At the start of 2018, things were grim for USA Gymnastics.

The organization that oversees one of the country's most popular Olympic sports was at an all-time low following a massive sexual abuse scandal. It faced shutdown by U.S. Olympic officials. Lawsuits were piling up. Major sponsors, such as AT&T and UnderArmour, had fled.

And perhaps the biggest critics were former gymnasts themselves, who began to speak more openly about a problematic culture in gymnastics that had long been overshadowed by years of Olympic success.

Now, six years later, the overhaul has been significant. No U.S. team is better poised for success in Paris than the women's gymnastics squad. The five-member team, led by 27-year-old Olympic veteran Simone Biles, is expected to win several gold medals, including the team all-around.

"People turned a blind eye to the abuse," said Dominique Dawes, a member of the 1996 Olympic squad that won the team all-around gold medal at the Summer Games in Atlanta. "People talked about the toxic culture, they talked about the abuses. But I think people were just in awe of what we were able to accomplish."

Now, the culture at USA Gymnastics has improved, Dawes and others said. A new organization oversees athlete safety and competitors are more empowered to raise concerns. Yet there may still be more progress needed before the turnaround can be considered complete.

"The thing is, I think there will always need to be work that needs to be done," Dawes said.

Hitting rock bottom

In January 2018, the organization's longtime team doctor Larry Nassar had just been sentenced to spend the rest of his life in prison after hundreds of young female gymnasts came forward to say he had used his position to sexually assault them.

The abuse scandal had involved others besides Nassar, as first reported by the Indianapolis Star in August 2016 during that summer's Olympic Games in Rio de Janeiro.

Victims of the abuse said that the organizational culture at USA Gymnastics was partly to blame for the abuse.

"Emotional abuse is rampant, and physical abuse is there. Sexual abuse is a byproduct of what happens when that is the culture," said Jessica Howard, a rhythmic gymnast who competed with USA Gymnastics in the late 1990s and early 2000s, speaking in an interview with CBS in 2017.

That problematic culture permeated the organization for years, former gymnasts have said. For decades, the women's program at USA Gymnastics was run by the legendary coach Marta Karolyi, who steered teams to repeated gold medals even as gymnasts left feeling that the success had come at personal cost.

The Karolyi regime was characterized by grueling training schedules and pressure to perform through serious injuries. Under the guise of protecting gymnasts' focus on the Olympics, emotions were tightly controlled, especially at meets, said Dawes. "We weren't allowed to look at our competitors. We were actually told to look away. We never cheered for one another," she said.

Gymnasts were required to attend training camps at the Karolyi gymnastics facility in Texas, where much of Larry Nassar's abuse took place, according to victims. Parents were not allowed to accompany their daughters. Access to food was strictly monitored, leading some of those who attended, including Biles, to sneak into the cafeteria at night in order to eat.

"Under Marta, the girls were systematically isolated from parents, siblings, real medical doctors and their own coaches, leaving them vulnerable to daily abuse and starvation," said former gymnast Rachael Denhollander, the first woman to publicly accuse Nassar, in a post this month on the social media site X.

Karolyi retired right after the 2016 Olympics, just before the Nassar allegations were widely publicized. She has long denied any knowledge of the abuse.

A 2021 legal settlement helped to turn the page, as has hiring former gymnasts to leadership roles

In 2021, USA Gymnastics settled a lawsuit from the victims of Nassar's abuse by agreeing to pay out $380 million dollars. The organization also agreed to assign a board seat to a representative of survivors of abuse.

"The survivors gave up money to get that," lead victims' attorney John Manly told NPR after the settlement in 2021. "They fundamentally want to change the culture of money and medals being the only thing that matters, because that way, they can protect other women, girls, boys and men from this happening to them."

Two of the major changes at USA Gymnastics have been to decentralize control of the women's program and to involve more former gymnasts in its administration.

In 2022, it hired three team officials to fill what had once been a single leadership position held for years by Marta Karolyi. Two of those three new officials — technical lead Chellsie Memmel and strategic lead Alicia Sacramone Quinn — are former Olympic gymnasts.

In a press conference last month ahead of the Olympic Trials in Minneapolis, Quinn openly acknowledged how gymnasts like herself were once discouraged from raising concerns about their health.

"Like, I know I wouldn't have gone, 'Hey, I don't think I can do 45 beam routines today,'" Quinn said.

She and other officials have worked to improve communication between USA Gymnastics and its athletes, she said.

"I think it's nice for us because we know where they stand. And I think it's great for them because we're going to respect their knowledge of their own bodies and what they're capable of doing," said Quinn.

Age is a factor, and Biles, at 27 years old, leads by example

Quinn and other gymnastics officials have praised the example set by team leader Biles, who at 27 years old is older than most top gymnasts.

She is routinely seen at meets cheering for competitors and comforting teammates who have hurt themselves. And her years of experience — including her withdrawal from several events at the Tokyo Olympics in 2021 over concerns about her mental health — have empowered her to speak more candidly with coaches and USA Gymnastics, officials and Biles herself say.

"I think now athletes are a little more in tune, and we trust what our gut is saying. We take mental health a little bit more serious," Biles said after the trials.

Female gymnasts are among the youngest of Olympic athletes. The youngest competitor on all of Team USA — which counts nearly 600 athletes in total — is the gymnast Hezly Rivera, who just turned 16 last month.

There are some promising signs of a turnaround.

When the Olympic trials wrapped in Minneapolis earlier this month, one big story was the gymnast Suni Lee's comeback from a debilitating kidney condition that had sidelined her last year.

When asked who helped most with her comeback, Lee named the USA Gymnastics team doctor.

"She was constantly checking up on me, making sure that I was OK," Lee said. "like reminding me of basically my worth and just telling me to never give up because she knew that I would be so disappointed with myself if I gave up with this dream."

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