Dr. Larry Nassar is back in court this week. The former Olympic gymnastics and Michigan State University sports doctor is accused of sexually abusing dozens of patients, under the guise of treatment.
For years, his alleged victims say they tried to report what was happening, only to be brushed off.
And whenever cases about child sexual abuse come up, it's natural to wonder: how could someone have missed all those warning signs? All those red flags?
(More: TIMELINE: See how the allegations against Dr. Larry Nassar unfolded)
But experts say there’s a predictable pattern for abusers. Understanding that pattern doesn't make the past ok. But it might help us protect more kids in the future.
With young gymnasts, Nassar says “if you break their train of trust, you’re done”
Today you see Nassar on TV, wearing that striped corrections jumpsuit, flip flops and white socks on his feet, sandwiched between suited defense attorneys.
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But less than a year ago, Nassar was seen as this kind of geeky-dad type: glasses, a tucked-in polo shirt, his phone holstered to his khakis.
And in the insanely demanding world of Olympic-level gymnastics, Nassar built his reputation as the guy who really did care about your kid.
“Not just physically, but mentally, you have to protect your athletes,” Nassar once said. “You have to let them know that we care. You have to let them feel it. Let them breath it. It can’t just be a pat on the back. It has to be sincere.”
This was the Nassar of four years ago, speaking on the popular gymnastics podcast, GymCastic. The host, Jessica O’Beirne, had worked with Nassar briefly as a student athletic trainer. She was a fan.
“I’m just gonna tell you that I’m totally biased in the interview!” she told listeners in a 2013 episode. “Completely and totally biased. Because I just love Larry Nassar.
“He looks like Inspector Gadget when he’s working. He’s super kind and accommodating to everyone. I’m super biased and I think he’s awesome.”
O’Beirne wasn’t alone in her enthusiasm. By all accounts, Nassar was an icon: the Olympic team doctor, a professor at Michigan State.
And in a sport where, as O’Beirne notes, “we literally have Olympians who had to have rods put in their legs” because their bodies have taken such a beating over the years, Nassar's approach was different.
“Gymnast first. Gymnast first. Gymnast first,” he told O’Beirne.
It’s all about trust, Nassar said. The most important thing is to get the gymnasts to trust you.
“If you break their train of trust, you’re done. Because they’ll never trust you again. And they’ll tell the other gymnasts,” he said.
Trying to report abuse, but “the community circles the wagons around the offender”
And then, during treatment, Nassar’s alleged victims say he used his ungloved hands to penetrate them vaginally and rectally, without any notice or consent. Some say the penetration could last as long as 45 minutes in a given appointment. In court and in lawsuits, young women and girls describe those experiences as painful, confusing, and traumatic. They've testified in court about panic attacks, nightmares, a fear of being touched, and shattered trust.
Since the initial allegations became public in September 2016, MSU police say they’ve received more than 80 complaints about Nassar. By some counts, about 100 women and girls have sued Nassar in state and federal court.
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Today, several former athletes and students say they told their MSU coach and trainers about Nassar years ago. One even went to the university’s Title IX office.
Larissa Boyce says as a teenaged gymnast in the late ‘90’s, she told MSU women’s gymnastics coach, Kathie Klages, that Nassar was digitally penetrating her.
“And she was sitting in her office in her chair behind her desk,” Boyce says. “And said, ‘Well you know, I could file this, but there’s going to be very serious consequences. For you and Dr. Nassar.’ I remember just, like, looking out the window behind her. And um, just not even wanting to look at her," Boyce says.
Klages denies ever receiving “any information to cast doubt on the appropriateness of [her] trust in Dr. Nassar,” according to a statement from her attorney earlier this year.
In 2014, a Michigan State University student told the school that Nassar had sexually abused her during treatment. The resulting Title IX investigation cleared him, concluding that Nassar’s methods were medically sound.
“I am happy this has resolved to some extend [sic] and I am happy to have you back in full practice,” Dr. William Strampel, dean of MSU’s College of Osteopathic Medicine, told Nassar in a 2014 email.
(After Nassar was later charged with multiple counts of criminal sexual conduct, MSU’s Office of Institutional Equity conducted at least one recent investigation into similar complaints against Nassar, and found him responsible.)
But for years, young women and girls say they were told, it was just a misunderstanding.
Clinical and forensic psychologist Carla van Dam says that’s not surprising.
“The community always circles the wagon around the offender,” says the author of The Socially Skilled Child Molester: Differentiating the Guilty from the Falsely Accused. “It happens in every single case…where there’s a powerful person who has created powerful allies who then help defend the alleged perpetrator.”
When kids offer warning signs, adults may miss them
The big problem, van Dam says, is that despite everything we know intellectually, adults don’t really think the people we like and trust, could hurt our kids.
“The sex offenders who are the successful offenders, who are 95% of the cases or more, are people that we know and trust and invite into our homes,” she says. “And [we] give access to our children to them.”
These “groomers,” as she describes them, are people who have “deliberately ingratiated themselves with the adult community” and are accepted as “upstanding citizens.”
They funnel all their energy into accessing children, building their lives around seemingly innocent activities. They’re dedicated coaches, teachers, parents, or volunteers. Adults in the community teach their own kids that these are “adored friends,” van Dam writes.
So it’s all the more confusing for kids when abuse occurs. Often, van Dam says, young children will “under report” abuse (if they report it at all) in a way that “they think is clear, but of course, it isn’t.” She gives the example of one boy who told his parents, “I don’t like [my babysitter,] he makes me stay in the bathroom all the time.” Or a little girl who angrily complained of the same abuser: “I’m big enough to wash myself. I don’t need him to scrub me in the bathtub.”
In the case of Nassar’s alleged victims, some say they were even more confused because they believed the digital penetration was a legitimate medical procedure.
One young woman, who testified against Nassar and is using the pseudonym Victim E in court documents, says she told her dad that Nassar had “done something weird” during their appointment. “I didn't know what it was,” she told the court. “So I did not go into detail.”
"I didn't understand how touching [my vagina] would help my heel issue...I was embarrassed."
Another young gymnast testified that she and her fellow athletes would talk about how “touchy” Nassar was, but figured that was par for the course. "I didn't understand how touching [my vagina] would help my heel issue,” that gymnast said, adding that she didn’t say anything about it during the appointment because “I was embarrassed."
Another alleged victim, who’s still a minor, told the court she “cried the whole way home” after Nassar allegedly put his fingers inside her. But it wasn’t until months later, when accusations against Nassar became public, that she says her mom asked her why she’d cried in the car that day.
Parents can feel paralyzed, overwhelmed
Even when parents do pick up on warning signs, van Dam says, often the most common reaction is paralysis. “It’s always ambiguous,” she says. “It’s always uncertain. It’s always scary.”
One mom told investigators she saw Nassar had a visible erection during two treatments with her teenaged daughter.
She was in the room as Nassar was apparently massaging her daughter, and “his respirations became quicker,” she told an MSU investigator last year. “He was talking on and off, normal talk…[he] asked questions about home schooling, and his face and neck got flush, and when he finished working on her, I noticed he had an erection.”
But at the time, she dismissed it. She “knew his wife was pregnant and maybe he hasn’t had sex in a while,” and thought “maybe he is getting aroused because he wasn’t having sex at home,” she told investigators.
Van Dam, the forensic psychologist, says in moments like that, our minds are rushing to make sense of what’s happening. We’re embarrassed, shocked, and at the same time, this one piece of isolated evidence feels smaller than all the good things we believe about this “nice guy.”
"Because imagine that mother turning around and saying, 'This is not ok, what are you doing with an erection here?' Can you imagine somebody actually saying that?"
“Because imagine that mother turning around and saying, ‘This is not ok, what are you doing with an erection here?’ Can you imagine somebody actually saying that and having everybody else support that mother?”
She calls this the “shock and disbelief” stage, when adults are more likely to discount evidence that later, seems glaringly obvious – but only in retrospect, and only after multiple people have broken their silence to share similar experiences.
Fixing a broken system: it’s not “virtually impossible to stop a…predator”
Nassar, for his part, maintains his innocence. His defense attorneys argue he only used legitimate medical treatments – some of which his patients may have been unfamiliar with, they argue, simply because his expertise in osteopathy and sports medicine is fairly unique.
As for Jessica O’Beirne, the podcast host who interviewed Nassar at length a few years ago, she looks at that conversation very differently now.
Word of the allegations against Nassar reached her through the gymnastics grapevine. “In a way, I was completely shocked. And in a way, I wasn’t at all,” she says. “He was in the perfect position to do this. I know this is the person you have to worry about, who has the position and power to groom people.”
Which is why, despite her personal feelings about that interview now, she kept it up on the GymCastic website.
“I just wanted to just destroy the interview, throw it in the trash, pretend it never happened, and apologize to everyone. And at the same time, I knew that I couldn’t do that.”
She couldn’t take it down, she says, because now it was “a piece of evidence.” Not criminal evidence that could come up in court, but historical evidence: proof, she says, of a mistake we keep making over and over again.
That child molesters know how to gain people's trust, get people to like them, and then can use that trust, to hurt kids.
But it doesn’t have to be a pattern that's repeated.
At a trustee meeting in April, MSU President Lou Anna K. Simon described some of the changes the school has made in response to the Nassar accusations. They’ve “strengthened policies regarding informed consent and the role of chaperones,” Simon said, and are reviewing safety standards at MSU health clinics.
The school also “held a workshop for all MSU youth program directors that focused on promoting the safety of minors at MSU...and we will roll out an enhanced youth protection policy and additional education within the next 30 days.”
But Simon came under fire for one of her remarks that day.
“I have been told it is virtually impossible to stop a determined sexual predator and pedophile, that they will go to incomprehensible lengths to keep what they do in the shadows,” she said, while noting that MSU must still “do all we can” to protect patients and young people on campus.
Rachael Denhollander, one of the first of Nassar’s alleged victims to speak publicly, blasted Simon in an open letter (which, in fact, recommended Simon read van Dam’s scholarship on the topic.) “Ultimately, officials who are willingly indifferent to abusers in their midst can wash their hands and walk away, because [you're saying] men like Nassar are ‘virtually impossible to catch,’” Denhollander wrote.
And van Dam also disagrees with President Simon’s about predators being “virtually impossible to stop."
“That’s absolutely not true,” van Dam says. “Not in this day and age. There are organizations that, because of lawsuits, have developed personnel policies that would have stopped sexual predators in their tracks.”
But too often it takes a sex abuse scandal to force an institution to change, she says. Afterwards, when victims sue, that’s what pushes organizations like children’s hospitals, churches, or universities, to shape up.
“In cases where an institution has inadvertently harbored a staff member who turned out to be unsafe, and the entire institution…came to the individual’s defense…they’ve developed excellent personnel policies [as a result of those lawsuits.]
“They’re basically about not tolerating many of the earlier boundary violations. That would be a way to say: this isn’t acceptable.” But you have to stick to those boundaries, she says. “You never have to go so far as to prove somebody’s a sex offender. You simply say, ‘Well, you violated our policy, and you knew about our policy, and therefore, that’s cause for dismissal.'”
On paper, at least, Nassar had actually been given strict conditions for treating patients after the 2014 MSU sexual assault investigation. He was supposed to have a chaperone in the room, avoid “skin to skin contact” in sensitive “regions,” and explain his procedures to patient ahead of time.
But those policies weren’t enforced, apparently, as Nassar’s supervisors noted in September 2016 after IndyStar ran a story about Nassar's alleged abuse and Denhollander filed a criminal complaint. In a letter to Nassar, MSU cited “serious allegations…that you deviated from the required best practices put in place following the internal sexual harassment investigation…” He was fired four days later.
Dozens of alleged victims have since sued Michigan State University, claiming its employees were made aware of accusations against Nassar years before any action was taken. Nassar, for his part, is facing numerous state and federal charges, and if convicted, could be facing life in prison.
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