Content Warning: The following content includes graphic descriptions of VCUG and strong elements of medical and sexual trauma. Discretion is advised.
Trauma is in the eye of the beholder, meaning that traumatic experiences are subjective and depend on each individual’s unique perception of the experience. This is especially crucial to understand in the context of VCUGs, which are primarily performed on toddler-aged children without the developmental capacity to perceive the test as necessary, let alone beneficial.
Despite this, the stigma around VCUG trauma persists today. With thousands of survivors speaking up all over the world, there is no question that VCUGs have inflicted life-altering trauma on generations of kids. Unfortunately, it can be difficult for the average person to perceive VCUG trauma through the child’s lens.
In this blog, we’ll unpack the different layers of VCUG trauma and explore how this experience affects children differently in adolescence and adulthood.
What Is VCUG Trauma?
VCUG trauma is widely misunderstood and underdiagnosed. Despite major advancements in our understanding of adverse childhood experiences (“ACE”) and post-traumatic stress in children, VCUG trauma is still a unicorn. This is largely because VCUG trauma is often a double-edged sword: half medical trauma; half sexual trauma. Both sides can profoundly affect children's health and quality of life.
Lesser-Known Components of VCUG Trauma
Every individual experiences life differently. The same goes for patients undergoing medical care. While not every child experiences trauma during VCUGs, there is longstanding research to support the traumatization of generations of patients since the 1960s.
There is no “one size fits all” for VCUG trauma. While its hybrid nature can make it difficult to understand, former VCUG patients have played a pivotal and courageous role in raising public awareness and educating the medical community about the real and lasting effects of pediatric VCUGs.
Below are 7 lesser-known layers of VCUG trauma that are commonly experienced, but often go unnoticed:
1. Public Humiliation
“The VCUG renders the child dependent on those in the room, as they may be separated from their parents and their legs may be forced apart and held down.” - 2016 study
The VCUG experience can be deeply humiliating for children. Even very young patients can experience shame, embarrassment, and awareness when their genitals are publicly exposed to a crowded room of strangers. This loss of privacy, dignity, and autonomy is often exacerbated by the indifferent attitudes of medical personnel, many of whom perceive children as “too young” to feel embarrassed or even aware of their sexual organs.
Perhaps the most humiliating part of the VCUG procedure is the command to void. This step usually follows the child being forcibly restrained, catheterized against their will, and having their bladder pumped full while lying down beneath massive fluoroscopy machinery. The radiologist will command the child to urinate on the table while their urinary tract is recorded for all to see. If the patient cannot void on command, the test must be repeated.
Being naked and on display in such a vulnerable position in the presence of strange and sometimes uncaring adults can haunt patients for the rest of their lives. As a result, many survivors struggle with severe performance anxiety, as well as using public restrooms and changing rooms.
Key Points:
Publicly exposing the genital area.
Lack of empathy or understanding from staff regarding emotional distress.
Feelings of powerlessness and judgment.
2. Sexual Violence
The VCUG procedure requires the insertion of a catheter without sedation, which is perceived by many patients as invasive and even life-threatening. The frequent need to restrain patients with straps or physical force can make VCUGs a terrifying and sexually violent experience for young kids.
Patients will endure forced genital contact while naked while their requests to stop and complaints of pain are ignored by the medical professionals in the room. The violation of a person’s body in such a vulnerable and intimate way can lead to long-term trauma and a deep distrust toward healthcare professionals and romantic partners alike.
Key Points:
Involuntary catheterization feels akin to sexual assault.
Physical invasion without consent, acknowledgment of pain, or emotional support.
Traumatic medical procedures being mistakenly normalized.
3. Dehumanization
VCUG patients often report feeling like “specimens” or “experiments” instead of human beings. The clinical nature of the experience, along with a lack of communication and empathy, can strip away a child’s dignity and make them feel as though their emotions or experiences don’t matter, robbing them of their voice. The absence of a compassionate and respectful environment fosters feelings of dehumanization, leading to further harm and revictimization in adulthood.
Key Points:
Patients treated as objects for medical observation rather than individuals.
Lack of emotional support or acknowledgment of pain.
Perception that medical staff prioritize efficiency over patient well-being.
4. Lifelong Inability to Seek Medical Care
Many former VCUG patients report a lifelong inability to seek medical care, even in urgent situations, as a direct result of their childhood VCUG(s). The violating nature of these early childhood procedures can cause patients to associate even routine medical visits with the pain, fear, and humiliation they experienced as children when their voices were ignored by the adults around them.
Key Points:
Fear of all medical care due to past trauma.
Aversion to healthcare institutions and professionals.
Reluctance to trust healthcare providers due to past dehumanizing experiences.
5. Invalidation & Isolation
In many cases, patients are told that the trauma they survived is "normal" or "necessary." This invalidates their authentic experience and makes it more difficult for them to heal. Remember, trauma is in the eye of the beholder. Dismissing the long-lasting impacts of VCUG trauma fosters a cycle of silence and isolation, distancing survivors from the tools they need to recover and live healthy lives.
Key Points:
Trauma being minimized or dismissed by medical professionals.
Pressure to "move on" from the experience without emotional processing.
Sense of shame and embarrassment discourages patients from speaking up.
6. Poor Sexual Health
VCUG trauma often has lasting effects on sexual health and relationships. The experience of feeling powerless and sexually violated in childhood can cause patients to feel disconnected from their bodies and struggle with intimacy and sexual health as adults. Because genital contact during VCUG is often a child’s first “sexual” experience, many survivors associate healthy sex and sexual pleasure with feelings of guilt, pain, shame, and terror. This can make it very difficult to enjoy healthy partnerships and consensual intimacy.
Key Points:
Difficulty feeling safe, comfortable, and “normal” in intimate situations.
Trauma impeding the ability to trust or enjoy physical closeness.
Challenges forming and maintaining healthy relationships.
7. Persistent Feelings of Powerlessness
Most patients feel powerless during VCUGs, robbing them of their agency in future scenarios. These feelings of helplessness are amplified by the lack of consent and understanding from medical professionals, family, and friends. Feeling like their bodies are out of their control can result in deep-rooted insecurities that persist well into their adult years.
Key Points:
Lack of agency and autonomy in decision-making.
Disempowerment due to a procedure they could not consent to.
Internalized feelings of worthlessness stemming from pediatric VCUG.
Take Back Your Power with the Unsilenced Movement
Since 2023, the Unsilenced Movement has been committed to unifying former VCUG patients in healing and empowerment. Our goal is to educate and empower families by equipping them with the knowledge, tools, and resources they need to make informed choices for their child’s care. Whether you’re looking to connect with fellow survivors in our monthly support group, discover healing resources, share your VCUG story, or support a friend or loved one recovering from VCUG trauma, we offer a wealth of resources for your healing journey.
Healing from VCUG trauma? You’re not alone. Join the Unsilenced Movement to help us reach fellow survivors and advocate for VCUG reform. Because kids deserve better. #MoreThanATest
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