Its a good thing today is my day off, there were so many questions and comments about my earlier post!
To answer the questions in the comments area:
Yes I am a GP in a Family Practice Group, located in a small community. As is the case in most rural areas, there is a dearth of specialists, and most of our referrals require a trip in excess of an hour. Sorry, but discussing masturbation is a fairly rare event, with either males or females. Ive actually spoken to more parents about it, than teens. Parents will ask me to speak to their children about the 'evil' of masturbation, and , obviously the problem isnt with the child it's with the parent. When a parent insists I have a 'talk', it is always alone with the teen, (always girls. I let my male colleagues deal with the boys)and generally revolves around offering support and removing the stigma the parent has put on the child. I explain that our talk is confidential, reassure them that masturbation is universal, and though a private issue, is nothing to be ashamed about. I offer to answer any questions they may have (which is rare), and offer a 'script' about what to tell the parent after our visit.
(Sorry, these chats are always 'fully clothed'). For the commentor that wanted examples of 'apprehensive females', I can assure you that every girl was not only apprehensive, but mortified. Tears are very common. I am proud, however, that every girl Ive had this talk with, seems to be generally relieved after, and their self dignity restored. Apprehension and embarassment happens in both males and females, when a 'masturbation event' has somehow caused bodily injury. I've had males with foreign objects stuck in their anus. Males that have burned their urethra using soap as a lubricant. The most awkward cases for females generally involve when they have injured their vagina when masturbating with a foreign object. It's fairly obvious what went awry when a boy comes in with a cigar tube in his rectum, and doesn't require much conversation before the forceps come out. However, a girl with vaginal bleeding and tears can indicate rape or abuse, and requires a full explanation. While discovering the injury was self inflicted... and I kid you not...by a banana / squash / vacuum hose / toilet plunger / baseball bat / tennis racquet etc. actually relieves you that the girl has not been raped, it does require a little chat about acceptable products for this type of activity. (Favorite story actually involved a boy that had for some reason inexplicably locked a Yale lock around his penis and scrotum while erect, then inconveniently dropped the key down the bathroom drain. When he arrived in our office with his father, his penis was in serious distress, with a potential for serious damage from loss of blood. There were hack marks on the side of the lock where he had, to no avail, attempted to saw it off. We actually called a locksmith, and he had it off within five minutes, to the great relief of the boy, who had no after effects.)
Another story comes to mind when a 14 year old girl with vaginal bleeding, vaginal abrasions and bruisings said it was the result of intercourse with her boyfriend. since our state law defines statutory rape as any intercourse involving a minor under age 15 where the other participant is more than three years older, we were required to involve the police. The police reported that the male was actually 13, and 'extremely endowed'.
I can assure the retired health care professional poster who stated that all states require by law that an observing member of the same sex as the patient be present during an examination involving nudity, that he is not correct. While it is required in my state when male doctor's examine female patients, the reverse is not true. I suggest you google 'female doctor accused' and 'male doctor accused' and you will find the reason why. To my knowledge, no female Doctor has ever been tried for molestation of a male patient. (The reverse however, is not true).
The rate of circumcision in my area of the country is about 66% for the past 20 years. In older patients, the level of circumcision rises, with 80% + of men aged 45-75 being circumcised. Years ago, you would see more uncircumcised men that were born before 1930, when many births were performed at home by midwives. There is definitely a trend over the past few decades away from circumcision.
I do not ask patients to retract their foreskins, unless they have indicated that it is a problem, or in the case of infants, the parent expresses concern.
Thanks again Theo for your poignant comments. I am very happy that you found the source of your rash, and that you no longer have the aching lumps problems you suffered in your teens, when in the company of females. Thanks for your concern that flashbacks by the QB could lead to fumbled snaps, but I doubt a 18 year old teen would have recurring fantasies about a middle aged doctor.
For the senior citizen asking about his Doctor reacting to him having shaved his pubic hair. Don't be concerned. I would neither comment on the lack of cover in the nether region, nor try to determine why you chose to shave. While I have rarely seen the 'bald' look on men, ( it is more common with females) it has become increasingly common to see 'trimming' on both men and women, particularly patients 40 and younger. If you prefer boeing clean shaven, go for it! (And it's nice that you still have a great sexual relationship with your wife, and I think I know the act to which you refer).