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  #51  
Old 11-09-2019, 07:40 PM
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Originally Posted by Manda JO View Post
Bolding mine. There's no reason for a pelvic exam if you have no symptoms.
Incorrect. In fact, your own cite lists getting an IUD a reason for getting a pelvic exam prior to the device being inserted. Getting fitted for a diaphragm also requires one, although that device is probably not as popular/common as it used to be.

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Originally Posted by Manda JO View Post
The idea that once you've had sex you need to be "checked out" is an artifact of the whole "becoming a woman" myth.
But seeing a doctor for reproductive health and information tailored to your individual self is NOT "an artifact", it's a sound medical practice.

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Originally Posted by Manda JO View Post
The insistence on an pointless, invasive exam before you can get medical care that you need hurts women.
Your continued insinuation that there is NEVER a need for a pelvic exam is getting tiresome. Yes, there are reasons for women to get a pelvic exam even at a young age. Fortunately, such reasons are not terribly common but they do exist. Young women with such conditions should not be denied a needed and useful exam - even if it is invasive - because no, in that case it is NOT "pointless".

Who determines if such an exam is needed? I hope it would be a doctor, someone actually trained to make such a determination.
  #52  
Old 11-09-2019, 07:52 PM
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Originally Posted by Broomstick View Post
Incorrect. In fact, your own cite lists getting an IUD a reason for getting a pelvic exam prior to the device being inserted. Getting fitted for a diaphragm also requires one, although that device is probably not as popular/common as it used to be.


But seeing a doctor for reproductive health and information tailored to your individual self is NOT "an artifact", it's a sound medical practice.


Your continued insinuation that there is NEVER a need for a pelvic exam is getting tiresome. Yes, there are reasons for women to get a pelvic exam even at a young age. Fortunately, such reasons are not terribly common but they do exist. Young women with such conditions should not be denied a needed and useful exam - even if it is invasive - because no, in that case it is NOT "pointless".

Who determines if such an exam is needed? I hope it would be a doctor, someone actually trained to make such a determination.

You said:

Quote:
Originally Posted by Broomstick View Post
Sexually activity (whether voluntary or not) would, actually, be a reason for a pelvic exam prior to the age of 18, as women are supposed to have one when they start having sex. So "I think my daughter is having sex" might be a reason to do one, though "I want to be sure my daughter is still virgin, can you check her hymen" is probably not the best opening line.
I have never said that a pelvic exam was never needed. I said that the idea that having sex was in and of itself a reason for a pelvic exam was outdated and paternalistic. Then you doubled down and said that "if a woman starts having sex at 14 or 15, waiting until she is 21 to start caring about her reproductive health is a bad idea". You are the one that drew a connection between having a pelvic exam and caring about your reproductive health.

Last edited by Manda JO; 11-09-2019 at 07:53 PM.
  #53  
Old 11-10-2019, 12:25 AM
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Originally Posted by Acsenray View Post
Even minors should have a right to privacy with respect to their own bodies.

And any father who needs to know whether his daughter is a virgin is a sick fuck.

It's very different from a parent's duty to ensure that ēs child is safe, properly educated and knows when and how to ask for help in matters of the body.
Even if, say, she is prepubescent? The only people benefiting from your POV are rapists and molesters.
  #54  
Old 11-10-2019, 04:44 AM
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Originally Posted by Manda JO View Post
I have never said that a pelvic exam was never needed. I said that the idea that having sex was in and of itself a reason for a pelvic exam was outdated and paternalistic. Then you doubled down and said that "if a woman starts having sex at 14 or 15, waiting until she is 21 to start caring about her reproductive health is a bad idea".
Yes... and what about the statement that ""if a woman starts having sex at 14 or 15, waiting until she is 21 to start caring about her reproductive health is a bad idea" says that a pelvic exam is mandatory? It doesn't. That's you reading more into the statement than there is.

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Originally Posted by Manda JO View Post
You are the one that drew a connection between having a pelvic exam and caring about your reproductive health.
I don't view a pelvic exam as a horrific invasion that must be put off until after someone or something else has entered the vagina. When it makes medical sense a pelvic exam is appropriate and that could be any age depending on circumstances that a doctor is far more qualified to determine than you or me. You're the one who construed my statements to mean "line 'em at age 14 and start the vagina probing", which is not what I said at all.
  #55  
Old 11-10-2019, 09:10 AM
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Originally Posted by Broomstick View Post
Yes... and what about the statement that ""if a woman starts having sex at 14 or 15, waiting until she is 21 to start caring about her reproductive health is a bad idea" says that a pelvic exam is mandatory? It doesn't. That's you reading
more into the statement than there is.
You literally said(bolding mine):

Quote:
Originally Posted by Broomstick View Post
Sexually activity (whether voluntary or not) would, actually, be a reason for a pelvic exam prior to the age of 18, as women are supposed to have one when they start having sex. So "I think my daughter is having sex" might be a reason to do one, though "I want to be sure my daughter is still virgin, can you check her hymen" is probably not the best opening line.
That was the line I responded to. I responded with:

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Originally Posted by Manda JO View Post
I disagree. You don't take your daughter to the doctor and say "I think she might be having sex, so can you check under the hood". You might take your daughter to the doctor and say "I think she might be having sex, so you two have a conversation about it".
Somehow you are turning that exchange into a claim that you never called for pelvic exams and I said they were never needed.

Look, the recommendations have changed since we were young. It turns out, routine pelvic exams when there are no symptoms don't tell doctors much and there was never much reason to do them, whether or not someone is sexually active or wants to go on the Pill. I don't know why you keep doubling down. Admit you learned something--I did, too. I knew that "deflowering" was not reason to do one, but I thought there was some medical reason to do one at well-woman checks starting at 18. Turns out, even that isn't needed.
  #56  
Old 11-10-2019, 05:59 PM
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You are doubling-down on ignoring that there actually ARE reasons to do pelvic exams early - such as fitting a woman for a diaphragm or prior to inserting an IUD. Any particular reason you're ignoring that? Or are you ignorant of the fact that there are options beyond the Pill for birth control? Or are you somehow convinced that pelvic exams are inherently traumatic and/or abusive or something?

Like I said - there are reasons to have them done early, although it's a good thing those reasons aren't too common. I'm not at all sure what you think I learned here that I didn't already know.

You and Joey_P seem to have over-the-top reactions to this whole topic. I find it puzzling.
  #57  
Old 11-10-2019, 06:24 PM
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Originally Posted by Novelty Bobble View Post
I had a reply to several of the points raised here but it basically amounted to what Broomstick said........so...........yeah, that.
What Broomstick did was to conflate
Quote:
And any father who needs to know whether his daughter is a virgin is a sick fuck.
with
Quote:
I do consider it bizarre to the point of creepy/sick to go about it by medical exams on their genitals
... by making it part of the reply to Joey P.

I assume that was not intention, but it means I can't fully endorse Broomstick, and it was very unfair to Joey P.
  #58  
Old 11-10-2019, 07:01 PM
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Look, Manda Jo, women need a complete physical, including a pelvic exam, before getting any kind of prescribed birth control, because the doctor (or PA-C or ARNP) can determine what is best for her, or inappropriate which is often the case, and discuss with her how it is to be properly used.

For as long as the Pill has existed, there has been discussion about making it OTC (and I'm pretty sure it can be purchased from a pharmacist in at least one state) and the medical and pharmacy boards have usually shot that one right down.
  #59  
Old 11-10-2019, 07:57 PM
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Originally Posted by Broomstick View Post
You are doubling-down on ignoring that there actually ARE reasons to do pelvic exams early - such as fitting a woman for a diaphragm or prior to inserting an IUD. Any particular reason you're ignoring that? Or are you ignorant of the fact that there are options beyond the Pill for birth control? Or are you somehow convinced that pelvic exams are inherently traumatic and/or abusive or something?

Like I said - there are reasons to have them done early, although it's a good thing those reasons aren't too common. I'm not at all sure what you think I learned here that I didn't already know.

You and Joey_P seem to have over-the-top reactions to this whole topic. I find it puzzling.
I never once said there was never a reason to do a pelvic exam. You said, explicitly, that any woman who has sex should have a pelvic exam. That having sex meant you were "supposed" to get a pelvic exam. I never said there weren't other reasons, I said that having had sex was not, in and of itself, a reason. I provided good cites demonstrating this.

You literally said anyone having sex should be getting pelvic exams. Do you see that you said that?

Quote:
Originally Posted by nearwildheaven View Post
Look, Manda Jo, women need a complete physical, including a pelvic exam, before getting any kind of prescribed birth control, because the doctor (or PA-C or ARNP) can determine what is best for her, or inappropriate which is often the case, and discuss with her how it is to be properly used.
Not according to the American College of Obstetricians and Gynecologists, as cited in post #49.

Quote:
For as long as the Pill has existed, there has been discussion about making it OTC (and I'm pretty sure it can be purchased from a pharmacist in at least one state) and the medical and pharmacy boards have usually shot that one right down.
No one has said anything about it being OTC. It's pretty clearly a good idea to have your medical history taken, your blood pressure, and discuss options and side effects with a doctor. There are real risks associated with hormonal BC and people on it need monitoring. What is no longer recommended is the routine pelvic exam as part of that visit--because unless there's reason to believe there's a problem, no one has ever been able to show that digging around down there tells the doctor anything new.
  #60  
Old 11-10-2019, 09:34 PM
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Originally Posted by Manda JO View Post
You literally said anyone having sex should be getting pelvic exams. Do you see that you said that?
No - that is your interpretation of what I said. I'm done going round and round with you on this, particularly with you refusing to acknowledge what I've said or examples I've given of circumstances where, yes, a pelvic exam on someone under 18 is medically warranted. You just keep doubling-down on it - now it's "anyone" having sex needs a pelvic exam, not just women. Sure, get the men up in stirrups, too.... I'm not even going to ask how you expect that to happen.

Quote:
No one has said anything about it being OTC. It's pretty clearly a good idea to have your medical history taken, your blood pressure, and discuss options and side effects with a doctor. There are real risks associated with hormonal BC and people on it need monitoring.
True. And some people shouldn't be on it at all. What do you expect them to do, just cross their legs and say "no"?

Quote:
What is no longer recommended is the routine pelvic exam as part of that visit--because unless there's reason to believe there's a problem, no one has ever been able to show that digging around down there tells the doctor anything new.
If a pelvic exam you've experienced involved "digging" in such a sensitive area I'd question the competency of your doctor....

... except I know you don't mean that literally. So get a grip already.

And there ARE circumstances where a pelvic exam can, in fact, tell a doctor "something new" about a patient - your own link gives examples of women who SHOULD have pelvic exams more frequently than average, like those exposed in uterero to DES. Or where a physical abnormality is suspected. Or for some types of non-hormonal birth control. Or after a sexual assault which is a type of sexual activity even if a wholly involuntary one, and one that can occur a hell of a lot earlier than 18 or 21 or whatever arbitrary age limit you set.

But I've given up, Manda Jo. Somehow you're convinced a pelvic exam is a horrific thing no one should be subjected to prior to age 21 no matter what. So... that's it. Reply all you want, this is my last post in response to you on this. Other people have been more rational about this than you.
  #61  
Old 11-11-2019, 12:19 AM
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Just another doc weighing in...

I would absolutely not do this exam on a parent's request, and I would question any physician who would do so.

There's no compelling reason to do a pelvic on a woman under 21 unless they're having specific symptoms or they're interested in a diaphragm or IUD (which is an option more of them should go for, IMO). Some offices still require a yearly exam before they'll prescribe birth control, but that's mostly a holdover from old recommendations or an attempt to make sure patients are coming in to be seen. ACOG's guidelines are generally rock solid, but they ultimately represent gynecologists, so if they're making a recommendation that results in less business for gynecologists (since they can almost certainly bill more for a visit that includes a pelvic exam) that's one you can REALLY believe.
  #62  
Old 11-11-2019, 07:16 PM
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Pelvic Examination, Rectal Examination, and the actual application of medical ethics.


OK, I'm a doctor, but not a medical doctor. I have and do wear a white coat when the occasion (very rarely now) calls for it, but my primary function is as an educator, and that includes discussion of case studies including questions of, and the application of, medical ethics. There are a number of spurious assumptions floating through this thread, and, while I see the OP's link to the specific case (The rapper's "fatherly devotion", I guess [another example of the crying need for sarcasm font]) is a very special circumstance indeed, the question, if posed in a larger frame of reference, is a far more complex issue and does not allow for simplistic reduction to "sick fuck" and/or attacks on womanhood or (insert your pet position here) moral reasoning. That's why medical ethics is an applied skill- no possible list, rules, or guidelines could possibly cover every conceivable scenario, and frankly, given my familiarity with the extent to which politics and personalities enter into the process, whatever the "experts" from national or international professional group X finally reach consensus on really don't mean a whole hell of a lot to me.
First, the results of such an exam are not totally meaningless, although that position is usually, but not always- correct. The absence of the hymen, in and of itself, means nothing, as many have declared. Sexual intercourse is not the only way, by any means, that a woman might loose her hymen. But the presence of the hymen is rather strong evidence the woman in question has not had vaginal sexual intercourse. While I heartily agree that such activity in an adult woman (including, and especially, when said woman is functioning in the social role of "the bride") is nobody's damn business, (including groom and either family) as a father, I can see some scenarios where interest about a negative result might exist without negative moral judgement (of the parents or the children) of either gender. Add the reality that abuse of a child/tween (of either gender) by a male unsub involving penetration shall leave evidence for some time, then there reasons such an examination might be meaningful.
If I (in the role of parent) have some reason to have a sneaking suspicion that someone close to the child (its usually a family member, but other classifications are also out there) might have sexually abused my child, and my child is young enough that what might have happened doesn't really register with them, I'm in a serious moral quandary.
If I immediately seek out the authorities, I run the real risk of a) falsely accusing a member of my (or my partner's) bloodline of inexcusably heinous behavior, and far more importantly, b) negatively shaping my child's attitude towards sexual relationships for their entire life. All I have are maybes, could bes, behaviors or statements on the part of my child or the unsub that have a distinctly odd "taint" to them, and just good old parental instinct. Nothing substantial (because if there were, the SWAT team would be on their way to attempt to pry the .30/.30 out of my hands), not enough (rationally) to take action, but disquieting enough to provoke the single greatest fear a parent can carry- reacting to the suspicion of some possible transgression of this nature by minimizing one's admittedly instinctual and seemingly paranoid suspicions, only to eventually learn, without question, that the "the" was incontestably real, enormously damaging, and an actually more guilt inducing experience as a consequence of parental non-response to this thing going on that the (now) older child must conclude their protectors knew about, or at the very least had suspicions about, and did nothing- thus either reaffirming the victim's induced sense of low self-esteem or propagating a false image of the crime in which the perpetrator's "needs" were perceived by the parent(s) to be of far greater importance than the child's sense of bodily integrity/self-determination/expectation of parental devotion/protective love.
If I (now in the role of health care provider) am approached by a parent in the above scenario, and they, carefully and rationally, explain how knowing their quite young (to keep the case scenario somewhat manageable) son or daughter has been passively sexually active in the relatively recent past, or absolutely could NOT have been involved in receptive sexual penetration would represent the knowledge they need to tip the scales sufficiently that they could justify and proceed to take/not take action (in the face of the possibly unjust destruction of a loved one's public reputation and mutilating that relationship for life, while excising one's child's trust of others and forever more warping the child's attitudes towards sexuality, and additional costs that exceed what I could write here in a day, or missing what will eventually be deemed to have been obvious to anyone BUT the parents...).
NOW we have the kind of real world moral dilemma that requires the care giver to engage in the personal application of medical ethical reasoning. There's no real black or white here. The practitioner (one hopes) knows the parent(s) adequately well enough to rule out psychological distortions; they also know that they could work in the needed physical assessment during the exam (in an admittedly dishonest bit of manipulating) to make that component of the exam seem somewhat routine, minimizing the immediate emotional impact on the patient, and can be reasonably sure the outcome of the clinical assessment will lead to serious actions only if the evidence is strong enough for the parent(s) to make a very hard call, facing an enormously difficult position, given the possibility (and only the possibility) that the "special" exam's outcome could be that precious knowledge might be enormously enhanced. No list from any group of "experts" can take into account the subtle, subjective factors in this kind of real-world scenario. In fact, using such guidelines would amount to the practitioner abandoning her own autonomy and hiding behind a justification generated by some high-powered reputations that just.can't.be.there.
SO-
You have to make the call. Saying "no" to the parent may constitute facilitating the continuation of truly malignant behavior that shall distort the child's entire life, undoubtedly leading to severe PTSD, likely to substance abuse disorder, and possibly to the abuse of others down the line. Saying "yes" may result in the child eventually loosing trust in the medical profession, their parents, and their entry into a long and cruelly judgmental judicial process, in which their anonymity may be violated as thoughtlessly and thoroughly as their bodies were.
Make the call. Right now, knowing the outcome, whichever way you go, shall be your responsibility, and your responsibility alone. Good. Now justify it- not just to yourself, but to the entire world. No other person's judgement will, nor should, supercede your own. You are the only practitioner close enough to the people involved to truly weigh all the factors.
This is were you earn the respect, status, and reimbursement due your profession. At least, when it is practiced so as to include personal integrity as one of your qualifications for the job. In matters of this delicacy, any guidelines that purport to provide absolute answers are a farce- a disservice to any profession and even more to the people whom they serve. If these truths make you uncomfortable, or if they make any young person you are privileged enough to be someone they look to for mentorship, then I highly recommend that you, or your mentee NOT pursue a white coat profession. Ugly truths, and making very difficult calls, well, they just come with the territory
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  #63  
Old 11-12-2019, 04:40 AM
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Originally Posted by Melbourne View Post
and it was very unfair to Joey P.
I didn't read it that way at all. It presented to me as a criticism of general behaviour not the individual. I can see how some might take it as a personal attack but I hope you can also see how others may be able to take it as a general comment. Broomstick clarified that the latter was intended and I see no reason to doubt them.
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Last edited by Novelty Bobble; 11-12-2019 at 04:40 AM.
  #64  
Old 11-12-2019, 05:50 AM
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Originally Posted by nearwildheaven View Post
And it has always boggled my mind that women who engage in casual sex with multiple partners can still have panic attacks over pelvic exams, whether done by a male or female doctor. It's as sexual as the dentist examining your teeth.
The dentist examining my teeth doesn't fucking HURT.
  #65  
Old 11-12-2019, 06:38 AM
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Actually, I've had more dental exams that caused pain than pelvic exams that caused pain - because I've never had a painful pelvic exam but thanks to gum disease even a normal cleaning can be pretty damn unpleasant. Don't get me wrong, pelvic exams aren't fun, but in my case they don't hurt.

Although, obviously, I can see how they could be painful. And I don't doubt the women who have said they have had that experience. It would be a valid reason to dread or even fear that exam.

Let's just say "your mileage may vary" and leave it at that. And shout down anyone who uses the experience of one woman to doubt the experience of others.
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