Medical but NOT MedFet | Turn Your Head and Cough: A T…

Views: 2216 Created: 2018.06.26

First post

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"

agracier

Moderator

agracier

Moderator

I sympathize with today's kids who are uncomfortable with genital exams and male nudity. .

I can't say that I sympathize much, maybe perhaps with the people who don't know better, but I certainly have no sympathy whatsoever with those in any kind of authority (moral or actual or whatever) who, collectively through the years/decades, have striven, agitated, preached, worked, cajoled and lied to push society in this direction.

Dr Nash

I have to add my applause to nebag's post. I agree that male-only bonding is so essential for our mental and social health. Like nebag, I too grew up showering with my classmates and the friendships I formed were strong. Years later while living in Boston, I went to the YMCA (actually the first in the USA) and was reminded of how essential it was for me to be in an all-male environment (and while it is true that many gay people were in gym it wasn't exclusively gay). I think it really helped me accept my body and it certainly was important for me psychologically. Today there is such fear around nudity (in the US) that it hampers some of the more subtle developmental features I feel are so integral to understanding "maleness."

Nick321

Wonderful find! Helped me recall that I had no formal explanation of what to expect when reaching puberty and having physical exams. Until then, there was minimal evaluation of my genitals though briefs were often lowered or absent! Still, it wasn't until I got to puberty that the notion of being undressed reached new significance. As I have explained before, the occurrence of erections during the day and at night fueled both masturbation fantasies as well as awkward moments where a spontaneous erection took place.

Group showers for gym or swim class became associated with heightened anxiety and wonderment. I began to notice differences in size as well as body hair distribution and pubic hair. Going to the Y meant seeing naked men with large ones! Who knew that this was possible when your a teen. Then my mind was full of misinformation from other teens including their exam experiences. Take those accounts and add teen hormones and one is likely to have an awkward erection episode. "Turn your head and cough" meant stand there naked with the doctor evaluating me while squeezing my testicles. Some how I went from, "Let's have a look," to now having my penis examined and testicles manipulated as if it was nothing. Surely that's what I wished for my mind to consider. My penis, on the other hand, sometimes had other objectives to achieve. At some point, I too joined the exam club experience of developing an erection during my exam. Who knew!

intub11

Something sort of similar, on the website for an all-female pediatrics practice: http://www.villagepedi.com/Medical-Advice/TEEN-ADVICE/Male-Genital-Exam

Why do we need to do a male genital exam at every well visit? We understand that this can be an embarrassing experience, but is very necessary for a complete evaluation.

JTMac

Something sort of similar, on the website for an all-female pediatrics practice: http://www.villagepedi.com/Medical-Advice/TEEN-ADVICE/Male-Genital-Exam

It's teens like that, and parents supportive to that nonsense that ruin it for the rest of us, where they don't want to bother to check everything, and perhaps running the risk of missing something potentially crucial. Perhaps because adults are better capable to notice when something's wrong, although several men have hernias and don't realize it.

MSGulfCoastMedFetCpl

Respectfully,

Was never done where I grew up, like always it seems something in excess of what's needed. Check for testicular cancer? then while your at it check for every other cancer. Hernia? I'm not a Dr. I've yet to come across someone who has/had a none symptomatic hernia. Why not ask the questions related tot the symptoms first? Girls are just as likely to be equally prone however not equally degraded in the same way, In my opinion, and its only an opinion. forcing young men, to undergo such a indoctrinated outdated medical exam yearly, is clearly unnecessary and as far as I'm concerned systematic abuse. I've never had a check for hernia in my life. I am 59 now, amazing how one can prosper medically without some Dr's hand being where it clearly shouldn't. However if I had the symptoms I would do something about it.

sensei1980

In my opinion, and its only an opinion. forcing young men, to undergo such a indoctrinated outdated medical exam yearly, is clearly unnecessary and as far as I'm concerned systematic abuse.

No matter the reason for the visit, my genitals were always examined. Other parts of the exam were sometimes excluded, but the genital exam was always performed. Why would this part of the exam seemingly carry more weight than the others? Could it be viewed as a ritual or right of passage? Could it be a power trip for doctors? Is it possible that some doctors may have enjoyed doing it for a variety of reasons? No matter how cursory the rest of the exam, the genital exam was always thorough, and always included.

Runner Up

Very interesting points of view. One might object both are female doctors. We could ask for a male doctor opinion on the matter. Would it be the same ?

On the other hand, male or female, I really (and I mean : really) don't think any Dr would perform a genital exam just for fun. I don't think they even enjoy doing it. It's part of the job, they learnt it's kind of mandatory, so they do it.

examined-teen

@Runner_Up you said On the other hand, male or female, I really (and I mean : really) don't think any Dr would perform a genital exam just for fun. I don't think they even enjoy doing it. It's part of the job, they learnt it's kind of mandatory, so they do it.

I think there are some Docs who perform unneccessary nude exam. Especially when they like the Patient. Im sure my ped liked to See young good looking boys nude and was more thorough then neccessary in order to be able to keep patients nude longer.

Thats what happened to me.