Simone Biles is the most decorated gymnast in history, with 41 world and Olympic medals to her name.
But the moment that may define her most did not happen on a podium. It happened when she walked away from one.
At the 2021 Tokyo Olympics, she stepped back from competition to protect her mental health, setting off a global conversation that reached far beyond sport.
What followed was a shift in how the world thinks about athletes, pressure, and the courage it takes to ask for help.
One decision made under the brightest spotlight in sport became one of the most important mental health moments of the modern era.
Simone Biles: Fast Facts
Before getting into the story behind the decision, here is a quick look at just how much Simone Biles has accomplished and why her Tokyo moment carried the weight it did.
| Olympic Medals | 11 across three Games |
| World Medals | 30+ world championship medals |
| Tokyo Withdrawal | Withdrew from 4 individual finals, returned to win bronze on beam |
| Presidential Honor | Youngest living Medal of Freedom recipient |
| Paris 2024 Return | 3 gold, 1 silver on comeback |
These numbers tell one story. What happened in Tokyo tells another, and it may be the more important one.
The Turning Point: Tokyo Olympics
No moment in recent sports history forced a harder conversation about athlete mental health than what unfolded across just a few days in Tokyo in the summer of 2021.
Withdrawing From Events
When Biles competed at the Tokyo Olympics, she withdrew from most of her events, citing the twisties, a condition that was likely the result of a combination of mental stress and pressure building in the lead-up to the Games.
The twisties cause athletes to lose control of their bodies mid-air, making a safe landing impossible and increasing the risk of serious injury during high-level competition.
Biles described the weight of expectation as overwhelming, saying that whenever she got to that level of stress, it reached a tipping point she could no longer push through.
Simone’s Message
Her words after stepping back were honest and unguarded.
She said plainly that she had to do what was right for herself, focus on her mental health, and not put her wellbeing at risk.
She also admitted she no longer trusted herself the way she once had, was more nervous in competition, and had stopped having fun in the sport she had given her life to.
On social media, she reflected that the support she received had helped her realize she was more than her accomplishments, something she said she had never truly believed before.
Simone as a Mental Health Advocate
Stepping back in Tokyo did not end Simone’s story. For millions of people around the world, it was where her most important work began.
From Athlete to Advocate
Simone never set out to become a mental health advocate and has admitted that advocacy was never her goal when she stepped away in Tokyo.
But the impact was immediate.
Coverage of her decision generated more social media engagement than some of the biggest news stories of that year, and Google searches related to mental health hit their highest peak in two months on the day she stepped back.
In July 2022, she became the youngest living person to receive the Presidential Medal of Freedom, with the White House recognizing her as a prominent advocate for athlete mental health and safety.
Continuing Conversations
Five years on from Tokyo, Biles told CNN Sports that the moment got her the therapy she deserved and that she remains in therapy to this day.
She has also credited fellow athletes like Naomi Osaka and NBA player Kevin Love for helping her feel less alone in speaking publicly about mental health.
She has continued to stress that asking for help is not something that comes naturally, but that leaning on a support system is something people cannot afford to skip.
Impact on Sports Culture
What Simone started in Tokyo quietly reshaped the way the sports world thinks about strength, openness, and what it truly means to compete at the highest level.
Changing Athlete Perception
For a long time, athletes were expected to push through pain, embody resilience, and project an image of invincibility, with any sign of emotion treated as weakness.
Simone’s decision began to dismantle that expectation in real time.
Her openness challenged the long-standing narrative that athletes must sacrifice everything, including their mental health, to succeed, and reminded the world that the mental strain of performing on a global stage carries very real consequences.
Her experience also highlighted how attitudes toward athlete mental health remain divided, with some still viewing mental health struggles as an excuse rather than a genuine condition requiring care.
Encouraging Others to Speak Up
Michael Phelps, the most decorated Olympian of all time, said he was deeply inspired when Biles and Naomi Osaka spoke publicly about their mental health, describing the experience as freeing for anyone willing to open up.
Fellow gymnasts, including Jade Carey, credited Biles directly with helping them step back and recognize that their minds needed the same level of care as their bodies.
Together, their voices have helped pave the way for future generations of athletes to approach mental health with the seriousness and compassion it deserves.
Lessons Beyond Sport
The conversation Simone started was never just about gymnastics. It reached into workplaces, classrooms, and everyday life in ways that continue to hold weight today.
Breaking Stigma and Making Mental Health a Priority
For too long, people felt pressure to hide mental health struggles out of fear of being seen as weak or uncommitted.
Research shows that when athletes speak openly, it has a measurable positive impact on public perceptions of mental illness. The media play a key role in shaping those perceptions, with positive portrayals helping to set the standard for how society responds.
Biles’ decision forced mental health to the forefront of conversation for athletes and everyday people alike. When leaders speak openly about mental wellbeing, it creates safer, more supportive environments in workplaces and schools. If mental health matters enough to come before a gold medal, it can matter just as much in daily life
Scientific and Psychological Perspectives
Science has long supported what Simone showed the world in real time. Mental health is not separate from performance or physical wellbeing: it is central to both.
Stress and High Performance
Research shows that around 35% of elite athletes experience mental health concerns, with burnout, depression, and anxiety among the most commonly reported issues.
Studies point to a wide range of stress triggers in elite sport, including competitive pressure, defeat, and relationship strain, all of which carry the potential to contribute to serious mental health problems.
Even athletes who receive dedicated psychological training continue to be affected by stress, with research confirming that pressure negatively impacts performance even at the Olympic level.
Mental vs Physical Health
| Source | Key Point |
|---|---|
| CDC | Mental and physical health are equally important, and depression can raise the risk of serious conditions like heart disease and stroke. |
| Brain and Body Research | Psychological stress directly affects sleep, appetite, inflammation, and immune response through neurological, hormonal, and immune pathways. |
| World Health Organization | Health is defined as a state of complete physical, mental, and social wellbeing, meaning mental health has always been part of the full picture. |
Public Response and Legacy
The reaction to Simone’s decision was loud, divided, and ultimately historic. Few moments in modern sport generated the kind of response that followed her steps off the competition floor in Tokyo.
Data showed that her withdrawal generated more public interest in mental health than either the Prince Harry and Meghan Markle interview with Oprah or Naomi Osaka’s French Open withdrawal.
The response was deeply polarizing, with tens of thousands of social media comments split between those praising her courage and those suggesting she had quit on the biggest stage in sport.
But over time, opinion shifted firmly in her favor.
Biles reflected that Tokyo gave athletes the opportunity to open a broader stage for the conversation, and that athletes now take mental health more seriously as a result.
Her Paris 2024 comeback, where she won three gold medals and a silver, brought that story full circle.
The Bigger Win: Simone Biles and the Mental Health Movement
Simone Biles changed more than gymnastics.
By choosing her wellbeing over a medal on the world’s biggest stage, she gave millions of people permission to do the same in their own lives.
Whether or not she returns to compete, it will likely be what she has done off the floor to prioritize her mental health that truly defines her legacy as the greatest of all time.
That conversation is still going, and she started it.
Frequently Asked Questions
Why Did Simone Biles Withdraw from The Olympics?
She stepped back from competition to protect her mental health after experiencing the twisties, a dangerous mind-body disconnect unique to gymnasts.
How did the Public React to Her Decision?
Reactions were mixed but largely supportive, sparking one of the biggest global conversations about athlete mental health in sports history.
How has Simone Influenced Mental Health Awareness?
She inspired athletes and everyday people worldwide to prioritize mental wellbeing over performance pressure without shame.
