Letter to the Editor Response to Kevin Mccarthy Dear Editor, Thank you for the comments to our study that gives us a possibility to clarify some important details. It is necessary to point out that the presented study was part of a larger study designed to investigate anatomy and microbiology in non-abused children. Mr. McCarthy is right about his objection that there were no medical reasons for the examination, as the families were invited to participate to extend the knowledge about what is normal anatomy and microbiology in non-abused preschool children. Additionally, the children and their parents were asked for their reactions to different parts of the examination. Both studies were approved of the Regional Committee for Medical Research Ethics. The letter of invitation was sent to families with a child in the relevant age group. The children were allowed to withdraw from the study at any stage (which some children also did). A sensitive approach to the examination was emphasized, and the examination of the genital area followed as a natural part of the full “top-to-toe” medical examination. Neither the responses from the children nor the responses from their parents gave evidence for the assertion of the genital examination representing child abuse. On the contrary, as presented in the result section, the overall majority stated the examination as not being traumatic. Finally, we believe the commentary represents a common misunderstanding that a genital medical examination is traumatic and thus can be considered a form of abuse. There is no evidence supporting this view, neither in studies of abused children or in our study of non-abused children. Kari Gulla Department of Paediatrics, University Hospital, N-7006 Trondheim, Norway Available online 29 May 2009