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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have a 5 year old daughter who is refusing to wear

Customer Question

I have a 5 year old daughter who is refusing to wear underpants or anything on her bottom half. It has gotten to the point where over the last few days she refuses to leave the house as she does not want to wear underpants or shorts or anything! He paediatrician said she has atrophic vulvovaginitis. She started off just wanting to wear a certain pair of undies every day and now it has progressed to wearing nothing. I am at my wits end. I don't know what to do. Getting even a pull up on her for over night use is a screaming, kicking crying frenzy... I am so desperate please help me. I have made an appointment with a psychologist but they are not open until January 11. I don't know what to do.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. May I ask is your daughter in pain from the Atrophic Vulvovaginitis? When asked why she does not want to put underpants on, how does she respond?

Customer: replied 1 year ago.
She just says it doesn't feel good. She keeps touching it and irritating it even more.
Customer: replied 1 year ago.
I just asked her and she said it doesn't hurt but it's annoying.
Expert:  Dr. Z replied 1 year ago.

It is possible this may be more medical than psychological if the underpants irritate her (and she is irritating it even more). Your daughter may benefit from a vaginal lubricant or anti-itch cream which can help to lessen the irritation and feelings of being uncomfortable, then she may be more apt to putting on underpants and pants. Also for the time being try to see if she would be open to long dresses, baggy sweat pants, etc...overall something loose to at least provide some cover-up. If this is psychological though than a positive/negative reinforcement, and punishment approach would be best. Here is where you want to focus on setting up a tier balance of rewards (e.g. if she can go the whole day without touching or irritating her groin area than she gets an extra treat for dessert), and try to increase the rewards based on what you feel is appropriate. For example if she wears something on her bottom half for a whole day than an extra hour of tv, if she does it multiple days in a row than another good reward like a new toy. You want her to know about these rewards to give her something to look forward to and if she does not comply with it than you take away the rewards as negative reinforcement. For punishment, you want to not yell or smack as that will not help, but instead take away positive things in her life like her favorite toys, tv time, play time, etc...This is not going to be a short process as it could take a few weeks to months to really make a difference in her behavior. A combination of the medical, clothing, and psychological approach could be appropriate too.

Customer: replied 1 year ago.
I have done some research and found some informative information from the RCH. I will try their suggestions and try and make it less uncomfortable for her. The reward program sounds promising and she responds better to positive reinforcement but I just become so frustrated at times... Hopefully things will improve.
Expert:  Dr. Z replied 1 year ago.

Its okay to be frustrated at times (welcome to parenthood), but try to maintain your composure as you do not want your daughter to feel shame as that can only worsen the situation. This could just be a phase or a legitimate medical concern where the underpants cause her to feel uncomfortable, itchy, mild pain, etc...The good news is that this will resolve and you are being proactive in her treatment, so try to be as patient as possible

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