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Lansing - Victims of disgraced former USA Gymnastics team doctor Larry Nassar confronted him at a sentencing hearing on Tuesday with gut-wrenching emotional accounts of the trauma and scars stemming from his sexual abuse.
Nassar, 54, has pleaded guilty to a total of 10 counts of criminal sexual conduct in two counties in Michigan, and could face life in prison.
His best-known victims of sexual abuse under the guise of medical treatment were members of the Olympic gold-medal winning gymnastics team including stars such as Simone Biles, Aly Raisman, McKayla Maroney and Gabby Douglas.
But Tuesday's hearing revealed the extent of his crimes: more than 100 victims have come forward, including his one-time family babysitter and athletes in several women's sports programmes at Michigan State University, where he worked.
"You used my body for six years for your own sexual gratification," Kyle Stephens, Nassar's former babysitter, told a hushed Lansing, Michigan, courtroom.
"That is unforgivable."
Addressing the slight, bespectacled Nassar directly, Stephens said: "Little girls don't stay little forever.
"They grow into strong women that return to destroy your world."
Former gymnast Alexis Moore said: "He betrayed my trust, took advantage of my youth and sexually abused me hundreds of times."
"Are you remorseful for your actions and all the lives you have changed forever?" Moore asked the former doctor in court.
Dressed in blue prison garb, Nassar spent most of the time looking down as the women and girls spoke, occasionally holding his head in his handcuffed hands or wiping away tears.
Some victims chose to be identified and testify publicly while others spoke anonymously.
Another former gymnast, Jade Capua, said the abuse by Nassar was a "life-changing experience that stole my innocence far too young."
"I'm really proud of you," Judge Rosemarie Aquilina told Capua after her remarks.
"Your scar turned into a powerful voice," Aquilina said.
"Thank you for your bravery."
Olivia Cowan, who now has two daughters of her own, said she suffers from post-traumatic stress syndrome and is afraid to send her children to birthday parties or sleepovers.
"If you can't trust a world renowned doctor, who in this world can you trust?" Cowan said through tears.
Stephens said she believed her father's 2016 suicide was brought about in part by his one-time defence of Nassar, who had been a family friend.
"You convinced my parents that I was a liar," she said.
"Admittedly my father was experiencing debilitating health issues but had he not had to bear the shame and self-loathing that stemmed from his defence of Larry Nassar, I believe he would have had a fighting chance for his life," Stephens said.
Among those who testified was Donna Markham, the mother of former gymnast Chelsea Markham, who was abused by Nassar from the age of 10.
A tearful Markham said her daughter quit gymnastics when she was 13, suffered from depression and took her own life in 2009.
According to the Michigan Attorney General's Office, nearly 100 women and girls are expected to deliver victim impact statements at the hearing, which could last several days.
Nassar already faces 60 years in prison after being convicted of child pornography charges.
The sentencing hearing began a day after Biles, the 20-year-old reigning Olympic all-around champion, revealed that she was among those sexually abused by Nassar.
"I too am one of the many survivors that was sexually abused by Larry Nassar," the 10-time world championship medallist said on Twitter.
Nassar's case forced the resignation last year of USA Gymnastics chief Steve Penny, who was accused of failing to quickly notify authorities about abuse allegations.
USA Gymnastics adopted a new "safe sport policy" in response to the Nassar scandal that requires "mandatory reporting" of suspicions of sexual abuse.
International Gymnastics Federation president Morinari Watanabe told AFP on Tuesday that his governing body will set up a victim support body.
"The welfare and safeguarding of children and young athletes is fundamental to our sport," Watanabe said. "We will not tolerate any abuse or sexual harassment in the gymnastics community."
A civil lawsuit has been filed on behalf of about 100 of Nassar's victims. Their attorney, John Manly, has said the total number could be as high as 160.
