Double standard in pediatric offices - Input?

I was talking to a friend of mine who works at a pediatric office as a receptionist, and she was saying that if a adolescent male is in for a physical exam by a NP, the boy is uaually told too undress completely from the start of the examination.

She said that NP's do most of the physical exam.

For girls, she said that they only usually remove their shirt, and other areas are uncovered and recovered as needed.

I asked her why this difference exists, and she said that she doesn't know...

Any Nurse Practitioners or nurses care to elaborate why this is?

Http://staff.wcasd.k12.pa.us/administration/healthservices/physicals.htm

Double standard... Says that "....these medical examinations will require the removal of sufficient clothing to insure a complete exam. This will include a hernia/testicle examination for males. It will not include a breast or genital examination for females.

I am not a medical person but there may still be the mistaken assumption that boys do not need to be shy about nudity or be modest and should just suck it up and be a man, so to speak.

It might also be that the NP likes looking at naked teenage boys.

ADPETXG77 how old is your friend? And how does she know that the boys are naked if she is the receptionist? Also has see chaperoned any of the physical exams?

My mother sent me to a female pediatrician when I was quite young, 7 and 8 or so, and she stayed in the room while I was being examined or treated. If I remember correctly, I had to undress down to my underpants for the exam or remove whatever was appropriate for treatment, as in removing undershirt if I had a cold so she could listen to my chest for example.

From age 9 on I went to the family's general practitioners, always male. Same for my younger brother. If I was being sent for a phsyical I came to expect that the nurse would show me into the exam room, ask some questions, tell me to strip down to my shorts while waiting for the doctor, and then leave the room. My shorts would stay on during the exam until the end, for the genito-urinary part. If the nurse had to come into the room, to give me a shot, for example, it was always while I had my shorts on. I don't remember ever being completely naked in front of a nurse as a child or teen. We weren't supposed to be shy or modest in front of the doctor because he was male too, and it was OK for males to see each other naked, according to me mother. This subject came up when I started taking swimming lessons at the Y (mid-1950s) and swim suits were not required and I asked my mother about it. I was also told to obey the doctors instructions and do whatever he asked me to.

I had my first prostate exam at age 14 from the family doctor, an experience which kindled lifelong interest and curiousity, and is probably one reason why I read and participate in these forums this very day.

As regards the posts ahead, Iam not sure that the double standard is still applied but I am sure that it was sometimes in the past because it was a common idea accepted by families that boys and male teenagers must not be modest and shy, may be it was also in relation with mandatory military service for young men.

Until you have done it, you were not consideed as a man, more like a lad, and everybody knew that in physicals for military service the modesty of young men was not taken in account, the physicals were organized as mass examinations which needed efficiency so it was no use to loose time with modesty and privacy.

so why would it have beeen more important for a student before?

But I doubt that today a boy is asked to remove all his clothes in a doctor'office from the start of the exam and as one of you has asked, how can a receptionist know that?

From the age of about 10 my son would have to strip naked for every exam. And nine times out of ten would have his scrotum felt and his foreskin pulled back.

Easterman,

I am sure you are right. In the past, especially at military medicals, complete nudity was probably considered acceptable because both doctors and patients were generally male. Moreover, at that time, males often swam naked in a male only environment. Also, in the past, certainly, in this country, doctors were considered gods (not servants - which is what they actually are) and you were trained to do whatever they told you to do.

Like you, I very much doubt this sort of thing goes on today, because people today have "rights" and, moreover, they are less cowed than they were in the past. Certainly, if a doctor or nurse tried to order me to strip today, I'd say. "No!"

Morrison, Whitclaw Reid A.M., M.D., and Laurence B. Chenoweth, A.B., M.D., Normal and Elementary Physical Diagnosis. 1st ed. 1928, Lea & Febiger, Philadelphia. “The subject should be exposed as much as possible because an efficient examination cannot be made unless he is undressed. Boys should be nude ...” (p. 20)

Second ed. 1932

“Ordinarily, boys should be nude for the examination. At times, however, a gown may be useful to protect them from the cold or to permit them to pass through corridors for various parts of the examination.” [pattern for gown follows] p. 21

Third ed. 1941

“Ordinarily, boys should be nude for the examination. Shorts may be worn when some clothing seems desireable. At times, however, a gown may be useful to protect them from the cold or to permit them to pass through corridors for various parts of the examination.” p. 14-15.

Fourth Ed. 1947. (same as 3rd) 12-13

Fifth Ed. 1955 (same as 3rd and 4th)

Deaver, George B., M.D. Fundamentals of Physical Examination,1939, W. B. Saunders Co., Philadelphia. “Gowns - The subject should be dressed so that the complete examination may be given without taking off or putting on clothing. This is not a problem with boys, as they can usually be examined in the nude. While the boys are being tested at various places, they can wear their short gymnasium pants and shoes, which can be removed when they reach the physician’s office.” p. 19

Rather than start a separate thread, I posted these interesting excerpts from older medical texts in this "boys vs. girls" thread.

Interesting article Darth.

Would you mind posting the entire excerpt?

I asked how how she knew, and she said that she can hear the nurse talking to the boy or girl in the exam room telling him or her to undress.

She said that usually when a boy comes in, she hears the nurse say something along the lines of "OK, take off everything including your briefs, and have a seat on the exam table, and she will be in shortly."

Thanks for your interest ADPETXG77. Unfortunately, I don't have any further excerpts available. Those books can probably be seen at a medical school library or some other historical collection. It's interesting to note the casual approach to medical nudity suggested by these passages.

No double standard. Even if the boys are nude, I can only assume that in most practices, the boys would still be appropriatedly draped/gowned. Failure to protect patient modesty, even in a child, is a violation of most practices code of conduct.

The double standard is alive and well today. At least in the hospital where I work (xray tech). Females, especially of child bearing age, are afforded much more privacy than men. It is almost universally expected that men are less modest for some reason. Male patients are casually exposed, and while no one thinks twice about a female tech doing a male patient, if the patient is female and it is an intimate exam such as a barium enema, all efforts are made to have a female tech do the exam. I'm not defending it, just saying that's how it is.

My ped always had a double standard and seems to have read the book excertped below. I wonder what it says about girls, probably not "girls should be nude..."

My pediatrician was female and I was told to strip nude for the entire exam. They would close the door, have me strip

Completely and weigh me. Blood pressure, temperature etc. all completely naked. Then the nurse would give me a paper gown and told me to wait for the doc. I'd get so hard the whole time. The doc would immediately have me remove the paper gown once she entered (not sure why I had it on to begin with to be honest) then she would proceed with the exam. Checking eyes, ears, throat. Reflexes etc. then she'd have me lie back and do the abdomen palpitations. My little penis would be so hard and sticking straight in the air. It was humiliating. She'd then stand me up, touch my balls and do the hernia test. After that was the scoliosis test where I'd have to bend over to

Check the curvature of my back. She'd then spread my cheeks and examine my hole as I was bent over. It was humiliating but arouses me to this day.

GF sais none of her drs ever looked at her breasts or genitals growing up. Gyno was the first for all of that at age 19..

I have my penis checked several times around 9-13 age.

Very interesting thread. As a healthcare provider we are ALWAYS reminded to only uncover the parts that need to be uncovered and only when they are being examined. Modesty is always a paramount concern. Whether it is close the door or the curtain ... there is always the modesty factor with older adults. However, with children it's almost expected that they won't be "shy".

I think it is fairly typical for boys to be subjected to full body exams while girls have only cursory exams. Before I was 11, the pediatrician would just have me take off my shirt for an exam. When I was lying on my back for the abdominal exam, he would just stick his hand down my pants and do a quick feel of the penis and testes. After 11, I started being stripped to my briefs for the whole exam. When I was 11 and 12, he pulled down the front of my briefs while I was on my back and examined my penis and testicles, but, when I turned 13, he started having me stand up and he would instruct me to take down my briefs. He added a hernia exam to the exam of the genitalia at this point. I think the idea is that modesty is not an issue for boys, but also that a real man has his pants down during a physical. I am not sure what percentage of men feel as embarrassed as I feel during this part of the exam, but I have always envied men who do not find it embarrassing.

For me, the process, which took place at the same medical office, didn't change from pediatrics to internal medicine. I was brought into the exam room and told to take everything off except briefs. This being the 1950's through '70's, the doctor did the whole exam with the nurse as guide to the room only.

I have written about it in another thread about school medicals but we always had to strip right off and stay naked for what seemed like ages including for the actual examination; not much scope for modesty then. Good to remember though.

My kids (boy, girl) were both nude for their exams until they were ten. After that my son was allowed to keep his briefs on, but had to remove them towards the end of the exam for the genital check-up. My daughter, however, was allowed to keep her bra and knickers on throughout the whole exam.

Re: post #2.

I fully agree that there is a double standard, but the sports exams is not an example of one. There's a good reason a male should be checked for an inguinal hernia prior to doing sports, but there's not sports related reason to perform a breast or genital exam on a female.

Plenty of other examples of the double standard, though.

Kim, I wonder why the boy had to remove his briefs completely for the genital exam. Pulling them down would have bee sufficient I think.

In my experience, every time I went to the paediatrician for a checkup, totally nude from the start. The rest of the vistis, for illnes, only the needed to do the exam.

Both as a child and an adult, I've usually been told to "strip to my shorts" and the shorts came down only for the genital exam and rectal exam, when that started. I had one physical where I was only asked to take off my shirt. My pants and shorts came down for that part of the exam, but that was it.

Although I was never completely naked at the pediatrician, when I got to be about 12, my bra started to come off at one point in the exam, and my underwear at another point. From what I can tell on the boards here, most guys at that age had underwear on and pulled them down at some point. Seems to be the same thing.

Yes underwear on until the end of exam then pulled down or off appears to be SOP. And really doesn't seem to be much of a difference between the two. Are we really less exposed if they're down around the knees, ankles or completely off?

Skyler - did you get to put your bra back on at any point or did it remain off for the rest of the exam?

Yes underwear on until the end of exam then pulled down or off appears to be SOP. And really doesn't seem to be much of a difference between the two. Are we really less exposed if they're down around the knees, ankles or completely off?

To me, completely off seems like the doctor saying, "you're going to be naked for a while." as pulling down is like "you can pull them up as soon as the genital exam is done."

The question is, if they're taken off, where are they put and how do you retrieve them?

If the doctor's doing a genital exam and my back is to my Mom and I only have to lower my shorts, she only sees my bare butt and I really don't have to bend over much to pull my shorts up.

If they're taken off, I may have to face her naked to get them back and even if I turn my back to her when I put them on, bending over all the way exposes me much more.