RICHMOND, Va. (AP) — Men who have come forward with allegations of abuse by former Cardinal Theodore McCarrick expressed disgust, frustration and outrage after an internal Vatican report outlined what was known about the clergyman's behavior — and what was ignored.

“It was very emotional to read. It was very emotional because there were so many opportunities to stop him. So many opportunities to stop him. And maybe my life would be different, maybe I wouldn’t be a victim if someone had," said John Bellocchio, a New Jersey man who has sued both McCarrick and the Holy See, alleging the prelate abused him in the 1990s when he was a teenager.

In interviews with The Associated Press, Bellocchio and others demanded that the Vatican institute changes to ensure nothing like what was described in Tuesday's extraordinary report can happen again.

Spanning 449 pages, the internal investigation found that bishops, cardinals and popes downplayed or dismissed multiple reports of sexual misconduct by the now-90-year-old McCarrick, who as one of the highest-ranking, most visible Roman Catholic officials in the U.S. traveled the world and hobnobbed with presidents.

McCarrick was defrocked by Pope Francis in 2019 after a separate Vatican investigation determined he sexually abused minors as well as adults. An attorney for McCarrick, who now lives as a layman in a residence for priests, declined to comment on the report.

The report detailed the alarm bells that were ignored, excused or dismissed in 1992-93 when six anonymous letters were sent to U.S. church officials and the Vatican’s ambassador to the U.S., alleging McCarrick was a “pedophile” who would sleep in the same bed with young men and boys.

The report contained heartbreaking testimony about McCarrick’s inappropriate behavior, including from a woman identified only as “Mother 1” who told Vatican investigators she also sent anonymous letters in the 1980s when McCarrick was bishop in Metuchen, New Jersey, after she saw McCarrick “massaging (her two sons’) inner thighs” at her home.

“It’s crushing," said Geoffrey Downs, who in a lawsuit filed in New Jersey accused McCarrick of abusing him when he was a teenager and serving as an altar boy. “It’s just crushing to those of us who went through it because you realize how small and incidental you are to these creatures, predators. You’re almost like a small nut and bolt in this giant machine of predatory behavior.”

Both Bellocchio and Downs suggested the church create lay review boards as a way to give parishoners an actionable role in holding priests accountable.

Bellocchio, who formerly worked as an administrator in Catholic school systems and went on to found a company that trains service dogs, said Francis should consider removing former Pope John Paul II, who took most of the blame in the report, from the calendar of saints. As pontiff, John Paul appointed McCarrick archbishop of Washington, D.C., in 2000, despite having commissioned an inquiry that confirmed he slept with seminarians, according to the report.

SNAP, a network representing survivors of sex abuse by clergy, said many more preventive steps need to be taken and that the crisis is an ongoing one, with transparency and accountability still lacking.

“This report contains no punishments, no concrete steps to prevent future crimes, and consequently gives us no faith that this investigation was conducted in earnest,” the group said in a statement.

SNAP and another organization that represents survivors, Ending Clergy Abuse, called on President-elect Joe Biden, a practicing Catholic, to assist their efforts.

In an open letter to Biden, released Tuesday, the groups requested a say in the selection of the next U.S. ambassador to the Vatican, as well as a commitment from Biden to convene a task force designed to investigate institutional sexual abuse and eliminate inconsistencies in states’ handling of the issue.

They also asked Biden to urge the U.S. Conference of Catholic Bishops to release the names of all known sex offender clerics and their files at its national meeting next week.

The Conference's president, Los Angeles Archbishop José Gomez, described the McCarrick scandal as “another tragic chapter in the Church’s long struggle to confront the crimes of sexual abuse by clergy.”

“To McCarrick’s victims and their families, and to every victim-survivor of sexual abuse by the clergy, I express my profound sorrow and deepest apologies,” Gomez said. “This report underscores the need for us to repent and grow in our commitment to serve the people of God.”

Michael Reading, an inactive priest who has said McCarrick harassed him and touched him inappropriately without his consent when he was a seminarian, said the report angered and saddened him but also helped him realize he was not alone in his suffering.

Reading said he was glad the Vatican had done the investigation. He hoped it was a sign that the church was headed to a new era of accountability, but he said he still felt a degree of skepticism.

“The church takes hundreds of years to change," he said.

James Grein, a Virginia man who came forward publicly in 2018 to disclose that McCarrick had abused him for about two decades, starting when he was a child, said the report's release marked a “powerful day” for both him and other survivors of clergy sexual abuse. But he and his attorney, Mitchell Garabedian, said there was more to be done.

Garabedian — known for his work representing survivors of Catholic clergy sex abuse, including those who took part in a 2002 settlement with the Boston Archdiocese — called for an investigation by law enforcement about why what he called a cover-up went on for decades. Grein, who has filed lawsuits in both New York and New Jersey over the abuse allegations, said he wants an apology from the church. He said the abuse had taken an immense toll on his life, describing suicidal thoughts, feelings of post-traumatic stress, and a decades-long struggle with drugs and alcohol.

“How they could ever repair my damage, I don’t know,” Grein said.

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Associated Press writers David Crary in New York and Nicole Winfield in Rome contributed.

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