Ryan began writing the book after performing research for a series of articles initially published in the
San Francisco Chronicle, where she was working as a sportswriter. In a 2018 interview, Ryan stated the thesis of the book was that abuse had become part of the normal culture of these sports. Ryan argues that the image of these athletes' beauty, glamour, class, and sophistication conceals a troubled reality of physical problems (weakened bones,
stunted growth, debilitating and fatal injuries), psychological issues (
eating disorders,
depression, and
low self-esteem), and life sacrifices (
dropping out of school, losing the chance to "be a child", and becoming isolated from their peers and families). While decrying these practices, Ryan advocates for systemic change in figure skating and gymnastics, calling for raised minimum-age requirements, mandatory licenses for coaches, careful scrutiny by national governing bodies, and a requirement for athletes to remain in regular schools at least until they are 16. Critics of the book claimed Ryan presented a relatively one-sided, bleak view of the sports, ignoring successes like
Mary Lou Retton.
Bela Karolyi was singled out for particular criticism in the book for his influence on
USA Gymnastics (USAG), which resulted in what she called "a system of abuse". When Ryan was working on an update to the book in 2000, she interviewed
Nancy Thies Marshall, a former gymnast who was then directing USAG's wellness program. The wellness program had been formed in response to the criticism USAG had received after the initial publication of the book in 1995. Marshall had written a 100-page manual with 30 recommendations and a referral network, but the wellness program had its budget slashed in half by the time Ryan contacted Marshall, and Marshall resigned shortly thereafter in 2001. The manual was praised by former US national sports team physician and convicted serial child molester
Larry Nassar in the introduction. ==Reception==