GP raised safeguarding concerns over daughter’s periods, itching and distress at appointment

[MyDearLeader]

DD age 10 under assessment for potential adhd (emotional dysregulation, sensory issues, sleep issues) has been showing signs of puberty for a few years (breast puds, hair etc) she is tall for her age. Anyway.. she started on what I believed to be her period on the 4th of July... we had been preparing for it but she is extremely private e.g when we went shopping for her first bra was extremely embarrassed and upset.. when she asked me to shave her armpits then got upset when I said she couldn't do it herself as needs supervision. She has big meltdowns shouting no no no over and over, i still sleep in her bed as she cannot sleep. Anyway the bleeding was very light lasted only a few days then went, it returned on the 19th unexpectedly.. 4 days very light. Anyway on the 1st it started again but this time heavier and bright red, she has also had intermittent itching on and off relieved by sudocrem. Due to all this I booked a gp appointment 1. To be sure this is actually start of period and not something else.

1. To investigate the itching and see if this was related to the bleeding.

My daughter initially refused to go crying hysterically (she wont even let me tell any family what is happening including her dad) I got her there i asked her should I speak or her she said me.

We saw a female dr, I explained everything she kept asking my daughter questions to which she kept hysterically crying shouting no no no.. the dr told me she was concerned at her distressed reaction I explained her history (which is all documented on her record including a diagnosis of anxiety disorder and camhs involvement) she said she was worried it was a trauma response? I informed her periods have been very much normalised in my house I have endometriosis and that she has emotional regulation problems never mind now with new hormones and she feels embarrassed.. she asked me to step out to talk to her alone, my daughter refused did not want to.. she wanted to swab her vagina.. my daughter went into meltdown screaming no no no, the dr said this was a concern?

She agreed it is likely period and the light bleeding were "test runs" gave me a swab to try at home but blindsided me by saying she has safeguarding concerns!!? I was absolutely blown away, I asked why she said the abnormal bleeding and itching.. said if her swab comes back as having thrush she will be formally reporting it? I said due to sensory issues she vigorously Wipes on repeat and I suffer with thrush frequently could she catch it from me? She said no.

Honestly i feel sick to my stomach. My daughter refused the swab by me and has let me supervise her doing it (very traumatic for her)

I just cannot believe it, i am an nhs professional and feel sick that I might need to report this to my line manager that I am being investigated.. my husband is distraught. I was just trying to ensure my daughter is definitely starting periods as mine did not do this and investigate the itching, she doesnt stay out and I sleep with her every night...

I understand processes need to be followed i am just so upset😥

I understand it's really upsetting to get a referal but as know, you have to follow the letter of safeguarding or it becomes futile if your layer over your own rules.

From experience ( 4 kids) it probably will come to nothing more than a home visit and a few questions. But better to check 50 innocent parents than miss one abuser.

My dd has SEN and it's a hard age and stage

I didn’t want to read and run
I was wrongfully reported to social services with a safeguarding concern. It turned out to be completley false, which I knew of course. But 6 years later I still suffer with complex ptsd however I have accepted that people were doing their jobs but it has severely affected my life and crushed my confidence.
i wanted to acknowledge how utterly stressful this must be for you and I totally understand. I hope everything is okay x

I understand why this upsets you, but equally

• disabled child
• abnormally anxious about having her vagina examined
• distressed about even talking about her symptoms or feelings
• clearly uncomfortable physically about being examined

I don't thing the GP had a choice about whether to report anything or not. They are mandated reporters, and your child's GP was dealing with a child who shows multiple symptoms that could be sexual abuse.

On another note. please try washable pads with your child. I had problems with itching and washable cotton pads instead of disposables has solved the problem.

Yes, I think GP would be more justified in worrying if OP were male...just as sadly, men are much more likely to commit SA. But OP is female. Mothers can commit SA but it's much less likely.

Well surely if the GP had immediate safeguarding concerns, then CS should have been informed promptly and OP or any male relative wouldn’t have been allowed any unsupervised access. Which hasn’t happened.

You’ve missed out that her daughter also had itching. I’m sure that without chat gpt, it’s pretty obvious for most woman that a ND child who is scratching down there and wiping harshly could have irritation or a UTI. Or like most NT children, would be distressed having an intimate and sometimes painful swab taken.

I'm very sorry to hear this OP. I'm autistic and would find this as distressing as your daughter does even at my age. In fact I rarely get smear tests done because I am autistic and find them traumatising.

The GP is sadly doing her job. Unfortunately us ND people tend to look like traumatised individuals to other people, which concerns them enough to do further investigations which are in themselves traumatising. It's a horrible vicious cycle.

My ND 12y old DD also refuses to discuss periods. Took quite a lot of insistence that she wore period pants rather than just trying to ignore the situation. And given she lately took a lot of persuasion to let the doctor look in her ear, the chances of a vaginal examination are non existent. You’d have to dart her with an elephant gun first.

I can see why it raises red flags for the GP but a ND child is not going to give the same responses as a NT child.

I get that you’re upset but I assume you know that there has been no sexual abuse and so you have nothing to worry about.

The gp absolutely did the right thing and that gp will save many other children who are experiencing SA.

@BerryTwister what do you think might be a normal reaction from a 10 year old to an invasive vaginal swab? Maybe to calmly and politely say yes doctor, of course you must insert something into my vagina, you are only doing your job after all.

Is that what you expect?

What do you mean? You think OP hasn’t noticed a third person in there with them?

As for the itching,sanitary pads used to make me sore and itchy.could you maybe try period pants,I only use them now,no more itches.M&S do some great ones.all the best xx

@Dancingonlies the point I’m making is that it would be dangerous to see behaviours that would be a red flag in NT people, but ignore them in a ND person. ND patients can become very distressed by examinations as part of their neurodiversity, but it might also be because they’re being abused. In fact, a PP said her sexual abuse was ignored because everyone assumed her behaviour was because of her autism.

To be fair the NHS seem to shrug everything else related to ND off so why change now? Just leave her for 2-3 years then blame her clogging up the system.

Either that or maybe prescribe some generic CBT, or another therapy that’s delivered by minimally trained NT types and disregards the autistic experience completely.

Oh, and don’t worry, the child’s distress at the idea of an unexpected intimate examination that challenges her bodily autonomy, sensory sensitivity and sense of personal space is definitely the mums fault.

It’s definitely not your ignorant approach and lack of basic bedside manners. Promise.

@DecisionTime123 well having been a GP for nearly 30 years, I can tell you exactly how the many 10 year olds I’ve seen behave. They’re not keen on it, they’re nervous and embarrassed, but as long as they have a trusted parent (it’s almost always Mum) in the room with them, they’re OK.

@SmallandSpanish I'm not sure why you’re attacking me!

Poor girl. This all sounds very distressing.

No, I don’t think you should just shrug when faced with a very distressed ND child. Why would you do that?

Totally agree. Dr is correct to raise concerns. The GPs job isn't to worry about the mothers feelings it's to make sure the patient is safe.

what?! There’s no mention of multiple people getting into the child’s bed. It’s not uncommon for children to sleep next to their parents for one reason or another.

There can be a tendency for GPs to call any involvement with children services ' safeguarding' Some GPs call any child on a Child in need plan ' safeguarding'
This can include disabled children who have a perfect right to child in need services on account of the disability if they meet the criteria. Some families are put off accepting help due to this mixing up of language.
Many ND children cannot tolerate examinations. These aren't usually seen as safeguarding issues though it poses a challenge to services.
She should have asked if you had ever requested help from children services and if you would agree to a referral for an assessment. She should also have been completely clear of the reasons for this. She could have tried to explore what approaches might work better for your daughter.
A difficulty examining can increase anxieties since the GP can't resolve the issue.
It's normal to enlist the parents agreement when referring and given the documented ND history some GPs are not skilled in handling these conversations or in thresholds. She was trying to be clear but has ended up being scary.
OP you need to explain patiently to any contact from SSD in what way you think the issues raised are ND related, you can escalate / ask to speak with a manager if you think this is not being heard.
I don't really get the ' formally reporting thrush'
What is she implying? it's a common condition and easily resolved? Actually you can sometimes identify by looking. Pharmacists can advise.
Do remain calm and polite and keep records. I hope it all works out.

She didn’t actually say that assumption was made.

She said it was 35 years ago.
She said she was ND and very distressed.
She also said she was being abused and GP didn’t refer unfortunately and it was missed.
She didn’t actually say why that was.

It could have been as you said, but it could be that safeguarding just wasn’t as good 35 years ago.

OP basically answered her own question by saying the itching could have been caused by repeated, presumably too vigorous, wiping due to sensory issues. And it was intermittent and relieved by Sudocrem. Sporadic itching is hardly a life or death problem that a child needs a GP appointment for. Neither is confirming a first period in a child with clear signs of puberty.

So both of those combined is probably what made the doctor a bit edgy. It's very unusual for a mother to come in requesting an intimate examination of her child without serious symptoms like pain or fever. The question of whether she could catch thrush from her is also mortifying because of how weird it was given the circumstances.

I am wondering this too.

10 year old me would have found this the worst experience of my life. I’d have been hysterical too, and I’m NT.

Hell, I find it traumatic now, and I’m in my 50s.

A GP examining a 10 year old’s vagina has a very, very high chance of causing medical trauma.

There’s scant regard or knowledge in the medical profession for the potential to cause trauma unnecessarily, despite research laying out what is more or less likely to cause it in the way that medical professionals deal with patients.

Here, though, I would have thought it obvious that this is bound to be a big problem for the child, ND or otherwise. I get that a GP needs to consider the possibility of SA here, but there needs to be a lot of thought before taking an approach that is likely to cause trauma. Causing trauma to check there hasn’t been trauma is about as far from ideal practice as it gets. I’m not sure what the answer is here, but it sure as hell isn’t GPs failing to consider the impact of their own actions, or being ignorant of child psychology.

Someone or you??

I'm allergic to the super soft & thick toilet paper everyone else uses in our house. It makes me itch like crazy.
Poor little girl is only 10 years old. I can't imagine being 10 and going through all this grown-up woman stuff - let alone having to hold still for a swab! I'd have gone berserk. I was 16 when I had my first period. At 10 I didn't even know how babies were made, let alone were born. I was born in the early 50's.