Language used to initiate genital exam

How have your current and past doctors conveyed to you that it's time to begin a genital exam? In other words, what language and instructions did they use to get you into position?

My pediatrician was always very calm yet direct when it came to genital exams. Throughout the exam he announced each part that he was going to do, and when it came to the genital exam he didn't change his tone. When I was younger for example, he would have me lie down and announced he was going to check my stomach. After palpating my abdomen, he announced he was going to "check my privates" and proceeded to unfasten my pants and lower my pants and underwear to perform the genital exam. His tone and manner in which he commenced the genital exam was very effective in making the genital exam feel like any other portion of the exam - no more, and no less important. The manner in which he exposed the portion to be examined was also similar to every other part where he had to raise my shirt or take off my socks - sensitively done, but quick and efficient. There was never a bigger deal made about genital exams than any other part.

As I got older, I saw the same pediatrician and started standing for my genital exams. Although the position I was in changed, the manner in which he conducted them didn't. He announced the exam and the instructions to lower my pants in the same manner as every other part of the exam. The instruction to lower my pants was delivered in the same way as the instruction to take off my shoes or stick my tongue out.

After "graduating" from my pediatrician, I've had 2 doctors since. They both have performed genital exams at all of my physicals but I have noticed that although the exam itself may be complete, there was a bit of a hesitate, maybe even apologetic tone, when announcing the genital exam.

The first adult doctor I had I only saw once before he moved on. I stayed fully clothed in literally everything except shoes (yes, even my belt and the contents in my pockets). I was doubting I'd even get a genital exam but at the very end he said rather softly something to the effect of "I like to do a testicular exam for males your age. Could you go ahead and stand?" There was no further instruction. Mind you, I was dressed from head to toe, so I stepped forward in front of the seated and gloved doctor and quite awkwardly began what felt like undressing directly in front of him. I don't know if anyone else has experienced being fully dressed and having to unfasten a belt, undo a button, pull down a zipper and lower both your pants and underwear in front of someone who's just sitting there in silence waiting, but it's not the most natural thing to do. In this case, the silence was quite uncomfortable and it singled out the genital exam as something awkaward and embarrassing.

My current doctor is much more straightforward in announcing the genital exam though there is a hint of that "sorry I got to do this" voice. He also doesn't give instructions to lower my shorts but when he's gloves and ready and I'm standing up, he'll give a clear "ok" as a signal to expose the area.

I personally don't need any special tone when it comes to genital exams, but maybe some of you appreciate that doctors recognize the genital exam as perhaps more uncomfortable than the rest of the exam? How do your doctors announce they need to examine your genitals and what instructions, if any, are given?

If I were to generalise first, with internal medicine doctors as an adult, if I am getting ready, meaning if I have stood up from the exam table, which might be as far as they go with instructions, as they turn to put gloves on, and perhaps notice from the side that I am slipping off my briefs: 'cough, cough.' The Dre does get prompts since doctors vary the approach, from 'bend over' or 'lie back on the table with....' I can't think of any of them telling me what they are doing, or going to do. I have had some ask me, either, 'Do you examine your testicles monthly?' or 'Do you know how to examine your testicles?'

My current doctor wants to 'examine the boys.'

Supermoney777...excellent account / summary. It sums up a lot quite perfectly. When I was a child / teen having school medical exams here in the UK, the doctors all seemed to be terribly well spoken with cut glass accents. They were always fairly friendly, but also very brisk and business like. Avuncular, but no nonsense.

They issued imperatives and spoke in a third person style -eg. 'How are we today?' 'Right. Let's have a look at you, shall we?' 'Good. Now..let's get undressed.' Even when I was in my late teens, these matter -of -fact instructions were always followed by phrases / comments like 'Splendid!' 'There's a good lad' etc.

They used euphemisms for genitalia etc, but you always knew what was coming up. They would just have a variation on: " Now...we just need to check your back passage and see what's going on down below." Of course, that meant..bend over, part your butt cheeks for visual anal inspection, followed by checking scrotal sac and testicles ( palpation) then penis check -incl. foreskin retraction to check the glans.

It was all done in a brisk, matter of fact way. So, I would agree that there was no more emphasis placed upon the genital exam than any other aspect. As the patient. ..it was just impossible to escape the terrible self - consciousness ( as a nervy adolescent ) whilst standing naked with the doctor checking you intimately.

All of that was nearly 50 years ago now. As an adult, I feel totally different about it and quite relaxed. But things have changed with the doctors I now see (not too often thankfully) here in the UK. They seem almost reluctant to get you to undress. The last time I needed my genitals checking...the doctor actually asked for my verbal consent to carry out the exam and almost apologised for explaining that I would need to remove my underwear. What a turn around in half a century!!

Also, I mentioned in another thread (about hospital gowns) that, a few months ago, I had to have a routine hip X Ray. Before going to the X Ray room, I was instructed by a nurse (she was very definite about it) to remove ALL of my clothes and put a gown on. This was not a problem, except that I could not tie the wretched thing properly. It was a farce. I passed other patients going from the reception area to X Ray. It was difficult to preserve my modesty (I was not worried for myself)..but the accompanying nurse was very flustered and kept apologising. The Radiologist and her assistant were also very concerned. I had to agree to another nurse doing the gown up properly. The problem genuinely was not with me being worried / embarrassed. No....it was the staff, they were genuinely paranoid about it. Sheer craziness!!

The information is helpful as I'm trying to think what approach and language is used when an exam gets to that stage. I'd assume there would be some conversation for transition. I would prefer to properly convey what's next and communicate as best as possible.

I have had a very similar experience as told by supermoney. Growing up, my pediatrician always explained everything that he was doing. He told me that he needed to examine my private parts to make sure that they were healthy. At my recent physical done by my internist (I posted about it on 6/13/2017) , he specifically said "stand in front of me as I need to examine your genitals". "I know most men don't like this part of the exam but it is very important to make sure that they are healthy and functioning the way that they should.”

As far as I can remember, they just did it. I never remember anything specifically being explained to me, but I equally if not more do not remember being surprised. It was just an expected part of the deal.

FWIW, I certainly did not know that they may have been checking for hernias until I was pretty much done with pediatricians and am pretty sure I did not even know what a hernia was until I was in high school.

My doctor is very up front and to the point. She asks me to remove my underwear, spread my legs apart a little and place my hands behind my head so she can check my groin area and prostate. "Try to relax, this won't take too long."

What do you mean by FWIW?

FWIW means "For what it is worth"

This is a great topic and, for some of us, the doctor's demeanor and instructions involved in initiating the genital exam is critical to the core of our medical fetish: the embarrassment of having the genital and hernia exam. In virtually all of my physicals, the genital exam was performed immediately following the abdominal examination. The patient is supine for the abdominal exam with the doctor standing over him. Almost all of the genital exams which I have undergone have been performed standing and facing the doctor. The doctor has either been standing or seated on a rolling stool with me facing him in either circumstance. This means the doctor has to reposition himself in his examining posture and has to instruct me as to how he wants me positioned. It is pretty obvious to the patient what is about to happen and, for those of us who are embarrassed by this part of the exam, we are apprehensive and feel some butterflies. All the doctors who have examined me reposition themselves, either standing or on the stool, in a quick and assertive manner, empahsizing their power status. Next he has to instruct me on positioning. I have never had a doctor tell me what he was about to do. All have made confident and direct instruction statements such as "stand here next to the table and slip your shorts down."

Last time I had it done (about a month ago) I was there for a physical for Scout camp. There is a specific form the doctor must sign. After a quick check of the heart, lungs and abdomen over my clothing he started checking off the boxes.

Then he stopped and said "since it's on here, let's go ahead and check you for a hernia." I was sitting on the table at the time and promptly jumped down and dropped my shorts and briefs to my ankles.

He put his finger in my inguinal ducts and had me cough. He didn't check my testicles or penis.

When I was a kid, the doctor I had liked the waistband of my tightey-whities down, uncovering my groin when he did the abdominal exam. He would say, "Let's skootch these down a bit." Then the doctor would tell me he needed to "take a look at your 'water works.' " The first time when I was about eight, he pulled down my underwear while I was standing in front of him.

Now that I think of it, when I was younger and went for the school physicals as it required genital exam every other year. The doc will always say 'Take everything off and lay on the exam table' I always leave my underwear on and the doc will taking it off for me.

When I was younger there was no specific request that the Doctor was going to examine my genitals. It was just' slip your underpants down' and just got on with it, even pulling my underwear down himself, with or without prior warning. Nowadays things are different and a request is made 'would you mind if I examined' or something similar. Privacy is more respected now.

I don't know if anyone else has experienced being fully dressed and having to unfasten a belt, undo a button, pull down a zipper and lower both your pants and underwear in front of someone who's just sitting there in silence waiting, but it's not the most natural thing to do. In this case, the silence was quite uncomfortable and it singled out the genital exam as something awkaward and embarrassing.

I am glad Supermoney brought up this experience because I had a similar experience and it also happened to be the first doctor I saw after going away to college and leaving my pediatrician. He was a middle aged doctor I was sent to for an employment exam for my first job after graduating from college. He had me take off my shirt off to begin the exam, leaving me in dress trousers with a belt and my socks and shoes. The exam started with me seated on the exam table, which was an old fashioned bench which was quite high off the floor and required a four legged step stool to allow the patient to get up onto it. He proceeded to perform a brief but systematic exam from the chest up. Then he told me to lie back on my back and did an abdominal exam. Then he stepped back one step from the table and said "step up on the platform facing me and drop your pants AND (emphasis) shorts. I had to stand up on the four legged stool, unbuckle my belt, open the hook and button on my slacks, unzip the zipper, and grab the waistband of my trousers and briefs and lower them to expose my penis and scrotum while he waited while staring at the front of my pants where the genitalia would appear for him. Very embarrassing that he was seeing my penis and also because it was so awkward exposing it for him.

I've had a number of different ones that stand out somewhat, partly because I had Tanner assessments done regularly, but the one thing that stands out the most was just overhearing a kind of grumpy doctor examining my older brother - who did not like going to the doctor at all and was a little uncooperative and tended to cover himself a lot. I was off to the side sitting and my brother was on the table and his underpants had come off and the doctor just suddenly said to him, very plainly and matter-of-factly, "spread your legs out to here."

Seems as though for the last several years, which included at least 3 different Drs. (all Family Practice), they haven't had me take off anything. And these were all for "complete physicals" which I was very clear to request when asked why I needed to see the Dr. The last appointment was with a female in the same practice as the previous Dr. When she entered the room she remarked that "Oh, you were just here last month for a Physical", to which I responded "Yes, but he had me in and out in 5 minutes and I didn't feel he did a very through exam". She spent a few more minutes talking about my history, but the exam was no more through- I didn't even remove my shirt, let alone my trousers.

Obviously I enjoy the thrill of being examined (let's face it, isn't that why we are here?), but equally important is to catch any developing medical concerns early enough to have options.

I'm not sure if the current trend towards cursory exams is a function of economics (get 'em in, get 'em out), changes in healthcare or fear of legal liability but I do know that the lack of thoroughness on the part of my Physicians has left me disappointed, but also less confident in my state of health.

BTW- While I was on flight status (probably the last time I had a thorough exam) we would routinely be told to "strip to your shorts" by the Nurse who took our vital signs. Then when the Flight Surgeon came in, he would conduct his exam up to the last items (genitals) then tell us to "drop your shorts and bend over the table", all the time reaching for the K-Y tube. We all knoew what was coming next!

Every time I've had a genital exam the doctor would ask me to stand up in front of the table and raise my gown and she would explain what she was doing and move forward with the exam

"Drop your shorts" is probably the most common instruction I have received over the years, including from my teens onward. That instruction was also what I was told during my physical last year so that much hasn't changed much. I had one doctor years ago who told me to "drop your jock". I was wearing briefs so "jock" was short for "jockeys". I saw him several times for exams and he always said the same thing.

I also remember doctors saying "drop your underpants to your ankles" or "drop your shorts to your ankles". When I have been in a gown only without underwear, which hasn't happen a lot, the doctor had me stand and told me to lift my gown in front. I had one doctor who had told me to keep my underwear on with the gown. He told me to "lift your gown and drop your underpants to your ankles" which really meant "drop your underpants first and then lift your gown" because you can't do it the other way very easy.

When I was a kid, the pediatrician would pull my briefs down to my hips when doing the abdominal exam and then for the genital exam she would say, "lets go ahead and take these off for now." And then she would pull them off and examine my genitals and then have me roll over on my side to examine my anus. Then she had me stand up and she checked for a hernia.

These days the urologist says, "stand up facing me and drop your pants and underwear so I can check you up front first." After that's "turn around and bend over the table and spread your feet apart."

I forgot to add below that I had one doctor for several years who would tell me to take my shorts completely off at the end of the exam so he could check my testicles, do the hernia exam, and then do the rectal exam. He would say something like, "go ahead and take your shorts off" as that was all I was wearing during the physical. So I would be wearing nothing for the last two minutes of the exam. There isn't much difference between taking underwear off completely and having them at your ankles anyway so I didn't mind.

My long-time female physician always had me undress to my underpants and put on a gown and a drape sheet, even as recently as a couple of years ago. When it was time for the genital and rectal exams she would say "just pull your undershorts down" and then she would expose me by lifting the gown and pulling down the sheet. She would then say "just roll on your side and bring your knees up" for the rectal exam. My current male physician recently did a very thorough work up, but I was fully dressed throughout, and no genital or rectal exam, although he did palpate my inguinal ligaments through my pants and have me cough.

I think these doctors are on to us... 😉

Are you saying that your doctor did a hernia exam through your pants? Do you mean pants as in underwear or pants as in jeans or trousers? I have never heard of a doctor doing a hernia exam with the patient wearing anything down below.

When I was growing up that the doctor would usually start the genital exam without saying anything - I would just find his hands sliding into my underwear.

Yes, pants as in trousers, davidwest. It was a first for me too, I had what amounted to a full physical exam without removing a stitch of clothing (which is, of course, not what any of us want...) It seems to be the current trend in medical exams to not have patients disrobe--hence my joke about how I think the docs are on to us med-fet folks...

"Drop your drawers captain. The turn your head and cough routine is next"

The first time I saw our long time family practice doctor, I did not know what to expect. I was in my briefs throughout the exam, and then toward the end, she mentioned that at my age (35 at the time), I was low risk for both testicle and prostate issues, but she would prefer to do them and asked for my concurrence. I agreed and she asked me to take my briefs off, and after examining my testicles, she added she would be taking a colorectal specimen while doing the prostate check.

"Okay, now scoot down as far as you can to end if the table...farther, farther. Good! Now just put your feet up in these stirrups and let's take a look"

Currently it's just something along the lines of "Right could you take off your underpants/boxers for me please".

When I was a kid the one that stands out most for me is "Ok I just want to have a look to see how you are downstairs". As it was a station to station exam and I'd already seen a classmate go before me I knew what I was expected to do.

I don't remember having a doctor pull my underpants down all for way for me but have had doctors years ago who would start to pull the waistband of my briefs down as a signal of what I needed to do. Are some doctors embarrassed to tell a male patient to pull his underwear down? I don't know although I remember doctors who would just motion with their hand that my underwear needed to come down now and I knew what they meant. Guess most doctors expect their patients to know what comes next after they ask the patient to get off the exam table and stand up. The genital and hernia exams are next so what male patient would be confused?

"Ok, if you could lower your shorts for me..." Said as she pulls on a pair of gloves.