MILES CITY – A former longtime high school athletic trainer in Miles City has been accused of sexually abusing potentially hundreds of student-athletes in what a lawsuit describes as a “sophisticated system of ritual sexual abuse.”

A lawsuit filed Friday in Custer County District Court alleges James E. “Doc” Jensen sexually abused males students at Custer County High School in Miles City starting in the 1970s until he left employment with the school district in 1998.

The lawsuit identifies at least 19 plaintiffs by initials and another 1 – 200 as “Joe Doe” victims who have yet to be identified. The lawsuit seeks unspecified damages from Jensen, the Miles City Unified School District, Custer County District High School and numerous unnamed individuals.

According to the 20-page lawsuit filed by Billings attorney John Heenan, Jensen was an athletic trainer with the school district for the Custer County Cowboys athletic teams. The lawsuit alleges Jensen, who was known by the nickname “Doc,” used that position of trust to sexually abuse male students between the 7th and 12th grades.

The sexual abuse happened both on school grounds and in several homes in Miles City where Jensen lived at different times, the lawsuit states.

Attorney Jeanie Leavick sent a statement to Q2 News on behalf of Miles City Public Schools Friday afternoon, calling the “absolutely atrocious” act described in the suit as “horrific.” She declined to comment specifically on the allegations.

“Miles City Public Schools is extremely concerned by the allegations set out in the Complaint. The absolutely atrocious acts described in the Complaint that took place 20 or more years ago are horrific. Each of us currently in the District — our educators, trustees and staff — cares first and foremost about the safety and well-being of our students. We believe that even one child harmed on our watch is not acceptable and will do everything we can to get to the bottom of this situation,” the district said in the statement.

Much of the abuse started during annual physical exams the students were required to take to participate in sports activities. Jensen was not a medical doctor but would check for hernias during students exams, “which involved the handling of the students’ testicles and genitals,” the lawsuit states.

“Over his tenure as athletic trainer, Jensen handled the genitals of hundreds of student athletes, while on school grounds, despite lacking appropriate medical qualification to do so,” according to the lawsuit.

Jensen also used his position “to perform inappropriate massages and sexual abuse in the training room of the high school. Jensen required the boys seeking treatment to remove all of their clothing regardless of the location of the injury on the body. Jensen would routinely massage and conduct ultrasound on each boy’s groin and genitals even when there was no injury to those areas.”

The lawsuit alleges the abuse escalated when Jensen created a “program” to enhance the performance of some students athletes. The “program,” he said, “would improve the boy’s testosterone production, strength, fitness and overall athletic performance.”

But according to the lawsuit, the “program” was a ruse to further sexually assault the boys. Jensen created levels of the program which used increasingly “more abusive and invasive” sexual abuse.

Jensen would “manually masterbate (sic) the boy to ejaculation,” the lawsuit states, claiming it was necessary for a male trainer because “any sexual arousal would be counterproductive to the production of testosterone.”

The lawsuit alleges the abuse went further and included him performing oral sex on the boys as a way to increase their testosterone production.

“Jensen increased the abuse through levels, eventually to the point where he would forcibly massage the boy’s prostate by anal-digital penetration while performing other sex acts on the boys,” the lawsuit alleges.

The National Athletic Trainers’ Association emailed Q2 to clarify that although Jensen is described in court documents as an athletic trainer, he was never certified by the national body and could not technically claim that title.

This is a developing story.

Related: Ex Miles City teacher in jail on suspicion of sex with underage student