# Survey of Physicians on the Need for Female Chaperones Based on the Body Areas Examined in Female Patients by Male Physicians: A Cross-Sectional Pilot Study

## TL;DR

This study surveyed physicians about the need for female chaperones during physical exams of female patients by male doctors, finding that female physicians requested chaperones for more areas.

## Contribution

The study identifies differences in chaperone necessity perceptions between male and female physicians in Japan.

## Key findings

- Physicians agreed on chaperones for intimate areas like chest, breasts, and perineum.
- Female physicians requested chaperones for additional areas like the head/face and abdomen.
- The need for chaperones decreased with the patient’s age.

## Abstract

Background

In the United States (US), most physicians who commit sexual misconduct are male, and such misconduct is associated with the absence of chaperones. Several organizations recommend a chaperone during all intimate examinations (breast, genital, and rectal exams). However, in Japan, guidelines are not clearly defined, and hospitals and medical societies have not established standardized protocols. At Chiba University Hospital’s Department of General Medicine, female nurses are requested to act as chaperones during female patients’ physical examinations. However, limited medical resources make this challenging. Thus, it is necessary to investigate the necessity of female chaperones for the examination area to prioritize their presence. This study surveyed physicians to determine which examination areas require the presence of female chaperones during the examination of female patients by male physicians. The necessity was stratified and compared by the physician’s sex and age.

Methods

This pilot cross-sectional study surveyed physicians in the Department of General Medicine at Chiba University Hospital. The study content was explained via email, and only those who consented to participate were asked to complete the questionnaire. Only physicians who had passed the Japanese medical licensing examination and had completed two years of residency were included. The primary factors were the physician’s sex and age. The necessity for female chaperones was measured using a five-point Likert scale for different examination areas and patient age groups. The Mann-Whitney U and Kruskal-Wallis tests were also employed.

Results

Responses were obtained from 17 of the 19 physicians (89%; 10 male and seven female). Regardless of sex, there was consensus on the necessity of female chaperones when examining intimate parts (chest, thighs (disrobed), breasts, inguinal region, perineum, and buttocks). Female physicians were more likely to consider chaperones necessary for additional areas, including the head/face (p=0.014), chest (clothed) (p=0.019), abdomen (clothed/disrobed) (p=0.003, 0.033), back (clothed) (p=0.001), buttocks (clothed) (p=0.023), shoulder-upper arm (clothed) (p=0.005), and thighs (clothed) (p=0.033). The necessity for chaperones decreased as the patient’s age increased.

Conclusion

Female physicians presented more cautious opinions, considering chaperones necessary for a broader range of examination areas beyond the traditionally defined intimate parts.