Traditional physical examination principles state a chaperone is warranted for female breast and pelvic examinations, while a chaperone for male genital and rectal examinations is optional. The American College of Obstetricians and Gynecologists recommends a chaperone for all breast, genital and rectal examinations in women, regardless of the gender of the physician. I always have a chaperone for both female and transgender patients, and may consider offering all male patients a chaperone after reading Richard Watson’s article,1 though Alam et al’s work would suggest almost all would decline such an offer. A chaperone observes sensitive examinations and can serve as a witness in the event allegations of sexual misconduct or assault are levied against the physician. Although such a charge can be alleged by any patient against any provider, Dubois et al’s analysis of 101 cases of sexual violations in medicine revealed all cases were perpetrated by male providers, usually middle age, lacking board certification, in a nonacademic setting, all while seeing patients alone.
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