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In September 2016, a hacking group published stolen medical records from the World Anti-Doping Agency's database, targeting elite athletes whose records had been accessed without authorisation. Among the names was Simone Biles, who had just won four gold medals at the Rio Olympics and was, at the time, the most decorated gymnast on the planet.
The records revealed that Biles had tested positive for methylphenidate, a stimulant medication prescribed for ADHD and a substance listed on the WADA prohibited list. The implication, whether the hackers intended it or not, was clear: here was evidence of something that needed explaining.
Biles did not allow anyone else to set the terms of that explanation. She responded the same day, publicly, on social media, with a statement that was direct, undefensive, and precise.
"I have ADHD, and I have taken medication for it since I was a kid. Please know, I believe in clean sport, have always followed the rules, and will continue to do so. Having ADHD and taking medicine for it is nothing to be ashamed of, nothing that I'm afraid to let people know."
That statement matters. Not because it is remarkable that someone defended themselves, but because of how she did it, and what her doing it at the level of global visibility she occupied meant for the millions of people living with ADHD who read it.
Simone Biles is an American artistic gymnast born in 1997 in Columbus, Ohio. She is the most decorated gymnast in World Championship history and one of the most decorated Olympic athletes in the sport. Across four Olympic Games, she has won multiple gold, silver, and bronze medals, making her by any measure one of the greatest athletes of her generation.
Her performances are characterised by a combination of power, precision, and a capacity for difficulty that has seen multiple skills named after her in the gymnastics code of points. The Biles, the Biles II, the Yurchenko double pike: these designations reflect elements so technically demanding that naming conventions required it.
She has also, particularly since 2021, become a significant public figure in conversations about mental health in elite sport, having publicly withdrawn from several events at the Tokyo Olympics to protect her mental wellbeing, a decision that prompted global discussion about the pressures placed on athletes and the relationship between performance and self-care.
The hacking group that published WADA data in 2016 accessed records of athletes who had been granted Therapeutic Use Exemptions, permissions to use substances otherwise prohibited in competitive sport because they were medically necessary. Biles was among dozens of elite athletes whose TUE records were made public without their consent.
What the records revealed was that Biles had tested positive for methylphenidate, had a valid TUE authorising its use, and had therefore competed within the rules of her sport. Every element of her situation was documented, transparent, authorised, and compliant with anti-doping regulations. There was no cover-up. There was no violation. There was a young woman with ADHD taking medically prescribed medication under official authorisation.
What the publication of those records implied, in the context of an anti-doping hack, was the suggestion of impropriety where none existed. The hack's framing was designed to invite suspicion. Biles's response removed the ground for it.
The statement Biles made in response is worth looking at carefully because its construction is precise in ways that matter clinically, legally, and culturally.
She confirmed the diagnosis directly: "I have ADHD." She confirmed the medication history without apology: "I have taken medication for it since I was a kid." She affirmed her relationship to clean sport without hedging: "I believe in clean sport, have always followed the rules, and will continue to do so." And she named, explicitly, what she was refusing to do: "Having ADHD and taking medicine for it is nothing to be ashamed of, nothing that I'm afraid to let people know."
The last sentence is the one that carried the furthest. Shame is one of the most consistently documented experiences of people with ADHD, particularly those who grew up without diagnosis or support and spent years attributing their difficulties to personal inadequacy. The explicit naming of shame, and the explicit refusal of it, as a prominent athlete speaking to a global audience, was a cultural intervention of a kind that clinical communication cannot produce.
ADHD is a neurodevelopmental condition characterised by differences in how the brain regulates attention, impulse control, and in many presentations, activity levels. These differences are rooted in the dopamine and noradrenaline neurotransmitter systems and in the functioning of the prefrontal cortex, the brain region central to attention, planning, and self-regulation.
In elite athletes with ADHD, the condition presents in both challenging and, in some contexts, facilitative ways. The attention regulation difficulties that ADHD creates can make the routine, repetitive, and organisational demands of training programmes genuinely harder to manage consistently. The impulsivity associated with ADHD can create difficulty in high-pressure situations where measured, calculated responses are needed.
At the same time, the hyperfocus that many people with ADHD experience in high-interest, high-stimulation activities can align exceptionally well with the demands of elite sport. The capacity to become completely absorbed in performance, to sustain extreme concentration during competition, and to bring high energy to demanding physical tasks are all features that the right sporting environment can draw out from an ADHD brain.
For more on how ADHD presents and what it actually involves neurologically, see our article on the ADHD brain and the prefrontal cortex.
Methylphenidate is a stimulant medication prescribed for ADHD under several brand names including Ritalin, Concerta, and Medikinet. It is the most commonly prescribed ADHD medication in the UK and one of the most widely prescribed globally.
Methylphenidate works by inhibiting the reuptake of dopamine and noradrenaline in the synaptic cleft, increasing the availability of these neurotransmitters in the prefrontal circuits that regulate attention and impulse control. In people with ADHD, whose dopamine system functions with reduced efficiency in these circuits, this mechanism directly addresses the neurological basis of the condition's core symptoms.
The medication helps the ADHD brain regulate attention more effectively, sustain focus on tasks that are not immediately stimulating, and manage impulse control more reliably. It does this by compensating for the specific neurological differences that ADHD involves, bringing the ADHD brain closer to neurotypical baseline functioning rather than pushing any brain beyond its typical ceiling.
The distinction between treating a medical condition and enhancing performance is central to understanding why Biles's TUE was granted and why its granting was entirely appropriate.
A substance that helps an athlete with ADHD function at a neurotypical baseline is not performance-enhancing in the sense that anti-doping frameworks are designed to prevent. It is medically necessary. An athlete with ADHD who is not treating the condition is not competing from a position of fairness against neurotypical athletes. They are competing with a neurological disadvantage. Medication that addresses that disadvantage is treatment, not enhancement.
Tony Lloyd, CEO of the ADHD Foundation UK, addressed this directly in the context of the 2016 incident, noting that ADHD medication does not give athletes an advantage but helps them function at the same baseline as others. He also made a point worth amplifying: physical exercise itself increases dopamine and noradrenaline naturally, meaning that the neurotypical athletes Biles competes against are receiving the same neurochemical effects from training that her medication provides for her ADHD brain. The playing field was never as uneven as the hack implied.
A Therapeutic Use Exemption is a formal permission granted by WADA or a national anti-doping authority that allows an athlete to use a substance listed on the prohibited list when that substance is medically necessary for the management of a legitimate health condition.
The TUE process is rigorous. It requires documented diagnosis by a qualified clinician, evidence that the substance is necessary for the treatment of the condition, confirmation that there is no reasonable alternative treatment that does not involve a prohibited substance, and evidence that the therapeutic use does not produce performance enhancement beyond the restoration of normal health.
Biles had a valid TUE. Her use of methylphenidate was authorised, documented, reviewed, and approved through exactly the process that anti-doping frameworks require. The presentation of her test results as suspicious ignored the existence of the very mechanism anti-doping systems have created to accommodate legitimate medical needs.
One of the most clinically interesting aspects of elite athletes with ADHD is the relationship between sport itself and ADHD symptom management. Physical exercise, particularly aerobic exercise, produces significant increases in dopamine, noradrenaline, and serotonin in the brain. These are precisely the neurotransmitter systems that ADHD medication targets pharmacologically.
For people with ADHD, exercise functions as a natural complement to medication or, for some, as a meaningful management tool in its own right. The neurochemical effects of a training session can improve attention, reduce restlessness, and support emotional regulation for hours after the session ends. For an elite gymnast training at the intensity Biles does, the training load itself provides a sustained neurochemical environment that is supportive of ADHD symptom management.
This does not mean exercise replaces medication for people who need it. But it does mean that the relationship between elite sport and ADHD is not simply one of performance despite a condition. For many athletes, sport and ADHD management are neurologically connected. For more on how exercise specifically supports ADHD, see our article on why sport and exercise are essential tools for managing ADHD.
Simone Biles is not alone. The number of elite athletes who have publicly disclosed ADHD is notable and consistent with what one would expect given ADHD's prevalence in the general population. Michael Phelps, the most decorated Olympian in history, has spoken extensively about his ADHD diagnosis in childhood and how swimming became both a therapeutic outlet and the environment where his neurological profile found its best expression. Lewis Hamilton, seven-time Formula One World Champion, disclosed his ADHD publicly ahead of the 2026 season. Mark Phillips, former professional footballer, received his diagnosis at 43.
The pattern across these athletes is consistent with the broader understanding of ADHD in high-performance contexts: the condition presents real challenges in some dimensions of elite sport while the high-stimulation, high-stakes environment of competition can draw out features of the ADHD brain that produce genuine performance advantages.
For more on Michael Phelps's experience, see our article on what we can learn from Michael Phelps about ADHD. For more on Lewis Hamilton's disclosure, see our article on Lewis Hamilton and ADHD.
The cultural impact of Biles's statement operated on several levels simultaneously.
For people with ADHD who read it, particularly young people, the statement offered something specific: a model for how to talk about the condition without apology. The refusal of shame was explicit. The affirmation of medical treatment as nothing to be afraid of was unambiguous. From someone at the absolute peak of a globally watched sport, that framing reached an audience and carried a credibility that no awareness campaign could replicate.
For people who did not know what ADHD was, or whose understanding of it was limited to stereotypes about disruptive children, Biles's statement was a corrective. Here was someone whose focus, discipline, and achievement had been demonstrated at an Olympic level, describing a diagnosis since childhood and ongoing medication. The distance between the stereotype and the reality was visible in a single statement.
For the broader conversation about medication stigma, which affects many more people than athletes, her directness about taking medication and having nothing to be ashamed of addressed one of the most persistent and damaging barriers to treatment-seeking: the belief that needing medication is itself evidence of weakness or inadequacy.
The demographic most directly reached by Biles's statement is young people with ADHD, particularly girls.
ADHD in girls has historically been significantly underdiagnosed. The presentations most common in girls, inattentive, internalised, less visibly disruptive, do not match the stereotypical image of ADHD and do not prompt the referrals that more visible hyperactive presentations in boys do. Many girls with ADHD spend years or decades without diagnosis, attributing their difficulties to personal inadequacy rather than neurology.
Seeing a female athlete of Biles's stature describe having ADHD since childhood and taking medication for it without shame is a specific and meaningful contribution to this group. It challenges the stereotype that ADHD presents as obvious, disruptive, and incompatible with sustained achievement. It models a relationship with diagnosis and treatment that is matter-of-fact rather than apologetic. And it reaches young women at exactly the age when ADHD-related difficulties often intensify, when academic demands increase and the gap between effort and output becomes harder to explain.
Clinicians working with young people who have ADHD consistently report the impact that visible public figures have on whether people seek assessment and on how they relate to their own diagnosis. The mechanism is recognition and permission: someone they admire describes an experience that maps onto their own, and this makes it possible to take their own experience seriously rather than dismissing it.
Biles's statement is particularly valuable clinically because it addresses medication specifically. Stigma around ADHD medication is one of the most significant barriers to effective treatment. Many people who would benefit from medication decline it, or discontinue it, because of cultural messages that equate needing medication with weakness. An Olympic gold medallist saying that taking medication is nothing to be ashamed of is a direct and specific challenge to that stigma.
For healthcare professionals who want to develop their clinical expertise in ADHD assessment and management, including supporting patients to navigate medication decisions and the stigma that surrounds them, our ADHD assessor training course and ADHD training for professionals provide CPD-certified education grounded in current international evidence.
If you or your child have ADHD and take medication, Biles's statement models something worth internalising: medication for a medical condition is not something to be defended or apologised for. It is treatment. The stigma around it reflects cultural misconceptions, not clinical reality.
If you have been avoiding seeking assessment or treatment because of concerns about what it would mean to be diagnosed or to take medication, Biles's example is relevant. A diagnosis does not limit what you can achieve. For millions of people it provides the explanation and the tools that enable them to achieve what their effort alone was not producing.
If you are a parent whose child has ADHD, the TUE framework in competitive sport is a practical example of how ADHD medication is understood in the most rigorous and scientifically informed environments in the world: as medically necessary treatment, not performance enhancement. That framing is the accurate one.
For more on ADHD medication and how to access it after diagnosis, see our article on how to get ADHD medication after diagnosis.
Did Simone Biles break any anti-doping rules?
No. Biles had a valid Therapeutic Use Exemption authorising her use of methylphenidate. She competed entirely within the rules of her sport. The hack that revealed her medical records implied impropriety where none existed.
Is methylphenidate a performance-enhancing drug?
For people with ADHD, methylphenidate is a treatment that helps brain function operate closer to neurotypical baseline. It does not provide a competitive advantage beyond restoring normal function. WADA's TUE process exists precisely to distinguish between medical treatment and performance enhancement, and Biles's exemption was granted through that process.
Is ADHD common in elite athletes?
ADHD affects approximately 3 to 5 percent of adults globally, and there is no clinical reason to expect elite athletes to be an exception. Several high-profile athletes including Michael Phelps and Lewis Hamilton have publicly disclosed ADHD diagnoses. The high-stimulation, high-pressure environment of elite sport may in some cases align well with aspects of how ADHD brains function.
Does exercise help manage ADHD?
Yes. Physical exercise, particularly aerobic exercise, increases dopamine and noradrenaline in the brain, the same neurotransmitter systems targeted by ADHD medication. Exercise does not replace medication for those who need it but is a well-evidenced complement to other ADHD management strategies.
Why is ADHD underdiagnosed in girls and women?
Because the presentations most common in girls, inattentive, internalised, less visibly disruptive, do not match the hyperactive stereotype that has historically driven referrals for assessment. Many girls with ADHD spend years without identification as a result.
Simone Biles did not choose to disclose her ADHD publicly. That choice was made for her by people who stole her medical records and published them without consent.
What she chose was how to respond. And the response she chose, direct, undefensive, explicit in its refusal of shame, reached millions of people with a message that clinical communication has struggled to deliver with the same force: having ADHD and taking medication for it is not a weakness, not a secret, and not something to be apologised for.
She said it as the most decorated gymnast alive. She said it in a single paragraph. And she said it at a moment when the cultural conversation about ADHD and medication in sport needed exactly the clarity she provided.
Medical Disclaimer
This article discusses a public figure's publicly stated experiences with ADHD for educational and awareness purposes. It does not constitute medical advice. If you have concerns about ADHD in yourself or your child, please speak with a qualified healthcare professional.
