Washington (AP) – President Joe Biden on Thursday presented the nation’s highest civilian honor, the Presidential Medal of Freedom, to 17 people, including gymnast Simone Biles, the late John McCain, the Arizona Republican whom Biden served with in the Senate, and gun-control advocate Gabby Giffords.

“Today, she adds to her medal count,” Biden said as he introduced Biles, a former foster child whose 32 Olympic and World Championship medals make her the most decorated U.S. gymnast in history.

“I don’t know how you’re going to find room,” for another medal, Biden joked. The 25-year-old is an advocate for athletes’ mental health, foster care children and sexual assault victims. She’s also the youngest person to ever receive the medal, Biden said.

The Democratic president, who took office at a critical point during the coronavirus pandemic, also honored Sandra Lindsay, the Queens, New York, nurse who was the first person to be vaccinated against COVID-19 outside of clinical trials during a live television appearance in December 2020.

It was the first time Biden had awarded the Presidential Medal of Freedom. His recipient list included both living and deceased honorees, some of them representing various stages of the president’s life, from the Catholic nuns who taught him as a boy growing up in Claymont, Delaware, to Republican lawmakers he served with in the Senate to a college professor like his wife, Jill, to advocates of tightening access to firearms. Biden introduced Giffords as “one of the most courageous people I have ever known.”

The former Arizona congresswoman founded the organization named Giffords to campaign for an end to gun violence and restrictions on access to guns. The Democrat almost died after she was shot in the head in January 2011 during a constituent event in Tucson.

Biden noted that he recently signed the most sweeping gun-control legislation in decades _ though he and others would like even more restrictions _ and credited Giffords and families like her own whose lives have been altered by gun violence for helping to make it happen.

“She’s the embodiment of a single signature American trait: never, ever give up,” Biden said.

Biden also recognized former Republican Sens. Alan Simpson of Wyoming and John McCain of Arizona, recalling a less partisan era of Washington in which members of different parties would argue over issues during the day and then meet over dinner at night.

McCain died of brain cancer in 2018. He spent more than five years in captivity in Vietnam while serving in the U.S. Navy. He later represented Arizona in the House and Senate, and was the 2008 Republican presidential nominee, competing against Democrats Barack Obama and Biden.

Biden said he didn’t appreciate the political competition, but “I never stopped admiring John … I knew his honor, his courage and commitment.” The 17 people receiving honors “have overcome significant obstacles to achieve impressive accomplishments in the arts and sciences, dedicated their lives to advocating for the most vulnerable among us, and acted with bravery to drive change in their communities, and across the world, while blazing trails for generations to come,” the White House said.

Biden himself knows what it’s like to receive the medal. Then-President Obama honored Biden’s decades of public service by awarding him a Presidential Medal of Freedom “with distinction” during a ceremony shortly before they left office in January 2017.

Biden closed the ceremony by declaring, “This is America.”

The other 13 medal recipients are: Sister Simone Campbell, a member of the Sister of Social Service and a former executive director of NETWORK, a Catholic social justice organization.

Julieta Garcia, a former president of the University of Texas at Brownsville. Garcia was the first Latina to become a college president, the White House said.

Fred Gray, one of the first Black members of the Alabama Legislature after Reconstruction. He was a prominent civil rights attorney who represented Rosa Parks, the NAACP and Martin Luther King Jr. and, at age 91, continues to practice law.

Steve Jobs, the co-founder, chief executive and chair of Apple Inc. He died in 2011.

Father Alexander Karloutsos, the assistant to Archbishop Demetrios of America. Karloutsos has counseled several U.S. presidents, the White House said. Biden said he is “one of my dear friends.”

Khizr Khan, a n immigrant from Pakistan, Khan’s Army officer son was killed in Iraq. Khan gained national prominence, and became a target of Donald Trump’s wrath, after speaking at the 2016 Democratic National Convention.

Diane Nash, a founding member of the Student Nonviolent Coordinating Committee who organized some of the most important 20th century civil rights campaigns and worked with King.

Megan Rapinoe. The Olympic gold medalist and two-time Women’s World Cup soccer champion captains the OL Reign in the National Women’s Soccer League. She is a prominent advocate for gender pay equality, racial justice and LGBTQI+ rights. Biden said she is the first soccer play to receive the Presidential Medal of Freedom.

Simpson, who served in the Senate with Biden and has been a prominent advocate for campaign finance reform, responsible governance and marriage equality. Biden called Simpson the “real deal” and joked that “he never takes himself too seriously nor takes me seriously.”

Richard Trumka, who had been president of the 12.5 million-member AFL-CIO for more than a decade at the time of his August 2021 death. He was a past president of the United Mine Workers.

Wilma Vaught. A brigadier general, Vaught is one of the most decorated women in U.S. military history, breaking gender barriers as she has risen through the ranks. When Vaught retired in 1985, she was one of only seven female generals in the Armed Forces.

Denzel Washington, a double Oscar-winning actor, director and producer. He also has a Tony award, two Golden Globes and the Cecil B. DeMille Lifetime Achievement Award. He is a longtime spokesperson for the Boys & Girls Clubs of America. Washington could not attend Thursday’s ceremony after testing positive for COVID-19, the White House said. Biden said Washington will receive his medal “when he’s able to get here.”