A former physician, now dead, at Ohio State University sexually abused at least 177 male students, likely more, during his two decades at the institution and faced no consequences until he was briefly suspended and then retired with an honorary title.

Administrators, coaches and students were aware of Richard Strauss’s actions -- fondling athletes’ genitals, performing sex acts on them and making lewd comments during exams -- but failed to act, according to an investigative report released Friday. Even when students told officials about Strauss, who died by suicide in 2005, those reports went unheeded. Ohio State’s investigation, conducted by Seattle-based law firm Perkins Coie, describes an environment in which Strauss’s misdeeds were an “open secret” and athletes considered the abuse a form of “hazing” or a “rite of passage.”

Many see parallels between this case and other sprawling sexual abuse scandals by doctors at other universities -- Larry Nassar at Michigan State University and George Tyndall at the University of Southern California. Nassar’s victims numbered in the hundreds and Michigan State settled with them for $500 million -- the largest payout related to sexual assault at an institution of higher education.

In the Strauss case, all of his victims were all young men -- men who were reluctant to come forward during the investigation, fearing, in part, the stigma around male sexual assault survivors, the report indicated. (In a separate case, men at USC have come forward alleging another physician sexually abused them.)

Trauma experts told Inside Higher Ed that the public often doesn’t take sex abuse allegations by men as seriously as women’s -- that men are expected to be able to “fight off” their perpetrator. But this stereotype reinforces men’s unwillingness to report sexual assaults -- and in this case, contributed to Strauss getting away with abuse for nearly his entire tenure. The power of these stereotypes was particularly strong given the victims were athletes.

“There are major differences in the stereotypes and assumptions made about male victims,” said Christopher Anderson, a trauma expert and former member of the Board of Directors of MaleSurvivor, a nonprofit supporting male sex assault victims. “Among these, perhaps the biggest difference is the perception that any man who was abused must be weak, vulnerable, less of a man. In addition if the perpetrator is male, then toxic prejudice and homophobia can be a major stigma leading many victims to stay silent.”

Strauss began at Ohio State in 1978 as an assistant professor of sports management and began volunteering in the athletics department within months of his hiring. He rose in the ranks and eventually worked both in athletics and the student health center. As early as 1979, athletics staffers and students knew of his misconduct -- mostly lengthy and unnecessary physical exams that involved him fondling men, forcing them to have an erection, the report states. But complaints weren’t elevated outside the athletics department until 1996, following a cluster of incidents in the late '90s.

University officials twice conducted “investigations” -- the word is deliberately in quotes in the report because the inquiries did not nearly uncover the extent of Strauss’s abuse. In one case, a fencing coach reported Strauss to another official, who was dismissive of the accusations and said they were based on “unfounded rumors.” After the second investigation in 1996, Strauss was stripped of his duties in athletics and the health center but retained his professorship until his retirement in 1998, when he was granted an emeritus title, even after the university was aware of the allegations against him. The university has said it will remove the title. (The report does not name any employees discussed who are still at the university, only those who have left or died.)

Strauss opened an off-campus clinic in 1997 after failing to appeal his punishments to administrators. Ohio State had never reported him to the state medical board. He claimed to specialize in sexually transmitted diseases and urological problems, but investigators found that he continued to abuse young men who came into the clinic. The report describes the operation almost as a “free clinic.” Strauss seemed not to charge the men who came in, and when he did, the cash was kept in a lockbox.

Investigators interviewed more than 500 individuals, mostly students who were abused and former Ohio State employees. They found that 22 coaches were aware of Strauss’s actions. The report also notes that 22 of the 177 victims did not believe they had been abused, but consulting with experts, the investigators said Strauss’s exams with them went far beyond appropriate medical conduct.

Strauss’s actions tended to escalate over time. His victims said in interviews that his most egregious violations did not occur in their first encounter with Strauss, which the report said is typical of sexual abusers.

A former student reported to investigators that in his first year, during a physical, Strauss spent more than five minutes inspecting his genitals. Strauss asked the student out to dinner, and the student declined. Strauss commonly took students out to dinner and paid, the report states. When the student saw Strauss again, Strauss touched him with the intent to try to make him ejaculate, the student told investigators. During another examination, when the student had a sore throat, Strauss fondled him again -- for no discernible medical reason. And in their final encounter, Strauss performed oral sex on the student and took off his pants, which the student believed was so the student could reciprocate.

The student never reported the behavior, noting that “student athletes were generally expected to be the ‘manliest of men,’” the report states.

Strauss would shower with players, sometimes for up to 45 minutes at a time, rubbing his genitals. No other athletics staffer did so, which made athletes uncomfortable, the report states.

When his behavior was reported, it seemed not to matter. When another former student injured himself during his sophomore year, the student told another physician treating him about a prolonged examination that involved Strauss touching his genitals. The physician asked the student to repeat the story to the head team physician, and the student told investigators both men looked concerned. But neither seemed to do much with the information. Strauss called the student later that night to check in on his injury but did not bring up the student talking to his colleagues. Strauss kept his job.

After multiple students reported Strauss had abused them in the late '90s, the university investigated the allegations and chose not to allow Strauss to work in athletics or in the health center.

Debra Warner, a professor at the Chicago School of Professional Psychology, and an expert in sexual abuse, said reports likely took so long to surface because society shames men who are vulnerable. The public -- wrongly -- considers men as hunters, protectors, she said, and not those who can be the victims of sexual violence.

“To say that they have been assaulted and victimized in any way shape or form, they are afraid about what everyone will think about them, that it will impact their future and their survival,” Warner said.

Jessica Davidson, the director of End Rape on Campus, said that Ohio State now must show how it will never allow such abuse to fester or go unnoticed again.

The university’s president, Michael V. Drake, issued a letter to the campus Friday, writing that the findings were “shocking and painful to comprehend.”

“On behalf of the university, we offer our profound regret and sincere apologies to each person who endured Strauss’ abuse,” Drake wrote. “Our institution’s fundamental failure at the time to prevent this abuse was unacceptable -- as were the inadequate efforts to thoroughly investigate complaints raised by students and staff members. This independent investigation was completed because of the strength and courage of survivors. We thank each of them for their willingness to share their experiences."

Ohio State currently faces three lawsuits from abuse victims.