USA Gymnastics: How the sport has become beset by allegations of sex abuse

In November, Dr Larry Nassar (pictured having the charges read out to him via videolink) pleaded not guilty to three counts of first-degree criminal sexual conduct in his Michigan home with a girl under the age of 13

As Britain comes to terms with reports of widespread sexual abuse in football, gymnastics in the United States is dealing with its own growing scandal.

A nine-month investigative report by the Indianapolis Star newspaper has just been published, and the scope of its claims is startling.

After reviewing hundreds of police files and court cases, the paper says "at least" 368 American gymnasts have made allegations of sexual abuse in the past 20 years.

The report claims 115 adults "at every level of the sport" are implicated in the abuse.

Dr Larry Nassar, who used to work for the body that governs US gymnastics, is the subject of two separate lawsuits alleging sexual abuse - which he denies.

And USA Gymnastics has itself been accused of failing to protect athletes.

Meanwhile, the journalists who have been investigating for much of the year believe "there is still a lot more to come out".

How did the allegations come to light?

Indy Star published a story in December on alleged abuse in gymnastics over the past 20 years

In August, the Indianapolis Star published a story detailing allegations of sexual abuse committed by coaches working for USA Gymnastics. It claimed that the sporting body did not report allegations of abuse to relevant authorities.

Tim Evans, one of the journalists working on the paper's ongoing investigation, told BBC Sport they first heard details of the abuse in March.

"My colleague Marisa [Kwiatkowski] was looking at another case in basketball when it was suggested she look at gymnastics," he said.

"When that initial story was published we had three women call us and say that Dr Nassar did things to them. They did not know each other and their stories were almost identical.

"We spent a month or so investigating Nassar."

In September, former club gymnast Rachael Denhollander waived her right to anonymity and, in an interview with the Indy Star, detailed the abuse she allegedly suffered at the hands Dr Nassar.

Speaking to BBC World Service's Sportshour programme, Denhollander said Dr Nassar allegedly sexually assaulted her during treatment for back and wrist injuries, despite her mother being in the room.

She said: "He would position himself so she could not see what he was doing. The other dynamic is that he was very trusted. It was very difficult to reconcile the person he was supposed to be with what he was doing, so the only conclusion I could come to was that I must be making a mistake.

She added: "That the truth has not come out in the past 18 years is something that has haunted me. The only thing that I feel now is very deep grief. I did not feel the need to come forward publicly for myself - there is nothing I gain from this for myself.

"But to be able to see the other women have a voice, that is worth everything. That is more powerful a motivation than fear."

What has USA Gymnastics been accused of?

Dr Nassar has been accused of sexual assault in two lawsuits filed by two former US women gymnasts. He denies the claims. The pair are also suing USA Gymnastics because they claim its policies allowed the abuse to continue.

Lawyer John Manley is representing the two athletes.

He told Sportshour: "Our allegations are that US Gymnastics made a choice at the highest level to cover up for Dr Nassar and others, and sacrifice children.

"Case in point: they fired Nassar in early 2015 and they didn't tell anyone, including Michigan State University, where he was allowed to continue to see young girls as a doctor, even after US Gymnastics had terminated his services because they believed he was an abuser.

"That is a stunning revelation, but they kept it secret. The reason child sexual abuse flourishes is because of secrecy.

"Our goal for our clients is to get them justice, but it is also to fundamentally change the way elite sport does business in this country."

What does USA Gymnastics say?

USA Gymnastics says it severed ties with Dr Nassar in 2015 when claims were brought to its attention. It denies that allegations of abuse were kept quiet in order to preserve the sport's reputation.

The organisation says it is "proud of the work it has done to address and guard against child sexual abuse" and has passed evidence on to the FBI.

USA Gymnastics was asked by BBC Sport whether its staff knew of Dr Nassar's alleged misconduct during the period he was employed.

It responded: "When USA Gymnastics learned of athlete concerns about Dr Nassar we immediately notified the FBI and relieved Nassar of any further assignments.

"Since then, we have co-operated with the FBI while the investigation has moved forward. Our support has and continues to include refraining from making further public statements or taking any other action that might interfere with the investigation. We are grateful to the athletes for coming forward to share their concerns."

Who is Dr Nassar?

Larry Nassar was a member of the USA Gymnastics medical staff from 1986 and team doctor for the women's team from 1996. He left the Indianapolis-based organisation in 2015.

He also worked with gymnasts at Michigan State University and has a website selling DVDs of rehabilitation programs for injured gymnasts.

He was arrested and charged on 21 November for alleged criminal sexual conduct against a child, who was neither a gymnast nor a patient. The abuse is alleged to have taken place at his Michigan home.

Others have alleged that they were sexually assaulted by him, including patients at Michigan State University. The university confirmed to the BBC that its police are currently investigating about 50 complaints.

Dr Nassar's lawyer Matt Newburg told the BBC his firm was continuing a "review of the reports".

Where are we now?

Nassar made his first court appearance this month. He faced three sexual assault charges against a girl under 13. He pleaded not guilty.

A preliminary hearing was due to take place in December but the judge granted a defence request to delay that until 17 February.

When the charges were brought in November, Michigan attorney general Bill Schuette said the case against Dr Nassar was the "tip of the iceberg".

Meanwhile, USA Gymnastics has announced it will conduct an independent review into its handling of sexual abuse cases.

In response to the Indy Star's latest report it issued the following statement: "Nothing is more important to USA Gymnastics, the board of directors and chief executive Steve Penny than protecting athletes, which requires sustained vigilance by everyone - coaches, athletes, parents, administrators and officials.

"We are saddened when any athlete has been harmed in the course of his or her gymnastics career."

Indy Star Journalist Mark Alesia told Sportshour that he believes more allegations of sexual abuse will surface.

He said: "There's a lot more to come out, we suspect, on how USA Gymnastics handles sexual abuse complaints.

"As part of our investigation we have learned that it was keeping files of sexual abuse complaints but not reporting them to authorities. If we get to those, we think there will be a lot more to report."