What Holds It in Place, Part 3

Naming Names and the Case for Reparations

In the spirit of giving thanks, I conclude this series on sexual assault with a shout-out to the Adult Survivors Act, which expires tomorrow. The ASA has raised awareness, brought convictions, and inspired further action in the wider effort to combat sexual assault.

Let's be clear: Sexual violence is not occasional or random. If it were, then how to account for the sheer number of victims--estimated to be between one-third to one-half of America's adult female population? No. Sexual assault is held in place by many forces, especially the institutions that protect abusers and silence their victims.

The prosecution of Harvey Weinstein revealed how the entertainment industry allowed his crimes to persist for decades. That he could, and did, derail careers caused his victims to remain silent. Bringing down Weinstein was a watershed moment for the #MeToo movement—and an extraordinary effort by dozens of women who corroborated evidence detailing a pattern of abuse that was mostly in plain sight. It was a well-known secret in Hollywood that Weinstein was exactly as the women said, but his power kept the status quo in place.

Sexual abuse is a hydra that does not die, even if Harvey Weinstein is decapitated. It flourishes amid the essential structures of society--the hospitals, the universities, and the corporations--that present a unified front allowing assault to fly under the radar. For offenders like Niels Lauersen, M.D., however, there was no radar. The knowledge that the victim has virtually no recourse afforded him plausible deniability.

Finally, doctor/abusers are coming under the same scrutiny as media figures. It is about time. Out of the public limelight, sexual assault by physicians has been going on for decades. The victims of Niels Lauersen did not have the klieg lights of Hollywood to help dramatize our stories. But it's theater of the absurd that a woman can be sexually assaulted in a gynecologist's office, have no claim against his malpractice insurance or the hospitals with which he might be affiliated, and be unable to press charges unless she raised an outcry during the office visit and demanded the police be called. The chances of that happening, in the mid-1980s especially, are less than none. The barriers were and are too high, the protection afforded the offender too airtight.  

It was—and still largely is—a system where victims have no shelter. I did not have insurance that covered me against sexual assault. No policy that could check the man with access to my private parts. As the victims of Larry Nassar well know, institutional complicity allowed him to practice unchecked for decades. A serial abuser for more than twenty years, Nassar only came under serious scrutiny in 2015 when USA Gymnastics moved against him after mounting accusations. But the sports industry and the university where Nassar worked provided the backdrop for his crimes. In Nassar's case, the collusion extended to federal law enforcement: several victims went on record to charge the FBI with mishandling the investigation. Another egregious offender, Robert Hadden, M.D., was an OB/GYN at Columbia University Medical Center for 25 years. Hadden was recently convicted on federal charges related to luring women to his office where he engaged in a range of sexual acts in the guise of providing medical treatment. Columbia University supplied Hadden with the carte blanche to carry out his flagrant activities.

Like Weinstein, Nassar and Hadden are monsters to revile. But rather than dismiss them as inhuman, we should focus on the opportunities their cases present. Nassar was perfectly situated within an academic setting at Michigan State University. The US National Gymnastics Team funneled hundreds of young women his way. These are two powerful entities, and he reigned supreme as the team doctor for 18 years. Hadden was in much the same position as a star OB/GYN at Columbia University Hospital. That they were such protected persons set the stage, was the stage on which their violent acts were committed. Only because his excesses were so legion and the profile of his victims so prominent was Larry Nassar brought to justice. It took the accumulated testimony from numerous young athletes--and the airing of their claims on national television--plus the belated cooperation of USA Gymnastics for him to be convicted on more than 500 counts of sexual assault and sentenced to 175 years in federal prison. Similarly, the guilty verdict against Dr. Hadden was the result of years of organizing, outcry, and advocacy by his victims. These cases demonstrate how difficult and how coordinated must be the pushback against a protected offender.

The doctor/abuser has another advantage. Apparently, many of Nassar’s assaults took place with a parent in the room. Hadden’s occurred with nurses present. The victims said they did not recognize what was happening or were too shocked to compute the doctors’ actions as sexual assaults. That's the point: the doctor has the automatic trust of the woman in his care. She places implicit faith in him. The doctor visit is not a negotiation between equals. One party, the patient, turns over her body to a more powerful person, the physician. That's what I did on a June day in 1984. 

Niels Lauersen had a vast opportunity to abuse. He was a genius at image-making and built a reputation as a woman's best friend through television appearances and magazine articles. Geraldo Rivera called him the "Dyno Gyno." He understood women's needs--for an easy new form of birth control, for help in conception. He built his practice from the ground up by appealing to individuals like me via a healthy mix of earnestness, media savvy, and charisma. When he laughed, which was often, his mop of curly red hair shook.

That acumen extended to his sexual offenses. Lauersen saw tiers of patients, both the rich and famous as well as the everyday woman. Part of his shtick was bringing care to the masses; hence, throngs of young women like me filled his waiting room. We formed the ready pool of unknown, young, non-affluent women who were unlikely to protest. His activity was shielded by celebrity clients like Denise Rich (with whom he had a relationship), Celine Dion, Liv Ullman and Foxy Brown, whose business he could not afford to lose.

The entertainment industry and New York society also helped to burnish Lauersen's status and his business. Anyone who has lived in this city for five minutes understands the power of the monied class and the celebrities who walk amongst us. It's a very stratified, star-struck town. That world welcomed Lauersen with open arms. It is no surprise that his reputation grew into something larger than life.

Of course, the scheme was not foolproof. Lauersen got sloppy. There are stories of reckless behavior in the delivery room, and a messy rape allegation he settled with a former patient. That case he dismissed as a lapse on his part, a failure to protect himself from "the crazies." These one-offs hint at the rot beneath the surface.

Lauersen was a less discriminating abuser than Nassar. His patients were a cross-section of New York City, not just an elite group of athletes. When he died in 2020, the obituaries note the dramatic rise and fall of his career. But a big piece was left out. He was a serial sex offender. Whose crimes flourished under the dome of protection afforded by the toxic mix of celebrity culture, the media, the insurance companies, and the hospitals. None of these societal forces bears accountability for enabling Lauersen's sexual assault. It is time that they did.  

Niels Lauersen got away with it. As do others who are encouraged by the structures that continue to undergird our world--the churches, the hospitals and the insurance companies--that are meant to provide safety. But that's the thing with sexual assault. It happens in places where trust is supposed to prevail. It's time to place a monetary value on such trust by ensuring the victims' safety is maintained. This is the case for reparations.

Damages against a perpetrator are the right of any victim. And individuals should be held accountable, both in court and financially, for the injuries they caused. But damages are insufficient to address the epidemic of sexual assault that threatens our social fabric. We live in a distorted world where unprotected victims must exercise inordinate effort to get redress--even to be believed--and where perpetrators are provided sanctuary. It is time to recognize the contribution of institutions like hospitals, in league with insurance companies that do not include sexual assault as an injury or outcome of malpractice.

It remains to be seen if I can seek damages against any of the hospitals with which Niels Lauersen was affiliated. But damages would not serve justice in the way that reparations would. I invite other victims to come forward and join this effort. And I call upon the hospitals and the insurance companies to admit their complicity by enabling the perpetrators.

There are signs of hope. In a guest essay in The New York Times, Dr. Helen Ouyang writes that Columbia has declared its intent to establish a $100 million settlement fund and "inform Dr. Hadden’s 6,500 patients that this money is available." This action opens the way for other institutions to do the same and acknowledge their role in the persistence of sexual assault.

Before change can happen, we must name the problem and acknowledge the harm that has been done. Reparations are one step toward ensuring that social structures do what they are chartered to do instead of supporting a status quo that enables criminals.