Photo of Larry Nassar in Ingham County Court: Scott Olson/Getty Images

Larry Nassar was sentenced to 40 to 125 more years in prison today by Judge Janice Cunningham for three counts of first-degree criminal sexual conduct in Eaton County, Mich. The sentence was the final of three for Nassar, following a 60-year sentence on federal pornography charges handed down in December, and a 40-175 year sentence on 10 counts of first-degree criminal sexual conduct last month in Ingham County, Mich. If Nassar, age 54, survives his federal sentence, he will then serve the Ingham County and Eaton County sentences concurrently.

“I am not convinced that you truly understand that what you did was wrong,” said Cunningham. “Clearly you are in denial, you do not get it, and I do not believe there is a likelihood that you could be reformed.”

Nassar was a prominent and respected doctor for decades within both USA Gymnastics and the Michigan State athletics department, where he provided medical treatment to collegiate athletes and Olympic champions. Throughout his career, he took advantage of his position to sexually abuse more than a hundred women and young girls, at times even with their parents in the room.

Despite multiple complaints by victims, nothing was done. Even after a criminal investigation by Michigan State police, the abuse continued, and Nassar remained employed. And even during a later investigation by the FBI, silence by USA Gymnastics (which alerted the FBI in July 2015 after firing Nassar) allowed him to continue working. Nassar reportedly molested at least 40 more women after he was fired by USA Gymnastics, before reporting by the Indianapolis Star in September 2016 set off a wave of women who came forward to speak out about what Nassar had done, which finally led to his firing by Michigan State.

At Nassar’s sentencing in January in Ingham County, 156 women gave victim-impact statements detailing his abuse and the trauma he inflicted on their lives. In Eaton County, 65 women gave statements. In total, 265 women have told police that Nassar abused them.