"Why Must Underwear Be Removed at School?"... Japan Stirred by 'Female Student Health Checkup' Controversy

Different Health Checkup Procedures by School
Confusion Persists Despite Government Guidelines
Concerns Over Checkup Avoidance Due to Shame

In Japan, controversy is brewing at school health checkups regarding whether female students should be required to remove their underwear or expose their upper bodies. Although the government has issued guidelines emphasizing the protection of children's and adolescents' privacy and emotional well-being, the absence of concrete, detailed standards has resulted in schools adopting widely varying examination practices. The struggle to find a balance between diagnostic accuracy and student rights is emerging as a new point of contention within Japan's education sector.

"Guidelines Exist, but No Standards"...Confusion on the Ground

Recently, the Mainichi Shimbun reported that parents' questions and concerns about whether their children are allowed to wear underwear during annual school health checkups are growing each year.

Previously, in 2024, Japan's Ministry of Education, Culture, Sports, Science and Technology issued nationwide instructions to local boards of education, urging them to improve the environment of health checkups to protect students' psychological stability and privacy. The main thrust was to allow students to wear gym uniforms or underwear, or to cover their bodies with towels or similar items.

The core problem, however, is that no clear standard has been provided for key issues such as whether upper body exposure is required. With only the caveat that "it should not interfere with accurate diagnosis," the responsibility for detailed decisions has been left to individual schools and medical staff, resulting in widely divergent practices depending on region and school.

Image to aid understanding of the article. Photo by Yonhap News

"I Really Hated It"...Growing Dissatisfaction Among Students and Parents

This confusion is directly fueling dissatisfaction among students and parents. One parent in Kawasaki City recounted an experience in which her sixth-grade daughter expressed deep shame after undergoing a health checkup. Although the prior notice distributed to families stated that certain types of underwear or gym uniforms would be permitted, at the examination site, the doctor requested that her daughter undress. After similar experiences continued in middle school, the student ultimately refused to participate in school health checkups and instead paid out of pocket to have individual examinations at an outside medical facility.

At some schools, female students have reportedly been required to remove their underwear before the examination and keep it in their pockets while waiting, resulting in a dehumanizing atmosphere. There have also been cases where anxiety about bodily exposure has caused students to avoid the checkups altogether. According to a survey by the Japanese Society of School Health, 87.4% of schools now conduct health checkups with students fully clothed to protect them. Nevertheless, a significant number of schools continue to uphold traditional practices involving upper body exposure, citing either custom or medical necessity, and disputes over interpretation persist.

"Unavoidable to Prevent Diagnostic Errors"...Medical Community Seeks Alternatives Amid Debate

On the other hand, many in the medical community argue that some degree of bodily exposure is unavoidable to ensure diagnostic accuracy. Wearing thick clothing or undergarments with wires can interfere with the stethoscope's ability to accurately pick up heart sounds, and it is difficult to visually detect skeletal abnormalities, such as scoliosis, which is prevalent among adolescents, without direct observation. Thus, some believe that the maintenance of upper body exposure at certain schools is not simply an outdated custom, but a medically grounded effort to facilitate early disease detection.

As the controversy grows, the Ministry of Education, Culture, Sports, Science and Technology has emphasized the need for flexible dialogue rather than a binary approach of strict prohibition or permission. A spokesperson for the ministry stated, "If wearing clothing directly interferes with auscultation or examination, it is difficult to allow it unconditionally," adding, "It is essential to build a reasonable consensus through sufficient prior consultation among schools, medical staff, and parents."

Education experts warn that bodily exposure is an extremely sensitive issue for adolescent students, whose physical and emotional changes are rapid and profound. If feelings of shame or anxiety accumulate at health checkups, this could result in trauma that causes them to avoid such exams even in adulthood. Currently, some leading schools are experimenting with various compromise measures, such as making privacy partitions around examination areas mandatory or adopting special examination gowns that do not interfere with the checkup. As a result, attention is focused on whether the Japanese government will introduce more precise and standardized guidelines in the future.

This content was produced with the assistance of AI translation services.