Editor’s Note: Jenny is the mother of two children with special healthcare needs and a Patient & Family Advisor at her local children’s hospital. In addition to her lived experience, Jenny calls upon her professional experience as a social worker to help her write blogs from her home in Wisconsin. – Cara L. Coleman, JD, MPH, Associate Editor, Pediatrics
As the mom of two school-aged children, I spend a lot of time talking about consent and boundaries. “No Means No,” “Stop Means Stop,” and “I Am the Boss of My Body” are phrases often heard around my house. We prioritize these values in our family, and thankfully our school and community do as well.
This is also important in medical settings, especially when exams focus on more sensitive body areas. I still feel grateful for the urology nurse we saw when my daughter was younger. Despite the necessary poking and prodding during those exams, the nurse always explained to my daughter why she needed to touch her “private parts” and made sure she asked before starting. Perhaps most importantly, the nurse made a point of saying that she could only do this because, “Your Mama is here and she said it’s okay.”
My daughter was just a toddler, too young to understand the words of the nurse, but I hope at some level she understood the intent. Physical exams, especially in the genital area and/or breasts, can be very vulnerable. Having thoughtful policies and practices in place can help ensure the safety and comfort of all patients. This month’s Pediatrics speaks to this need in an article entitled “Use of Chaperones for the Pediatric and Adolescent Encounter: Policy Statement” (10.1542/peds.2025-071810).
What is a chaperone?
A chaperone is a clinical staff member who comes into the room during an exam of more sensitive body areas. The designated chaperone should understand the purpose of the exam and be alert for any concerns. This person should ideally be a doctor, nurse, or medical assistant but could also be a student or office staff member if needed. Medical chaperones exist to help children and youth feel safer and more comfortable during sensitive exams, while also minimizing risk for providers.
Best practices for chaperone use
Depending on the size and resources of the medical setting, the use of chaperones may be varied. However, here are some best practices for using a chaperone:
- Clearly explain the role of the chaperone to the patient and their families.
- Consider framing the discussion as an opt-out choice (e.g., “Our practice is to have a chaperone present during this part of the exam. Please let us know if you have any questions or concerns.”).
- If possible, give the patient a choice for the gender of the chaperone.
- Document the name of the chaperone in the visit record as well as any discussion notes.
- Ensure that all chaperones are trained in trauma-informed care and cultural awareness.
The report also included a number of special situations to consider, such as:
- Telehealth visits
- Children in foster care or legal custody
- Children with a history of abuse, exploitation, or trafficking
- Patients with gender dysphoria/diversity
- Patients who cannot assent to care due to disability, mental illness, or substance use
Suggestions for best practices in these situations can be found in the policy statement.
What can you do with this article?
- Share this article with your care team. Encourage providers to develop chaperone policies that are feasible and realistic for their settings.
- If you are on the advisory council for your children’s hospital, ask if they have a policy like this in place. If not, review this article together and work toward creating something new.
- At your child’s next exam, request a chaperone if one is not offered. If no chaperone is available, ask about other options to ensure the safety, comfort, and protection of everybody in the room.
- Have these conversations with your child before you get to the appointment. Talking about consent and boundaries can be awkward and stressful, but practicing first can help.
