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A Type of Child Abuse

Marcia E. Herman-Giddens, PA, MPH; Nancy L. Berson

JAMA. 1989;261(4):577-579.

Abstract
Little attention has been paid in the literature to children's genital hygiene in recent years. We describe harmful genital care practices that produce physical and/or psychoemotional abnormalities in children. These practices comprise unusual and ritualistic handling and inspection of the child's genitals. Abnormalities produced include chronic and varied somatic complaints and behavioral anomalies, changes in genital anatomy, unnecessary medical diagnostic and therapeutic interventions, and, sometimes, overt sexual abuse. The practices need to be recognized as harmful to children, and effective intervention must be sought.

(JAMA 1989;261:577-579)

Author Affiliations
From the Child Protection Team, the Division of General Pediatrics, the Department of Pediatrics, Duke University Medical Center, Durham, NC (Mss Herman-Giddens and Berson).

Footnotes
Read in part before the National Symposium on Child Victimization, Anaheim, Calif, April 29,1988.

Reprint requests to Department of Pediatrics, Duke University Medical Center, Box 3937, Durham, NC 27710 (Ms Herman-Giddens).

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