Shouldn't all pediatric physicals include breast and genital exams?

Maybe, just maybe for the start of puberty. Other than that, no. It almost seems odd to ask, not going to lie.

I think the genitals are just as important as everything else, but I’m very much against forcing pre-pubescent or pubescent children to have their lower regions examined. They’re at that age where they get embarrassed and self conscious and forcing them to do that at such a vulnerable age can be damaging. I know, because when I was thirteen, a doctor wanted to look at my genitals and rectum, I told him that he didn’t have my consent and I wasn’t comfortable with it, but my parents and the nurses just assumed I was being an uncooperative child and forced me into doing it. It’s stuck with me to this day and now I’m always reluctant to have my privates examined, even if there is something wrong.

I think the genitals are just as important as everything else, but I’m very much against forcing pre-pubescent or pubescent children to have their lower regions examined. They’re at that age where they get embarrassed and self conscious and forcing them to do that at such a vulnerable age can be damaging.

Assessment of puberty development is one of the important parts of prepubertal and pubertal examinations. In order to make this assessment, the doctor has to expose and touch the genitalia. The parents need to prepare a child for these parts of the exam in order for him to get an adequate exam and to prevent the doctor from being placed in an awkward position. I think it is important for children to learn to do things that are not necessarily easy for them, but important for their well being.

I know, because when I was thirteen, a doctor wanted to look at my genitals and rectum, I told him that he didn’t have my consent and I wasn’t comfortable with it, but my parents and the nurses just assumed I was being an uncooperative child and forced me into doing it. It’s stuck with me to this day and now I’m always reluctant to have my privates examined, even if there is something wrong.

That may be another issue. Let's say you never told him he didn't have consent, and I presume your parents brought you there for the exam. Now you may not have wanted him to do it and may have been really upset about having it done, but let's say you didn't take a stand against it. And as a result, there was no "force" by parents/nurses, because they would have felt you were complying. Would you still be having these reluctance issues in regards to allowing a medical professional to examine an intimate part of your anatomy?

(Not looking for an immediate response. I'd rather you think about this question over some time. Like mull it over. )

I don't pretend to know the rules or the legal situation but I can't imagine a doctor would ever be allowed to force treatment on an unwilling patient, or would wish to.

Very young children tend to be reluctant towards many kinds of medical treatment, whether concerning private parts or not, and have to be won over, persuaded, encouraged etc to allow treatment to take place. I mean that this is done often through trust in and reassurance from parents and medical staff, rather than any kind of bribery or appeasement.

Older children can be reasoned with and made to see the consequences of not being treated: it will hurt more / get worse / prevent you from doing x if you don't let the doctor do what he needs to do. But if teenage stubborness kicks in then they surely should not be forced.

I had to have regular exams and treatment over a couple of years in my teens for issues to do with puberty and phimosis. It won't come as any surprise to know that I dreaded them, and on a few occasions I had sometimes tearful, sometimes angry conversations with my parents about not wanting to go any more.

But I always went to those exams, albeit reluctantly. I'm sure that if I had refused then nothing would have been forced.

Breast, genital, and rectal are all important. Rectal should be added to this discussion. My pediatrician did them all.

Breast, genital, and rectal are all important. Rectal should be added to this discussion. My pediatrician did them all.

Did the pediatrician do a digital exam or just an anal inspection?

Rectal!? The only times I had rectal as a kid was to confirm appendicitis. I don't think there is any rationale to do it on a regular basis (that is, outside of specific issues).

Children don't need rectal exams unless there is a specific problem.

A quick visual exam (mostly for hygiene) is all that is needed.

Anal inspection makes sense if the kid complains of itching, irritation etc; in this area but not even sure (any physician here?) that it needs to be checked otherwise.

I think it is important for children to learn to do things that are not necessarily easy for them, but important for their well being.

As a thirteen year old, and even as an adult now, I think the patients privacy and making sure they consent is far more important. Not only for their dignity, but because it’s one of their human rights. From birth, anyone has the right to refuse medical treatment or examination from a doctor. I wish I’d have known that back then.

Would you still be having these reluctance issues in regards to allowing a medical professional to examine an intimate part of your anatomy?

I think the reason I’m so reluctant nowadays is because of how quickly the nurses were to disregard my wishes and privacy. It was as if they didn’t think it was possible for me to feel any sense of embarrassment.

I think if you’re going to do it at all, start it at a young age, even if it’s not necessary until the pubescent years, at least you’re getting the child used to it and not dumping it on them at a fragile age. Teens are less likely to get embarrassed about it if it’s always happened to them.

From birth, anyone has the right to refuse medical treatment or examination from a doctor. I wish I’d have known that back then.

I completely agree. Just do not go to a doctor if you do not wish to be examined or treated.

Just do not go to a doctor if you do not wish to be examined or treated.

My parents took me. I didn’t exactly want to go.

In the same manner as ten year old girls do not need a pap smear and twenty year old men to not need a colonoscopy, children do not need every orifice examined at their physical exams unless there is a specific problem in need of treatment.

In the same manner as ten year old girls do not need a pap smear and twenty year old men to not need a colonoscopy, children do not need every orifice examined at their physical exams unless there is a specific problem in need of treatment.

@SwitchableSusie EXACTLY!

Just do not go to a doctor if you do not wish to be examined or treated.

That's ridiculous

Exam doc said

Assessment of puberty development is one of the important parts of prepubertal and pubertal examinations. In order to make this assessment, the doctor has to expose and touch the genitalia. The parents need to prepare a child for these parts of the exam in order for him to get an adequate exam and to prevent the doctor from being placed in an awkward position. I think it is important for children to learn to do things that are not necessarily easy for them, but important for their well being.

Children do not have the right of consent when their parents bring them to the doctor. The child gets what the parent brought them in for.

Still, not every orifice needs scrutiny.

@MinMin said, “ at birth anyone has the right to refuse medical treatment or examination from a doctor. “

At birth ??? We are going to start asking for consent from newborns ? Come on now this is ridiculous.

Sorry your feelings were hurt or you were embarrassed, thats just life .

Yes, parents and health care workers should try to explain things to children and make them as comfortable as possible but lets also remember that some things that are are not so pleasant need to be done for the sake of keeping them healthy. Saying a child , repeat, a child can refuse necessary medical treatment is absurd .

@MinMin said

. . . at birth anyone has the right to refuse medical treatment or examination from a doctor. . . .

Only in your fantasies.

If a parent or guardian brings you to the doctor and you are a minor, with very few exceptions, you will get the exam the parent and doctor decide is appropriate.

Exceptions are things like pregnancy tests where children have recently gained some privacy rights.

I got a genital exam every time that I can remember getting a physical when I was a kid. From the doctor's perspective, why not? I saw in the article linked below that boys' genitals can be examined in the lateral decubitus position while young girls should be examined frog leg style while sitting in a parent's lap. The lateral decubitus position for boys means lying on one's side. Which is a weird way to do a genital and hernia exam.

My pediatrician always examined my penis and my testicles.

Same with everyone else I know.

I think that's just pretty standard.

I know that the sports physical form we used in high school actually had "testicle exam" listed as one of the things the doctor was supposed to check.

When I had my exams at school as a teenager, it was just a standard part of the exam that boys had their genitals checked out, everyone just took it as something that happened. It is important that the doc checks that you're developing ok and there's nothing wrong so it should be part of the exam, even if it is a bit embarrassing at the time!

I don’t remember ever having a genital exam by my pediatrician to be honest. Might be why my varicocele went undiagnosed until I was 23.

In the hypersexualised U.S.society any Pediatrician in his or her right mind will not touch or examine a minor child's breast or anything below the beltline without a nurse or parent witness. To do otherwise risks all manner of legal consequences and/or lawsuits--even 20 odd years down the road. Medical insurance for Doctors is astronomical to begin with. It's a serious matter that any Doctor who has any patient under age 18 should be fully aware of.

I had these exams I can remember my pediatrician looking at my genitals up close very thorough exam I must have been under 10 years old. This was in the1970s always did it with my mother in the room I don't ever remember seeing him without my mother I think I would get upset if she wasn't in the room. After my parents divorced my mother moved out of state when I was 16. I lived with my father he was gone all the time working 10 hours a day or on business trips. I quit going to doctors unless I was really sick a few times with bronchitis those were urgent care. Schools at least in my state didn't have any doctors doing exams at school. I remember a few times they would do a lice check at school run a comb though each kids hair probably one kid turned up with lice. I didn't have another physical exam until I was 30 years old. In those days 1980's males didn't really get physicals until they were older 40s, 50's maybe that is the same today. Woman usually see a gyno once a year when they are younger which was required to renew birth control meds.

I can't see an argument against it and from own experiences that was the case.

As long as modern idea of seeking the patients approval to do the exam it should be done.

Why treat the gentiourinary system different to any other body system and not examine it.

The parent that objects is likely to be the ones who would file law suit for missing something.

Does it make genital and anal area more taboo to the patient if the dr cant bring themselves to perform just a simple visual check.

The genitals are part of the body, so i think its impotant to exam this parts. Its should be nomal.

My Pediatrician always check med m genitals and breast as part of checking my development

As patient Jacqui, I got my breasts and genitals examined every time when I had my annual checkup with the pediatrician doctor.