Examination of genitalia in children: 'The remaining taboo'

Trained student observers rated 123 physical examinations by pediatric house staff during health care maintenance visits to assess the frequency of examinations done on male and female genitalia compared with examination of ears, heart, and abdomen. Sixty-five observations were made of 21 male house staff and 58 observations of 18 female house staff. One to five examinations per physician were observed. Whereas physicians examined the ears, heart and abdomen of pediatric patients ≥97% of the time regardless of the sex or age of the child, female genitalia were examined 39% of the time and male genitalia 84% of the time. Female genitalia were examined approximately half as frequently as male genitalia at all ages with a trend to less frequent genital examinations on older children. Both male and female physicians examined female genitalia less frequently than male genitalia. It is concluded that increased emphasis is needed in house staff training programs on the examination of genitalia.