Mike Birbiglia, a comedian, has a great bit to say about gymnastics. After a long bout of twisting and turning, gymnasts must salute judges with grace. This salute isn't just a tradition or custom, it is a requirement for the sport. If you don't telegraph it, you could lose points.Simone Biles, the great gymnast of all time, didn't have it all on Tuesday. In the first rotation, she had the lowest score of all Team USA athletes. After briefly leaving the floor, she returned in her sweatsuit and indicated that she was finished for the day. USA Gymnastics circulated a statement saying that Biles had withdrawn from team competition because of a medical issue. She was to be evaluated daily to determine her medical clearance for future competitions.Biles broke down at a press conference a short time later. She said that there was no injury to her body, but that the pressure had become too intense. I could barely sleep, and was shaking. Biles stated that she had never felt this excited about entering a competition. I wanted to have fun and go out there. The warmup in the back went slightly better. Then, when I got out there, I realized that I had mental issues. This could have caused a gymnast to lose control of their bodies if they don't keep track of how many twists she has done. It is dangerous to have neither awareness nor control in a sport that is all about awareness.A further update was made Wednesday by USA Gymnastics. Biles will not compete in Thursday's all-around competition, which she hasn't lost since 2013. These are remarkable moves by an athlete who has revolutionized the sport at just 24 and is now considered perfection. Biles' admission that the pressure was too high is extraordinary. This is also a remarkable vindication of how mental health conversations have changed over the past decade.We have seen significant and positive changes in how mental health is being discussed in the public sphere. Today's newsrooms have made significant changes to their coverage of mental health issues. They have also changed their style guides to reduce stigma. Celebrities have spoken out about their experiences and invited us to share ours. Employers are now learning how to accommodate employees with mental health needs. There is now a common language for talking about mental health.This lexicon is evident throughout the Biless statement. She stated that she must focus on my mental well-being and not compromise my health. This is the kind statement she can now make because of the fact that anxiety is being de-stigmatized. Although Biles was criticised for her withdrawal, she also received a lot of support for sharing what is happening.Biles is not the only one. She said that Naomi Osaka, a tennis player, inspired her to withdraw from the French Open in May. Osaka insists that Osaka hold press conferences which she claims bring doubt into her mind. These press conferences are detrimental to her mental health and cause her anxiety.These moves by Osaka and Biles reveal the limitations of focusing only on stigma. It is not enough to just name the problem. Osaka is consistent in her assertion that the press conference format is exploitative and only benefits tennis organizations that can leverage a star's presence for TV time and, therefore, ad revenue.Biles, however, has made it clear that she doesn't like USA Gymnastics. This is an organization that has been in turmoil for many years. Biles said last month that she does not represent USA Gymnastics. Why should she? American gymnasts, including Biles, have voiced their dismay at the inability of the organization's protection of athletes following the Larry Nassar abuse scandal.Many things have changed since America's last love affair with Biles at Rio de Janeiro's 2016 Olympics. The first of many stories about Nassars abuse was published three weeks after the Olympics were over. Biles revealed to Vogue last year, that she was depressed during that time. She said that she used to sleep so much at one time because it was the only way for her to die without causing harm to herself. Biles then spoke out publicly in 2018 about her experience as one of hundreds of women who were abused by Nassar. She tweeted that it was much harder to say those words loudly than to write them down.Biles, the sole Nassar survivor of the US women's team at the Tokyo Olympics 2020, is Biles. She is the key to USA Gymnastics moving beyond the scandal. It's not wrong to still win medals. She is unquestionably the most famous US Olympian. She is under immense pressure to make it seem like she has moved on from her trauma. Vogue spoke to her that she felt that America wanted her to be perfect. You feel like America's sweetheart when an American wins the Olympics. It's like she was feeling let down by the way this happened to America's sweetheart.Pressure is a real thing. Anxiety is a real thing. It's a relief to hear Biles say this. It's a relief that Biles can openly tell us that she prioritizes her mental health. We can also understand and celebrate this. We have also learned that stigmatizing mental health is only a temporary solution. USA Gymnastics has not yet developed a plan to address its problems.Biles has not spoken much on social media since her return. On Wednesday, Biles retweeted a screenshot from an anonymous gymnast who defended her decision. She also expressed anger at those questioning her toughness. The statement said that we are talking about the same girl, who was molested by her coach throughout her childhood and teenage years. The statement railed against the joke that an organization protected her predator for years instead of her and her team-mates.Biles was greeted by a lot of well-wishers, including two former Olympians.