Let’s talk about medical consent, as we get a lot of questions about it in my free Facebook sex education group for parents, that parent group.
This post was created as a collaboration by US and Australian moderators from that parent group. As always, use common sense, be an advocate and do what is best for your individual child.
Let’s talk about bodily autonomy and medicine. Our kiddos may not want whatever treatment the doctor has ordered, be it a shot, steroid cream to the vulva, or having to show the doctor their bottom or genitals due to a medical concern, but for most of us, visiting doctors is a necessary part of life.
We encourage bodily autonomy in this group, but like anything, there’s a limit.
Safety must be our top priority with our kiddos. More than anything, it’s our job as parents to keep our kids safe. Wearing a seatbelt isn’t optional. Wearing a life jacket isn’t optional. We would never allow our children to refuse such things.
The same goes for caring for our bodies, which sometimes means we need the doctor’s help.
This is how you explain medical consent to children. “You’re not able to let the doctor examine you on your own right now, so I’m going to help you to keep your body safe and healthy. You can do this on your own when you know how to keep your body safe and healthy without my help.”
What if my child is resistant?
If your child shows fear or resistance to a medical exam or treatment, talk to them about it.
Ask them what circumstances they need for the treatment or exam to be the least objectionable, and then do everything you can to meet those circumstances reasonably.
Call the clinic and ask them if your child’s requests can be met.
Brainstorm ideas with older kids.
With younger kids, offer distraction and comfort.
With a very distressed child, ask a nurse or medical assistant to control your child’s body, and you are the person who is strictly for comfort. If that’s not possible, offer your kiddo the comfort they need after the intervention is over – in the clinic or at home.
Give your child as much control as possible without taking away the option of going to the doctor or receiving the treatment, if it is medically necessary.
Prepare your child for medical appointments
Preparing kids for medical appointments goes a long way toward gaining their cooperation.
Roleplay what will happen at the appointment (younger kids)
For littles, have them act out each step with a stuffed animal or doll what will happen, letting your child play the doctor. A doctor may also be able to demonstrate what they are going to do on the toy first.
Having a fun event afterward, like visiting the playground or having a treat, is a good thing for them to do.
Create a list of what will happen & tick it off as it happens
For older kids, let them create a list of things that will occur and cross them off as you go so they know how long until it’s over.
No matter how old, they may like to bring a comfort toy, have a special treat afterward or take a device and listen to music as a distraction- don’t assume they’re too old or too cool! Everyone loves a lollipop.
Take your child along to your own medical appointments
Positive exposure to healthcare professionals can be beneficial for all ages. Consider taking your kiddos alongside you for a blood test or a routine exam.
Normalise talking about appointments you’re attending solo, eg “I am getting a mammogram today, I get this every 4 years as a preventative measure.”
TV shows that are age appropriate and explore doctors visits can also be great for exposure, some suggestions include Daniel Tiger, Operation Ouch and Doc Mcstuffins.
Practice what may happen
Get creative. Whatever visualizing or acting out of each step you can do with your child before the appointment or intervention helps them prepare before they’re activated.
Trying to gain that cooperation with no practice after they’re upset is like trying to pick up a greased watermelon. It’s not happening without a fight.
Medical examinations of genitals (or pelvic exam)
In the US, physicians often do a very quick visual exam of a child’s genital area annually. These are more important when the child is young and unable to vocalize if something is wrong.
As kids grow, parents will often allow kids to refuse this part of the exam, as they can report symptoms or changes. This is, in large part, due to medical liability. If a physician fails to assess a child physically fully, and something later is wrong, American patients can sue physicians for overlooking the genitourinary system.
I know it seems weird to people not from the US, but in medicine, practicing with a certain level of thoroughness to ‘cover your arse’ is common. You have the right to refuse this check if you and/or your child are uncomfortable.
If you do consent to a genital exam, we would suggest a parent or guardian always stay in the room with the child for their protection and your peace of mind.
You may find this journal article on how to take an ethical approach to genital examination in children helpful. It has some suggestions on how you can make it more comfortable for your child.
What happens in Australia, with medical exams and kids?
In Australia, genital examinations are not routine practice. They support the right of parents and/or children to decline genital examinations and for the doctor to gain relevant information using other methods. The Royal Children’s Hospital Melbourne has a Fact Sheet that provides information about genital examinations in Australia. They also share the research that supports their recommendation and believe that regular genital examinations have a negative impact on children. Please do have a read for yourself.
All newborns will have a visual genital examination to assess for variations in sex characteristics (intersex or DSD/Difference of Sex Development or Disorders of Sex Development).
For children and adolescents, they may have to have ongoing physical exams if they have variations in sex characteristics. Some of these reasons could be if they are considering surgery (pre and post op), have questions about vaginal dilation
Other reasons for medical exams may include: pain or discomfort in the genital regions, assessment of puberty, or if the child would like information about their body.
Non-binary or transgender children may require a genital examination if they are considering endocrine hormone therapies.
Resources about consent
Grappling with consent? Learn how to educate your child about giving – and asking for – consent in this popular crash course about consent.
There are some fantastic children’s books about consent that will help you to start talking to your child about consent. They are also sorted into ages, so you can quickly find the best book for your child, tween or teen. If you have a baby, then you need to look in this list of books for babies and toddlers, as there are some simple board books about consent in there.
A lot of the sex education books (that talk about lots of sex-ed topics) also talk about sexual consent. So that is a list to look at if you child, tween or teen might be more open to reading a book about sex than consent.
Safe Secure Kids (from the USA) is an educational program for younger children that is funded to teach respect for bodies and boundaries and to keep the children in your life safe. It has free resources and activitities you can use to teach your child about consent.
If you have a teenager aged 14 years and older, than BISH (Best in Sexual Health) from England has great content about sexual consent that is engaging for teens to read.
Amaze.org have educational videos on Youtube for tweens and young teens about consent.
Every Body Curious (from Canada) has a 10 minute video about consent that is suitable for 9 to 12 year old children.