How do you perform a testicular exam on a birthing-person? #wokemedpearls. Daunting right? The lack of a scrotum and testes, however, should not dissuade you from performing this exam. Testicular cancer is devastating if the diagnosis is missed. Here's how I perform this exam =>
2/ Expect some puzzled looks at first. Many birthing-persons are expecting a speculum exam of the so-called 'vagina'. Explain the necessity of a testicular exam and the consequences missing the diagnosis of testicular cancer. "But, Doctor, I don't have testicles!" =>
3/ This is a common reaction. My answer goes like this… “Person, you THINK you don’t have testicles, but it’s entirely possible that you are a trans-male and simply have not discovered this yet. Check your cis-privilege please and let me proceed.” This sometimes works. =>
4/ I then place my hands in the area where testicles would be if they existed in this person. I close my eyes and imagine what I am palpating. Sometimes I sense a nodule. If you sense a nodule order the ultrasound and set follow-up. =>
5/ Testicular cancer being much more aggressive than cervical cancer the Pap smear and speculum exam can wait. If you get an angry patient, and this happens with some frequency, then you can confidently fire them from your practice as they are transphpobic. =>
6/ If you get an irate radiologist on the phone saying (and it’s almost always these exact words) “YOU ORDERED A FUCKING TESTICULAR ULTRASOUND ON A WOMAN YOU FUCKING IDIOT!” Report them to the medical board. They clearly are transphobic and need to find another job. =>
7/ Together we can stamp out testicular cancer and transphobia. From each according to their external genitalia, to each according to their true genitalia. //
@TheAntiPCProf closer and closer to the reality in academic medicine. Thread.
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