With Larry Nassar present, multiple victims and victim representatives speak out about the abuse they suffered from the former USA Gymnastics doctor. (0:52)

LANSING, Mich. -- Larry Nassar leaned his forehead against his folded hands covering his eyes, unable to look at the woman speaking in front of him in a Michigan courtroom Tuesday morning. He was less than an hour into a four-day sentencing hearing for seven counts of criminal sexual conduct.

The woman in front of him was Donna Markham. She was speaking to the court and to the disgraced former doctor and convicted serial sexual predator on behalf of her daughter, who she said "could not join us today," she said. Chelsea Markham died by suicide at age 23 in 2009.

"It all started with him," Markham told the court. "It all started with him."

Nassar, 54, at one time was the national medical coordinator for USA Gymnastics and a renowned physician at Michigan State's sports clinic. He pleaded guilty to 10 total counts of first-degree criminal sexual conduct in the same Lansing courtroom in November. He has already been sentenced to 60 years in federal prison on child pornography charges, and the prosecuting attorneys have asked for another sentence of 40 to 125 years for his sexual abuse.

Judge Rosemarie Aquilina said in court she plans to honor the plea agreement reached in November and told Nassar's victims that "his story will end in prison."

"The monster who took advantage of you is going to wither," Aquilina told one woman who testified in the afternoon.

Markham said her daughter was sexually abused when she went to see Nassar for help with a gymnastics injury when she was 10, 11 and 12 years old. She said her daughter quit gymnastics when she was 13 after encountering Nassar at a gymnastics meet and "started down a path of destruction."

Prosecutors expect 98 women to speak or submit written statements this week. There were 28 submitted statements Tuesday. Police have received 125 complaints about Nassar since September 2016 when Rachael Denhollander, a 32-year-old lawyer and mother of three, shared her story about Nassar's assault with the Indianapolis Star. The girls and women who have filed police reports ranged from those who say they were assaulted when they were as young as 6 years old to a woman who told the court Tuesday that Nassar preyed on her when she went to see him after his divorce.

Prosecutors expect 98 women to speak or submit written statements during the sentencing hearing for former USA Gymnastics medical coordinator Larry Nassar. Scott Olson/Getty Images

The women who spoke in court Tuesday provide a window into the array of girls and women who say Nassar abused them. That list includes several Olympic medalists, youth gymnasts, figure skaters, college athletes who played a variety of sports, others who saw Nassar for non-sports injuries and family friends.

Kyle Stephens, the first woman to speak Tuesday morning, said her family regularly visited Nassar's home to share Sunday dinners when she was young. She said he first assaulted her when she was 6 years old.

"Let me remind you of the interests of a 6-year-old girl," she said. "My favorite TV show was 'Clifford the Big Red Dog.' My favorite book was 'Junie B. Jones.' I could not do a multiplication problem and still had not lost all my baby teeth."

More than 150 women have also filed lawsuits against Nassar and others in civil court. Those suits allege that Michigan State, USA Gymnastics and high-ranking officials and coaches at both institutions failed to stop Nassar when they had opportunities to do so. Several women have alleged that they told officials at Michigan State in the late 1990s about Nassar's abuse.

Police in Michigan investigated claims against Nassar in 2004 and 2014, but no charges followed at that point. Nassar was also cleared of wrongdoing in a 2014 Title IX investigation conducted by the university. Brianne Randall submitted a written statement to the court Tuesday in which she identified herself as the woman who told police in Meridian Township in 2004 that Nassar penetrated her and cupped her breasts during a medical appointment when she was 17 years old.

Randall said she was alone at the appointment because her father was battling a terminal cancer diagnosis. She believes Nassar took advantage of that situation to assault her. She talked the same day to police, who in turn scheduled a meeting with Nassar and her parents. Nassar told them that Randall didn't understand that what he was doing was a legitimate medical procedure and they decided not to pursue the claim any further.

"They missed this one," Aquilina said of the police.

Jennifer Rood-Bedford, a former Michigan State volleyball player, said she attempted to lodge a general complaint with her team's athletic trainer in the early 2000s. She said she decided not to pursue a formal complaint then because she blamed herself more than Nassar for the assault. Rood-Bedford joins four other women who have also said they complained to an authority figure at Michigan State about Nassar's intervaginal sexual violence more than a decade ago.

"To the MSU volleyball team, Dr. Nassar was jokingly referred to as the 'crotch doc' for his unconventional methods," Rood-Bedford said. "I told myself it was normal. 'He knows what he's doing; don't be a baby.'"

Nassar at times took notes during the statements Tuesday. At other times, he held his forehead in the palm of his hand, nodded along as women quoted scripture to him and shook his head at comments from others. When Rood-Bedford finished her statement, he removed his glasses and wiped tears from his eyes.

Some of the women who spoke in court Tuesday used their platform to chastise USA Gymnastics and Michigan State for inaction or their failure to communicate with each other about Nassar's track record.

Michigan State president Lou Anna Simon and members of the board of trustees said last week they intended to attend this week's sentencing hearing, but later decided not to come. Olivia Cowan, one of the women to speak in court Tuesday, called the Michigan State administrators "cowards" and said their reaction to this case have been "beyond my wildest dreams of wrong."

"Your decision to watch from the sidelines is a perfect representation of your lack of leadership," Cowan said.

Several of the women said that speaking up and publicly identifying themselves has been a cathartic or empowering experienced. Markham said it upset her that her daughter never got that opportunity.

"I wish she could have said what she wanted to say and what she experienced, but she's not here," she said. "This was the last thing I can do for her."

Another woman who wished to remain anonymous said she wonders whether she may have been Nassar's first victim. She said Nassar assaulted her in the early 1990s as part of a "research study" when he was in medical school and she was barely a teenager. She said Nassar, who was not yet famous but at the time had a reputation of being a friendly and omnipresent doctor at the local gymnasium where she trained, may have been the most significant male influence in her childhood. The woman, now an attorney, said at one time she wanted to be a sports doctor to follow in his footsteps.

She finished her message to Nassar by referencing the ninth circle of hell in Dante Alighieri's poem "The Divine Comedy." She said that it is a frozen lake reserved for "those guilty of treachery against those with whom they have special relationships."

"I had a special relationship with you, Larry, as did every little girl you violated," she said. "You gave us treachery, and now your punishment awaits you."

After listening to some words of praise from Aquilina, the woman stepped back from the podium, looked Nassar in the eye and mouthed the word "goodbye." She smiled as she walked away.

The final statement of the day came from Lindsey Schuett, 34, via a video recording. She said that in 1999, when she was 16 years old, she saw Nassar for medical help. She said she knew immediately that what he was doing was sexual abuse. She told a high school counselor and her mother about what happened. They chose not to report and brought her back to Nassar for another appointment.

Schuett said she asked Nassar not to perform the intervaginal procedure, but he attempted to do it anyway. Two times during that appointment he attempted to penetrated her, she said, and she screamed as loud as she could both times. She said after the second time, he referred her to another doctor.

At the end of the day, Aquilina reminded the court that Michigan does not have the death penalty and that the Constitution doesn't allow cruel and unusual punishment, but "if it did, I have to say I might allow what he did to all of these beautiful souls, these young women in their childhood, I would allow someone or many people to do to him what he did to others."