Can You Refuse A Testicular Exam?

Just like any medical procedure, you can definitely refuse to have a testicular exam. But doing so might not be the best idea. Specifically if it’s part of a routine check-up or you suspect yourself having a problem.

The thing about testicular cancer, as we all learn in med school, is that the early signs of the disease can be difficult to spot. Getting past your embarassment and letting a physician examine you, especially if you’re in the target demographic (average age of diagnosis is 33), could well save your life. So maybe think twice about refusing the short few minutes it would take to check.

What can make this confusing is the way a doctor may ask. Telling you they “need” to examine your testicles is a bit of a misnomer. Really they should say they’d ‘like” (but only with your permission obviously) to instead. Doing so would probably make the whole thing less intense.

Of course, being a male myself, I get that it’s not the nicest of experiences. It’s not exactly a procedure I’d be up for my medical school colleagues practicing either! (See my article: do medical students practice on each other).

But, as my research shows, it does raise quite a few interesting medical questions.

When Can You NOT Refuse a Testicular Exam?

The only time a physician may absolutely have to examine your testicles is in the case of emergency. But even then this part of your body should be involved in the emergency (trauma or impact etc).

Otherwise, due to the fact doctors have a “duty of care” to their patients, they must respect a patient’s wishes in non-emergency settings.

Can A Male Physician Opt Out of Performing Testicular Exams On Other Males?

Weirdly, this is a question I’ve heard from a couple of male colleagues during my time in med school. The short answer is no. Performing a testicular exam on a patient is part of a doctor’s core responsibilities. Failing to do so could be seen as constituting harm.

Why another male would have a problem with it, especially one who’s chosen to be a doctor, does seem a little strange. Performing a testicular exam is a common health procedure. It has no erotic implications of any sort.

Refusing to do one, putting aside the patient’s health for a second, also carries further consequences. Working in a hospital or clinic, this responsibility will then shift to another doctor or nurse. Taking them away from critical work and wasting both time and resources.

If you don’t want to conduct a testicular exam on other males as a male physician? Maybe rethink being in the profession.

How Do Female Doctors Perform Male Health Checks?

Just as male doctors are expected to perform breast examinations, pap smears and other gynecological procedures, female physicians are also educated and tasked with conducting physical health check-ups on males.

The process happens exactly the same way as it would for either gender except for the issue of ‘chaperones’. Chaperones are people (usually nurses, nursing assistants etc) who stand in the room with both the patient and the doctor during the performance of an “intimate” exam (one involving private parts). This is usually done for liability reasons but in some hospitals can also be part of their operating policy too.

Where it gets complicated, especially in the US and the UK, is when female physicians may perform such procedures on males. In these circumstances there exists something of a double standard. Unlike male doctors examining female patients – where a female chaperone is almost always present, female doctors examining males don’t usually expect chaperones.

There is also a standard for same gender (physician and patient) procedures also. In these circumstances it’s often considered fine not to have a chaperone present too. But this is also dependent on what the exact procedure is (all rectal exams in the NHS for example, regardless of gender, call for the presence of chaperones). As well as what hospital policy dictates.

Aside from these finer details though, female physicians would perform a male health check in exactly the same way as their male colleagues. For testicular exams that would mean palpating both to check for lesions, lumps or other irregularities. And doing this with medical gloves on of course.

Is It Inappropriate For a Doctor To Touch Your Chest or Privates During a Physical?

It’s not inappropriate for a doctor to touch your chest or privates in common health examinations and check-ups. If you report pain or discomfort relating to those regions, they absolutely should be expected. Not doing doing so could cause further harm to you in case the disease worsens in severity.

Where it would become inappropriate is when examinations of these areas are done without your consent. Or when they are requested by a physician in relation to a non-related complaint. But even this last reason is not definitive, considering the concept of “referred pain” (pain transmitting to other areas of the body but originating elsewhere).

Obviously, for a first time patient presenting to a clinic, it might not be that easy to tell if something is appropriate or not without prior experience. So this is where chaperones can help. They are there to protect both doctor and patient by standing as a witness to any untoward behavior.

One final thing to remember; touching (palpation) is a necessary and a routine action for a physician when examining body parts of a patient. Many pathologies, especially relating to private regions, aren’t visibally obvious. So touch is the next best way of determining a problem before referral to more precise diagnostic measures (x-rays, CT’s, MRI’s for example).

Professional doctors will explain exactly why this is all appropriate of course. As well as asking your permission and making sure you’re comfortable.

How To Ask Your Doctor For a Testicular Exam

Although you can self-check your testicles (and men are routinely requested to do so), it’s also important a physician checks routinely too. This is because we are specifically trained to look out for signs relating to disease – things that patients could otherwise miss or not be aware of.

A physician should always ask you permission before completing a testicular exam. They should also give you a brief explanation as to why it’s important too.

Asking a doctor to complete a testicular exam for you, usually if you suspect a problem in the area or just want confirmation there’s no sign of anything unusual, is a reasonable request.

Here are a few tips on how best to ask for one:

  • Ask politely and explain your reasonings for wanting a testicular exam
  • Assure your doctor that they have your full consent to perform the exam
  • Discuss the opition and possibility of requesting a chaperone
  • Have no fear or shame in asking (it’s a completely normal and necessary procedure)

Usually, as it’s part of their job, a physician shouldn’t have any problem meeting your request. Just remember to check regularly yourself (about once a month) and report to them immediately if you suspect any of the following:

  • Swelling or feeling off pressure in your scrotum
  • Painless lump
  • Dull ache or pain
  • Enlargement or swelling of breast tissue

Final Thoughts

Refusing certain procedures in medicine and healthcare is first and foremost a patients right. Standing on the other side of the fence though, I’d also encourage those patients to think twice about the consequences of not having a physician examine them against the risk of disease.

The risk of testicular cancer, although rare, can be significantly reduced by testicular check-ups and examinations. It shouldn’t be a cause of embarassment or shame.

Image Credit – @1990