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😥

Ok so there are many ND people including children who never have proper dental examinations and are skipped over when NT children would have blood tests, because they can't tolerate those procedures. The medical.professionals involved make a professional decision about the relative impact of not having the test over the potential.impact of sedation and one or the other is persued. Sometimes desensitisation work is attempted, sometimes successfully.
The parents of these children are not accused of anything. No one assumes it might be abuse.

A Nd child who won't tolerate an examination of their genitals - or even just a NT child who was disinclined- oughtn't there be a medical pathway equivalent to facilitate the treatment or the decision not to treat? And this explained to parents?
Finally people are talking about red flags and tick boxes but the decision to refer to anyone is not a tick box. It's professional judgement based on the child's interests taking guidance into account, which should be documented and explained clearly. . Always. That's the law. There's no rule that says every child who co sleeps with a parent or every child who has irregular bleeding. An examination for potential sexual.abuse involves a paediatrician looking. If the child is highly resistant it won't work anyway. Why aren't highly anxious children who don't want examinations allowed to access a route which actually recognises and works with the refusal? And documents relevant work to be carried out to improve the child's access to the service such as getting to know a GP or health worker who can support going forward?
It's not rocket science. You can't examine the genitals of an unwilling child anymore than you can take their blood. There's no substitute for relationship.

It seems some posters think neurodiversity in this instance means the medical professional should not have had safeguarding concerns.
If there are red flags then any professional will make the relevant referral.

The GP did the right thing based on what they witnessed and were told by the child's parent. Of course neurodiversity is likely the answer, but what GP wants to take the risk.
I understand its upsetting for the OP but its a case of better safe than sorry..
Red flags cant be ignored due to neurodiversity. This would surely make a ND child even more vulnerable than they potentially already are.
Regarding the cosleeping comments raised, I think its personal choice.
Two of my children are ND and ill be honest and say I wouldnt want either of them in my bed.
They suffer with anxiety but we deal with it during the daytime and they are happy to go to their own rooms at bedtime. Maybe im lucky but cosleeping just wasnt an option for me. Once it starts there is no going back
I know a lady who still cosleeps with her 15 year son. A safeguarding referral has recently been made following a comment he made at a routine medical appointment about needing a bigger bed for them both as he'd grown so much recently.

Are you talking about a safeguarding referral or a consensual referral to children services for child in need support due to the need of the Child and parent for support to manage him into his own bed? ( Which would most likely also go through the CS front door?) And crucially did the referrer understand the difference? Was It felt that unless the spectre of alleged SA was raised, there might not be a response? Or do they actually think the parent might be inappropriate /sexually abusive?
It seems very significant as to whether the professionals involved actually suspect sexual.abuse. In that case there's a question as to why all of a sudden since he is 15 and no one right through school and all his health checks had that issue previously.
The process of giving the support could throw up more concern or no concern. But the practical step of support is key. If parent is agreeing to support then the professional involved needs to at least be able to explain their safeguarding issues and why now and not before in relation to that particular thing. You'd expect the safeguarding lead to be able to have that discussion.. If the issue is resource rather than suspected SA,the escalation should look very different. Don't forget ND children do internalise professional responses. That's why care is needed. If support hasn't worked what are the reasons and what is the professional view of the credibility of the reasons?

Agree with this.
There has to be weighing of benefit Verses Harm.

My child is ND and has severe medical anxiety..
We have had huge issues with procedures and push and pressure just causes more resistant refusal and distress.
Our dentist is amazing now but we had some awful experiences previously. Blood tests are not possible. We have had the desensitized support which was working until the nurse decided to opt for pressure approach as child wasn't progressing quick enough for the nurse. Now we have regressed right back to blood tests being impossible.
In a situation where child was very unwell and blood tests were 100% necessary then sedation would be needed. But routine tests the trauma caused by forcing the test outweighs the benefit

There is no way my teen would tolerate a vaginal exam without needing sedation and even then I would question if other approaches would be better.
I would suggest that a ND trained therapist would be far more efficient and effective to undercover abuse than a GP forcing an exam in a distressed child who is refusing it.

@Warmlight1 As it stands I dont have any information regarding the mindset of the referrer. Im not involved professionally so I dont have any more details to date.
The child in question is ND and has been under CAHMS for many years. Support is already in place..
Personally I dont think SA will be suspected upon.investigation.Theres been a huge amount of support in place for a significant period of time for this family which consists of a lone parent and an only child. I would describe their relationship as enmeshed with blurred boundaries.

The GP could have acted on her concerns in a more sensitive manner. Nobody is saying she should ignore a situation where she is worried about a child, but her actions caused trauma to the child and she should have handled things differently.

Is it usual protocol to ask the mother of a 10 year old distressed child to leave the room for example? I can’t think that it is.

There is also the issue that her (apparent) lack of training around neurodivergence means that she misread signs. Behaviours that are quite usual in ND children seem to be misunderstood and misinterpreted as meaning abuse. And yes, of course, she does need to make sure, but if ND was suspected at all, surely a GP should have known that the ham-fisted approach she was taking would cause further distress?

I don’t think she should ignore, but surely there are better approaches available to the GP. As it is, I think she has done harm.

Just an update

This is my post.. I deleted my account the comments got too much.

Thank you all for your helpful comments and different perspectives.

The GP retracted their concerns, apologised that the guidelines they were citing are children who have no signs of puberty and that given my Daughters height, weight and physical appearance this is definitely onset of periods, she also apologised for the thrush comment this also is only a red flag in prepuberty. she spent time after the consultation going through my Daughters file (her health anxiety CAMHS reports) and was satisfied that her presentation was due to being ND.

Although I feel the whole thing has been rather traumatic for me and my Daughter i have decided not to put in a formal complaint as ultimately the GP has taken accountability and underneath it all i think she had my Daughters best interest at heart.

I do hope however, she reflects.

So glad to hear your update OP! What a horrific thing for you to have to go through.

So glad the GP reflected on their behaviour. But points out how vulnerable you feel as a parent to misunderstanding when you have an autistic child. My child often seems very unhappy in public as they find the sensory and social environment very hard. This can mirror behaviours safeguarding training suggest are a red flag. In reality home is the safe place and family are his safe people. I live in fear that some overzealous and under educated person will make, what is already hard, much harder.

Can you not see that reporting parents of autistic children every time they see a medical professional is hugely damaging? You need to understand a child’s normal state to know whether something is a red flag or not. Just treating all children the same is not only ableist, it is deeply tramatising.

Do better.

Very glad the GP took the time to go through things properly (belatedly!) though I’m sorry you were put through this OP. I think the GP will have learned something that will help them going forward, but I’m sorry it was at you and your daughter’s expense. Hope she is doing okay now.
Thank you for the update 💐