Miss Hawaii USA Savannah Gankiewicz was offered the Miss USA crown after winner Noelia Voigt said on Monday that she was stepping down from the role to prioritize her mental health.

Voigt, who represented Utah in the 2023 pageant in Reno, Nevada, said in a statement on Instagram that resigning was “a tough decision.” Voigt was crowned the title in September.

“In life, I strongly value the importance of making decisions that feel best for you and your mental health,” she said.

Gankiewicz was the first runner-up. The three other runners-up were from Wisconsin, Pennsylvania and Texas.

Voigt, who was born in Florida, said that she was the first Venezuelan-American woman to win Miss USA, which started in 1952. As the winner, Voigt went on to compete in the Miss Universe pageant in El Salvador in November. She placed in the top 20, and for the costume competition, she wore an outfit that featured small models of landmarks including the Statue of Liberty, the Washington Monument and the White House.

Her surprise resignation prompted questions among pageant fans, including those who noticed that the first letters of the first 11 sentences in Voigt’s statement spelled: “I am silenced.” (The first letters of the final three sentences spell “hip.”)

Voigt and Miss USA did not immediately respond to requests for comment.

In a statement on the Miss USA Instagram account, the organization said it respected and supported Voigt’s decision to step down.

“The well-being of our titleholders is a top priority, and we understand her need to prioritize herself at this time,” the statement said of Voigt. “We are currently reviewing plans for the transition of responsibilities to a successor, and we will soon announce the crowning of the new Miss USA.”

Voigt said in her statement that her favorite parts of being Miss USA included working with Smile Train, a nonprofit that supports people with cleft palates, and campaigning against bullying and in favor of immigrant rights.

“Deep down I know that this is just the beginning of a new chapter for me,” she wrote, “and my hope is that I continue to inspire others to remain steadfast, prioritize your mental health, advocate for yourself and others by using your voice, and never be afraid of what the future holds, even if it feels uncertain.”

This article originally appeared in The New York Times.