During the trial ayres himself took the stand, and a good proportion of the questions that he was asked related to establishing the frequency and reasonableness of his "examinations."
The defense appeared to be trying to establish a pattern that would have some sort of clinical regularity or follow some consistent guideline.
The prosecution appeared to be attempting to show that the only consistency in his "examinations" had to do with his propensity to molest young boys, rather than out of any clinical need.
I think that ayres did a pretty good job of making the prosecution's point, all by himself, even before the prosecution had a chance to question him.
Some notes about what I've copied from court transcripts here: To the best of my knowledge, I typed them exactly as recorded, with some minor modifications: There are places that I omit portions of the text, usually when ayres is off on irrelevant tangents, or when he is elaborating further and it doesn't provide any added clarity. I use "[...]" to indicate that I've left something out. Also, the court record does not use the word "adolescent" in many places where it should, and instead uses the word "adolescence." (As in: American Academy of Child and Adolescence Psychiatry) Rather than append "(sic) to each incorrect useage, I have corrected these where they are clearly in error, and left them if ambiguous. I've also added headers in front of the sentences to clarify who's speaking.
For the majority of ayres' comments, I will simply leave them in chronological order. I am going to pull one or two Items out for later discussion, so they will not appear in order. Also, I'm going to start with some notes from the prosecution's questioning which actually came after the bulk of ayres' testimony, and then move back to the defense's presentation.
When the prosecution began their questioning, they started by asking ayres to recall statements that he had made in his earlier depositions for the civil lawsuit against him for his molestation of another young boy. That suit ended in a confidential settlement in 2005, with no admission of guilt from ayres.
The prosecution, in a successful attempt to show that the statements that ayres made during the criminal trial about the frequency and reasoning behind his "physical examinations" bore no resemblance to those that he made in the 2003 - 2005 civil lawsuit depositions, read to ayres and the court these statements from the transcripts:
Question: Under what conditions would you ask a male child to drop his drawers and look at his testicles?
ayres: "I can give three -- I , well, you know --- I would -- I can give you three, over the years that may be -- I think it's unusual. It's not a -- It would not be a common thing" "Poison Oak, complaints of rash, and there's something called Tinea Curious, which is jockstrap itch. And also I had a couple of kids who turned up with crab lice. But I would always say "you know, what's the problem?" and then I would always say, "Well, you know, you want to see your pediatrician.""And then later:
"if they were complaining of possibly having -- well, if they thought they had a hernia or they made comment that made you think they might have a hernia or some other deformity or some problem, like a missing testicle or some abnormal formation, or some concern that somehow the genitals were deformed or something like that, and Tinea Curious, as I mentioned before."On the whole, ayres, in his deposition, seems to have a reasonable frequency of exam, and the circumstances that he is stating seem to possibly warrant a physical: Three exams over the many years, unusual for him to do genital exams... severe rash in the area, "jockstrap itch," crab lice, hernia, abnormality in structure. Of course the real problem, which wasn't addressed to the satisfaction of the jury, is that ayres' was a shrink, not a pediatrician, and these kinds of medical problems and examinations should have been left to a fully competent pediatrician with current training and caseload.
Unfortunately for ayres' "patients," this relative infrequency of "medical examinations" that ayres is trying to represent, is a far cry from reality, and a far cry from even the statements that he'd spent the last two days making, which varied widely from not "giving" that many "examinations" all the way to... well, you'll see:
Defense Question: Did you in your practice, routinely give physical exams to every patient?So, there's an interesting point here, in that one of the common occurances in pedophiles is that as they get older, into their later seventies and eighties, their molestation fantasies and actions sometimes tend to decrease over time. I nearly choked when I heard this testimony.
Defense Question: You have heard that there are some people who advocate that psychiatrists should always give physical examinations. Do you advocate that?
ayres: No, I don’t. It might be salvatory. It might be good, but no, I don’t. And it’s fewer later, as I got older.
Defense Question: You mean, as your practice progressed you were doing fewer exams, fewer physical exams?
ayres: Yes, but I also got better at being able to read children [...]
Defense Question: You indicated that there’s been some decrease in the frequency with which you give physical exams as you got older and you were no longer in practice. Was there ever a time when you routinely gave physical examinations to adolescents?
ayres: No, not to every patient. The ones that I would examine are children in wheelchairs […] and I think if I had a child who had diabetes […] or something that they’re really struggling with, some kind of developmental disease like diabetes.
From the American Psychiatric Association (APA) Fact Sheet on Pedophelia:
Even after intensive treatment, the course of the disorder usually is chronic and lifelong in most patients, according to the DSM-IV, which is the reason that most treatment programs emphasize a relapse-prevention model. However, both the fantasies and the behaviors often lessen with advancing age in adults.
Defense Question: Is there any way that you can approximate for us how often in your practice, normal course of your practice, you would conduct a physical examination?So already we're seeing a VAST "physical examination" count difference between ayres' 2003 - 2005 civil suit statements and his current count. This also doesn't seem to correlate well with his number of "physical examinations" dropping off in later years.
ayres: Well, I would say probably once every couple of months. It varies because sometimes children complain and they ask me to look at something and that’s a physical exam, although it may not be a complete physical. But if you’re looking at something like a complete physical, it would be like once every two or three months, but partial physicals it would be more often.
Defense Question: When you say “physical exams” Do you distinguish between physical exams that do and physical exams that do not involve the genetalia?
ayres: Well, certainly when you do a complete physical, you – as a pediatrician, you should do a complete physical. That means that you listen to the heart and lungs and feel the belly […] and in boys – in the case of a boy, you should check and make sure where the testicles are in what state the – what’s in the scrotum, if there is foreign objects – not foreign objects from outside, but there are lots of different cysts and other kinds of malformations. So it’s – Now I’ve lost the question.
We've also now clearly established that in most cases, when ayres is talking about "giving" "physical examinations," he is including genital "examinations" which he alleges are comprised of feeling the testicles (and looking for pubic hair as you'll see later...) at the very least. (Please keep in mind, during this lengthy discussion of "medical examinations" that his exams actually included his attempts to stimulate the penis (masturbation) and in at least some cases prolonged digitial manipulation of the prostate in attempt to cause ejaculation, among other things which are clearly not "medical procedures")
Also of note... every time ayres begins talking about the testicles and penis of young boys, he begins to excitedly expound, and frequently gets "lost" and has to stop himself. Equally often, the defense attorney has to stop him with a detracting question to move him off the subject of the genetailia of little boys.
Defense Question: What kind of circumstances would lead you to give a physical examination?Well, ayres seems to get started on the accepted party line, (Well... accepted for pediatricians and physicians, but not really for psychiatrists...) exams only for the really odd stuff that would make sense. Then he branches into getting adolescent boys to take their shirts off in the in the ultra-rare circumstance that they develop acne. Imagine that... every once in awhile (maybe three over the course of several years, or maybe once every two or three months) one of the thousands of adolescents he was seeing would get a pimple. SHOCKING... let's rip that shirt off... after all... ayres took a CLASS on acne!
ayres: Well, as I said, if they have an established illness, orthopedic, or diabetes, or asthma or things like this, then I would like to sort of do a physical and get to know them, so that they know that I know their physical structure.
And then there are those who ask for it. The will say that they have a pain here or they’re worried because they’re having skin trouble. A lot of adolescents tell me that they have acne, and they don't take their shirt off when they see their pediatrician, because they have acne all over their back. And I would say, "Well why don't you let me look at it and I would -- Because I know quite a bit about acne. In fact, I've taken a course in acne.
So there are times when children will come with sort of specific areas of focus, and it’s obvious that it’s something of concern to them […] and if you talk to them all the time so they hear your choice, it’s all right to do physicals. And many of them will relax if you start asking them questions, which is always a good sign.
Incidentally, you're going to see lots and lots of comments about ayres patients "asking for it." This is a very common (very, very, very, common) trait in pedophiles. They frequently claim that the child asked them for sexual contact, or that they were educating a child about sexuality. It's so common that it sickens me every time he says something like: "I did a medical exam if the child asked for it..."
Apparently, we all liked to have ayres do all kinds of "examinations" and were always asking for it, as they help us to relax, and develop a relationship.
And by the way: I suspect that the "good sign" that ayres is always talking about is the indication that he's getting that likely we're going to keep our fucking mouths shut, and that he's going to get away with diddling yet another kid. I could be wrong...
Defense Question: What do you see the relationship to be between you as a psychiatrist and the child's pediatrician?Translation: Pediatricians: big FAIL. Horny Pedophile Psychiatrist: the BOMB.
ayres: [...] You know, the pediatricians are more and more pushed economically by having less and less pay for shorter and shorter time, so that it's difficult for pediatricians to spend time with patients the way they used to. But a lot of the examinations that were done by pediatricians are very quick and not very thorough and are just focused on just getting through it, and that's not what a physical exam is for a psychiatrist.
Defense Question: If there was a specific issue or specific complaint relatively limited in scope that you could check out yourself, would you send the kid to the pediatrician, rather than checking it out yourself?Translation: Try to answer this one specifically and without incriminating yourself further, you sick fuck...
ayres: I would probably -- I would probably, if the child was asking me to check it out, I would check -- I would check it out, but if it was something I knew about, If it was something that I didn't -- But I know a lot about a lot of things, so I would.Translation: I can pretty much find whatever excuse to do an "examination..." why would I send them to some stupid pediatrician?
Defense Question: I understand that you were willing to give and ready to give physical examinations to the extent you believe they were appropriate, correct?Right. Got it... You were always willing to do an exam, and we all wanted it really badly... you keep telling us that... got it...
ayres: Yes. And that the child was accepting and that it was okay with the child.
Defense Question: I just want to be clear, did you routinely do medical examinations or physical examinations in all cases in which you mentioned the possibility to the parents?If there doesn't appear to be a reason to do a medical exam that the parents will believe, you'll just wait it out and THEN find something to use as an excuse. You know... not rush it... just ease into it... but definitely "do it."
ayres: No. No. I would say that in case it turned out -- And there are many, many cases that I know right from the beginning that there sounds like there's nothing related to a physical exam. And I would -- I would -- what I would do is I would wait until I saw them the second time, and I would say, "I think it might be useful to do a physical sometime along the way." You know, not rush it but to do it.
On Gynecomastia:OK.. JACKPOT so in 40 percent of your male "patients" you've pretty much got a built in guarantee that you're going to be able to AT LEAST get their pants off to have a good look at their pubic hair, and a good chunk of the time, you're going to "need" to cop a feel, too.
ayres: In 40 percent of males, you have on either one side or both sides, you have a small gynecomastia, which can be as small as a penny or a dime [...] So it's very variable, and it's very embarrassing. Boys -- some boys don't notice it [....] Others find it very upsetting and worry that it's breast tissue [...]and I would look at it.
Defense Question: What would you examine?
ayres: Well, I have to -- what you want is a Tanner scale, because if it comes before Tanner three or at least Tanner two, then you'd wonder where the hormones are coming from [...] So I said, "Well, we need to take a look and see, " because I mean, if you see that Tanner, Tanner one is -- Tanner zero is what little children would look like. They don't have any development. Tanner one is when you have small hairs that are not pigmented, so there's -- and they get sort of wavy and they started on either side of the penis. And Tanner two, the hairs turn black in color. And then you know that there have been -- hormones [...]
Defense Question: Did you have any hesitation in providing a physical examination to a patient who had expressed concern about his gynecomastia?
ayres: No. I would do that. I would check to make sure. And of course, if they're early, like a tanner two, you can't just look at the scrotum and tell the size of the testicles, so it's -- yes.
This is beginning to seem like a far cry from that three exams over many years, or the one every three months that we were talking about earlier!
So is 40ish percent the BEST you can do?
ayres: There are some children who are very skittish [...] So there are some that I wouldn't -- wouldn't do a physical. Sometimes I wouldn't do it until something came out, if the child had a real belly pain, and almost all the time, if you have children you know that they have belly pain now and then. So if they walk in and they have a belly pain, then I might do a physical at that time.Let's just look at that again (Just the important phrase):
"Almost all the time, if you have children you know that they have belly pain." If "they have a belly pain, then I might do a physical at that time."
And once again (Logical Tautology this time):
Almost all the time, I do a physical.
Didn't take long to get to this point did it?
So are we to infer from all of this that ayres pretty much did "physical examinations" on all of his patients?
Oops... I left this part out earlier:
Defense Question: Did you examine female patients?SO: Even though ayres is "First of all, a physician; and, secondly, then a psychiatrist" I guess girls are only second rate in ayres' eyes.
ayres: No, I wouldn't do physical on females. I would do physicals on part of females. [...] I had a girl complain she had a red skin problem. and she pulled down her, her neckline so I could see it [...]
Defense Question: Why did you not examine females?
ayres: Well, because I don't have access to someone who would be in the room at the same time. And I can tell you, adolescent girls would not want their mothers there. [...] but it's -- girls, at least with me, when I've had a chance to be seeing a girl and they talk about things, they would be very open about it. And I've had to stop them, because girls who have very large breasts, it's very difficult for them when they're young and they want surgery and all this. And if you don't watch out, they'll pull their stuff down and bring their breasts out, so I would have to say "Stop, stop, stop." [At this point, ayres is waving his hands in an "Icky -- don't show me that" Truman Capote-esque effeminate fashion.] "You know, "Don't show me that."
Defense Question: Were you ever taught that you needed that somebody present when you examined a boy?
ayres: No. At Yale, in pediatrics and...
Defense (Changing the subject): Was there -- when you looked at sombody or examined them, you would sometimes make observations, correct?
Defense Question: You have your own personal philosophy of how to be a psychiatrist, do you not?
ayres: Well, yes. But I read everything, and I'm not some sort of strange -- I wouldn't have had all those jobs. I'm pretty, pretty much the accepted model.
Lordy, How I'd hate to have all those girls waving their boobies in my face.
There are links to more quotes from ayres' testimony on the
In ayres' Own Words link on the main page.