In February 2018, Saunders announced they were leaving Ole Miss due to “personal and medical issues,” but that they intended to return to complete their degree.

[18] In April 2018, Saunders turned professional, launching this new phase of their career as a shot putter at the War Eagle Invitational at Auburn University with a throw of 19.56 m (64 ft 2 in).

[19] In June 2018, Saunders announced that they had signed with Nike, the same week that they finished third in shot put at the USA Outdoor Track and Field Championships with a throw of 18.74 m (61 ft 5+3⁄4 in).

[1][22] On August 1, 2021, at the pandemic-delayed Tokyo Olympics, Saunders won the silver medal in shot put, with a throw of 19.79 m (64 ft 11 in).

[23][24] On the podium during the medal ceremony, Saunders raised their arms above their head and formed an “X” with their wrists, later explaining: “It’s the intersection of where all people who are oppressed meet.“[25] As a result, the IOC launched a probe to whether the gesture violated Olympic rules, which prohibited athletes from "[any] kind of demonstration or political, religious or racial propaganda" in any Olympic site, including playing fields and podiums.

[1] Disappointed with their performance, Saunders announced in July 2022 that they would be taking the rest of the year off in order to fully recuperate from hip surgery, with the intention of returning for indoor meets in early 2023 and the goal of qualifying for the 2023 World Athletics Championship.

[33] In March 2023, the United States Anti-Doping Agency (USADA) suspended Saunders until February 2024 for having three “whereabouts failures” in a year, either through missing doping tests or improperly filing paperwork.

Saunders released a statement saying that they "accepted full responsibility for their failure to update their whereabouts according to the prescribed procedure on multiple occasions” and that they intended to spend the duration of their suspension focusing on their mental health and training in preparation for the Paris Games.

[35] The statement further acknowledged that Saunders had been under added pressure following their hip surgery in 2021 and new family responsibilities after the death of their mother, in addition to the demands of being an elite athlete, but that they were committed to their career and to using their platform to raise awareness about mental health issues.