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Confidence, consent and chaperones for pubertal staging examinations: a national survey
  1. Rebecca Jane Moon1,2,
  2. Justin Huw Davies1,3
  1. 1Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
  3. 3Faculty of Medicine, University of Southampton, Southampton, UK
  1. Correspondence to Dr Rebecca Jane Moon, Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK; rm{at}


Objective General Medical Council (GMC) guidance describes an intimate examination as one that may be embarrassing for the patient, for example, breast or genitalia examination. Documentation of consent and use of a trained impartial observer (chaperone) is recommended. Pubertal staging is often necessitated for assessment of growth and puberty. We assessed current practice of pubertal staging by paediatricians and paediatric endocrinology nurse specialists (PENS) in the UK.

Methods An electronic survey was distributed to paediatricians (consultants and trainees) and PENS across the UK. The survey enquired about training received, confidence in and typical practice for pubertal staging examinations.

Results 235 responses were received. Low confidence in pubertal staging was commonly reported by trainees and consultants without an endocrinology interest.

Most respondents consider pubertal staging to be an intimate examination for male (94.9%) and female (93.1%) patients. Consent to examination is always documented by 38.2% of respondents. 62.0% and 54.8% report always using a chaperone for male and female pubertal staging, respectively. However, many respondents use a parent as the chaperone. Few document the name of the chaperone used. Patient objections and availability of chaperones were commonly perceived barriers to chaperone use.

Conclusion Most clinicians consider pubertal staging an intimate examination, but documentation of consent and use of formal chaperones is not standard practice. The use of a parent as a chaperone was common but is not recommended by the GMC. Local chaperone policies should address these issues to protect patients and clinicians.

  • adolescent health
  • endocrinology
  • paediatrics

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors RJM conceived the study, designed the methodology, acquired and analysed the data, interpreted the data, drafted and revised the manuscript. JHD designed the study, acquired the data, interpreted the data and revised the manuscript. Both authors approved the final submitted version of the manuscript. RJM is guarantor and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding RJM is funded by an NIHR Academic Clinical Lectureship.

  • Competing interests JHD has received travel bursaries from Novo Nordisk, honoraria from Kyowa Kirin.

  • Provenance and peer review Not commissioned; externally peer reviewed.