them were diagnosed with CTE — a stunning rate of almost 92%.
And though the disease has been studied in men for years, women have typically been excluded from CTE studies.
“This is representative of a broader trend in sport and exercise science research to exclude women from studies because their bodies are perceived as more complex than men’s and thus more difficult to accommodate in testing,” researchers wrote in the Conversation.
That history of exclusion from studies makes the recent finding of Anderson’s CTE all the more important.
“Despite the fact that we know that women have greater rates of concussion, we haven’t actually got any long-term evidence until now,” study co-author Dr. Alan Pearce, of La Trobe University, told the ABC. “So this is a highly significant case study.”