Once again, you are making sweeping generalizations.

It is not that hard to refer out, but it is arrogant to assume you don't need to.

Do you think that I, a licensed massage therapist, did all the medical procedures to resolve a case of testicular cancer? Obviously, I made the proper referrals.

What I do not think you are acknowledging is that athletes and most men require some pushing to get that extra help they need. I do not think it controversial to point out that guys in general avoid seeing the doctor. They assume that they can tough out the pain.

Along those lines, the point of doing a hernia check is that it establishes the credible diligence to show that an actual issue likely exists, which in turn will help persuade that guy to actually go to the doctor. Same with a testicular exam.

You cannot point to any law that says this is illegal. Even if there turns out that it was not to be a hernia or testicular cancer or anything else, it still would not be illegal.

The only times when this would be illegal is if the client, after discussion, requests you not to do anything and you still do it, thinking that you know better. This has never happened to me, but if a client told any therapist to stop and the therapist did not, that would be assault, a different violation of licensing that is not even close to this issue of improper diagnostic behavior.