Simone Biles at Tokyo: The Twisties and the Right to Withdraw

Timeline

1. Jul 27, 2021Biles performs a vault with fewer twists than planned in the team final and withdraws; the U.S. wins silver.
2. Jul 28, 2021She withdraws from the individual all-around final.
3. Jul 30–31, 2021She withdraws from the vault, uneven bars and floor finals.
4. Aug 3, 2021She returns to win bronze on the balance beam.
5. Sep 15, 2021Biles testifies to the Senate about the Nassar abuse.
6. Aug 2024Biles wins three gold medals and a silver at the Paris Olympics.

The ethical issues

• Safety: performing high-risk skills while disoriented.
• Mental health: whether it is a legitimate reason to withdraw.
• Team obligations: duty to teammates against duty to oneself.
• Public pressure: expectations placed on a star athlete.
• Media and fans: how critics and supporters treated her decision.

Stakeholders

Stakeholder	Interests & obligations
Simone Biles	Her physical safety, mental health and career.
U.S. teammates	Team results and their own opportunities.
USA Gymnastics and the USOPC	Athlete welfare and medal goals.
Broadcasters and sponsors	Audience and commercial expectations.
Young athletes	The example set for speaking about mental health.
Fans and commentators	Their expectations and the tone of public debate.

The case

By 2021, Simone Biles was the most decorated gymnast in history. She had won four Olympic gold medals in 2016 and many world titles, and several skills bear her name.^[1] She was also one of the survivors of USA Gymnastics doctor Larry Nassar’s abuse.^[1]

At the Tokyo Olympics, delayed a year by the pandemic and held without spectators, Biles was favored to win at least four of the six women’s gold medals.^[1]

Background

Biles’s standing in the sport made the decision especially visible. She is the originator of the most difficult skills on women’s vault, balance beam and floor exercise, and so far the only gymnast to attempt them.^[1] Her Tokyo teammates in the team competition were Sunisa Lee, Jordan Chiles, who trained at Biles’s club, and Grace McCallum.^[1] Wikipedia describes the twisties as a temporary loss of proprioception, the body’s sense of its position, during twisting elements.^[1]

In the beam final, Biles used a scaled-down routine with an easier double pike dismount and won bronze behind China’s Guan Chenchen and Tang Xijing.^[1] She was not the only Olympian in Tokyo to speak openly about mental health. Others did too, part of a broader shift toward athletes putting their health ahead of performance.^[1]

The rules and governance

Once Biles withdrew, her teammates had to adjust in the middle of the team final, and they won silver.^[1][2] Biles made the call after leaving the floor with a trainer, and explained it in her own words.^[1][2][3]

The context of USA Gymnastics mattered. Biles was a survivor of an abuse scandal in which, she later testified, “the entire system” had failed athletes.^[1]

The team final

On July 27, 2021, Biles opened the team final on vault. She planned two and a half twists but completed only one and a half, landing awkwardly. She left the floor with a trainer, returned, and withdrew from the rest of the competition. Her teammates finished with silver behind the Russian team.^[1][2] Afterward, she said: “I have to focus on my mental health,” and that she did not want to risk her health and well-being.^[2]

At the news conference that night she described the day in detail. After a morning workout and a wait of about five and a half hours, she said, “I was just like shaking, could barely nap. I’ve just never felt like this going into a competition before.” On the competition floor, “I was like no, mental’s not there.”^[3] On the vault: “I was trying a two and a half, and I ended up doing a one and a half. Just got a little bit lost in the air.”^[3] She said she was not injured and stepped back “because I didn’t want to do something silly out there and get injured.” She also “didn’t want to risk the team a medal for kind of my screwups.” When teammates told her she looked fine in warmups, she answered, “I can’t risk a medal for the team, so I need to call it.”^[3] She credited them with the silver: “they did it without me.” Her advice to others was to “put mental health first,” adding that “it’s OK sometimes to even sit out the big competitions to focus on yourself.”^[3]

She later explained that she had “the twisties,” a mental block in which gymnasts lose track of where they are in the air during twisting skills. In a sport where athletes spin several meters above the floor, that can lead to serious injury.^[1][4] She said she had experienced it on vault and floor before, but this was the first time on uneven bars and beam.^[1] In Instagram posts three days after the team final, she said the problem had “randomly started happening” the morning after qualifying and called it “the strangest, weirdest feeling.” She said she “literally can not tell up from down” and had “no idea” how she landed her vault on her feet.^[4] She posted, then removed, practice videos showing her failing to complete twists on uneven bars dismounts.^[4] In her absence, teammate Sunisa Lee won the all-around title.^[4] Unlike her earlier experiences, the twisties were now affecting all four apparatuses. “It’s honestly petrifying trying to do a skill but not having your mind & body in sync,” she wrote. “10/10 do not recommend.”^[6] USA Gymnastics announced each withdrawal in turn, and a British gymnast took her place in the floor final.^[6]

Further withdrawals and return

Biles withdrew from the all-around final on July 28, and later from the vault, uneven bars and floor finals.^[1][3][5][6] On August 3, she returned for the balance beam final, using a dismount without twists, and won bronze. She said the medal meant more to her than her golds.^[1] She also revealed that her aunt had died unexpectedly two days before the beam final.^[1]

Reaction

Many athletes, mental health advocates and fans praised her for prioritizing her safety and speaking openly. She cited Naomi Osaka, who had withdrawn from tennis tournaments earlier that year, as an inspiration.^[1] Some commentators criticized her, saying she had quit on her team.^[1] Some called her a “quitter” or said she was selfishly denying another athlete a chance to compete. Russian state-owned media attacked her with racist, sexist and transphobic comments, and some openly accused her of being a drug cheat because of her therapeutic use exemption for ADHD medication.^[1] Other gymnasts defended her and shared their own experiences with the twisties.^[1]

In September 2021, Biles testified to the Senate that “the entire system” had enabled Nassar’s abuse.^[1] She returned to competition in 2023 and won three gold medals and a silver at the Paris Olympics in 2024.^[1]

Aftermath

Biles was named to the 2024 Olympic team with Jade Carey, Jordan Chiles, Sunisa Lee and Hezly Rivera.^[1] The United States won team gold ahead of Italy, with Biles competing on all four apparatuses.^[1] She fell in the beam final and did not medal, the first time in nine Olympic or World beam finals that she missed the podium.^[1] At the closing ceremony she took part in the handover of the Olympic flag to Los Angeles. In 2025 she was named Laureus World Sportswoman of the Year for the fourth time, having won Comeback of the Year in 2024.^[1]

The core dilemma

Biles faced a choice in which performance, safety and mental health were bound together. Her withdrawal changed her team’s chances and disappointed fans and sponsors. What does an athlete owe teammates, and who should decide when it is unsafe to continue?

Competing values

• Personal safety vs. team obligation: protecting oneself against contributing to the team.
• Privacy vs. public interest: an athlete’s health against fans’ desire to understand.
• Resilience vs. self-care: pushing through against recognizing limits.
• Individual vs. institutional responsibility: the athlete’s choice against the system’s pressures.

Strongest arguments

For her decision: the twisties posed a real risk of catastrophic injury. Her withdrawal allowed teammates to compete instead and to win a medal. Speaking openly reduced stigma for other athletes.

For her critics’ concerns: teams depend on members to compete when they can, and elite sport involves performing under pressure. Some argued that more support should have been available before the Games to prevent a crisis.

Applying the frameworks

Ethics of care

The care lens centers Biles’s safety and wellbeing, and the support her teammates and coaches gave her. It asks what an athlete owes her team when her health is at risk, and what the team owes her.

Rights

A rights lens emphasizes an athlete’s right to make decisions about her own body and safety, free from coercion by coaches, federations, sponsors or public opinion. Her history as a survivor of institutional abuse makes that autonomy especially significant.

Virtue

Virtue ethics asks what courage means in sport: competing through fear, or recognizing a dangerous limit and saying no. It also considers honesty and humility in explaining the decision publicly.

Walk it through: the Simple Decision Model

1. Spot the issue. You are the U.S. team’s head coach when your top gymnast tells you after one vault in the team final that she feels lost in the air. The stakeholders include the athlete, her teammates, USA Gymnastics, sponsors and fans. The codes in play are competition rules on substitutions and the federation’s athlete-safety policies.
2. Gather facts. What is the athlete telling you? What do the medical staff say? Can teammates adjust their routines safely?
3. Test options. Options: (a) encourage her to continue; (b) support her withdrawal and adjust the lineup; (c) support withdrawal and arrange medical and mental health support. Weigh team success against the athlete’s safety.
4. Check codes and law. Would you accept this decision if the athlete were your own child? Are you responding to her needs, or to outside pressure?
5. Decide and document. Record the decision and the medical advice.
6. Communicate and follow up. Communicate the decision with the athlete’s consent, protect her privacy and support her teammates.

What’s settled and what’s contested

• Settled: the timeline of withdrawals and her beam bronze; her later Paris success.
• Contested: how far mental health should excuse withdrawal; what teams and federations should do differently.

Why this case matters

Biles’s withdrawal became a defining moment in the conversation about athletes’ mental health. It shows that, in some sports, mental and physical safety cannot be separated.

Key terms

Agency

An athlete’s ability to make decisions and act independently about their body, career and voice.

Duty of care

The responsibility of coaches, organizations and institutions to protect the health, safety and well-being of those in their charge. It is not a license for total control.

Framing

How the choice of angle, language and emphasis shapes the way a story is understood.

Consent and autonomy

Whether people have agreed freely and with full information, and whether their right to make their own choices is respected.

Definitions from the Ethics Cases glossary.

Discussion questions

1. Biles said continuing could have caused serious injury. How should athletes, coaches and doctors decide when to withdraw?
2. Did Biles owe her teammates a duty to keep competing? How should duty to a team be balanced against personal safety?
3. Why do you think some commentators criticized her? Were any of those criticisms fair?
4. How did Biles's experience of the Nassar scandal and the pressure of expectations shape the way her decision was understood?
5. What should Olympic teams do to support athletes' mental health?

Sources

1. Simone Biles — Wikipedia
2. Simone Biles says 'I have to focus on my mental health' after pulling out of team final — BBC Sport
3. Read What Simone Biles Said After Her Withdrawal From The Olympic Final — NPR
4. What are the 'twisties?' Simone Biles explains gymnastics struggle at Tokyo Olympics — NBC News
5. Simone Biles withdraws from vault, uneven bars at the 2021 Olympics — ESPN
6. Simone Biles withdraws from floor exercise final at Olympics — USA Today