Its rare for younger girls to have or need pelvic exams – usually an exam isn’t needed until 12 or 13 at the earliest. But, in some cases, they are required sooner. Usually an exam will be done sooner if sexual assault is suspected and needs to be confirmed or if there are health problems such as vagina pain, etc.
Girls under ten are almost always fully sedated for a pelvic exam – its usually done in hospital while they are totally asleep. From ten to twelve, the doctor along with the parents determine the best option. While full sedation may be required, girls who are more mature can easily undergo the exam while awake.
At first glance, it would seem best to require any girl suspected of sexual abuse to be sedated for the exam, but the sedation can also cause a feeling of helplessness in the girl that is stronger than having the exam while awake.
Your doctor and you as a parent will make the best decision.