(Adds details from hearing, statement from USA Gymnastics, comment from victim)
LANSING, Mich., Jan 24 (Reuters) - As his victims wept in a Michigan courtroom on Wednesday, disgraced long-time USA Gymnastics team doctor Larry Nassar was sentenced to up to 175 years in prison for abusing young female gymnasts who were entrusted to his care.
"I've signed your death warrant," Ingham County Circuit Court Judge Rosemarie Aquilina told Nassar, following days of harrowing accounts from about 160 of his victims.
Spectators and victims cried, applauded and embraced as Nassar, 54, wearing a dark blue jailhouse jumpsuit, was led out of the courtroom. Rachael Denhollander, the first woman to publicly accuse him in 2016, shared a hug with Angela Povilaitis, the lead prosecutor.
Nassar, who served as the program's physician through four Olympic Games, had apologized to his victims during the hearing, telling them, "I will carry your words with me for the rest of my days."
But Aquilina dismissed his statement as insincere and courtroom spectators gasped as the judge read aloud from a letter he wrote to her claiming he was a good doctor who was manipulated into pleading guilty.
Nassar, who already is serving a 60-year sentence in federal prison for child pornography convictions, also said his accusers fabricated claims to gain money and fame and wrote, "Hell hath no fury like a woman scorned."
"Would you like to withdraw your plea?" Aquilina asked Nassar after tossing aside his letter with evident disgust.
"No, your honor," Nassar said.
"Because you are guilty, aren't you? Are you guilty, sir?" the judge demanded.
After a long pause, Nassar said quietly, "I have said my plea, exactly."
Both the prosecution and Aquilina emphasized the broader significance of the sentencing, coming amid a national debate over sexual misconduct and abuse prompted by scandals involving powerful men from Hollywood to Washington.
Povilaitis said the conclusion of Nassar's case takes the victims' shame and puts it "where it belongs, right on him."
"At this particular moment in history, this sentence and hearing will be viewed as a turning point in how our community, our state, our nation, our culture looks at sexual abuse," she said.
Aquilina rattled off a series of disturbing statistics about the prevalence of sexual abuse before saying, "It stops now."
The sentencing followed an extraordinary weeklong hearing that saw a parade of Nassar victims tell their stories in raw and unflinching terms, describing how he used medical treatments as a cover to justify penetrating their bodies with his fingers.
Although Nassar only admitted to seven instances of abuse in the case, Aquilina allowed other victims to speak at his sentencing. Throughout much of the proceedings, the bespectacled Nassar sat with his head bowed, rarely making eye contact with his victims.
His accusers ranged from famous Olympic gold medalists like Aly Raisman to women like Denhollander, who was the last of the victims to speak on Wednesday and whom Aquilina described as "the bravest person I have ever had in my courtroom." The accusers had testified Nassar won their trust with kind words and by giving them snacks forbidden by their coaches. Testimony came McKayla Maroney, a gold medalist at the 2012 London Olympics, who called Nassar a "monster human being" and a former member of the U.S. national team who said his abuse led to depression and an eating disorder.
Another gymnast said she was only 6 years old when Nassar began molesting. She blamed Nassar for her father's suicide once the man realized his daughter had not been lying about the abuse she endured.
"I've been forever changed by all of this and I will never feel small again," said Bailey Lorencen, who was an anonymous accuser until she spoke in court this week. "I have a different confidence in myself as a woman."
In addition to his work with Olympic teams, Nassar also was the team physician for the Michigan State University gymnastics and women's crew teams, as well as an associate professor at MSU's College of Osteopathic Medicine.
The National Collegiate Athletic Association said on Tuesday it had opened an investigation into Michigan State's handling of the case. In her statement on Wednesday, Denhollander criticized the school for failing to adequately investigate complaints against Nassar dating back years.
In addition to Raisman, Olympic gold medalists Simone Biles, Gabby Douglas and McKayla Maroney have gone public in recent months, saying they were assaulted by Nassar while undergoing treatment.
Victims and others have criticized USA Gymnastics, the sport's governing body in the United States, for ignoring their complaints and have accused the federation of suppressing their accounts in a bid to avoid bad publicity.
On Monday, three top board members resigned in the wake of the scandal, following the exit last March of the federation's president and chief executive.
In a statement on Wednesday, Kerry Perry, who became USA Gymnastics president in December, applauded the sentence and vowed to "create a culture that empowers and supports" the program's athletes.
Several companies have announced they would not continue to sponsor the federation, including AT&T Inc on Tuesday.
Nassar pleaded guilty in November to seven counts of first-degree sex assault in Ingham County, as well as three additional charges in Eaton County, where he will be sentenced next week. (Reporting by Steve Friess in Lansing; Additional reporting by Keith Coffman in Denver and Jonathan Allen in New York; Writing by Joseph Ax in New York; Editing by Cynthia Osterman and Bill Trott)