We also need to hear from an important segment of the math population: those who burned out or dropped out for reasons related to math perceptions engendered by the math-competition culture. We all know people who did great at math or science competitions in high school but just disappeared from the scene after that. One may say that there are other underlying causes that lead them to not live up to some hypothetical promises, but I strongly feel that success and failure at math competitions can be a cause in itself. A lot of space is dedicated to how math olympiad triple-gold medalists went on to become great mathematicians. We also hear about those like Grothendieck and Hardy who weren't big in the competition circuit.
But missing are the stories of those who didn't make it big in spite of great competition performance, and those who fell out of math because of failing at math competitions.
In India, for example, competition math is everything at the high school level. This is because competitive exams like the famed IIT JEE, etc. are essentially variations on the competitive math theme. A few serious math enthusiasts do take up broader math-specific exams for math institutes, but those numbers are minuscule. The worst affected in my experience, are the talented and the enthusiastic who were discouraged and/or dropped out altogether because of failing at optimizing their skills and learning for competitions and similar exams.