Sometimes a story finds you not because it’s unusual, but because it’s heartbreakingly common. When I started asking for medical trauma stories, I expected a variety of experiences from different procedures and settings. What I got instead was something that left me staring at my computer screen in disbelief.
The same four letters kept appearing: VCUG. Over and over. Nearly identical accounts of the same procedure, the same trauma, the same lasting damage. The pattern was so clear, so consistent, so obviously devastating that it seemed impossible the medical community could have missed it. Except they didn’t miss it. They ignored it. For thirty years.
Today, I’m documenting two of these accounts that have come to me, not because they’re unique, but because they represent what appears to be systematic medical negligence hiding in plain sight.
In 2023, a practicing pediatric urologist said something to a medical journalist that should have made headlines. Dr. Anthony Caldamone, speaking on the record about voiding cystourethrograms (VCUGs), admitted something remarkable:
“With or without sedation, we just don’t have the data. We don’t know how many children are affected.”
This wasn’t an admission about some experimental treatment. This was about a procedure performed on hundreds of thousands of children annually, a procedure that medical websites describe as “uncomfortable but not painful,” a procedure that, according to medical literature, has never been studied for long-term psychological effects.
Let me say that again: they’ve never studied what this does to children’s minds.
This isn’t medical ignorance. This is medical negligence. And I’m done pretending otherwise.
The Timeline of Betrayal
In 1994, researchers needed to study how children retain memories of traumatic experiences. They chose children who had undergone VCUGs as their research subjects, specifically because—in their own words:
“This invasive procedure is similar in many respects to incidents of sexual abuse.”
Read that again. In 1994, researchers explicitly stated that VCUG procedures resemble sexual abuse. They used these children as proxies for abuse victims in their studies.
In 2004, UC Davis psychology professor Dr. Gail Goodman conducted another study using VCUG patients.
“I was studying it because it was a traumatic stressor for a lot of children. Some of the kids didn’t seem too hurt by it, but others were just screaming.”
Dr. Goodman’s team filmed children’s reactions during these procedures. What they saw was so disturbing that when she tried to share the footage at a medical conference, “the people in the audience couldn’t even watch the videotape.” She described the experience as “traumatizing for us researchers.”
In 2016, the American Academy of Pediatrics published new guidelines acknowledging that VCUGs could be “stressful or even traumatizing” for children. They recommended patient education but provided no specific guidance on how to minimize trauma.
In 2023, when STAT News asked the American Academy of Pediatrics and the American Urological Association about research on psychological effects of VCUGs, both organizations declined to comment.
Thirty years. Three decades of evidence that this procedure traumatizes children, and still no long-term psychological studies. Still no systematic changes. Still children being strapped down to tables and told this is “for their own good.”
What the Research Refused to Study
The accounts that found their way to me tell a story the medical community has refused to document. They’re remarkably consistent, these stories. Eerily so. As if the same trauma is being inflicted, systematically, on child after child, with the precision of a factory assembly line.
Let me share two of them with you. These stories reveal a devastating pattern that the medical community has refused to acknowledge.
The Girl in the Orange Dress
She was three years old on May 10, 2006. She remembers her fancy orange dress, the sculpture in the hospital lobby that changed colors, the excitement about the special toy she’d been promised afterward. A Child Life Specialist had prepared her with a doll, telling her she would clean the baby’s “lady parts” with a little red towel called “red soap.”
That’s what her three-year-old brain understood: she would clean a doll.
What actually happened was something entirely different.
“I’m strapped down to the table with the bright light shining on me—completely naked, legs spread and strapped open… A bunch of nurses and doctors came into the room, some male and some female, and they shone the light directly at my private parts. I had been potty trained for a while now, and had always been very modest, so this felt weird at best. But I knew my dad had told me that ‘no one could ever look at or touch my girl parts’, and that I had to say ‘no’ if anyone ever tried to. But for some reason, I couldn’t speak right now.”
She describes the “red soap” that wasn’t soap at all but antiseptic solution that burned her skin. The strangers touching her. The catheter insertion that felt like being stabbed. The male doctor who asked “Mind if I take a peek?” before examining her genitals while she lay paralyzed with fear.
“I couldn’t scream, couldn’t cry, couldn’t do anything but just lay there and stare at the ceiling.”
When it was over and she tried to walk, she couldn’t take more than two steps because of the burning pain. At home, she discovered blood in her underwear and was terrified they had damaged something inside her.
“I knew I couldn’t let my mom see, or she might make me go back.”
But perhaps the most devastating part of her account is what happened afterward. When her father asked if it hurt:
“I lied and said no, because I knew it wasn’t supposed to hurt, and everyone told me that it wouldn’t, so it was probably something wrong with me.”
A three-year-old was already learning to blame herself for medical trauma, already internalizing the message that her pain didn’t matter if it contradicted what adults said should happen.
Even the medical staff reinforced this gaslighting. After the burning antiseptic procedure, the nurse told her:
“See? that didn’t even hurt!”
The child wanted to tell her mother that it did hurt, but found herself voiceless:
“I couldn’t do anything. I was just frozen, watching this whole thing unfold.”
Twenty-two years later, she’s been diagnosed with PTSD and vaginismus from this procedure. She requires trauma-informed pelvic floor physical therapy and still flinches when touched. She also has what’s been described as a “catheter injury” from that day in 2006.
The Eight-Year Nightmare
The second account comes from someone who endured this procedure not once, but yearly from age two to ten: eight times total. Eight annual appointments with terror.
“I really fear coming across as unreasonable or dramatic here, but I can’t emphasize enough how false this is. It was incredibly painful.”
She’s responding to those ubiquitous hospital websites that describe VCUGs as “uncomfortable but not painful.” Her lived experience directly contradicts every official medical description of what this procedure feels like.
“I have VIVID memories of every aspect of this test. The discomfort and fear I experienced spreading my legs in front of a room of 3-5 nurses/technologists. The dreaded question: did I want my legs in frog position or butterfly position? (I quickly learned to pray for a technologist who allowed frog position, because whenever I had to do butterfly, two nurses/aides would stand on either side of me and hold my knees down flat on the table so I couldn’t fold them up… I never even fought, but for some reason children needed to be restrained just to make it easier?)”
But what devastates me most about her account is the confusion she felt about her parents’ role in this violation:
“One of my parents was always in the room for it, so it was really confusing for me as a kid to understand how this person who was supposed to protect me could allow strangers to hurt me in such an invasive, intimate way and just stand by.”
She’s careful to add that she knows they thought they were doing what was best for her health. But the trauma of feeling abandoned by the very people meant to protect her compounds the medical trauma exponentially.
“I felt so violated every time, and it quickly became clear to me that my body was not mine to control.”
The psychological impact was so severe that this child began planning her own death:
“I would spend the months before the procedure planning and plotting how I could get out of it this time, and then I would spend the months after the procedure with a renewed sense of powerlessness I’ve never been able to shake. It got to the point where, as an older child (about 7-10), I became very suicidal, and often considered killing myself just to avoid another VCUG. I used to pray for God to just let me die in my sleep on the nights leading up to the test. One time, the night before the test, I even climbed out on my roof and tried to convince myself to jump, but I just couldn’t do it.”
Making matters worse, the trauma itself prevented the procedure from working properly:
“I actually was never able to complete this part… I would just lie there trying not to cry until they finally pulled the catheter out and allowed me to pee into a cup. I didn’t know it at the time, but it turns out this actually means a major part of the procedure was missing and they couldn’t even really effectively monitor what they were looking for.”
So not only was she being traumatized annually, the trauma itself was making the procedure medically ineffective. They were hurting her for no diagnostic benefit whatsoever.
The long-term consequences persist today. She’s now twenty-three and vomits before doctor’s appointments. She cannot be intimate with partners. She has vulvodynia (chronic pelvic pain often associated with sexual trauma) and vaginismus that makes penetration nearly impossible. At age eleven, years after her final VCUG, she began experiencing “an intense, near-constant burning soreness in my whole pubic region.” She was too embarrassed to tell anyone. It took twelve years for her to successfully insert a tampon, and even now she can only use small ones with moderate pain.
When she finally allowed a PAP smear last year, she dissociated afterward and found herself in a parking lot with no memory of how she got there.
“I was still too suicidal to trust myself driving home, so I went to sleep in the parking lot for a while.”
Perhaps most heartbreaking is how the trauma shaped her relationship with medical care:
“I become very compliant/meek and ‘small’ in any medical setting, and I find it impossible to voice any of my concerns, because I just want to be ‘good’ and an easy patient and not be perceived as dramatic.”
This is what medical trauma does to children: it teaches them that their pain doesn’t matter, that questioning medical authority makes them “difficult,” that being “good” means enduring harm without complaint. She learned these lessons so thoroughly that even as an adult, she cannot advocate for herself when she needs medical care most.
The Researchers Knew
Here’s what makes this even more devastating: the medical community has known for decades exactly what these procedures do to children.
The 1994 study that used VCUG patients as sexual abuse proxies found that six weeks after the procedure, children still remembered the majority of the examination. Behavioral measures during the test showed many were severely distressed.
Dr. Goodman’s 2004 research demonstrated similarities between VCUGs and child sexual abuse, including:
- Genital contact by authority figures
- Forced removal of clothing
- Penetration while the child is restrained
- The child’s inability to resist or escape
In 2012, pediatric urologists Dr. Caldamone and Dr. Liza Aguiar conducted a small study on VCUG effects in the two weeks following the procedure. Of thirty-five families surveyed, eleven noticed behavioral changes in their children that were described as “worrisome.”
But here’s the crucial detail: that study only looked at two weeks. Not two years. Not two decades. Two weeks.
Andrea McDonald, a graduate student at the University of Pennsylvania, struggled to get funding for her research on long-term VCUG effects. In 2022, she managed to conduct a small pilot study with twenty-one participants that suggested VCUG patients were more likely than control groups to experience depression and PTSD symptoms.
“If we want to do anything serious in public health, I want to see the money show up. We need to get more people and institutions invested.”
The money isn’t showing up because the medical establishment doesn’t want the answers. They’ve built an entire diagnostic framework around a procedure that systematically traumatizes children, and admitting that would require massive systemic change.
The Language of Denial
Look at how medical institutions describe VCUGs to parents:
The National Kidney Foundation:
“The test is not painful, but the child may have some stress and short-term discomfort.”
Hospital websites universally describe the procedure as “uncomfortable but not painful.”
The 2016 American Academy of Pediatrics guidelines acknowledge the test can be “stressful or even traumatizing” but provide no specific guidance on prevention or treatment of that trauma.
This language is carefully crafted to minimize what actually happens. “Uncomfortable” sounds manageable. “Short-term discomfort” suggests it ends quickly. “Stress” makes it sound like stage fright, not trauma.
But listen to the survivors:
- “Easily the worst pain I had felt in my life thus far”
- “Incredibly painful”
- “It burned horribly”
- “Felt like being stabbed”
The disconnect isn’t accidental. It’s protective. It protects the system from having to acknowledge what it’s doing to children.
The Grassroots Truth-Telling
While medical institutions denied and minimized, survivors began finding each other. On TikTok. On advocacy websites. In scattered corners of the internet where people share truths too painful for polite medical discourse.
Shelby Smith launched the Unsilenced Movement after processing her own VCUG trauma. When their TikTok video about the procedure went viral, hundreds of comments poured in from adults sharing nearly identical experiences. The advocacy site documents multiple studies linking VCUGs to child sexual abuse research and calls for informed consent that actually informs.
These aren’t scattered anecdotes. This is systematic evidence of systematic harm.
But here’s what’s most telling: when medical journalists finally started investigating, when survivors finally had platforms to speak, the response from major medical organizations was silence. The American Academy of Pediatrics declined to comment. The American Urological Association declined to comment.
They declined to comment on thirty years of evidence that their standard procedure traumatizes children.
The Alternatives They Don’t Mention
The most damning part of this entire story is that alternatives exist. They’ve existed for years.
Contrast-enhanced voiding urosonography (ceVUS) uses ultrasound instead of X-rays and allows parents to hold their children during the test. Children can urinate sitting upright instead of lying spread-eagle on a table. It’s about as accurate as VCUG but significantly less traumatic.
The majority of U.S. facilities don’t offer it.
Some hospitals use sedation to minimize trauma. Some use child life specialists. Some physicians advocate for trauma-informed approaches.
But these remain exceptions, not standards. Most children still undergo the same procedure described in 1985, with minimal modifications for trauma prevention.
Why? Because changing would require admitting the current approach is harmful. It would require acknowledging thirty years of institutional failure. It would require taking responsibility for generations of children who were needlessly traumatized in the name of diagnostic necessity.
The Cost of Medical Hubris
The human cost of this negligence is staggering. Not just the two survivors I’ve shared, but hundreds of others who’ve reached out through advocacy sites, TikTok videos, support groups. People in their twenties, thirties, forties, even sixties, carrying trauma from procedures performed when they were preschoolers.
They describe:
- PTSD and anxiety disorders
- Inability to tolerate medical exams
- Sexual dysfunction and intimacy issues
- Chronic pain conditions
- Suicidal ideation
- Trust issues with medical professionals
- Secondary trauma from having their experiences dismissed
This isn’t rare. This isn’t a few sensitive children who “overreacted.” This is a predictable pattern of harm that the medical establishment has chosen to ignore because acknowledging it would be inconvenient.
Ellen Lonnquist, a family and trauma therapist, explains why this trauma is so profound:
“It’s an experience that your body and brain can’t possibly process in the moment. There is the messaging we appropriately give children around protecting themselves and their bodies. So, with the VCUG and lots of other medical procedures, it can be harmful if no one is working with the child to help them understand what’s happening.”
Children are taught that their bodies belong to them, that they should say no to unwanted touching, that trusted adults will protect them. Then they’re brought to a medical facility where all those protections are stripped away and they’re told this violation is “for your own good.”
The Path Forward
This story doesn’t have to end with more children traumatized in the name of medical necessity. Change is possible, but it requires several things:
Immediate implementation of trauma-informed practices: Every facility performing VCUGs should be required to use child life specialists, offer sedation, and provide detailed informed consent that includes psychological risks.
Research funding for long-term studies: The medical community must finally fund the psychological outcome studies they should have conducted thirty years ago.
Wider availability of alternatives: CeVUS and other less traumatic diagnostic options should be standard, not exceptions.
Acknowledgment and accountability: Medical institutions must acknowledge the harm they’ve caused and commit to systemic change.
Survivor support: Resources for adults dealing with VCUG trauma must be developed and publicized.
But most importantly, the medical community must confront an uncomfortable truth: for thirty years, they’ve prioritized diagnostic convenience over children’s psychological wellbeing. They’ve dismissed survivor accounts as “anecdotal” while refusing to collect the data that would prove those accounts represent systematic harm.
To the Survivors Reading This
If you’re reading this and recognizing your own experience, I need you to know some things that no one told you when you were small and afraid:
You were not dramatic. You were not overreacting. You were not “making it worse than it was.” When they told you it “shouldn’t hurt,” they were wrong about your reality, not the other way around.
When they told you to “relax” while violating your body, when they said “see, that didn’t hurt” while you were screaming inside, they were teaching you to distrust your own perception of reality. When your parents stood by and allowed it to happen year after year, you learned that the people meant to protect you would sacrifice your wellbeing for medical authority. That betrayal cuts deeper than the physical pain.
When you became “compliant” and “good” in medical settings afterward, you were protecting yourself the only way you knew how. But you shouldn’t have had to learn those survival strategies as a toddler.
To the child who couldn’t speak while strangers examined her most private areas: your voice mattered then, even when no one listened. It matters now.
To the child who learned to lie about pain because telling the truth meant something was wrong with her: you should never have been put in that position. Your pain was real, and it was never your fault.
The chronic pain that started years later, the inability to be intimate, the panic attacks in medical settings, the dissociation, the suicidal thoughts—these aren’t character flaws or evidence of weakness. These are normal responses to abnormal trauma.
To the parents who were in those rooms, watching: some of you were doing what you thought was best with the information you had. But some of you knew something was wrong and chose medical authority over your child’s obvious distress. Your children remember. They remember who protected them and who didn’t.
Your voices matter. Your experiences matter. And increasingly, people are listening.
To the three-year-old in the orange dress who couldn’t speak as strangers examined her: I hear you.
To the child who climbed onto a roof rather than face another VCUG: I hear you.
To everyone carrying this particular weight: you’re not alone anymore. The silence is breaking. The truth is coming out. And change, finally, is coming.
For medical professionals reading this:
It’s not too late to do better. It’s not too late to listen to survivors, implement trauma-informed practices, and prioritize children’s psychological wellbeing alongside diagnostic necessity.
But the time for denial is over. The evidence is overwhelming. The accounts are consistent. The trauma is real.
Your patients deserve better. They always did.
Sources:
- Wang, M. “As kids, they underwent a common test for UTIs. As adults, it haunts them as a traumatic ‘nightmare’.” STAT News, September 11, 2023.
- Frimberger, D., et al. “Establishing a Standard Protocol for the Voiding Cystourethrography.” Pediatrics, November 2016.
- Goodman, G.S., et al. “Trauma, memory, and suggestibility in children.” Development and Psychopathology, 1998.
- The Unsilenced Movement advocacy organization and survivor testimonials.
- Personal accounts shared with permission by VCUG survivors.