There is no test to determine if a woman is a “virgin,” yet “virginity testing” still occurs. Virginity testing is a culturally-mediated practice that is poorly understood by western clinicians and is considered a human rights violation by major international groups. Global migration has increased requests for virginity testing in the west, but it also has been anecdotally reported in non-immigrant populations, such as the Orthodox Jewish community and among certain Christian fundamentalist groups. Last November, the American celebrity rapper TI made an appalling announcement that his daughter underwent “annual virginity testing” by a gynecologist.
The value of a woman’s virginity is deeply ingrained in some societies. The “virginity test” usually consists of examination of the hymen by a medical professional, with the false assumption that predictable changes to the hymen occur after first intercourse. In 2018, the United Nations (UN) Human Rights Office, UN Women, and World Health Organization issued a statement stressing that “virginity testing” was unscientific, a violation of human rights, and that “this medically unnecessary, and often painful, humiliating and traumatic practice must end.”
As a practicing clinician for over 20 years, I have been confronted with requests for virginity testing, but had no practical guidance from medical organizations. After contemplation and discussion with colleagues, we established patient-focused practical guidelines. A request for a virginity test from a consenting adult should be used as an opportunity to provide education and reproductive health services. I think a reasonable approach is to engage with the patient, learn about her reasons for wanting a test, and to understand the consequences to her if she does not obtain a “certificate of virginity,” which might include social or physical harms.
A request for a virginity test from a consenting adult should be used as an opportunity to provide education and reproductive health services.
Adopting a harm reduction model could include providing a certificate based on a complete history, with or without an external examination, only to document clinical observations. In most cases, the physical examination will not show evidence of prior vaginal penetration, which can be truthfully documented. A physical exam of minors should never be performed, and any exam without voluntary informed consent is sexual assault.
Following the media storm set off by rapper TI’s announcement, New York and California submitted bills calling for legislation to end virginity testing. I do not support criminalization of virginity testing, because it will drive the practice further underground, putting girls and women at risk. It will also result in lost opportunities to engage women in medical and reproductive health care.
History tells us that changing social norms, attitudes, and practices aimed at oppression of and violence against women and girls, including virginity testing, does not occur easily. Research on the sexual and reproductive issues of girls and women from communities where virginity testing and other practices are prevalent is urgently needed so that health systems can be designed to meet those needs.
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