Gender matters, especially if you are a Polish teenager being examined by a doctor or a doctor examining a teenager

Abstract

To analyse how the specific gender configurations of the adolescent patient and the doctor affect the performance of intimate areas examinations during adolescent well-care visits and the emotions that accompany these examinations, the use of comfort measures, and the subsequent willingness of adolescents to visit the doctor in the future. An anonymous questionnaire was completed by adolescents (n = 1072) and their parents (n = 685) recruited from 80 randomly selected secondary schools in Poland. Genital examination and puberty assessment were performed more often in boys than in girls (OR = 14.1, p < .0001 and OR = 5.5, p < .0001, respectively). Female doctors performed intimate examinations more frequently than male doctors (OR = 2.2, p = .0059). Male doctors were more likely to ask for consent than female doctors, 66.7% vs. 40.2% (p = .0556), and use the screen more often than female doctors, 46.7% vs. 21.7% (p = .0393). Intimate examinations significantly discouraged adolescents from revisiting the doctor, especially when performed by a physician of the opposite sex. The majority of Polish adolescents and their parents believe that routine prophylactic genital region examinations are illegal, especially if girls' genitals are to be examined by male physicians.

Conclusion: The implementation of preventive genital region examinations in adolescents depends largely on non-medical factors-the gender of the patient, the physician, and the mutual configuration of these genders. The level of public non-acceptance of these procedures should not be underestimated by experts setting standards of well-care for adolescents.

What is known: • Although the assessment of sexual maturity is an integral part of the preventive examination of adolescents (both girls and boys) these examinations are often overlooked.

What is new: • The gender of the physician and the congruence of his/her gender with the gender of the adolescent patient influence whether a puberty assessment will be performed, as well as the social acceptance of such procedures. • Examinations of the intimate area are a significant factor discouraging both adolescent girls and adolescent boys from seeing the doctor again.

Keywords: Adolescent medicine; Adolescent-friendly health services; Gender inequality; Genital examination; Well-care visits.

Fig. 1

Beliefs on the permissibility (under the law) of prophylactic genital examination in adolescents depending on the gender of the patient and the gender of the physician. The figures in the tables outline the percentage of respondents who believe that, in a given gender configuration, preventive genital examination is permissible under the law

Fig. 2

Distribution of adolescent preferences on the gender of the doctor conducting examinations (healthy and in the case of infection). The respondents indicated the preferred gender and the strength of this preference on a scale from − 5 to 5 (with zero indicating no preference, scores less than zero indicating a male preference, and scores greater than zero indicating a female preference)

Fig. 3

Influence of age and sex of adolescents on their preferences for the gender of the doctor conducting examinations of the genitals (healthy and in the case of infection). The graph shows the mean value (triangles and circles) of the preference assessment on a scale from − 5 to 5 (with zero indicating no preference, scores less than zero indicating a male preference, and scores greater than zero indicating a female preference). Horizontal line = standard deviation