I just wanted to re-state something in case anyone missed this discussion a while back. As they get older it is NOT necessary for EVERY endo appointment to include an examination of the genitalia. Unless there is a problem in that "region" other than virilization, or you are dealing with possible early puberty, your endo should agree to an every other time schedule or every third time. We read post after post from adults with CAH who said that that was ONE of the most dreaded and damaging things to have to go through as a helpless child. I can tell you that it can definitely shape the way we feel about ourselves in the future. Just by simply letting the child feel that they have some control over the situation can make all the difference in the world. Perhaps you can ask them if they want that part of the exam at the beginning or at the end of the visit. Depending upon their age, you could have them look at a calendar marked with their next few visits and pick which one would be OK or perhaps even having the child participate in some small way, like holding the flash light for the doctor. Of course all this should be approved by the endo first. If he has a problem with it press him for a viable reason. This subject has come up on numerous occassion in relation to girls with CAH, but I have found that IT APPLIES TO BOYS AS WELL. I have watched my son turn seven shades of red and try to crawl out of his skin during these exams. Then, to add fuel to the fire, the mere act of examining the penis can act as a stimulant and cause arrousal. On those occassions I can tell that my son wants to be anywhere but there. I have asked him after he had been given several shots and had sufferred through a couple of collapsed veins 9hence re-sticks), what is the part of the exam that he likes the least. It is ALWAYS conveyed to me by a quick pointing jesture to his penis. There are a lot of things that we can't do anything about, but this isn't one of them. Being proactive in your child's healthcare management can also give YOU a sense of control. I hope some of these suggestions prove to be useful in some small way.