The Olympics women’s gymnastics tournament suggests that this is a sport coming to terms with its devastating recent history. Indeed, Simone Biles has been determined to make sure this is the case.

The superstar was assaulted by physician Larry Nassar, who pleaded guilty to criminal sexual misconduct in 2018, after sexually abusing more than a hundred young gymnasts under the guise of medical treatment. Biles decided to compete in Tokyo to force the Olympics to reckon with this history. “If there weren’t a remaining survivor in the sport, they would’ve just brushed it to the side,” she told Hoda Kotb in an NBC interview in April. “But since I’m still here, and I have quite a social media presence and platform, they have to do something.”

That’s a lot of pressure. On Monday, Biles posted on Instagram, “I truly do feel like I have the weight of the world on my shoulders at times.” Soon after, she pulled out of the team final and then the women’s all-around competition, where she was the defending gold medalist, to focus on her mental health.

The extent of the damage done, and not just to Biles, is mind boggling. It raises the uncomfortable question that hangs over the gymnastic competition in Tokyo: how could this happen? How could a medical doctor regularly sexually assault children, sometimes with a parent in the room, and get away with it for so long?

The answer is a combination of the sport’s culture and the long-standing and contested practice of the pelvic exam.

Many gymnasts had given over their lives to the sport, enduring regimented starvation diets, long hours of training and multiple injuries in the hopes of becoming the next Nadia Comaneci or Mary Lou Retton. Especially given their age, they were in no position to understand that the “treatment” they were receiving, as Nassar cupped a breast or penetrated a vagina with his fingers, was not a medical procedure.