Title IX of a law passed in 1972 bans discrimination on the basis of sex in schools receiving federal funds. It has received wide attention when applied to college sports for it mandates equality of treatment and numbers in arenas long dominated by males. Positive reforms, however, often have negative implications, some serious.

When the law was passed, only about 30,000 women played college sports. Today that figure has increased nearly 600 percent, something to celebrate. Alas, in this arena as in others, not all good things go together.

Three unanticipated problems arose as a direct result of Title IX. We’ve seen a crowding out of men’s teams to achieve gender parity in sports, and a huge increase in litigation over salaries and equal treatment of women coaches and athletic administrators. The third, and in my judgment most difficult and serious, problem is the increase in serious injuries among female athletes. More women are participating at higher levels of intensity for longer periods of time. The results too often are traumatic and disruptive.

All problems could have been predicted, but it was considered unseemly or boorish to address them so they were ignored or pretended away, a poor strategy for long haul projects of reform.

Title IX requires equal numbers of female and male participants, thus, one obvious result of the 1972 act is the elimination of men’s minor sports, such as lacrosse, and the addition of women’s teams. The large rosters carried by men’s football teams generate huge adjustment problems. Although the New York Times tells us there are 80 women’s football teams, among colleges this sport remains male. Hence, many men’s minor sports teams had to be eliminated to comply with Title IX. This is a clear, arithmetic implication of efforts to equalize participation by males and females.

In 2005, the U.S. Supreme Court ruled that those who complained of discrimination and suffered retaliation could sue for damages. This ruling may address injustice, but it is also a “come-and-get-it” hunting license for attorneys seeking contingency fees. Several coaches in California have been awarded millions of dollars, the highest being $6.6 million plus $2.5 in legal fees. Closer to home, former MSU basketball coach Robin Potera-Haskins has sued the school over alleged discrimination.

Disbanding male sports and settling lawsuits are disruptive and costly in time, emotions, and money. Some traditions and prejudices die hard, but ultimately, folks adjust to new conditions.

The third problem, serious injuries among women, is likely to grow worse and more troubling. The NY Times Sunday Magazine observed on May 11: “Everyone wants girls to have as many opportunities in sports as boys.” It then asked: “But can we live with the greater rate of injuries they suffer?” And suffer they do.

I’ve just returned from visiting my daughter Sara, who carries large scars on her reconstructed knee, results of a sports injury. I know the Times question involves life-changing events. In Sara’s case, this includes a prohibition on skiing and, hence, less incentive to visit Montana in winter.

Girls are psychologically and structurally different than boys. They are more prone to ignore pain and play when hurt—and more likely to get hurt. A 2007 Ohio State University study showed that high school girls are three times more likely than boys to get concussions when playing basketball.

This pales in comparison with ACL tears, a disruptive and often lifetime debilitating knee injury. In sports played by men and women, basketball, soccer, and volleyball, ACL ruptures are approximately five times as frequent among girls, but drops as they become college-age women.

The medical reality of substantial and life changing injury associated with serious and intense female participation in sports is indisputable. It is also independent of our wishes and immune to politically correct considerations. The physical differences between males and females are expressed in accident rates. Unless the injuries are prevented by training or protective gear, those of us who support equal sports opportunities for girls and women have an ethical medical problem it is cowardly and irresponsible to ignore.