Last week was significant for the victims of sports doctor Larry Nassar, who sexually abused female athletes for decades while employed by Michigan State University and USA Gymnastics.

On Wednesday, Michigan State University announced a $500 million settlement with 332 victims molested by Nassar; that same day, ESPN announced the victims would receive the 2018 Arthur Ashe Courage Award.

Nassar pleaded guilty to child pornography charges in 2017 and ten counts of sexual assault earlier this year and subsequently received three prison sentences that will ensure he spends the rest of his life in prison.

He is, as far as we currently know, the worst sex abuser in sports history. More than 150 women gave victim impact statements during the trial. Nassar’s victims include multiple Olympic gold medalists, and he felt secure enough in his power that he even had the audacity to continue the abuse at the 2012 London Olympics with at least one member of the nationally beloved “Fierce Five” team.

Who knows how long he would have preyed on young athletes if not for the bravery and courage of one victim?

Rachael Denhollander was 15 years old in 2000 when Nassar first molested her. Sixteen years later, she broke the silence about Nassar’s abuse – the first victim to do so publicly – and started an avalanche of accusations that eventually toppled a corrupt system.

Denhollander deserves endless respect for finding the incredible courage to come forward; Time, quite appropriately, named her to its 2018 list of the world’s 100 Most Influential People. It was her word against a respected and admired Olympic doctor, who had become nearly as much a legend as the young Olympians in his care.

She told the IndyStar, “I was terrified. I was ashamed. I was very embarrassed. And I was very confused, trying to reconcile what was happening with the person he was supposed to be. He’s this famous doctor. He’s trusted by my friends. He’s trusted by these other gymnasts. How could he reach this position in the medical profession, how could he reach this kind of prominence and stature if this is who he is?”

How, indeed?

Because Denhollander wasn’t the first victim to report Nassar. Three years before Denhollander ever saw Nassar, MSU received the first complaints about Nassar’s conduct. Four different women had complained about Nassar’s conduct before Denhollander ever became his patient. And yet, no action was taken.

In a pattern that lately seems all too common, an investigation into USA Gymnastics revealed USA Gymnastics “followed a policy of not reporting all sexual abuse allegations against its coaches.” This failure resulted in the coaches being able to continue “preying on children despite repeated warning signs” and to “shift from gym to gym, again despite warnings of inappropriate behavior.”

Perhaps even more disturbing? IndyStar reviewed court records that revealed “some coaches weren’t banned from the sport until years after they were convicted of crimes against children” (emphasis mine).

Meanwhile, MSU received multiple complaints and allegations against Nassar that they repeatedly covered up, while discouraging the victims from making further reports.

Even with the knowledge of rampant sexual abuse in the industry, USA Gymnastics still forced young athletes to obey Nassar and to submit to mandatory treatment with him, with no other adults present, ungloved, in hotel or dorm rooms, on their beds, and behind closed doors.

How many victims could have been saved from Nassar’s abuse if MSU or USA Gymnastics had acted sooner?

During her court statement, Denhollander asked, “How much is a little girl worth?”

The reality is that for decades in this instance, and for centuries and millennia throughout the course of human history, the people who could have stopped abuse simply did not prioritize the safety of the victims.

The lack of action by MSU and USA Gymnastics is an example of the way many in our society trivialize, dismiss, or otherwise tolerate sexual abuse — because other things are deemed more important. Here, reputations and gold medals were at stake — and, for many, were more important than the safety and well-being of these young women, as is often the case when it comes to sexual abuse in sports.

This is absolutely not to say that we must automatically assume every person accused is guilty — far from it. Due process and the concept of innocent until proven guilty are both crucial aspects of our criminal justice system.

It’s not healthy skepticism that is the issue — it’s the absolute unwillingness to listen to an accusation, to review the facts, and to decide if the accusation is credible; it’s the refusal to follow proper procedures to ensure justice.

This is the culture in which Rachael Denhollender debated whether or not to go to the police for 15 years. “I was 100% confident that I would not believed,” she told the IndyStar.

This is the culture in which Nassar’s victims were victimized first by the doctor, then by authority figures who allowed Nassar to continue working with young athletes, refused to investigate him or to report complaints, and forced young women to obey the doctor’s commands – or be punished:

“I had to see him, there was no choice,” Raisman told the Washington Post, “because if you didn’t then it would be reported that we didn’t see him — and if you had a bad practice the next day, we’d get in trouble for not being ‘disciplined’ and not getting treatment from him.”

The Washington Post revealed the extent of the athletes’ quarandry:

The National Team Agreement required them to “submit to all reasonable requests for examination or evaluation by medical personnel retained by USA Gymnastics.”

The chief medical officer was Larry Nassar.

Physical therapy was mandatory “to maximize your performance.”

The head trainer for USA gymnastics was Larry Nassar.

A 2000 memo at a national training camp for girls as young as ages 9 to 12 instructed them that if they had a problem at night in the hotel they were to call a list of three people. The first name on the list? Larry Nassar. The memo also instructed them, “Please do not call your personal coach.”

[…]

But the rules said anyone who protested, who refused “verification of her illness or injury by a physician (or medical staff) approved by USA Gymnastics … may be removed.” She’d be off the team. To speak up meant losing everything.

Would it be that shocking if any of these victims believe society betrayed her?

In fall 2016, after Nassar had been publicly accused of molesting athletes, MSU gymnastics coach Kathie Klages – who, according to court documents, had been informed decades earlier of Nassar’s behavior and chose not to report it – allegedly asked her athletes to sign a card in support of Nassar.

According to NBC News, 21-year-old gymnast Lindsey Lemke said, “[Klages] said, ‘You don’t have to sign this if you don’t want to, but it’s for Larry and it would be appreciated if we could let him know that we’re thinking about him.”

Are these girls allowed to feel as though their safety and well-being were last on many’s list of priorities?

McKayla Maroney’s victim impact statement is damning:

How could have Larry Nassar been allowed to assault so many women and girls for more than two decades? The answer to that question lies in the failure of not one, but three major institutions, to stop him: Michigan State University, the United States Gymnastics Association, and the United States Olympic Committee. If Michigan State University, USA Gymnastics, and the U.S. Olympic Committee had paid attention to any of the red flags in Larry Nassar’s behavior, I never would have met him, I never would have been treated by him, I never would have been abused by him.

In 2016, Maroney signed a confidentiality agreement with USA Gymnastics that originally financially penalized her if she spoke out about Larry Nassar. It was only after the agreement became public amid widespread outrage that USA Gymnastics said it would “not seek any money” from Maroney if she publicly spoke about the abuse she endured.

Like Maroney, Denhollander on Wednesday criticized Nassar’s enablers:

I remain deeply disappointed at the missed opportunity for meaningful reform at the University. My choice to come forward publicly against Larry, and later against the institutions that allowed him to prey on children for decades, was motivated by the need for accountability and reform, so that other little children don’t live the nightmares we lived. … This includes continuing to advocate for desperately needed accountability and change at USAG and in the USOC.

Are these women allowed to feel as though the institutions and the people around them dismissed and trivialized their experiences and allegations of sexual misconduct against Nassar? How did so many people find it acceptable to ignore or sweep these women’s stories under the rug for years while a sick man preyed upon them and hundreds of other girls?

The officials of the United States Olympic Committee did not even make the effort to attend Nassar’s trial.

Is it understandable why people feel many in our society don’t always take allegations of sexual abuse as seriously as they should?

Undoubtedly every person reading this feels revulsion and anger at the people who enabled Larry Nassar. This article is not meant to insult or blame any person who is sickened and would have interfered on behalf of the victims. This is simply to address how these situations occur, to illustrate why people argue society tolerates sexual abuse, and to highlight how often these abuses of power occur — much more than we realized.

This is why the #MeToo movement is so important, because it provides courage and support to victims worldwide. For perhaps the first time in human history, victims overwhelmingly feel empowered to speak up — which is why the recent revelations of sexual misconduct should actually be seen as positive. Past victims of abuse of power throughout human history mostly suffered in silence; now they are coming forward and refusing to treat such behavior as acceptable. And it is by confronting and addressing predatory behavior by those in power in the workplace or by authority figures that we can prevent future abuse. This starts with listening to victims.

Denhollander asked how much is a little girl worth. The answer last week was at least $500 million and an Arthur Ashe Courage Award. That’s a start. But the larger truth is that little girls (and boys) are worth protecting. They’re worth showing abuse will be treated as unacceptable behavior. And they’re worth taking the steps to demand accountability and to ensure this cannot happen again.

The views expressed here are those of the author and do not represent those of any other individual or entity. Follow Sarah on Twitter: @sarahmquinlan.