A quarter of a century ago, one of the nation's most respected child psychiatrists stood in front of his colleagues and dropped a bombshell.
With characteristic confidence, Dr. William Ayres suggested at a Bay Area conference that psychiatrists should assess the sexual development of their adolescent patients by conducting intimate physical exams. It was important, Ayres contended, to determine whether a patient had reached what were known in the profession as Tanner stages -- milestones of sexual development, such as the development of pubic hair.
Most of Ayres' peers weren't comfortable doing much more than weighing a patient in order to gauge the proper dose of a medication. Anything more, certainly anything that involved undressing, would be handed over to another physician.
"My training was very strict on that," said Hugh Wilson Ridlehuber, a retired child psychiatrist who said he was present for Ayres' presentation and once worked out of the same group practice as Ayres. "Even if it's done innocently, there is a very high risk of a patient sexualizing it and affecting your relationship with the patient."
Ayres was arrested Thursday at his San Mateo home and charged with molesting male patients.
Although the psychiatrist is not expected to enter a plea until next week, he maintained in a past civil case that he was not molesting his patients but was conducting physical examinations in the course of his job. In a deposition in that case, Ayres said that there was no "standard of care that says it's inappropriate" for a child psychiatrist to conduct physical examinations.
Police and prosecutors said he could try to use a similar defense in the criminal proceedings. "We are prepared for that defense," one of the top officials behind the case said Friday, speaking on condition of anonymity. "But I don't care what Bill Ayres thinks he was doing. It was molestation."
In an interview Friday, an alleged victim described how, when he was 12, Ayres conducted a physical examination of his genitals, prescribed a medicinal cream, applied the cream to his penis and molested him. The man said he was sent to Ayres because he was introverted and socially undeveloped.
"How is that [treatment] relevant to a behavioral emotional problem in a child?" said the alleged victim, now 43 and a Los Angeles-area resident who works in the television industry. "That's wrong. That's clearly wrong. What is he going to say, that I misinterpreted a physical examination? I'd like to see him try that."
Ayres was not charged in connection with the man's allegations because they fall outside the statute of limitations, but the man has been interviewed by authorities and could be asked to testify in a criminal trial. The man said he was sent to Ayres as a 12-year-old in 1976. Like many of the alleged victims, he did not tell anyone about the incident for years, he said, because he was confused and embarrassed.
"I had a sense that this was not right," he said. "I tried to convince myself that it was legitimate. Over the years I realized I had been molested."
Ayres, a past president of the American Academy of Child and Adolescent Psychiatry, practiced in the Bay Area for nearly 40 years and was considered one of California's preeminent child psychiatrists.
He wrote and narrated a widely disseminated sex education television series called "Time of Your Life," which was seen by tens of thousands of pre-teen students. Scores of youths were referred to his practice by local schools and the juvenile justice system -- some after authorities had received complaints about alleged molestation.
Ayres, 75, has been charged with 14 counts of conducting lewd and lascivious acts on children under age 14. The 14 counts involve three alleged victims, officials said Friday, all of whom say they were fondled repeatedly when they were boys in the early and mid-1990s.
Ayres' defense attorney did not return phone calls seeking comment.
San Mateo County Deputy Dist. Atty. Melissa McKowan said prosecutors think there were "many additional victims" whose cases were too old to fall within the statutes of limitations -- a formula incorporating the age of the victim today and the date of the alleged offense. That limitation, imposed by the U.S. Supreme Court in 2002, is "a huge source of frustration," McKowan said.
"I understand it. Constitutionally, it makes sense, and of course I am obliged to abide by that," said McKowan, who is assigned to her department's elder abuse and sexual assault units. "But the idea that people who spend a lifetime molesting children ... don't have to be held accountable for that, of course it frustrates me. It frustrates the whole system of justice, in my opinion."
At Ayres' first court appearance Friday, Superior Court Judge Thomas McGinn Smith lowered Ayres' bail to $250,000 from $1.5 million, over the strident objections of prosecutors, who fear he might try to flee the country. Officials believe that Ayres, who recently sold his home in the San Mateo area, can meet the requirements of the reduced bail and will be released if they cannot persuade the court to increase bail during Ayres' scheduled court appearance next week.
"His ties to the community are beginning to diminish," McKowan said. "Anybody facing the number of charges and the amount of time he's facing poses a flight risk."
Each of the 14 counts could bring a maximum penalty of eight years in prison.
McKowan said prosecutors would be ready with a strong argument for increasing bail, in part because additional alleged victims contacted officials Friday after reading or viewing media coverage of Ayres' arrest.