Don't make us strip: Kids, parents raise concerns over half-naked school checkups in Japan

KYOTO -- Students and parents in Japan are voicing serious concerns over the former being instructed to strip to the waist for elementary and junior high school health checkups, saying it can be an embarrassing or even traumatic experience for some children.

As there are no uniform government rules about the practice in Japan, schools handle it in different ways, with some institutions demanding students be examined in their underwear. Petitions have been launched calling for schools not to make children undress during regular checkups.

"Feelings about it may differ from one person to another, but it's wrong to have children strip off their clothes almost forcibly," said Hitomi Kanai, 48, from Nagaokakyo, Kyoto Prefecture.

There, both male and female students at all 14 elementary and junior high schools underwent their health checkups for academic 2022 naked from the waist up. A group of parents opposed to this formed an association in October to demand a format where children can feel safe about school checkups. The group initiated a signature drive to urge the municipal government and education board to allow children to remain dressed during examinations.

When Kanai, who heads the association, asked her daughter in high school about her past physicals, she replied, "I hated it deep down, but I thought I shouldn't say that to anyone." One parent told Kanai, "My child doesn't want to go to school on days when the checkups are scheduled."

What heightened parents' worries was the arrest of a doctor in the city of Okayama in July on suspicion of secretly filming female students in their underwear with a pen camera during checkups at a junior high school -- a violation of Okayama Prefecture's nuisance prevention ordinance. The 47-year-old doctor was also indicted for secretly filming topless female pupils during an elementary school checkup. Upon hearing about these cases on the news, Kanai thought, "These may be just the tip of the iceberg."

Schools, meanwhile, have their own position on the issue. According to the Nagaokakyo Municipal Board of Education, a local doctors' association has said examining students naked to the waist is necessary "to avoid overlooking scoliosis and other disorders," and the city's schools have followed this view. While some schools have taken measures such as setting up screens to prevent students from being seen naked by their peers, or allowing them to cover themselves with bath towels, the education board believes that topless checkups are unavoidable.

But there are schools that do not ask children to be examined half-naked. In 2018, the Kyoto Medical Association surveyed public elementary and junior high schools across the prefecture, excluding the city of Kyoto. The results showed that, of the 259 schools that responded to the survey, 71% of elementary schools had their students examined half-naked, while just 32% of junior high schools did the same. Measures at schools that avoided making students undress included allowing girls to keep their bras or shirts on, or asking them to pull up their clothes as necessary.

"If students can technically be examined with their clothes on, these steps should be adopted at more schools to reduce the number of children having an awful time," Kanai said.

Similar moves are spreading across the country. Chiba Prefecture resident Aiko Takata, 34, launched an online petition in 2020 calling for the education ministry to allow students to be examined with their clothes on. In just around half a year after starting the campaign, more than 20,000 signatures were collected, with one signatory saying, "I hate those memories so much I want to die," while another said, "I'm too scared to go to the hospital."

Takata herself was shocked when she was forced to go half-naked before a male doctor during junior high and high school checkups. When she talked to a school nurse about it, she told her, "Doctors aren't looking at you with obscene gazes. You're the one who's wrong by being suspicious."

The voices of those suffering from the seminude checkups have eventually found their way to the Tokyo Metropolitan Assembly. In March this year, the assembly adopted a petition calling for informing students of their right to refuse internal medicine checkups involving showing one's chest to doctors. In response, the Tokyo Metropolitan Board of Education began an initiative to let parents know in advance that they or their children can consult their school nurses if they are worried about the examinations.

"I thought I wasn't the only one having had a hard time," Takata told the Mainichi Shimbun, adding that she will keep on with her campaign.

The education ministry in March 2021 issued a notice to prefectural boards of education regarding health checkups requiring students to get undressed. It urged schools to use their health bulletins to gain students' and parents' understanding for how the checkups will be conducted, and pay heed to children's privacy as much as is technically practical. As there are no national rules, however, a ministry official said, "It's difficult for us to give instructions as school physicians have different ways of doing it. It's essential to obtain understanding by giving parents prior explanations."

Tatsuya Mima, a doctor and professor of medical sociology at Ritsumeikan University graduate school, commented, "If scoliosis and other disorders are overlooked during checkups, a school physician may be subject to civil liability. School doctors are to examine students in ways they can be responsible for, and it's understandable that schools have different policies on letting students keep their clothes on during checkups.

"The fact that many people have raised questions about the issue is proof that human rights awareness is growing, and schools' uniform checks of sensitive information about children's bodies is out of step with the times. Students' physical attributes and information about their illnesses could also lead to bullying," he said.

The professor added that schools should inform children and parents that school checkups are not mandatory and that they can be examined by their primary care doctors. "Moving forward, the system should be changed to allow students to get checkups on their own," he said.

(Japanese original by Kanae Soejima, Kyoto Bureau)