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It's hard to be a champion. It may be even harder if you're a Black woman

Doctors say Black women in high-profile positions face disproportionate pressure and stress.
Tokyo 2020 Olympic Games: Day 4
Experts say that Black women like Simone Biles face extraordinary amounts of pressure, and many look at her decision to prioritize her mental health as a positive turning point.Mustafa Yalcin / Anadolu Agency via Getty Images

When Simone Biles withdrew from some Olympic events in Tokyo, citing mental health pressures, it shocked the world, but many found the decision particularly powerful for one reason: Biles is a Black woman.

And Black women haven't historically felt that they were able to take space for mental health, experts told TODAY.

"Simone Biles showed us that there are choices," said Lisa Orbe-Austin, Ph.D., a psychologist and coach who focuses on leadership development and career advancement. "You can still be the greatest of all time and choose something different, even in a high-profile moment."

That hasn't always been the case, she explained.

"The adage (for Black women) is that you need to work three times as hard to get half as much," Orbe-Austin said. "All these different frameworks that we're taught are that if you don't show up to the nth degree, we don't get a seat at the table — which, a lot of times is true, because of discrimination and opportunities that don't come our way. But it also perpetuates this need for us to perform at these extreme levels to just get noticed, which is highly problematic for us long-term."

Black women in high-profile positions face a disproportionate amount of pressure, which can affect both mental health and physical health, said Dr. Uche Blackstock, M.D., a physician and the founder of Advancing Health Equity, which is focused on eliminating systemic racism in the health care industry.

"Black women, especially in the public eye or in leadership positions, have to face both racism and sexism," she told TODAY. "We feel like we're under a microscope to perform, and a lot of times we over-perform. You're doing a great job, but it's at the risk of your mental health. There are also really unequal and unrealistic expectations of you."

While Biles' teammates were supportive of her decision to step back, not everyone agreed. Critics described her as "weak" and "a quitter." On social media, fans, including many politicians and activists, pointed to that criticism as further evidence that Black women have historically been afforded less empathy than others when it comes to self-care.

Some drew comparisons to Naomi Osaka's decision to withdraw from the French Open earlier this year.

"They are at the top of their game, but folks think nothing of working Black women until they're beyond exhausted," political strategist Atima Omara said on Twitter.

"It's disgusting how Black women in particular are held to these impossible standards," wrote activist and author Keah Brown on Twitter. "We can’t feel anything but grateful, have to go out of our way to make sure everyone else is good and if we don’t meet these expectations we’re weak? That’s bulls---. Simone Biles deserves better."

The mental health of high-performing athletes has been in the spotlight since Osaka revealed that she was stepping down to prioritize her mental health and revealed that she had suffered depression. Fellow tennis star Serena Williams spoke up in support for Osaka, saying, "I know what it's like." Last month swimmer Simone Manuel revealed that she suffered from depression and anxiety after dealing with a condition called overtraining syndrome. Experts say young Black athletes like these are helping spur a mental health revolution.

Biles in particular is being credited with helping break down the harmful stereotype of the "strong Black woman."

"I think a lot of Black women fear penalization for taking time out," Orbe-Austin said. "Several people were saying, 'Well, we don't have the space to take time.' And that's ridiculous. (Biles) is on the highest stage. She has to perform at the highest level. But even at the highest end and on the biggest stage, you need to be able to take care of yourself."

Blackstock added that, while it's a good step forward, it's not enough for athletes to speak up; they need institutions to back them up.

"We need to think about how organizations can encourage a culture where athletes feel like they can make this choice," she said. "In organizations where Black women are leaders, ensuring that they can come to work as their full selves, that they can be expressive and talk about what they need, and then make sure that they have the resources to lead and the resources to be empowered.

"Hopefully this is an opportunity for organizations to do that inner work and ask, 'Are we supporting Black women within our organization? Because we know they are dealing with an extra layer of stress, because they are Black and because they are women.'"