Charlotte Simpson wasn't drafted until she was 19 years old.

Externally the narrative was that she simply wasn't fit enough to be signed to an AFLW list, but the reality was far more complicated.

"Coming into my draft year I had some medical issues. I had a cyst on my ovary," Simpson told AFL.com.au.

"I was really sick with that. Any time I'd exercise it would twist and I'd vomit, so that just didn't help with getting fitness up. And then I pushed to play with the (Geelong) Falcons in my 18th year and then, round four, broke my cheekbone."

They were significant setbacks for a player who was aiming to be drafted later that year. The physical challenge that the cyst on her ovary presented not just when it came to footy, but life in general was a tough one.

"You miss out on doing things that you like doing outside of sport," Simpson said.

"No wonder I was so sick."

Surgery was required, not just to remove it, but to ensure it wasn't cancerous. There was a chance she would lose her ovary at just 18 years old, but she was able to avoid that worst-case scenario.

"I was really lucky," Simpson admitted.

"I've had check-ups every six months and I'm all good, nothing's come back."

True to Simpson's nature, however, she describes the ordeal as "annoying, really" and refuses to use it as an excuse for her fitness levels ahead of the draft.

"I don't think you can blame that fully … I've been playing footy since I was nine, so I probably could have gotten fitter before that happened," she said.

She is incredibly hard on herself, trying to live up to the highest of expectations. So, when she was overlooked in the draft, it was a reality check.

"As soon as I didn't get drafted it was like 'Oh okay, shit, I'm not going to stop until I get drafted'," Simpson said.

After that, she had the option of either playing in the Coates Talent League for the Geelong Falcons as an ove-rage player, or to shift across to the VFLW and really test herself. Of course, she chose the latter.

"It's pretty easy to beat up on a 16-year-old girl that's half my size," Simpson said.

That season in the VFLW was a chance to prove her strength against hardened midfielders, and caught the attention of St Kilda recruiter Anthony Tang.

"She was always a good footballer, and her weapon is her inside work, her ability to win the ball around the contest and also be quite fierce with her tackling, defensive pressure," Tang said.

"She's got that versatility to be strong, hold her ground, own her space."

The choice was ultimately the right one, with Simpson named the joint-winner of the VFLW's best and fairest award, the Lambert-Pearce medal.

It was an important vote of confidence, a sign that the hard work was paying off. But it's never enough for Simpson, who is desperate to keep improving.

"It was really nice to be awarded that, obviously, it's such a huge achievement. Then it really set me up to then feeling like what more could I have done?" Simpson said.

Part of it all is also ensuring she treads her own path, rather than that of her dad Sean, or brother Sam.

Sean Simpson played 121 AFL games between 1988 and 1998, 114 of which were at Geelong, the other seven at the Saints. As a result, Sam was drafted to Geelong as a father-son, but with a lower threshold in father-daughter rules, Charlotte was able to land at St Kilda.

Simpson will wear the No.33 despite being offered her dad's 38 worn at the Saints, because it is the number she has worn since her junior days. It is a symbol of her being her own footballer.

"I've always been tied to Geelong more than here, I never grew up being like 'Oh my dad played for St Kilda'," Simpson said.

So, the Saints present a fresh slate for Simpson to forge ahead with her footy.

"No one knew who I was as a person. It's still fully, a couple of weeks ago something was brought up about me being a father-daughter and a few of the girls were going 'What? You're a father-daughter?'" Simpson laughed.

"It's good, they didn't have any preconceptions of me as a footballer, as a person, nothing. I can just come in, be myself, and prove to them that I'm a good person."