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12 year old physical....... - Page 3

post #41 of 114
I should clarify that at my dd's 12 y.o. exam, just a few weeks ago, she did not have a pelvic exam, meaning an internal exam. All the doctor did was take a look at the vulva area to see that everything was in good shape and confirm whether or not dd had any hair sprouting yet.
post #42 of 114
Quote:
Originally Posted by journeymom View Post
I should clarify that at my dd's 12 y.o. exam, just a few weeks ago, she did not have a pelvic exam, meaning an internal exam. All the doctor did was take a look at the vulva area to see that everything was in good shape and confirm whether or not dd had any hair sprouting yet.
I think your Dd can figure out if there is any hair down there. No need for doctor to be looking in that area. That would be WAY out of my comfort zone for myself or my children.
post #43 of 114
Yeah. This thread is really upsetting me.

Thinking back, I was fairly humiliated by the mass scoliosis exam in 7th grade. I was sexually harrassed constantly during those years and was very sensitive to invasions of my body or privacy. I think even just a quick "look-see" of my private areas by ANYBODY would have been outright traumatic. And since it is NOT medically necessary, it enrages me to think of kids being put through it for no reason other than in the name of being "thorough." It seems like we must have become a lot more tolerant of these invasions in the interveneing years because I cannot imagine my parents or my peers' parents allowing this kind of thing. Heck, the doctor didn't even make me undress when I had a bladder infection at 14, even though it might have even made sense in those circumstances.
post #44 of 114
Quote:
Originally Posted by smillerhouse View Post
This is intersting. My daughter is going to have a physical for volleyball camps this summer. The last physical,aound 12, she was very uncomfotable with the pelvic exam portion. She tends to be very private and modest. The dr. she has had since infant has retired. With the new one, this has inspired me to ask to hav ethat portion skipped. Sallie

Skip this! Holy cow. There is no reason EVER a 12 year old boy or girl should be subjected to an exam like this. If the doctor insists, find a new one. I didn't have anything like this done until I was in college and an adult.
post #45 of 114
Quote:
Originally Posted by journeymom View Post
All the doctor did was take a look at the vulva area to see that everything was in good shape and confirm whether or not dd had any hair sprouting yet.
Good shape? What the heck does that mean?

Confirm hair? We all know what hair looks like so why does a doctor need to see it?

I'm beginning to think that all these docs are doing this to get girls used to having their bodies inspected and their physical changes approved or validated by a doctor just so that they are used to mistrusting their bodies when they become pregnant:
post #46 of 114
Quote:
Originally Posted by orangefoot View Post
Good shape? What the heck does that mean?

Confirm hair? We al know what hair loks like so why does a doctor need to see it?

I'm beginning to think that all these docs are doing this to get girls used to having their bodies inspected and their physical changes approved or validated by a doctor just so that they are used to mistrusting their bodies when they become pregnant:
Actually, there are lots of reasons to have a look at the genitals when doing a complete physical exam. If you or your child doesn't want to have it done, fine, but be aware of what the reasons are behind it.

Personal hygiene is a huge problem with girls this age; it is unfortunate how many girls are not taught (or are uncomfortable with) proper personal hygiene. Either it is to much (I think you all would be shocked at how many girls that age are already doing some form of douching with fragrance and chemical laden commercial products), or too little. Normal development of the external genitalia also typically correlates to normal hormone levels. And, unfortunately, the doc is also ALWAYS looking for signs of sexual abuse. Symptoms of STDs (like abnormal drainage and smell, presence of warts or rashes, etc), signs of trauma like bruising, tearing and burns, etc. This has become the main reason to perform a visual exam of the genitals of all children, at all ages.

So, no, the doc is not trying to get his/her kicks or trying to traumatize your child, nor trying to sow the seeds of poor body image. As a nurse, I'm a bit insulted that some people always think that medical personnel are staying up late trying to think of ways to make the rest of you feel really horrible about yourselves. If you don't want your child to have the exam or the child doesn't want it, fine. But to make a blanket statement about how idiotic and unreasonable it is, and accuse the docs of this conspiracy of undermining women everywhere is a bit much. I wonder how many people would be up in arms if a child was sexually abused, but had many years of normal physical exams, because the parent who was abusing them refused to allow the doc to visualize the child's external genitals? How many lawsuits would follow? How many times would we hear that the doctor was negligent?
post #47 of 114
Quote:
Originally Posted by lorijds View Post
I wonder how many people would be up in arms if a child was sexually abused, but had many years of normal physical exams, because the parent who was abusing them refused to allow the doc to visualize the child's external genitals? How many lawsuits would follow? How many times would we hear that the doctor was negligent?
Are you saying that a child should be FORCED into exposing their private area's to any doctor who demands it? I get so sick and tired of everyone being forced to submit to something "just in case." 99% of the time there is no reason for it and it does nothing but humiliate the child.
post #48 of 114
No, I most emphatically was not. I think if you read through my post you will see that several times I stated that if you or your child don't want the exam, fine.

I was trying to explain WHY the exam is performed. Not due to malicious ulterior motives, but assessing for very real medical issues.
post #49 of 114
I don't think anyone has seriously proposed the exams are done solely for "malicious" reasons. However, a lot of things done "for our own good" at the doctor's office can be double-edged, at best. I'm thinking, for instance, of a whole raft of OB procedures considered routine and harmless.
post #50 of 114
I'm sorry you feel that I may be discrediting the medical profession; it's just that here in the UK medicals of this type are not common practice and neither are VEs in pregnancy, GTT or erithromycin eye creams.

From afar it all looks a bit odd which is why I question the motive in general, not individual doctors per se.
post #51 of 114
Quote:
Originally Posted by lorijds View Post
No, I most emphatically was not. I think if you read through my post you will see that several times I stated that if you or your child don't want the exam, fine.

I was trying to explain WHY the exam is performed. Not due to malicious ulterior motives, but assessing for very real medical issues.
So are doctors required to back off if the kid says "no"? Because I strongly feel that if someone says "no" and that's not answered...it's abuse.
post #52 of 114

I had to say something

: Well a Dr might not get their "kicks off" by looking at a childs genitals without permission, but it certainly seems that some parents and Dr's who get a lot out of power and control.
If a child says NO then it's NO.
One needs to think about the emotional harm that can do to a kids head.
A "peek" isn't worth the potential trauma. My goodness most grown people don't like their privates being looked at. Sometimes I think Dr's don't even see children as HUMAN BEINGS but rather as "specimins" and "property".
This whole thread make me very angry and shakes something deep inside my soul!
Are we and our children to disrobe and expose ourselves to any "white coat" that wants to see our pevlic area and then - if we refuse then "we have something to hide". Any decent Dr. would put a human beings psychological needs above a "need to peak", my goodness.
I have a three year old daughter and she's fine if she gets a change and doesn't mind a surface wipe, BUT if she gets a little poo in and around her vaginal area tha requires a good q-tip or wipe cleaning she goes crazy,she slaps your hands, squeezes her legs together, rolls over, screams and tries to get away, she clearly feels violated so after a few of these "episodes" it became very clear to my husband and I that it was very emotionally perhaps spiritually damaging to her- so we found a solution - WHEN THAT HAPPENS IT IS TIME FOR A BATH- LET THE WATER CLEAN HER. ALLOW HER SOME RIGHTS! We love her, should we say to her and ourselves :" LOOK KID THIS IS HOW IT IS, AND YOU ARE JUST GOING TO HAVE TO TAKE IT". That will only foster anger, rebellion, distrust, betrayal and come between us. We love her. We do not wish to control her.
Anyone who feels that need really needs to look at themselves and their true motivation.
post #53 of 114
I'm glad the op has had a good outcome to this. I think a lot of these procedures are just routine and are invasive and debasing. I've had a coupla dodgy docs , one when I was like 8-10 yrs old who I just knew was acting strangely and was always reaching down there on the pretext of examining my abdomen, even tho it was toncilitis I had each time, it was odd, my foster mother used to leave the room each time, it seemed like an unspoken agreement,(doc is god) years later I mentioned this to a mate who still lives in the area of this doc and she said there has been other mention of this over the years,from other people, but of course nothing done.
Next was the sexual health clinic as a teen( doin my bit to try and stay safe) no less than serious clitoral manipulation on that occasion and I was fuming and embarrased when I escaped. So fuming I made quite a fuss, was ignored and asked to leave! The nurse asked stuff like 'what did he do?' and then a giggle. I casually asked what the deal was with said pervy doc on my next visit and was told that several complaints had been lodged by other people but nothing was done as usual in these cases. Actually I think he was in court like about 20 yrs later!
I see no reason why a child should be subjected to these examinations short of a serious medical complaint,none of my dc would even entertain invasive procedures as I have told them their bodies are their own and they are under no obligation to be fingered (that is what they are doing imo) or have their genitals exposed to a doctor, what sort of way is this for children to have what can be like a physical sexual encounter and probably their first, imo there quite often is more to it than meets the eye, protocol, routine,unneeded diagnosis and perverts aside, it is a route to control us and hand over our autonomy and privacy to docs As for docs treating us like pieces of meat, well my vag is private, intimate and very personal, I have felt degraded and robbed after every examination. Definitely robbed.
post #54 of 114
Quote:
Originally Posted by moondiapers View Post
So are doctors required to back off if the kid says "no"? Because I strongly feel that if someone says "no" and that's not answered...it's abuse.
I'm sorry, how many times can I say, "If your child doesn't want the exam, fine" before someone actually reads that line?

Unless there is a prevailing need, then no, the doc should not force an exam. We are in complete agreement there. The entire point of the post, if anyone bothered to read it, was to explain WHY a practitioner would want to do a visual exam. The REASONING behind the visual exam. There are reasons behind every routine medical treatment, and it is up to the responsible party (in the case of a minor that would be the doc, the parent, and the child) to decide if it is necessary for the individual. Because of the way our litigious society has evolved, a visual exam of the external genitals is the standard of care. You want to refuse that, fine. But a doc could be charged with negligence if he/she didn't offer/attempt it with every complete physical. Not by the patient, charged by the state.

That's why it's so hard for some practitioners now to attend VBACs, for example; because if the standard of care in their geographic area is not NOT attend VBACs, at that practitioner does anyhow, then he/she is risking her license should the state Board of Healing Arts decide to take action. The physician I used to work for went through this very procedure, it is a time consuming, expensive issue.

So yes, docs are going to practice to the standard of care--do you have to accept that? No. But then the responsibility is on you. That's all. That's all the post was about, not that you or your child must submit. That there is an actual compelling reason from the physician's point of view, for this exam. That they are required by their Board of Healing Arts to perform it. Not that you or your child are required to submit to it. I'm trying to give you the perspective from the other side.
post #55 of 114
Quote:
Originally Posted by lorijds View Post
I'm sorry, how many times can I say, "If your child doesn't want the exam, fine" before someone actually reads that line?
That was read, but then you said this:

Quote:
Originally Posted by lorijds View Post
I wonder how many people would be up in arms if a child was sexually abused, but had many years of normal physical exams, because the parent who was abusing them refused to allow the doc to visualize the child's external genitals? How many lawsuits would follow? How many times would we hear that the doctor was negligent?
Which seems to say they should be forced because the refusing parent might be abusing the child.
post #56 of 114
Has the doctor clarified what he's looking for? If it's testicular cancer, then I agree, a self exam should be just fine. But my first thought was that this was for the good ol' "turn your head and cough" exam, which is to check for hernias. And it's my understanding that it's a standard part of a boy's sports physical. Dh says he didn't "have" to do that one until high school though, so maybe 12 is a smidge young?

I do not argue in the slightest that he should have autonomy over his own body and should refuse any procedure he's uncomfortable with. But to make an informed choice, I think he needs to know what the purpose of the exam is, KWIM?
post #57 of 114
Quote:
Originally Posted by myjulybabes View Post
Has the doctor clarified what he's looking for? If it's testicular cancer, then I agree, a self exam should be just fine. But my first thought was that this was for the good ol' "turn your head and cough" exam, which is to check for hernias. And it's my understanding that it's a standard part of a boy's sports physical. Dh says he didn't "have" to do that one until high school though, so maybe 12 is a smidge young?

I do not argue in the slightest that he should have autonomy over his own body and should refuse any procedure he's uncomfortable with. But to make an informed choice, I think he needs to know what the purpose of the exam is, KWIM?
thats what i was coming to say- i asked my dh if he got one that young and he said yes, it was to check for hernias
post #58 of 114
No, my point was to show the difficult position practitioners are put into, and how the pendulum of opinion would swing the other way in the case of an abused child who had "normal" physical exams. Then he/she would be hung out to dry by the public AND the court system. Puts them in a tight spot, eh. I was asking you to view the rationale from the practitioner's perspective. And every time a parent or child refuses that part of the exam, that's what's going on in his/her head. Is this kid/parent refusing because the child is shy, or are they refusing because there is some sort of abuse they are trying to hide?

At the age of 12, they should be asking the parents to step out, anyway, to ask questions about drugs, smoking, alcohol, and sexual activity, and to discuss the practice of patient confidentiality. And that's the point when they should also clarify WHY the child is refusing the exam.
post #59 of 114
Quote:
Originally Posted by lorijds View Post
No, my point was to show the difficult position practitioners are put into, and how the pendulum of opinion would swing the other way in the case of an abused child who had "normal" physical exams. Then he/she would be hung out to dry by the public AND the court system. Puts them in a tight spot, eh. I was asking you to view the rationale from the practitioner's perspective. And every time a parent or child refuses that part of the exam, that's what's going on in his/her head. Is this kid/parent refusing because the child is shy, or are they refusing because there is some sort of abuse they are trying to hide?

At the age of 12, they should be asking the parents to step out, anyway, to ask questions about drugs, smoking, alcohol, and sexual activity, and to discuss the practice of patient confidentiality. And that's the point when they should also clarify WHY the child is refusing the exam.
Lorijds, I can see where you are coming from on this and agree that if there is a valid reason behind the exam then the doctor shouldn't be demonized for offering it. However, the key in this whole situation is going to be honest communication up front. Unfortunately, it is simply not standard in this culture for doctors to state to their patients "(this) is what I would like to do, and (this) is why I would like to do it." Much less give their patients so much as a second to refuse the exam. Maybe you haven't seen it personally, but it is all to common for the doc to order the patient to strip, lie down and spread, perform some mysterious fidgeting, then declare the patient "fine" and schedule the next visit. That is NOT clear communication and NOT informed consent. Frankly, people would be a lot less fearful of dr's intentions if treated their patients with a lot more respect by looking them in the eye (not the "ailing" bit of anatomy) and having actual conversations with them as equals.
post #60 of 114
DD, I would agree with you completely. Just because there is a compelling and reasonable rationale behind performing the physical, doesn't mean that they don't have to explain themselves.

Some of this is still a left over mentality of "I know best, because I'm the doc." I think though that more frequently it is a case of the procedure being so routine (from his/her perspective) that the doc doesn't even think that someone might not understand the reason; or that the patient doesn't want to hear the rationale for every little act performed. And it is true, some people are like that. I always carry on a constant stream of explanations when I'm taking care of someone, and most people like it, but every once in a while a person (usually an older adult) tells me, "I don't need to hear WHY you are doing this, just do it if the doctor ordered it." Okay then.

I think a lot of the knee-jerk reactions and general animosity stems from complete miscommunication between patients and practitioners. If practitioners would take two seconds to explain their rationales and then listen, really listen to their patient's questions; and if patients would articulate their questions instead of nodding their head or staying silent.

I personally find that the younger the doc, the more likely they are to want to explain and to expect the patient to question them. In med school they are pushing this a lot more (and as a side note, they are pushing collaboration and respect for your patients and co-workers -- ie nurses). If for no other reason than the simple fact that if you give the patient more info and more responsibility (ie choice), and then respect their decision, those patients are less likely to sue. But they are less likely to sue because they feel they were able to make decisions, and that their doc wasn't playing God, but was helping them make a choice about themselves.
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