After an extraordinary seven-day hearing that drew more than 150 young women to speak out publicly about sexual abuse they said was committed by Dr. Lawrence G. Nassar, the former team doctor for the American gymnastics team, a judge sentenced him on Wednesday to 40 to 175 years in prison.
He had faced a minimum term of 25 to 40 years.
Judge Rosemarie Aquilina, who had opened her courtroom to all the young women who wanted to address Dr. Nassar directly, and forced him to listen when he pleaded to make it stop, handed down the sentence, saying to him, “You’ve done nothing to deserve to walk outside a prison again.”
“It is my honor and privilege to sentence you,” she said, and noting the length of the sentence, added, “I just signed your death warrant.”
Given an opportunity to address the court before sentencing, Dr. Nassar apologized and, occasionally turning to the young women in the courtroom, said: “Your words these past several days have had a significant effect on myself and have shaken me to my core. I will carry your words with me for the rest of my days.” Several women sobbed in the gallery as he spoke.
Just before sentencing Dr. Nassar, the judge read parts of a letter he submitted to the court last week. In the letter, he complained about his treatment in a separate federal child pornography case and wrote that his accusers in this case were seeking news media attention and money. “Hell hath no fury like a woman scorned,” he wrote in the letter. There were audible gasps from the gallery when the judge read the line.
Dr. Nassar, 54, was accused of molesting girls for years under the guise of giving them medical treatment. Some were as young as 6. Many of them were Olympic gymnasts. In November, he pleaded guilty to sexually abusing seven girls. He had already been sentenced to 60 years in federal prison for child pornography convictions.
The case and its ramifications are far from over. It has ignited outrage in the sports world and beyond, leading to the resignation this week of the chairman and several board members of the governing body for gymnastics in the United States, U.S.A. Gymnastics. Last week, the organization cut ties with the Karolyi Ranch, the training center at a remote Texas ranch where some of the abuse occurred.
There have also been calls for the resignation of the president of Michigan State University, where Dr. Nassar spent decades on the faculty and treated its athletes. He also treated some members of the United States national gymnastics team there. The N.C.A.A. on Tuesday formally opened an investigation into the university’s conduct.
A number of civil lawsuits have also been filed.
The sentencing hearing itself, streamed live on the internet, garnered much attention for extending several days to allow for victim impact statements from girls and women who said they were molested by Dr. Nassar over the years. Many of the victims had not previously identified themselves. Initial plans to conclude after four days were altered as more women came forward.
Judge Aquilina was a fierce advocate for the victims, often praising or consoling them after their statements. The hours and hours of victims speaking candidly about their abuse unexpectedly turned the hearing into a cathartic forum. Dozens of women who had remained silent came forward with accounts of abuse.
Among those who have accused him are the Olympic gold medalists Aly Raisman, McKayla Maroney, Gabby Douglas, Jordyn Wieber and Simone Biles.
The final three victims spoke on Wednesday. Rachael Denhollander, who was one of the first women to come forward with public accusations against Dr. Nassar, was the last to speak at his sentencing hearing. “Larry is the most dangerous type of abuser,” she said. “One who is capable of manipulating his victims through coldly calculated grooming methodologies, presenting the most wholesome and caring external persona as a deliberate means to ensure a steady stream of young children to assault.”
Judge Aquilina praised Ms. Denhollander for opening the floodgates. “You are the bravest person I have ever had in my courtroom,” she said.
The sentence carries a minimum 40 years imprisonment, adhering to the terms of the plea agreement, but the judge advised that should Dr. Nassar improbably live longer than any human has, and come up for parole after serving the federal and state sentences, his time in prison should extend to 175 years.
Nassar also pleaded guilty in November on three sexual abuse counts in a neighboring county and that sentencing is later this month.
The statements by the young women were forceful and at times anguished.
“Imagine feeling like you have no power and no voice,” Ms. Raisman said in court on Friday. “Well, you know what, Larry? I have both power and voice, and I am only just beginning to use them. All these brave women have power, and we will use our voices to make sure you get what you deserve: a life of suffering spent replaying the words delivered by this powerful army of survivors.”
“I was told to trust him, that he would treat my injuries and make it possible for me to achieve my Olympic dreams,” Ms. Maroney said in a statement read by a prosecutor on Thursday. “Dr. Nassar told me that I was receiving ‘medically necessary treatment’ that he had been performing on patients for over 30 years.
“Dr. Nassar was not a doctor,” she said. “He in fact is, was, and forever shall be a child molester, and a monster of a human being.”
As part of a lawsuit settlement, Ms. Maroney had signed a nondisclosure agreement with U.S.A. Gymnastics that would have caused her to be fined more than $100,000 for speaking about the abuse. After several celebrities offered to pay the fine for her, the organization said it would not fine her, and she was able to make her statement.
Ms. Wieber made a statement in person on Friday, saying: “Nobody was protecting us from being taken advantage of. Nobody was ever concerned whether or not we were being sexually abused.”
Dr. Nassar objected to the many statements, saying that Judge Aquilina had turned the hearing into a “media circus.” The judge dismissed his complaint. “Spending four or five days listening to them is significantly minor, considering the hours of pleasure you had at their expense and ruining their lives,” the judge replied.
A lawsuit has been filed by scores of victims against Dr. Nassar, U.S.A. Gymnastics, the sport’s governing body and Michigan State, where he worked.
Moments after the judge delivered her sentence, the United States Olympic Committee issued a statement calling on the entire gymnastics board to resign and announcing other steps to investigate Dr. Nassar’s conduct and repair the damage done to the sport. The Olympic committee’s chief executive, Scott Blackmun, also apologized for not attending the hearing, after gymnasts took the U.S.O.C. to task for failing to protect them.