OBJECTIVES: To determine the attitudes of male and female patients to the use of chaperones during genital examination within a sexually transmitted diseases clinic. STUDY DESIGN: An anonymous, self-completed questionnaire was administered to patients attending the Melbourne Sexual Health Centre, Australia, between September and October 2006. RESULTS: The participation rate among male and female patients was 60% (166 of 276) and 73% (153 of 210), respectively. Among male patients, only 7.3% and 6.0% expressed a desire for a chaperone when being examined by a male and female practitioner, respectively. Among female patients, 26.8% desired a chaperone if they were going to be examined by a male practitioner when compared with 5.5% for a female practitioner (P <0.001). Around one-third of male and female patients indicated they would feel uncomfortable having a chaperone present and this did not vary by the sex of the practitioner (P >0.48). For female patients being examined by a male practitioner, the desire for a chaperone was associated with having had a previous cervical smear (odds ratio, OR = 0.35, 95% CI: 0.12-0.98, P = 0.04) and feeling comfortable about the presence of a chaperone present (OR = 28.9; 95% CI: 11.1-75.0; P <0.001), but not age (P = 0.16) or previous genital examination (OR = 0.55, 95% CI: 0.21-1.45, P = 0.2). CONCLUSIONS: In a sexual health setting, female patients undergoing genital examination by a male clinician should be asked whether they would like a chaperone to be present.