# 12 year old physical.......



## gumby74 (Jan 2, 2005)

Dh and I adopted my brother, who is now 12. Yesterday DH took my brother to get a physical for camp. As soon as the doctor told him he was going to have to look at his testicles.....my brother freaked and left the room and ran outside of the clinic. He refused to have the physical and did not care that he would no longer be able to go to camp. My brother is diagnosed with bipolar disorder, which I realize has something to do with the behavior and the reaction to the physical, but the reality is.......he is eventually going to have a testicular exam whether he likes it or not. Soooooo my question is: "How do I get him to go through with it?' To my knowledge he has never been sexually abused. I really feel this has more to do with his need to stay in control of every situation, as well as the fact that he is embarrased. Any thoughts and suggestions would be appreciated.


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## journeymom (Apr 2, 2002)

Wow. I don't know what you should do to get him to have the exam. But I'm bipolar and I can provide a little insight. Bipolars feel the same emotions that everybody else does, only stronger (more strongly?). Our feelings are more intense. So, while it's reasonable for any 12 y.o. to be a little alarmed or nervous about being examined in the nether regions, a bipolar is going to feel that anxiety ten fold. You feel a little nervous, he feels panicked anxiety.

I do have some ideas, now I think about it. Dd just had her 12 y.o. exam a couple of weeks ago, and neither of us were expecting the 'private' exam. If your brother wasn't mentally prepared for it, it probably freaked him out. Knowing now what to expect he might be willing to consent to the exam.

Also, was the doctor male or female? Would a doctor of the other sex help him feel more comfortable? My dh has said he actually feels more at ease with female doctors than male docs. Maybe your brother has a preference!

Tell him you're going to schedule another exam, and if possible he can pick the doctor (if possible). Tell him it'll be easier this time since he knows what to expect. Also, ask the doctor to explain what the exam is for and to reassure him that it's purely for medical reasons.

Good luck. You're a neat sister to take your brother in.


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## fek&fuzz (Jun 19, 2005)

Can he just opt out of the testicular exam? Maybe the doctor can explain (or give him a pamphlet on) self exam and the importance of it, and then tell him that they can just put it off until the next exam.


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## alegna (Jan 14, 2003)

I say let him put it off. That is very invasive for some people at that age. I never too off my underwear at the drs. at that age and would have felt very uncomfortable doing so.

-Angela


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## AMagicalWishxoxo (Jan 24, 2007)

thats kind of strange to get exams down there for only being 12. I have never had a physical exam where the drs looked down there only until I found out I was pregnant. I say let him make his own decision, if he doesn't feel comfortable then he doesn't need to get one. He is still too young and I am sure when he is other and actually needs a physical he will be willing to and will understand it more.

<33 Italy


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## angelpie545 (Feb 23, 2005)

I'd let him opt out of the testicular exam. I think it's a little invasive at that age, especially if he's very uncomfortable with it. You shouldn't have to have that part of the exam just to go to camp. Perhaps you could go back, have a physical without the genital exam? That way he can still go to camp, but he doesn't have to have an uncomfortable exam.


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## Arduinna (May 30, 2002)

I'd let him opt out also.


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## juicypakwan (Jun 19, 2002)

I'd let him opt out. He's 12 he won't feel like that forever. Kind of like a nursing baby won't be nursing in college analogy. I would have been horrified at 12 but didn't care much when it really matter during pregnancy.


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## Aliviasmom (Jul 24, 2006)

I'm not sure on the "opt out" idea, but, maybe you can take him in just to get to know the doctor first. You know, set up a meeting (like an interview) with the doctor, in the exam room, where they talk about all the equipment, what it does, what it's used for, etc. (Not to make your brother feel babied, but just so that he knows what to expect.) And THEN do a physical, either that day, or another.

And I don't remember EVER having to take off my pants until I was 15 and hospitalized for being raped.


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## BelgianSheepDog (Mar 31, 2006)

I cannot imagine forcing someone to go through with such an exam against their will. Give him an instruction sheet for a self-exam on the very off chance that he's actually at risk for any kind of testicular cancer. And then leave the poor kid alone.


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## A&A (Apr 5, 2004)

Moving to a new home is traumatic enough; he doesn't need his privates handled by a strange doctor. Lighten up on the kid and get him counseling (to deal with changing families....I know you're family, but you're not his mother.)


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## Milvudeeshna (May 4, 2004)

Wow, the camp requires a testicular exam for PRE-TEENS?? Weird. I'd let him opt out.


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## ComeOnLetsGo (Nov 19, 2001)

My guys have been through many sports/camp physicals. All that is required is that the doctor sign a form stating that there is no physical reason that the child can not participate in the stated activity. There is no reason the doc cannot skip the testicle check and still sign the form. Heck, the last sports physical my son had took place in the school hallway - he was weighed, measured, heart and lungs checked, bp taken and that was it. I'm sure that the doc will sign the camp form without the testicle exam. I'd let him wait on that until he's more comfortable.


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## Roar (May 30, 2006)

My suggestion would be to call and speak with the doctor and explain the situation and find out what your options are. It may be that the doctor can complete the physical without this part of the exam. Or, that the doctor may be able to suggest some materials for the kid to read. Or, they may be able to sit down together and discuss what the exam is about and give him an idea ahead of time what to expect. It may be that the exam was an unexpected shock for the kid, but with more time, information and preparation it is something he could handle just fine.


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## gumby74 (Jan 2, 2005)

Thanks so much for everyone's input. I should probably clarify that he has been living with us for about 7 years now and the doctor is a family friend. However, that being said, I think I am going to call the camp and see if we can opt out of that part of the exam. I agree that he will most likely feel more comfortable as he gets older. I also agree that he is probably feeling the same feelings I would, only more intense because of his bipolar disorder. He sees a counselor, but we are in the process of waiting to start with another one that he clicks with better. Normally, I would have just asked his counselor what to do, but I can't now because he is supposed to start seeing someone new in a couple of weeks. Thanks again!


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## CarrieMF (Mar 7, 2004)

Quote:


Originally Posted by *Roar* 
My suggestion would be to call and speak with the doctor and explain the situation and find out what your options are. It may be that the doctor can complete the physical without this part of the exam. Or, that the doctor may be able to suggest some materials for the kid to read. Or, they may be able to sit down together and discuss what the exam is about and give him an idea ahead of time what to expect. It may be that the exam was an unexpected shock for the kid, but with more time, information and preparation it is something he could handle just fine.

I agree with this.

I am guessing there are some family dynamics for you and dh to have adopted your brother. Was he going for regular physicals before this? Has he ever met this dr before? Going in for an exam at 12 without knowing what to expect I'd run too. I don't think being bi-polar has anything to do with his reaction. Puberty & being a pre-teen has more to do with it, plus everything else that has been going on.

FWIW my dr has alot of male ADULT patients who go for their physicals and still refuse a rectal exam. I don't know why I know that other than my dr talks alot.lol


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *BelgianSheepDog* 
I cannot imagine forcing someone to go through with such an exam against their will. Give him an instruction sheet for a self-exam on the very off chance that he's actually at risk for any kind of testicular cancer. And then leave the poor kid alone.









:

Quote:


Originally Posted by *gumby74* 
Thanks so much for everyone's input. I should probably clarify that he has been living with us for about 7 years now and the doctor is a family friend. However, that being said, I think I am going to call the camp and see if we can opt out of that part of the exam. I agree that he will most likely feel more comfortable as he gets older. I also agree that he is probably feeling the same feelings I would, only more intense because of his bipolar disorder. He sees a counselor, but we are in the process of waiting to start with another one that he clicks with better. Normally, I would have just asked his counselor what to do, but I can't now because he is supposed to start seeing someone new in a couple of weeks. Thanks again!

I wouldn't even call the camp. When DD had a physical for GS camp my doctor wrote "deferred" on that portion of the paper. No one said a word. They also wanted urine analysis and all kinds of other stuff. Doc just wrote N/A. All they really want to know is if the kid can participate in activities.


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## Yoshua (Jan 5, 2006)

umm why is he going to have a testicular exam weather he likes it or not?

I did not have a doctor look at my testicles until i was 23 years old and worried I contracted an STD from my then soon to be ex-wife. I had the routine exam for std's and checked out, but I never even contemplated having my testicles examined prior to that.

Having someone look at or touch your genetalia should be a personal choice, and should not be forced on you by anyone.

You can explain to him why it is no big deal, but I would NEVER force someone to undergo such an invasive exam until THEY were ready.


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## journeymom (Apr 2, 2002)

Quote:


Originally Posted by *Yoshua* 
umm why is he going to have a testicular exam weather he likes it or not?

Umm, nobody said he's going to have a testicular exam whether he likes it or not.

Apparently the nether regions/private parts/'down there' exam is a standard part of the 12 y.o. full physical exam as established by AMA. That the young man's camp required a physical exam is coincidental; they aren't asking about his testicular health anyway. The doctor can sign the medical form without having done that portion of the exam.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *gumby74* 
but the reality is.......he is eventually going to have a testicular exam whether he likes it or not.


Quote:


Originally Posted by *journeymom* 
Umm, nobody said he's going to have a testicular exam whether he likes it or not.

The OP did. That stood out to me as well the first time I read it. He doesn't eventually HAVE to do anything. If he wants he can go his whole life without this exam. Might not be the best idea.. I dunno... but he doesn't HAVE to.


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## MillingNome (Nov 18, 2005)

If the camp says you can't opt out they better have a damn good reason why. I can not imagine one that would matter for 12 year old







:


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## Mama Dragon (Dec 5, 2005)

The camp isn't going to see the medical records, this is all on the doctor, the OP, and her brother.

I would never expect a 12 year old girl to go through a pelvic exam, why expect a boy? Because there's no fingers going inside him? It's still a private area, at a very shy age. Leave his testicles out of this.


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## smillerhouse (Aug 5, 2006)

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


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## BelgianSheepDog (Mar 31, 2006)

I'm seriously boggling at the idea of a pelvic exam for a 12 year old minus exceptional circumstances. Much less for a volleyball camp. I didn't have a pelvic until I went in for a bcp prescription. I think I was 18 and sexually active. At 12, I would have been traumatized, no overstatement.


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## momazon4 (Dec 19, 2006)

I would definately let him opt out. I actually see it as a positive and normal reaction that he doesn't want anybody down there at that age. I see no real point having that on his physical anyway.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *BelgianSheepDog* 
I'm seriously boggling at the idea of a pelvic exam for a 12 year old minus exceptional circumstances. Much less for a volleyball camp. I didn't have a pelvic until I went in for a bcp prescription. I think I was 18 and sexually active. At 12, I would have been traumatized, no overstatement.

I was traumatized at 5 when they took my pants and made me put on a stupid gown so I could have my tonsils out. Took my mom and two nurses to get them from me, kicking and screaming the whole way.

No way in heck I would let them do a pelvic exam at 12.


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## gumby74 (Jan 2, 2005)

I called the camp and they said it was absolutely ok to not have that exam done. I also called the doctor and he was ok with the camp's rec. Thanks though for all of the comments. It made me think....which is a good thing







Sometimes I get too worked up about believeing what the "professional" thinks I should do instead of using logic and common sense. I can't begin to express how much better I feel about this whole situation. My brother will be relieved as well. Thanks again!


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## orangefoot (Oct 8, 2004)

I'm glad its not a problem. In this country no-one has 'medicals' for anything unless you are actually ill. When my son goes on trips I sign to say he has no medical problems or allergies but state that he wears glasses and has a second pair with him. I give the name of our doctor but the doctor has nothing to do with it.

My mind is boggling too that a 12 year old would need to have his testicles examined or a pelvic exam. All contact with doctors is with consent - as an adult or a child. Tell your doctors to keep their hands off your children.


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## Yoshua (Jan 5, 2006)

Quote:


Originally Posted by *journeymom* 
Umm, nobody said he's going to have a testicular exam whether he likes it or not.

Apparently the nether regions/private parts/'down there' exam is a standard part of the 12 y.o. full physical exam as established by AMA. That the young man's camp required a physical exam is coincidental; they aren't asking about his testicular health anyway. The doctor can sign the medical form without having done that portion of the exam.


Quote:


Originally Posted by *gumby74* 
Dh and I adopted my brother, who is now 12. Yesterday DH took my brother to get a physical for camp. As soon as the doctor told him he was going to have to look at his testicles.....my brother freaked and left the room and ran outside of the clinic. He refused to have the physical and did not care that he would no longer be able to go to camp. My brother is diagnosed with bipolar disorder, which I realize has something to do with the behavior and the reaction to the physical, but the reality is.......*he is eventually going to have a testicular exam whether he likes it or not.* Soooooo my question is: "How do I get him to go through with it?' To my knowledge he has never been sexually abused. I really feel this has more to do with his need to stay in control of every situation, as well as the fact that he is embarrased. Any thoughts and suggestions would be appreciated.


Yes they did....


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## Yoshua (Jan 5, 2006)

Quote:


Originally Posted by *gumby74* 
I called the camp and they said it was absolutely ok to not have that exam done. I also called the doctor and he was ok with the camp's rec. Thanks though for all of the comments. It made me think....which is a good thing







Sometimes I get too worked up about believeing what the "professional" thinks I should do instead of using logic and common sense. I can't begin to express how much better I feel about this whole situation. My brother will be relieved as well. Thanks again!

Glad to hear the outcome of this. Always good to bounce off a sounding board when in doubt.


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## Marsupialmom (Sep 28, 2003)

At my son's last physical the doctor didn't look or feel.

I would explain why a doctor would want to do this. I would also talk to your brother/son about testical cancer and how to do his monthly self exam, then OPT OUT of that part of the physical.


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## AbbieB (Mar 21, 2006)

Quote:


Originally Posted by *smillerhouse* 
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











I am majorly shocked that a 12 year old would be asked to have this kind of exam as part of a routine physical.

What kind of information is the doctor looking for with this? I don't think 12 year olds need to be worried about cervical cancer (or testicular cancer).


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## journeymom (Apr 2, 2002)

Apologies, my mistake.


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## inogenius (Aug 5, 2006)

Quote:


Originally Posted by *AbbieB* 









I am majorly shocked that a 12 year old would be asked to have this kind of exam as part of a routine physical.

What kind of information is the doctor looking for with this? I don't think 12 year olds need to be worried about cervical cancer (or testicular cancer).

It's not at it's peak at 12, but it is a worry, and I highly doubt a 12 year old would really know what he's looking for if he were to do the check himself.


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## BelgianSheepDog (Mar 31, 2006)

Uh, how hard can it be? The breast self-exam is pretty straightforward--get used to what the usual texture is and if it changes, look into it. DH says the self-exam is simple and a 12 year old could DEFINITELY do it, that's about when he learned (health class handout.)


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## rmzbm (Jul 8, 2005)

If, at age 12, anyone forced me to strip for a Dr. I would scream like I was being raped.







: Not cool.


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## Terabith (Mar 10, 2006)

Is there a link on what to expect at well child exams at different ages?


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## laketahoemama (Aug 29, 2006)

I had my physical exam for school sports when I was 12, and my teammates talked about the pelvic exam. Some of us had it and others didn't. I was terrified! But much to my relief, my doc skipped it. It's obviously not a huge deal if some docs skip it.


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## Helen_A (Mar 22, 2004)

I'm horrified to hear that this is considered part of the general exam aged 12 in the US!!

A pelvic exam is suggested in the UK for the first time that you see someone as an adult! And even then its the cough test (males) and for females is palpation of the uterus *only* which would be part of a general check of the stomach area anyway. There is absolutely no expection of suggestion of anything more intimate unless there was a damn good reason why! Smear tests are suggested to be every 3-5 years and then only once one is sexually active; and never never done on an under 16 unless there is another situation that warrants it (like pregnancy, rape etc. and then only with the complete consent of the female herself, possibly her parent/guardian (or a.n.other adult if she chooses to either not involve her parents, or her parents are those whom are under question).


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Helen_A* 
Smear tests are suggested to be every 3-5 years

Wow 3-5 years? They are just no saying every 2 years is OK. I can't imagine 3-5. Well it makes me feel better for going almost 4 years between my last one.


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## journeymom (Apr 2, 2002)

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.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *journeymom* 
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.


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## BelgianSheepDog (Mar 31, 2006)

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.


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## mirlee (Jul 30, 2002)

Quote:


Originally Posted by *smillerhouse* 
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.


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## orangefoot (Oct 8, 2004)

Quote:


Originally Posted by *journeymom* 
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







:


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## lorijds (Jun 6, 2002)

Quote:


Originally Posted by *orangefoot* 
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?


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *lorijds* 
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.


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## lorijds (Jun 6, 2002)

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.


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## BelgianSheepDog (Mar 31, 2006)

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.


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## orangefoot (Oct 8, 2004)

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.


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## moondiapers (Apr 14, 2002)

Quote:


Originally Posted by *lorijds* 
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.


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## november21 (Feb 14, 2007)

: 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.


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## forthebest (Jun 19, 2006)

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.


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## lorijds (Jun 6, 2002)

Quote:


Originally Posted by *moondiapers* 
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.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *lorijds* 
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* 
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.


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## myjulybabes (Jun 24, 2003)

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?


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## ashleyhaugh (Jun 23, 2005)

Quote:


Originally Posted by *myjulybabes* 
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


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## lorijds (Jun 6, 2002)

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.


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## dancindoula (Jun 20, 2005)

Quote:


Originally Posted by *lorijds* 
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.


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## lorijds (Jun 6, 2002)

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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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *lorijds* 
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.

Maybe shyness has nothing to do with it and they just don't want a stranger poking around in their private parts. A child doesn't have to be shy to want to keep their privates private.

As for stepping out.. Yea right.. If a doc told me to leave I would be taking my child with me. I will NEVER leave my child to be bullied by a so called doctor again. She once had a tooth pulled with NO PAIN meds. They just sedated her so she couldn't move and janked the thing. When I brought her home she told me I "lied to her" because I told her they would give her medicine so it wouldn't hurt. It was standard practice for parents to "step out" there too. Never again!

And what makes you think a child would tell the doctor the truth even if the parents weren't in the room? I didn't. I mean come one just because it is a doctor asking someone is going to admit to taking illegal drugs? It would be a pretty naive doctor to believe they would. Especially when they are just in there for a physical, not due to a problem.


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## lorijds (Jun 6, 2002)

I think it's disrespectful of your child to not allow her privacy with her practitioner, either. When we do exams on kids 12 and older, we always ask the parent to step out for a few seconds while we ask some personal questions, and we tell them we will ask them right back in; and we do, unless the child requests otherwise.

We take a moment to explain to them the concept of patient confidentiality, and how they can always come to us with questions and concerns with or without the knowledge of their parents; that we ENCOURAGE them to always ask questions of their parents; but if they feel they can't, or if they need to discuss things with us first and then have us help them discuss a medical concern with their parents, they can contact us. We also ask about certain activities at that time. Very few children are going to admit to the use of alcohol, drugs, or nicotine, or sexual activity, in the presence of their parents. The third thing we discuss is whether they feel safe in their home and school environment. Finally, we ask them if they have anything they want to discuss with us during this visit. If they bring up any topics, we ask if they want to discuss these things before their parent returns to the room, or afterward.

These are things your child has the right to discuss in the absence of your presence. You are hindering their right to privacy with their practitioner, and therefore their access to health care, when you refuse to leave.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *lorijds* 
I think it's disrespectful of your child to not allow her privacy with her practitioner, either. When we do exams on kids 12 and older, we always ask the parent to step out for a few seconds while we ask some personal questions, and we tell them we will ask them right back in; and we do, unless the child requests otherwise.

We take a moment to explain to them the concept of patient confidentiality, and how they can always come to us with questions and concerns with or without the knowledge of their parents; that we ENCOURAGE them to always ask questions of their parents; but if they feel they can't, or if they need to discuss things with us first and then have us help them discuss a medical concern with their parents, they can contact us. We also ask about certain activities at that time. Very few children are going to admit to the use of alcohol, drugs, or nicotine, or sexual activity, in the presence of their parents. The third thing we discuss is whether they feel safe in their home and school environment. Finally, we ask them if they have anything they want to discuss with us during this visit. If they bring up any topics, we ask if they want to discuss these things before their parent returns to the room, or afterward.

These are things your child has the right to discuss in the absence of your presence. *You are hindering their right to privacy with their practitioner, and therefore their access to health care, when you refuse to leave.*

Wow, I just don't even know where to begin with this post. I am sure you believe what you are saying is true. I however do not agree with you. I have had too many doctors try to intimidate me, call me a lier, and flat out lie to me about "required procedures." I wouldn't put it past a doctor to try to strong arm my child into a vaccine that she does not need or other "necessary" medical procedures. (In this case a pelvic exam.)

99% of children WILL NOT admit to using alcohol, drugs, or having sex even without the presence of their parent. I would have lied to the doctor, as would all my friends. You are deluding yourself if you believe otherwise.

I also know my child and I know her well. She would NOT discuss ANYTHING with a stranger, she would be UPSET if I left the room and she was forced to talk to the doctor herself, and she would just sit there like a lump when/if you tried to talk to her when I was not present. Hell she got pissed off because a clerk at the Van's store talked to her while I was taking one of the younger kids to the bathroom. Yes, eventually she will grow out of this, but right now she is only 13 and at 13 I don't believe she is old enough to be thrown to the wolves in the medical profession to strong arm her into doing whatever they want.

Also I would like to point out, should my daughter need an exam of this nature and doesn't want to discuss it with me, I have shown her where the local pregnancy resource center is, "just in case her or one of her friends needs their help."

If my daughter seeks health care without me being there that is going to be up to her, not some doctor with a god complex.


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## veganf (Dec 12, 2005)

Quote:


Originally Posted by *gumby74* 
Dh and I adopted my brother, who is now 12. Yesterday DH took my brother to get a physical for camp. As soon as the doctor told him he was going to have to look at his testicles.....my brother freaked and left the room and ran outside of the clinic. He refused to have the physical and did not care that he would no longer be able to go to camp. My brother is diagnosed with bipolar disorder, which I realize has something to do with the behavior and the reaction to the physical, but the reality is.......he is eventually going to have a testicular exam whether he likes it or not. Soooooo my question is: "How do I get him to go through with it?' To my knowledge he has never been sexually abused. I really feel this has more to do with his need to stay in control of every situation, as well as the fact that he is embarrased. Any thoughts and suggestions would be appreciated.

I'd have done the same thing at that age. I think it's unnecessary and embarassing. When he's older and can understand why it's important and has gotten over the pre-teen identity stuff, then sure. I'd talk to the doctor or take him to a different one, but come on, why does a doctor need to be feeling up a 12 yo. If there was some anatomical problem it would have most likely been identified as a baby or young child.


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## CallMeMommy (Jun 15, 2005)

Quote:


Originally Posted by *lorijds* 
I'm sorry, how many times can I say, "If your child doesn't want the exam, fine" before someone actually reads that line?

I hate to use your post as an example, but it's been implied in previous posts but you actually come out and say it. Generally, I'm wondering what kid would ever WANT a pelvic/genital exam by a doctor? Why should it even be offered if there's not a pressing need? Obviously some kids and parents are going to think they HAVE to submit simply because the doctor offers it and some kids and parents will feel foolish declining even if the doctor gives them an out. Why even go there if it's not standard of care? Pelvic exams aren't recommended until the age of 18 or the start of sexual activity (I realize this thread started out with a male in question but has since evolved to include females, which is why I ask). Even the "turn your head and cough" exam can be performed with underwear on.


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## MCatLvrMom2A&X (Nov 18, 2004)

Quote:


Originally Posted by *lorijds* 
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.

I am sorry but I will never step out of the room for my dd or ds until they are to a age were they can defend themselves if needed. I will not put my child in a position to be abused ever. I have went through more dentists because of the no parents in the room policy and there is no way I will leave my child alone in a room with a stranger.

I have taken dd to the same ped since she was born but you know what the ped's in this group are still strangers to me and always will be. I dont know what sort of thing they might try to do. I dont have a feeling they would but I am not willing to risk it.


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## Neldavi (Jun 28, 2005)

My mother would not let me be alone with a doctor at 12-13 years old and I was extremely resentful, and actually still am at 29 years old. I told her I didn't want her there and she forced herself in because she didn't trust me to be complete in everything SHE wanted the doctor to know. I was not being abused.

I realize this is different than the 12 year old who WANTS their parent there, just wanted to mention this as a confirmation of the patient confidentiality *loridjs* was talking about. I would have appreciated that at that age, but did not get it.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Neldavi* 
My mother would not let me be alone with a doctor at 12-13 years old and I was extremely resentful, and actually still am at 29 years old. I told her I didn't want her there and she forced herself in because she didn't trust me to be complete in everything SHE wanted the doctor to know. I was not being abused.

I realize this is different than the 12 year old who WANTS their parent there, just wanted to mention this as a confirmation of the patient confidentiality *loridjs* was talking about. I would have appreciated that at that age, but did not get it.

In that case, your mother should have gone in, told the doctor her concerns, then left. You flat out told your mother you didn't want her there.

That is different that 1. a child who says they want their parent to stay, and 2. A child that doesn't speak up because she is shy/afraid.

If a doctor asked me to leave and I did, my daughter wouldn't say anything until we left. She would be afraid/shy to protest in front of them. She would tell me with her eyes, her expressions, but I would KNOW she didn't want me to leave. Other's may not pick up on this. So just because a child isn't protesting verbally doesn't mean the child is not protesting.

But yea.. the kid telling mom to step out is completely different. And if that were to happen I would wait RIGHT outside the door so my child knew I was close if they did need me.


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## Yoshua (Jan 5, 2006)

I actually sorta agree that not stepping out is hindering your childs privacy with their practitioner statement. However I do not think that means a parent MUST step out.

If a parent does not want to allow that privacy, that is called parenting.

Also if the child wants some sort of privacy you can simply ask the patient 'would you like me to ask these next questions in private or with your parent present?' and hand them a list of questions you are about to ask without the parent seeing.

Problem solved, and if all else fails have hte patient write the answers down out of eyesight of parent so that it is still honest and confidential.

Many non invasive ways to ask questions if you think about it.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *aniT* 

I also know my child and I know her well. She would NOT discuss ANYTHING with a stranger, she would be UPSET if I left the room and she was forced to talk to the doctor herself, and she would just sit there like a lump when/if you tried to talk to her when I was not present. Hell she got pissed off because a clerk at the Van's store talked to her while I was taking one of the younger kids to the bathroom. Yes, eventually she will grow out of this, but right now she is only 13 and at 13 I don't believe she is old enough to be thrown to the wolves in the medical profession to strong arm her into doing whatever they want.


Take this for whatever it is worth, but what is the plan for her to "grow out of it"? 13 isn't three or four and if she feels angry if a store clerk talks to her if you aren't there to supervise I'd consider that a problem. Some kids really need more help and nurturing to develop independence and social competence and if it is always excused or dismissed or parents have so little confidence in their kids it can be a problem.

One thing we appreciate about our son's doctor is that from time he was five or six she addressed HIM to ask him how he felt instead of expecting us to totally speak for him. The goal is to help him develop the skills to advocate for himself at the doctor's office. That is a learned skill not just something a kid necessarily grows into. I will say that if I viewed the doctor as a "wolf" who was out to hurt the child we'd find a different doctor!


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Roar* 
Take this for whatever it is worth, but what is the plan for her to "grow out of it"? 13 isn't three or four and if she feels angry if a store clerk talks to her if you aren't there to supervise I'd consider that a problem. Some kids really need more help and nurturing to develop independence and social competence and if it is always excused or dismissed or parents have so little confidence in their kids it can be a problem.

Actually this is a new problem that has developed in the last year or so. And it is just around strange adults. She has no problem with other kids or teachers for the most part. Although she wont stand up for herself when she thinks a teacher is wrong, she will just "do it over cause I don't want to deal with it."

So because she hasn't "always" been this way, I believe it is a stage and she will grow out of it.


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## readytobedone (Apr 6, 2007)

Quote:


Originally Posted by *journeymom* 
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.

WTF? why on earth does the DOCTOR need to know whether your daughter has pubic hair? seriously! that is whacked!

this reminds me...i was born with some orthopedic and bladder problems, had to have a lot of surgery as a girl and some of it involved showing my privates to doctors. some of it made sense, sure. but once my orthopedic surgeon just lifted up my underwear and looked in to check for pubic hair. supposedly, he was trying to gauge when i would stop growing so they could do another surgery. i felt completely violated, and what's worse, my parents were in the room with me and seemed to think it was fine. well, it wasn't.

btw, they never did that other surgery...i never went back to him again. i told my parents i wouldn't see him again. there is no reason to do what he did other than being a power tripping pervert. sounds like the same thing with your DD, if you ask me. i would slap a doctor who thought he needed to see my 12 year old's pubic hair status.


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## BelgianSheepDog (Mar 31, 2006)

I don't think this has to be either/or. I am extremely uncomfortable with the idea of "routine" pelvics or similar exams for young teens. However, I'm fine with the idea of stepping outside during the exam for a child that age. Granted it's a long time before my daughter is 12, but I could easily see being ok with this. Now there are things I insist upon both for myself and my daughter that make me FAR more comfortable with this idea. One, I insist on a female MD/ND/midwife for our care. And two, I'd expect that there would be a second practitioner, also female, in the room as well when I was gone--a nurse or second CNM, so forth. I also tend to work with practitioners who are more of the midwifery model and take lots of time to get to know their patients, so there's a trust relationship.

I think that's fairly ideal, actually. Best of both worlds.

I remember starting to get peeved around age 14 that my mom insisted on being present for my exams still. I had nothing to hide from her, but it was awkward and embarrassing having to answer the sex/drugs/DV questions in front of her anyhow. Also, I adore my dh and find him to be extremely supportive and wonderful, but after a while I got weirded out that my mws never asked him to step out for a moment alone with me during prenatals. If I had a problem with him, they would have never known. Not just that, but even in a great relationship where you share everything you might want an excuse to just discuss, I don't know vaginal discomfort or whatever in privacy with a professional woman. Anyhow.

So. Anti: "routine" poking and prodding of kids. Pro: medical privacy.


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## readytobedone (Apr 6, 2007)

Quote:


Originally Posted by *lorijds* 
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.

sorry you feel insulted, but i think some doctors actually ARE complete perverts. actually, i know some are. i was molested by one when i was 13. he put his finger in my vagina in order to catheterize me (?!) and then, when i protested, he told me i was getting to the age where i was going to have to start getting used to this kind of thing.

my parents were standing out in the hall, and after he did it, he had the nerve to go out there and tell them the physical exam/'procedure had really upset me, and had i ever been sexually abused?

uh, no, i hadn't--not until i met him.


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## lorijds (Jun 6, 2002)

Quote:


Originally Posted by *aniT* 

And what makes you think a child would tell the doctor the truth even if the parents weren't in the room? I didn't. I mean come one just because it is a doctor asking someone is going to admit to taking illegal drugs? It would be a pretty naive doctor to believe they would. Especially when they are just in there for a physical, not due to a problem.


Not all of them will, but I myself was surprised at how many did. It's not just the idea that they will tell; it's also simply giving them the opportunity to tell. They don't have to say anything; but they can if they want.

Look, you obviously have some major issues with the medical community and there is no way I am ever going to say anything right; I think we are talking
past each other at this point.

I will again say, though, that I am very much an advocate for patient rights; ALL patients, including children. As I worked for several years at a birth center that also did primary care for women, I felt it was especially important to get young women (ages 12-20) comfortable with their access to their doc/np/mw, and to help them advocate for themselves. I see a child's right to privacy as one aspect of self-determination and personal responsibility for their own health care. I'm sorry you see that as arrogant and throwing a child to wolves.

If your child's doc is a wolf, why on earth do you go there in the first place? Why have practitioner that you can't trust at all? What sort of example are you setting for her--just grin and bear it? Why not help her find a practitioner who is competent and trustworthy, so trustworthy that you would even consider allowing her some privacy with her at some point? Teaching her that she shouldn't settle for sub-optimal practitioners, but to advocate for herself, be active in her health care by seeking out a practitioner who is right for her; that seems like a better deal than teaching her that all docs are not to be trusted.

Any how, there it is. I'm sure you won't agree with me, I'm sure I've reinforced everything evil you think about the medical profession. I'm sorry you've had such horrible experiences; I hope you can find a practitioner someday you can trust.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *lorijds* 

Why not help her find a practitioner who is competent and trustworthy, so trustworthy that you would even consider allowing her some privacy with her at some point? Teaching her that she shouldn't settle for sub-optimal practitioners, but to advocate for herself, be active in her health care by seeking out a practitioner who is right for her; that seems like a better deal than teaching her that all docs are not to be trusted.


I agree.

And, I have to note that I've heard so many stories about people who were worried about a lump or whatever but because they don't like doctors or men who refuse a prostate exam because it is uncomfortable...and then they regret it later when it is too late to get treatment. We've emphasized with our child from the beginning the idea that there are times when private areas of your body need to be examined by a doctor. Earlier this year he had a problem with abdominal pain that could have been a hernia and I'm glad no one had to make a quick exam a bigger deal than it needed to be.


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## guestmama9908 (Jan 23, 2007)

My mother never went into my exams with me past the age of 12 or 13.

I think that it would have been a bit strange for me if she had. However, the nurse at my Pediatricians office was always trying to talk me into have a pelvic exam. I was an educated pre-teen and knew that pelvic exams in the absence of health problems were not recommended until you began sexual activity. So I always refused. She was a REALLY pushy nurse though and would hound me about having the pelvic so I started just lying to her everytime I went and telling her I was on my period so she would leave me alone.







I didn't end up having my first pelvic until I was 19 years old and became sexually active.

I think that parent's need to respect their child's need for privacy with their practioner. However, I think it is important for parent's to teach their children to advocate for themselves and make sure they understand that they have the right to refuse procedures. I can also see that some children would not be able to stand up for themselves with a Doctor/Nurse so those children would need their parent there to advocate for them.


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## theretohere (Nov 4, 2005)

I'm amazed at the moms saying they wouldn't leave the room. That doesn't give your child much of a chance to bring up anything embarrassing that's been going on.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *lorijds* 
If your child's doc is a wolf, why on earth do you go there in the first place? Why have practitioner that you can't trust at all? What sort of example are you setting for her--just grin and bear it? Why not help her find a practitioner who is competent and trustworthy, so trustworthy that you would even consider allowing her some privacy with her at some point? Teaching her that she shouldn't settle for sub-optimal practitioners, but to advocate for herself, be active in her health care by seeking out a practitioner who is right for her; that seems like a better deal than teaching her that all docs are not to be trusted.

My child has already been the victim of a bad doctor. Even though I trust my ND unless my daughter asks me to leave I will not. I need to make sure nothing happens to her again.

And you should never take a doctors word 100%. You need to research things on your own so you go to the doctor with the knowledge to counter with things you don't agree with.

Some people however, may not have the luxury of finding another doctor. Maybe they live in a small town. Maybe they can't change their primary care doctor. I believe Kaiser assigns people doctors. I tried to change doctors when I was pregnant and the other OB in town refused to take me because I was too far along. My reasons for switching weren't good enough I guess. I shouldn't NEED reason, I should be able to switch if I want.. but I wasn't allowed too. So as you see, not everyone can just up and switch doctors.


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## pixiesmommy (Apr 19, 2007)

I admit, I did not read each and every reply, however, I will say that my best friend's son is 11 and also bi-polar. Going to the dr or dentist is a VERY big deal with him. They have to reasearch beforehand and find out EXACTLY what procedures will be done, in what order sometimes, etc. She also goes online and shows him pictures of things (like root canals, etc) so that he can be prepared.

Lots of people have fear of dr's, and he is still a child. I wouldn't FORCE the issue, but I would explain that it is part of being healthy and preventing disease.

I know this isn't a ready-made answer, but I hope it helps.

'Manda


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *lorijds* 
I think it's disrespectful of your child to not allow her privacy with her practitioner, either. When we do exams on kids 12 and older, we always ask the parent to step out for a few seconds while we ask some personal questions, and we tell them we will ask them right back in; and we do, unless the child requests otherwise.

I would hate drs. even more in a practice like yours. I would NOT have been comfortable with my mom stepping out when I was 12 or 13 or 14 etc. And I was PAINFULLY shy and would have felt VERY awkward asking that she stay.








:

I would have felt bullied and manipulated.

-Angela


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *theretohere* 
I'm amazed at the moms saying they wouldn't leave the room. That doesn't give your child much of a chance to bring up anything embarrassing that's been going on.

If my CHILD asked me to leave the room, sure, I would.

-Angela


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## MidgeMommy (Mar 22, 2007)

Quote:


Originally Posted by *3boysmom* 
My guys have been through many sports/camp physicals. All that is required is that the doctor sign a form stating that there is no physical reason that the child can not participate in the stated activity. There is no reason the doc cannot skip the testicle check and still sign the form. Heck, the last sports physical my son had took place in the school hallway - he was weighed, measured, heart and lungs checked, bp taken and that was it. I'm sure that the doc will sign the camp form without the testicle exam. I'd let him wait on that until he's more comfortable.

I saw this, and I read what you wrote under it, and just wanted to say







: . He doesn't have testicular cancer. He's twelve. And poking around down there just clinicalizes sex and makes kids feel exposed. I'm all for 'natural' and 'no-shame' approaches, but bi-polar or not a 12 year old will, and has every right to be, freaked out by a genital exam. I kicked my first ob-gyn (and I'm proud of it!) when my mom took me in at 11. I don't plan to take my daughter in until she asks for it, either for BC or for her own reasons. Sex should be taken at an individual pace, and I think that becoming open and mature enough to deal with your genitalia in a non-sexual and practical way takes just as long, if not longer.

PS - My general practitioner doctor always signed off on those forms. Didn't even blink, and certainly didn't ask for a genital exam. He actually rolled his eyes at one, once, because he thought it was that ridiculous. He did this up until I was 17, which is when I needed the last one.


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## MidgeMommy (Mar 22, 2007)

Quote:


Originally Posted by *Helen_A* 
I'm horrified to hear that this is considered part of the general exam aged 12 in the US!!

A pelvic exam is suggested in the UK for the first time that you see someone as an adult! And even then its the cough test (males) and for females is palpation of the uterus *only* which would be part of a general check of the stomach area anyway. There is absolutely no expection of suggestion of anything more intimate unless there was a damn good reason why! Smear tests are suggested to be every 3-5 years and then only once one is sexually active; and never never done on an under 16 unless there is another situation that warrants it (like pregnancy, rape etc. and then only with the complete consent of the female herself, possibly her parent/guardian (or a.n.other adult if she chooses to either not involve her parents, or her parents are those whom are under question).

I'm moving to the UK.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *alegna* 
I would hate drs. even more in a practice like yours. I would NOT have been comfortable with my mom stepping out when I was 12 or 13 or 14 etc. And I was PAINFULLY shy and would have felt VERY awkward asking that she stay.








:

I would have felt bullied and manipulated.

-Angela

That is the point I was trying to make about MY daughter, but apparently she NEEDS to learn to take control of her medical care by herself NOW. Apparently NOW is the time she needs to grow out if this can't wait until she is older.







:


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## BelgianSheepDog (Mar 31, 2006)

Quote:


Originally Posted by *alegna* 
I would hate drs. even more in a practice like yours. I would NOT have been comfortable with my mom stepping out when I was 12 or 13 or 14 etc. And I was PAINFULLY shy and would have felt VERY awkward asking that she stay.








:

I would have felt bullied and manipulated.

-Angela

I was painfully shy too. My mom stayed and SHE made me feel bullied and manipulated by her insistence that she could not trust me and could not allow me privacy. She wanted to come in for my first pelvic when I was 18 and became enraged when I asked her to sit outside and the nurse told her she had to comply. I don't think it's far-fetched at all to think that some of the "protective" parents here might do the same.

Increasingly I come to see how much of the "protective" nature of AP is anxious people's grasping for CONTROL. And I speak as the child of prototypical "AP" parents, not just as a member of MDC or AP circles in the real world.


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## BrooklynDoula (Oct 23, 2002)

Quote:


Originally Posted by *Yoshua* 
umm why is he going to have a testicular exam weather he likes it or not?

I did not have a doctor look at my testicles until i was 23 years old and worried I contracted an STD from my then soon to be ex-wife. I had the routine exam for std's and checked out, but I never even contemplated having my testicles examined prior to that.

Having someone look at or touch your genetalia should be a personal choice, and should not be forced on you by anyone.

You can explain to him why it is no big deal, but I would NEVER force someone to undergo such an invasive exam until THEY were ready.


For what it is worth, teens and young men are at a higher risk for testicular cancer and having exams BEFORE helps, like with breast exams, to get a baseline.

At 20 my brother got testicular cancer and it took the docs 4 months of complaints to finally get a clue. He lost all his hair, a year of college, one testicle, and likely his fertility. He was in the hospital for almost a month. It had spread into other areas of his body by the time he got treatment. He was so weak he could not walk to the bathroom and I stayed home from high school some days to wipe vomit off of him while he layed unable to get around.

Lots of people underestimate how important these exams are but by 23, it would have been too late for my brother.

That said, your brother needs to be okay with it for it to happen, I agree that forcing is not the way. While I argee that opting out at 12 is fine, I also think this is an issue that would be worth resolving in a way that recognizes the importance of such exams.


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## BrooklynDoula (Oct 23, 2002)

Here is a self-exam guide -- perhaps he could start with self exams and then would eventually become more comfortable with getting exams from the doctor

http://kidshealth.org/teen/sexual_health/guys/tse.html


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## theretohere (Nov 4, 2005)

Quote:


Originally Posted by *BelgianSheepDog* 
I was painfully shy too. My mom stayed and SHE made me feel bullied and manipulated by her insistence that she could not trust me and could not allow me privacy. She wanted to come in for my first pelvic when I was 18 and became enraged when I asked her to sit outside and the nurse told her she had to comply. I don't think it's far-fetched at all to think that some of the "protective" parents here might do the same.

Increasingly I come to see how much of the "protective" nature of AP is anxious people's grasping for CONTROL. And I speak as the child of prototypical "AP" parents, not just as a member of MDC or AP circles in the real world.

I'm going to have to agree.


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## orangefoot (Oct 8, 2004)

I'm back here reading more and wondering how you go to the doctors for one thing and end up being invited to talk about drug use and consent (or otherwise) to a pelvic exam.

Questioning of those who proclaim themselves to be knowledgeable is never a bad thing IMO. Yes I am cynical about the medical profession in lots of ways but it is not a knee-jerk reaction: it has taken years for me to feel this way and not without cause. I have lived in places where you pay for treatment and places were you don't and I am more sceptical about the pay-per-visit to be honest because I believe it distorts priority.

Have you heard of Harold Shipman? He was a well respected GP here in the UK who murdered scores of his patients over several decades. There is evidence that he killed 215 of his patients but the number may be higher. No-one suspected him of wrongdoing because he was a doctor. That culture of complete faith is breaking down here little by little partly due to his case.

The doctor patient relationship is not one of equals and can be a very threatening one; after all some doctors can ultimately decide if you live or die by choosing treatments or surgery for you.

I know not all doctors are bad but it does no harm to scrutinise their practice, question their protocols and challenge them if necessary.


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## choli (Jun 20, 2002)

Quote:


Originally Posted by *orangefoot* 
I'm back here reading more and wondering how you go to the doctors for one thing and end up being invited to talk about drug use and consent (or otherwise) to a pelvic exam.

For the same reason that, when a woman visits a hospital for another reason, she gets routinely asked "Do you feel safe at home?" Because it may be the only time that she is able to answer honestly because she is by herself in a trusted environment.

I believe young people should also routinely be allowed to be alone with a health care provider so that they can discuss things that they may not be able to discuss in front of their parents - abuse by said parents, drug use, or sexual activity of which their parents would not approve.


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## alegna (Jan 14, 2003)

Quote:


Originally Posted by *choli* 

I believe young people should also routinely be allowed to be alone with a health care provider so that they can discuss things that they may not be able to discuss in front of their parents -

I have no problem with them being allowed to. I do have a problem with them being pressured or coerced.

-Angela


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## aniT (Jun 16, 2004)

:

They should not be forced to be alone with a doctor if they are not comfortable with it.

And at 18 I don't think I would even go to the doctor with my daughter, let alone try to force my way into a pelvic exam. There is a huge difference between protecting our young teens for needless prodedures, and uncomfortbleness with a doctor, and trying to control our adult children.


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## orangefoot (Oct 8, 2004)

Quote:


Originally Posted by *choli* 
For the same reason that, when a woman visits a hospital for another reason, she gets routinely asked "Do you feel safe at home?" Because it may be the only time that she is able to answer honestly because she is by herself in a trusted environment.

OK. We live in different worlds.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *aniT* 
That is the point I was trying to make about MY daughter, but apparently she NEEDS to learn to take control of her medical care by herself NOW. Apparently NOW is the time she needs to grow out if this can't wait until she is older.







:

I would suggest reading about anxiety. It is not normal behavior for a child who is 13 to be unable to speak to people in public. While I understand the impulse as a caring parent to make everything easier for your child, with anxiety that can actually be doing the child a disservice because the more they stop doing the less they are able to do. The more you excuse them not engaging in normal behavior (speaking to shop clerk or the doctor) the more you tell them that there is something real to worry about and that you don't have trust or confidence in them.

I didn't get from anyone here that kids should be thrown off a bridge and told to swim. Rather, that learning to take control of your own medical care is a long learned process that should start when kids are young. If your kid is already into the teenage years and they are doing none of this (not even able to speak to the doctor) as a parent I would be concerned about it.


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## choli (Jun 20, 2002)

Quote:


Originally Posted by *orangefoot* 
OK. We live in different worlds.

They don't ask that in the UK? It's routine here, in Massachusetts at any rate.

It gives women in DV situations an opportunity to get help that she might not be able to bring herself to ask for otherwise.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Roar* 
I didn't get from anyone here that kids should be thrown off a bridge and told to swim. Rather, that learning to take control of your own medical care is a long learned process that should start when kids are young. If your kid is already into the teenage years and they are doing none of this (not even able to speak to the doctor) as a parent I would be concerned about it.

Thanks for your opinion. I am not concerned in the least. My daughter hasn't even been to the doctor since she was 11 anyway. I don't believe in "routine" physicals. The last one she had was when she was 11 for GS camp. If she needs one for something else, I will again take her to our ND who is just as POed about the new recent vaccines as I am and I don't have to worry about her trying to push them or a pelvic exam on her.

If for some reason however my DD was to go to the ER, I WOULD NOT leave the room case I don't know/trust those doctors.

I see nothing wrong with her not wanting to talk to doctors. I myself wouldn't when I was her age, and if I was forced to answer questions I would lie.

Quote:


Originally Posted by *choli* 
They don't ask that in the UK? It's routine here, in Massachusetts at any rate.

It gives women in DV situations an opportunity to get help that she might not be able to bring herself to ask for otherwise.

I have never been asked such questions either. Never! So it is NOT routine everywhere. Of course I haven't been to a hospital since DD3 was born three years ago. But nope.. they never asked me anything of that nature when DH was out of the room either.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *BelgianSheepDog* 

Increasingly I come to see how much of the "protective" nature of AP is anxious people's grasping for CONTROL. And I speak as the child of prototypical "AP" parents, not just as a member of MDC or AP circles in the real world.

I agree.

I'd like to suggest the book The Price of Privilege http://www.amazon.com/Price-Privileg...8068483&sr=8-2

While it is superficially talking about how social class comes into play parenting teenagers it has a lot of insight into how children are hurt when parents don't foster some independence. It isn't an all or nothing overnight thing but a gradual process and a process that some parents think they can protect their kids from...but that doesn't turn out very well.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *aniT* 
Thanks for your opinion. I am not concerned in the least. My daughter hasn't even been to the doctor since she was 11 anyway. I don't believe in "routine" physicals. The last one she had was when she was 11 for GS camp. If she needs one for something else, I will again take her to our ND who is just as POed about the new recent vaccines as I am and I don't have to worry about her trying to push them or a pelvic exam on her.


Ah, the assumptions there... We don't do routine physicals or vax either. I still believe though that our son should be able to function in society - to speak to other people, etc. I'd prefer the first time he practice these skills not be when he's sick or afraid. Independence is an ongoing process that takes steps every single day.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Roar* 
Ah, the assumptions there... We don't do routine physicals or vax either. I still believe though that our son should be able to function in society - to speak to other people, etc. I'd prefer the first time he practice these skills not be when he's sick or afraid. Independence is an ongoing process that takes steps every single day.


Are you saying my daughter cannot function in society because she chooses not to speak to strangers?

And what assumptions?


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## lorijds (Jun 6, 2002)

Quote:


Originally Posted by *BelgianSheepDog* 
Increasingly I come to see how much of the "protective" nature of AP is anxious people's grasping for CONTROL. And I speak as the child of prototypical "AP" parents, not just as a member of MDC or AP circles in the real world.

I'm beginning to notice this as well. I was really taken aback on the cell phone thread, by the number of mothers who vehemently felt that having a cell phone was a requisite safety measure, like wearing a seat belt. I think we all probably struggle with this to a degree, this control issue, this anxiety about the safety of one's children; where to draw the line, when to let them deal with it, when to step in, balancing independence and safety.

Thanks for the book recommendation, roar.


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## MidgeMommy (Mar 22, 2007)

Where are the mods? This thread isn't even about the 12 year old boy, anymore. It's about everyone else's kids going to the doctor!


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## aniT (Jun 16, 2004)

This thread IS on topic. The topic is 12 year old physical and we are talking about procedures and how they make the children feel. I am not sure what the problem is.


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## BelgianSheepDog (Mar 31, 2006)

Roar, that book looks FASCINATING. Thank you for pointing me to it.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *aniT* 
Are you saying my daughter cannot function in society because she chooses not to speak to strangers?

Part of functioning in society is being able to make social contact with other people. If a teenager's anxiety is so out of control that they are "pissed off" if a shop clerk speaks to them or they can't speak to a doctor, then yes that is impaired functioning! As a parent I would be concerned about that rather than trying to come up with excuses or reasons why it is good she isn't able to interact in a normal social fashion.

Quote:


Originally Posted by *aniT* 
And what assumptions?

I hear an assumption that it doesn't matter if the child is unable to interact because you above getting routine physicals or vaxs. It would only be a concern if a parent hook line and sinker did everything a doctor said or bought into the belief system of mainstream medicine. What I'm telling you is that there are people who think critically about medicine, who don't get routine exams, who don't vax or whatever, who still believe their teenagers shouldn't be capable of normal social interaction.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Roar* 
Part of functioning in society is being able to make social contact with other people. If a teenager's anxiety is so out of control that they are "pissed off" if a shop clerk speaks to them or they can't speak to a doctor, then yes that is impaired functioning! As a parent I would be concerned about that rather than trying to come up with excuses or reasons why it is good she isn't able to interact in a normal social fashion.

She can if she wants, she doesn't WANT to. And we are just going to have to agree to disagree. I don't agree with you. She does NOT have impaired functioning and I guess it's a good thing you aren't her mom since she apparently doesn't live up to YOUR standards.

Quote:


Originally Posted by *Roar* 
I hear an assumption that it doesn't matter if the child is unable to interact because you above getting routine physicals or vaxs. It would only be a concern if a parent hook line and sinker did everything a doctor said or bought into the belief system of mainstream medicine. What I'm telling you is that there are people who think critically about medicine, who don't get routine exams, who don't vax or whatever, who still believe their teenagers shouldn't be capable of normal social interaction.

Maybe you are making assumptions on what is "normal social interaction" between YOUNG teens and strangers. You have your standard, I have mine, obviously we don't agree and are not going to convince each other of our points. We are just going to have to leave it at that.


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## forthebest (Jun 19, 2006)

Everybody is different I think. I have plenty of friends who don't expect their children to communicate with every person they meet, stranger or no, official capacity or no. I've always been a bit of a hermit and not terribly sociable, in fact I am happier on my own than with people in general.I get fed up with empty conversing just for the sake of it. I think there are very fixed ideas of what is 'normal' in this society, some people just need more space. I always tell my dc not to bother answering mundane, nosy or ignorant questions from any people and the majority of stuff they get is just that.My children have that choice to communicate with who they want not who their parents or anyone else expects. That choice extends to their bodies as well. I would disagree that a child who does not wish to communicate with various shop clerks, doctors etc has a problem, I would say they have a firm grasp of their own rights to interact how they see fit. I'm so glad all my friends are 'alternative'. I was made to talk to every last bed and breakfast guest my foster mother had in our house. It used to sicken me and even a few guests couldnt grasp why she felt this urge/need to have me communicate with total strangers all the time. Just to be polite, to conform etc etc.It made me even more reclusive.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *forthebest* 
I always tell my dc not to bother answering mundane, nosy or ignorant questions from any people and the majority of stuff they get is just that.My children have that choice to communicate with who they want not who their parents or anyone else expects. That choice extends to their bodies as well. I would disagree that a child who does not wish to communicate with various shop clerks, doctors etc has a problem, I would say they have a firm grasp of their own rights to interact how they see fit. I'm so glad all my friends are 'alternative'.

Yes, I think there is a difference in world view there. I'm not aiming for my child to grow up to be a hermit.

I don't believe everyone should be chatty or should be an extrovert. I live with two introverts who don't particularly enjoy meeting new people and that's fine. It isn't fine though for people to be incapable of normal polite human interaction or be incapable of getting their needs met (talking to the doctor, etc.) because they view all people as "strangers" who are out to get them. That doesn't mean people are obligated to answer overly personal or intrusive questions. It does mean though that you are able to navigate in the world without seeing every conversation as an attack on you. I'm sorry that you were forced to chit chat against your will, but it seems pretty sour to then decide every little old lady at the grocery store who says "nice weather we are having" is mundane and isn't worth a polite response.


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## Roar (May 30, 2006)

Quote:


Originally Posted by *aniT* 

Maybe you are making assumptions on what is "normal social interaction" between YOUNG teens and strangers. You have your standard, I have mine, obviously we don't agree and are not going to convince each other of our points. We are just going to have to leave it at that.

So, exactly what interaction do you consider normal for a teenager? You don't consider it normal social interaction for a teenager to be able to talk to a shop clerk without getting anxious that their mom isn't with them for a minute or without getting angry that someone spoke to them?

What is your long term goal? Are you, as the other poster, aiming to raise hermits? If not, what do you see changing in the next four years to render her capable of functioning independently?

My understanding of the goal of AP is to raise attached, independent, confident people. I am having trouble understanding how teaching teenagers that it is abnormal to talk to adults accomplishes that.


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## forthebest (Jun 19, 2006)

Roar, I am deffo not trying to raise hermits. My two dd's are very sociable, the phone is always ringing for them and they have a very good social life, far better than mine







My son is a bit more reserved but still more than capable of interacting with others should he wish to. We as humans are social creatures, I mean I can see that. But not everybody needs that interaction a lot and I think it's good to set your own boundaries as a child because there can be an underlying acceptance that children aren't really able to make their own decisions especially if that decision( say not to talk to someone) does not correspond with the accepted 'norm'. I have known many children and adults who are not particularly chatty with others and I don't think thats a problem. Perhaps it takes some children longer to find that level of comfort when engaging with others and it's not like everyone on planet earth is an ok person either and so some reticence may be expected. FWIW I'm now quite chatty with strangers( 39 now) but feel more useful if I'm actually helping someone, like helping old ladies across the road, opening doors for ladies with buggies etc, actions speak louder than words.


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## aniT (Jun 16, 2004)

Quote:


Originally Posted by *Roar* 
So, exactly what interaction do you consider normal for a teenager? You don't consider it normal social interaction for a teenager to be able to talk to a shop clerk without getting anxious that their mom isn't with them for a minute or without getting angry that someone spoke to them?

She was NOT anxious. She simply didn't want to talk to him. And FWIW he was an older teenage boy. So that might have had a lot to do with it.

And yes, I consider it PERFECTLY normal to not want to speak to older teenage boys when you are only a 13 year old girl. She is shy and will come out of it when she is ready. Pushing her is NOT going to accomplish anything.


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## EricaLeigh (Apr 25, 2005)

I always remember the boys joking about the doctor asking them to "turn their head & cough" Is that what the doc wanted? Also, I'd much rather be checked by a stranger then a close family friend. If hair is developing it can be embarassing! I'm glad it all worked out.


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## doctorjen (May 29, 2003)

I'm having a hard time with some of the animosity towards medical personnel here. I hope that anyone who felt I was out to harm their child would take their business elsewhere.

I cannot agree more about giving preteens and young teens the opportunity to speak with me privately. In my state kids 12 and up can consent on their own for care for pregnancy, STD testing or counseling, birth control, mental health issues or substance abuse. When I do a sports physical for a 7th grader, I merely mention that as they get older they may have issues they wish to discuss, and that they are welcome to ask here without fear that I'll be reporting immediately to their parents. I always tell teens that I hope they'll discuss any issues with their parents, and that it's always best if their parents know what's going on in their lives, but that they can get care from me for birth control, or STD testing, or whatever on their own. An awful lot of kids tell me in private that they are sexually active and wondering about preventing pregnancy, or they just started smoking, or whatever who wouldn't say the same in front of their parents. And unfortunately, not every young teen has supportive, understanding parents and might be in physical danger if their parents knew they were having sex, or drinking, or whatever. Having a neutral place they can discuss things is helpful for a lot of teens. Knowing ahead of time where they can go if they have a sudden need for birth control, or are feeling depressed or whatever

I also take a few moments alone with the parent to make sure they don't have any particular concerns, and to clarify for them that I'll be telling their child about their right to confidential care.

I also agree that any patient has the right to know why I'm suggesting any part of the exam or tests or whatever. I'm perfectly fine with an informed patient declining anything they want, and have many clients who've not wanted this or that and it's no big deal. I see my role as offering services and expertise, and my patients choose them or not. I assume that's why people hire me - not that they are feeling like they need to protect themselves from me.

I love teens and preteens, actually, and really enjoy seeing them. I like their honesty and enthusiasm. I think the fact that I genuinely enjoy my young patients is obvious to them, as that is one area of my practice that is always booming as young folks send their friends to me. I see visits with young folks not as an opportunity to coerce them into a bunch of stuff or prepare them to be sheeple, but as the chance to start a good working relationship together so if they need me for anything more personal/serious down the road they are comfortable coming back and know I will be respectful and helpful. That's all I'm trying to do.

As for the OP, good for you for working it out in a way respectful to this young man. Perhaps the doc can explain to him at a time when he is not needing any exam why he looks for hernias in young guys and help him feel more at ease in the future. And if he's never more at ease, at least he'll know what exactly he's declining.


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## Terabith (Mar 10, 2006)

I was always traumatized by the "quick peeks" at my private areas. I had precocious puberty, however, so I do understand why it was necessary. I didnt have a pelvic until I was 18. (I still wasnt sexually active, however.) I was always bothered that my parents were in the room for exams (and never left). Even the dr asking me if I wanted them to leave would have been problematic....you cant exactly tell your parents you want them to leave, if there is something dysfunctional about the relationship. (Sure, they might leave at the moment, but as soon as you leave the harassment would begin, "Why'd you want me to leave? What's going on? How could you do that to me? What were you thinking? etc) IME it would have been better for the parents stepping out to have been routine. Now, obviously there are exceptions. If a child obviously did not want the parent to leave, that should be respected. I was 18 and in college before I was ever alone with a dr. But I also really want to know, with all the discussions of teenagers having medical privacy and being able to go to their dr with concerns, how would that work, exactly? How are they going to go to the dr without their parents knowing/ signing off on insurance/ etc? I had things I wanted to see a doc about as a teenager, but I never knew how I could go to a doctor without my parents.


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