Turn Your Head and Cough: A Teenager’s Nightmare

I found this article very interesting: https://www.archerfriendly.com/2015/06/turn-your-head-and-cough-a-teenagers-nightmare

"Dear Adolescent Boys,

Whenever I tell you that a genital exam is part of your annual well child check, your eyeballs fall out of your head in complete horror. The expression on your face makes me feel like my office is a haunted house, and you just saw a goblin for the first time ever. In other words, you act like you had ABSOLUTELY NO IDEA WHAT YOU WERE IN FOR.

I have a hard time deciphering this behavior. I’m not sure if you’re putting on a show to get out of the exam, or if you really are that mentally unprepared and completely clueless as to what would happen at your “well child check”.

First, let’s get the terminology out of the way, because the word “child” is a little off-putting. A well child check is the politically correct terminology for your annual physical exam. It is technically called a “well child exam” until you reach the age of 18. I’m sorry we call you a child. I know, the term makes you hate the pediatrician even more because you already feel too big and too grown up to visit a waiting room full of crying babies and kiddie toys. We should really call your yearly physical exams, “well adolescent checks” or “well adolescent exams”. Unfortunately, whatever term we choose to use, we’ll always be dorky to you because you’re a cool cat now — you have your driver’s license, you have a girlfriend, and you’re the drummer in a band.

I recommend that you get a routine physical exam once a year, for every year of your life! This includes every year up until you turn 18 and then one at age 19, 20, 21, etc.

It is standard for your well adolescent check to include a genital exam. Your doctor should ask for your consent before doing it. Most of the time, you say no anyways. But sometimes you say yes.

You should know why physicians do a male genital exam on adolescents. There are four main reasons:

1. To make sure you don’t have testicular cancer. Testicular cancer can occur at any age.

2. To make sure you don’t have an inguinal hernia. This is where your guts come out of your abdomen in all the wrong places.

3. To do a sexual maturity rating (SMR). This is where we make sure your sexual development is on par with your age.

4. To make sure everything is normal.

It’s true that routine male genital exams are controversial. In other words, some physicians think that it is unnecessary to do them on a regular basis. The USPSTF (a fancy acronym for an organization that sets the standards for health prevention & screening) actually recommends against testicular exams as a means to screen for testicular cancer in adolescent men. Some argue that routine hernia exams aren’t even necessary. A concerning inguinal hernia will most likely cause symptoms. A hernia found on exam without symptoms is usually a “watch and wait” situation.

If you feel uncomfortable about your genital exam, the best thing you can do is voice that discomfort to your physician. Have a conversation about the exam beforehand. Discuss specifically why you don’t want to get it done. The ability to have these conversations with your doctor helps to develop the skill set you need to comfortably talk about sex and your genitals with your peers. If you can’t talk about your genitals with your physician, how will you be able to discuss them with your future partner?

One last thing all guys everywhere need to know. When a physician checks for hernias, he or she will say the classic phrase associated with the male genital exam. Say it with me now:

“Turn your head and cough.”

This is NOT to distract you from the discomfort of the exam. The cough adds force to any guts that may be protruding in the wrong place, so that your physician can more easily detect them. In other words, the cough increases intra-abdominal pressure to accentuate the hernia to aid in diagnosis. The reason we ask you to turn your head is so that you don’t cough all over us. Brilliant, right?

Some physicians actually require a chaperone to be present during the genital exam. They do this for not only your protection and safety but also for legal purposes. In my practice, I require a parent to be in the room during the male genital exam, but the parent doesn’t have to watch directly.

Lastly, please note that some guys do incidentally get an erection during the male genital exam. It happens and there’s not much you can do about it.

K, so promise me, that the next time it’s your turn for a male genital exam, and you feel awkward and weird, that you’ll talk to your doctor about how you feel about the exam rather than acting like you had ABSOLUTELY NO IDEA WHAT YOU WERE IN FOR. Because now you know.

Sincerely,

Dr. Archer"

That chick's hot. I'd love to chat with her about physical exams. She's into the "feeling". That right there can be a whole discussion.

Yes, I would gladly receive a male genital exam from her. I found it especially interesting that she's a naturopathic doctor, not a MD. I honestly didn't realize that those doctors conducted full exams, including the genitals. I may need to look into that option locally. 😃

I'd love to chat with her about physical exams.

Yes, I would gladly receive a male genital exam from her.

I concur with these two statements.

Here's a similar article: https://survivorpediatrics.wordpress.com/2011/11/24/to-teen-guys-yes-we-really-need-to-check-em/

Hi all,

Not once as a child growing up was I ever examined there, if I would have had a problem, I would have gone to a Dr. But the routine examination of a child's genitalia at your GP or School was unheard of. No annual physical, no requirement for sports, we as kids played out every day playing soccer etc. Maybe it was not a requirement in the time I was a teen, at school from 1968 to 1980. Any school exam, was just a cursory look over, no removal of pants or underwear. Nothing intrusive. We all survived. God I was so lucky.

It was pretty common for me, but apart from being a bit embarrassing not too bad. The part I didn't like was the blood draw.

Even when the "dreaded" hernia check made an appearance it was worse in anticipation than it was in reality.

Most of the Doctors who examined me seemed very old to me. All male doctors when my genitals were examined. Female doctors twice who didn't require me naked.

At school it was just part of the routine and you accepted it. Parents expected it to happen, and in the early years one would be present. Rumours went through the school as to what the doctor this time would do. No Internet in those days to gain more information. We just had a thick medical dictionary at home, probably out of date.

After my time at school had ended, had to have some pre-employment exams. Came as a bit of a surprise to have my balls checked out then.

I guess I probably hated it when I was younger. But sometime around puberty is when I developed my medical fetish.

Not once as a child growing up was I ever examined there, Maybe it was not a requirement in the time I was a teen, at school from 1968 to 1980.

I grew up in the '70s and '80s and I had my genitals examined all my childhood and teen years. The pediatrician I saw prior to age 11 would put his hand down my underwear and feel my testicles. I had to change pediatricians at age 11 and that one had my underpants down for full visual and palpation until I went away to college. I just thought it was something every boy dreaded but accepted like a man. It seems like kids now want to make everything up for discussion and negotiation.

I guess I probably hated it when I was younger. But sometime around puberty is when I developed my medical fetish.

This kind of reminds me. I hated it when i was younger as well. But I hated it too as an adult in my early 20's, until i passed my mid 20's, had matured, and didn't mind it so much. My nightmare was from lack of being exposed at the command of strangers. Which morphed into just being homophobic, and not comfortable in a nude setting around men at all.

Then, as i had started becoming more open to men & comfortable with them, my reservations I had-had, became a root to my medfet.

I consider it ironic, that now that a hernia check, which once seemed so mandatory where we felt forced and awkward and uncomfortable submitting to them, is now seemingly non existent, yet that i'd actually welcome it.

I received a genital exam at every physical I received from my pediatrician from birth through the age of 18 and at every adult physical since then. As a teen, there was zero doubt that I would have my genitals checked and the thought of questioning such an exam never crossed my mind.

I’m surprised that so many teens would be taken aback by a genital exam. Is it a product of them not consistently or ever receiving such exams in the past? Or is it that they now feel more empowered to protest? Even during puberty when awareness of my body was heightened, I never felt nearly distressed enough to question the doctor.

Hi as a teenager I had two medicals at school and both times I had my genitals examined .

the male doctor pulled my y fronts away from my waist and down exposing my genitalia.

then taking hold of my testicals and telling me to turn my head and to give him a good deep cough

he then told me to cough a second time.

Student getting a sports physical. Of course he has to strip to his underwear for his physical. It’s part of the drill. For the most part he will be examined with them on. Really nothing to it; for the most part it’s like a walk in the park.

But at some point, those briefs will have to come down and then the hard part begins. The doctor will see the guy's penis and balls. The groin has to be examined and the guy has to be checked for a hernia. The doctor will push his index finger into the inguinal canal on one side pushing it up there through the scrotum. Then he tells the guy to "turn your head and cough. Cough again. Good." Then he repeats in the other groin. That’s part of the drill, too. When that aspect of the physical is over, off he goes and the briefs can come back up. That part he just has to deal with.

I appreciate how articulate her article is. The reality is, this is an important part of a routine physical for boys. Yeah it sucked for many of us growing up, but medfet aside, it's a necessary part of the exam like it or not.

Articles like this are interesting to me because they seem to make such a big deal out of such a minor part of the exam. I wonder if playing up the anticipation of the check makes the patients think that it's worse than it is.

For example, right from the start of the article, she says:

Whenever I tell you that a genital exam is part of your annual well child check, your eyeballs fall out of your head in complete horror.

That hasn't been my experience at all. In fact, with the exception of one visit during my entire time going to the practice, I only had one doctor one time "tell" me that a genital/hernia exam would be part of the physical. The others just went ahead and did it, and I think that might be better. I'd be laying or standing there, and the doctor would just pull my underwear out or down, and the exam was finished before I knew it. No need to fuss or stress over it.

The other part that stuck out to me was this bit:

“Turn your head and cough.” This is NOT to distract you from the discomfort of the exam. The cough adds force to any guts that may be protruding in the wrong place, so that your physician can more easily detect them. In other words, the cough increases intra-abdominal pressure to accentuate the hernia to aid in diagnosis. The reason we ask you to turn your head is so that you don’t cough all over us. Brilliant, right?

It's such an iconic phrase, but I never actually heard it, and that's because there are so many other ways for the doctor to conduct the exam. And I think I experienced most of those different ways.

- Once I was laying down on the table, and the doctor just asked me to "cough". My face was far enough away from him that I wasn't coughing in his face, so it didn't matter which way my head was facing.

- Another time, I was standing, but instead of standing in front of me, the doctor was standing sort of to my side. Again, he just said "cough", and having me turn my head might result in me turning toward him.

- But most often, standing or laying down, the doctors would just tell me to "tighten up" during the exam -- no coughing required. It was a little unusual, and to this day I'm not sure I did it right, but I'd squeeze those "gotta pee" muscles, he'd feel what he needed to feel, and we moved on to the next part of the exam.

All that said, reading that article, I like Dr. Archer and would enjoy receiving an examination from her. She seems very caring and cognizant of her patients' feelings. I'd be a great patient for her. I wouldn't fuss over her calling it a "well child check". I wouldn't look surprised when she tells me that she has to do a genital and hernia exam; I'd say yes when she asks for my consent to do it. I'd even cough nice and hard, careful not to do so right in her face.

I don't know any boy who plays sports who are terrified of this part of the exam. I think that article over exaggerates how we feel about it.

I would love to have a physical from Dr. Archer.

I would hope she puts as much thought and consideration into the rectal and prostate exam.

I don't know any boy who plays sports who are terrified of this part of the exam.

I have previously posted about a female nurse seeing me naked before an exam. I was preteen at the time, after puberty would have been way worse. IMHO the doc didn't exaggerate at all!

The other part that stuck out to me was this bit:It's such an iconic phrase, but I never actually heard it, and that's because there are so many other ways for the doctor to conduct the exam. And I think I experienced most of those different ways.

- Once I was laying down on the table, and the doctor just asked me to "cough". My face was far enough away from him that I wasn't coughing in his face, so it didn't matter which way my head was facing.

- Another time, I was standing, but instead of standing in front of me, the doctor was standing sort of to my side. Again, he just said "cough", and having me turn my head might result in me turning toward him.

All that said, reading that article, I like Dr. Archer and would enjoy receiving an examination from her. She seems very caring and cognizant of her patients' feelings. I'd be a great patient for her. I wouldn't fuss over her calling it a "well child check". I wouldn't look surprised when she tells me that she has to do a genital and hernia exam; I'd say yes when she asks for my consent to do it. I'd even cough nice and hard, careful not to do so right in her face.

I was never asked to “turn your head and cough” and agree it is such an iconic phrase. I have usually been asked to “cough”, “and again” at which time I always turned my head, put my hand over my mouth and coughed. The first time I had a hernia check. I had no idea what the doctor was doing or what they were checking for. It took me a couple of years to find out. No internet in those days. When I was asked to cough, I actually thought something was supposed to happen (rather than the opposite). I rather wish articles like this had been around when I was having my school medicals.

For sure having a genital/hernia exam was and remains part of my exam experience for as long as I can remember. I am now past the nightmare stage but as a child and teen, it was something I had a lot of anxiety and embarrassment over. Each doctor had his own approach. Some just had me stand up and lower my briefs to view and examine my testicles and penis. Others had me stand and remove my briefs for the same thing including cough twice for each testicle and also bend over so the doctor could see my anus. The doctor I saw the most would just tell me to lift my hips and he then pulled off my briefs and placed them on a chair. He would then feel my belly and then pulse between my legs before reaching for my testicles and rotating each one. I would just stare at the ceiling avoiding all eye contact. Then I was asked to stand, legs spread and felt him hold each testicle while I coughed and checking for an inguinal hernia. I always remember feel a dull achy sensation as he squeezed me. There was a quick look at my penis then or while on my back. Lastly he had me turn around and lean onto the table so he could inspect my anus and told me to push or bare down a few times. All of these experiences remain in the memory banks.

@Nick321

They certainly are memorable experiences and I can remember mine still vividly,.

I always had my genitals examined as a kid an now as a adult. It wasn’t until I was 11 or 12, that my pediatrician began pulling my underwear down (himself) for a full visual and palpation of my penis and testicles. For me, every physicals (yearly, sports or employment) involved a full genital and hernia exam. Actually, I found the employment physicals somewhat exciting since I would have to expose my genitals to a different doctor every year. (Note: during college I worked for the same company (5 years) during summers which required a complete physical.)

Honestly, some guys may have dreaded it be done but I just accepted it as being part of a guys exam. Also, I would have never dreamed of questioning or protesting any of my doctors preforming necessary parts of a physical. Like the article suggests, some kids & parents think or believe everything up for discussion and negotiation. I actually had a doctor that explained why and the importance of a genital and hernia exams.

I’ll admit, I found some testicle or hernia exams somewhat awkward or uncomfortable but it has to be done.

My experience was very much like Surfboard's, in the sense that all my physical exams - from just before puberty up to when they seem to have gone out of fashion about 20 years ago - always included a genital/hernia check. If I remember correctly, the words our family doctor used were something like "Look to the left", I would feel his finger go up one side or the other of my groin and press, followed by "Now cough for me". Then he would do the other side. Sounds silly now, but at the time (11-12) I wondered why, if I had to look left for one side, he didn't ask me to look right for the other.

Growing up, many of my friends professed to hate this part of their exams. I loved it. I looked forward to physicals. I was fascinated by the entire doctor visit scene. I liked standing there and having my shorts taken down, naked, being touched, and told everything was fine and I was growing up healthy.

Almost seven decades later, I recently found a local play doctor and we've exchanged exams. He uses the hallowed phrase, "Turn your head and cough", which I happily do.

Growing up, the genital exam was part of every doctor's visit whether for a full physical or just because I was sick. I never understand stories these days of boys as old as teenagers being shocked by this experience. It also sounds like boys aren't even made to take their shirts off. One of my fondest memories is always being made to strip to briefs right from the beginning and going through the whole exam that way.

One of my fondest memories is always being made to strip to briefs right from the beginning and going through the whole exam that way.

I would slightly alter this to say “one of the memories I enjoy reflecting back upon was being made to strip to my briefs and go through the exam dreading the moment when the briefs would have to go down to expose my genitalia. It was miserable to go through but makes for some good masturbating memories later.

I would slightly alter this to say “one of the memories I enjoy reflecting back upon was being made to strip to my briefs and go through the exam dreading the moment when the briefs would have to go down to expose my genitalia. It was miserable to go through but makes for some good masturbating memories later.

I would third that and say that it was embarrassing being stripped down to my boxers and knowing that my erect penis was going to be on display in front of a female doctor, but looking back on it it's something I have good memories of.

I sympathize with today's kids who are uncomfortable with genital exams and male nudity. We're all products of our own time and place. When I was growing up the situation was utterly different. We boys were comfortable with nudity because we were socialized that way. When we went to the pediatrician we were told to take everything off except underpants (no gown of course). You did as you were told. As your mom looked on, the doc stripped off your underpants and you lied there completely naked and let him handle your testicles and penis. It all seemed (and was to us) perfectly normal. When you reached puberty your mom and the doc saw your pubic hair, and sometimes (as once happened to me) they might see your penis become erect and squirt semen. When we would go to a public pool we were required to take a nude soap shower (for hygienic reasons). My Dad and I would get naked and shower together with all the other naked dads and sons. It was a great bonding experience. In Jr. High gym class all us boys were required to strip totally naked and shower together. Again, a wonderful bonding experience. We all knew that our dads and our friends had penises and testicles like we did and that at a certain point hair would grow above our penises and our genitals would become larger and more developed. Nudity was and is natural. It felt so good to just be ourselves and literally let it all hang out.

Nebag,

Everything you said was true in my life except I was never comfortable with it. I was very shy and didn't like any of those experiences where I had to be nude with others. It wasn't until I was 50 and started doing enemas that I finally became comfortable being nude with others.

Yes, @buttshotlover, within any cohort there are going to be varying degrees of how comfortable individuals are with something. I'm sorry that those experiences were uncomfortable for you at the time, but glad that you are now comfortable with group nudity. I recall there were a few boys in gym class who on the first day were terrified of having to strip completely naked and shower with all the other boys, but once we all did it even those boys came to enjoy the freedom and naturalness and it drew all of us closer together.