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Virginity testing: recommendations for primary care physicians in Europe and North America

Published on Jan 1, 2020in BMJ Global Health
· DOI :10.1136/bmjgh-2019-002057
Sondra S. Crosby9
Estimated H-index: 9
(BU: Boston University),
Nicolette Oleng (BU: Boston University)+ 1 AuthorsRanit Mishori4
Estimated H-index: 4
(Georgetown University)
Abstract
Virginity testing is a complex, culturally mediated practice that is poorly understood by Western clinicians. While advocating for global elimination of the practice of virginity testing as a human rights violation, clinical practice is often more complicated and ethically nuanced, and the clinician must act in the best interest of her patient. Upholding human rights does not have to be incompatible with providing a needed service to a patient, which should never include an invasive exam if not medically necessary, but should include education and safety assessments.
  • References (13)
  • Citations (0)
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References13
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#1Ranit Mishori (Georgetown University)H-Index: 4
#2Hope Ferdowsian (UNM: University of New Mexico)H-Index: 1
Last. Thomas McHale (Physicians for Human Rights)
view all 5 authors...
Conclusions about women’s and girls’ sexual history are made in some settings based on assumptions about the hymen, a small membranous tissue with no known biological function, which typically occupies a portion of the external vaginal opening in females. Clinicians, however, continue to refer to changes in the hymen to assess for a history of consensual or nonconsensual sexual intercourse. We reviewed published evidence to dispel commonly held myths about the hymen and its morphology, function,...
Source
Last. Duarte Nuno VieraH-Index: 1
view all 31 authors...
3 CitationsSource
#1Rose M. Olson (UMN: University of Minnesota)H-Index: 1
#2Claudia Garcia-Moreno (WHO: World Health Organization)H-Index: 33
Abstract Background So-called virginity testing, also referred to as hymen, two-finger, or per vaginal examination, is the inspection of the female genitalia to assess if the examinee has had or has been habituated to sexual intercourse. This paper is the first systematic review of available evidence on the medical utility of virginity testing by hymen examination and its potential impacts on the examinee. Methods Ten electronic databases and other sources for articles published in English were ...
1 CitationsSource
#1Amirhossein Moaddab (BCM: Baylor College of Medicine)H-Index: 8
#2Laurence B. McCullough (Cornell University)H-Index: 47
Last. Alireza A. Shamshirsaz (BCM: Baylor College of Medicine)H-Index: 20
view all 8 authors...
Objective To assess patterns of honor-related practices—including virginity testing, virginity restoration, and female genital mutilation (FGM)—among US obstetrician–gynecologists (OBGYNs). Methods Between June 1 and August 31, 2016, 1000 members of the American College of Obstetricians and Gynecologists were invited by email to complete an anonymous online survey. The survey comprised 42 questions evaluating the demographic and practice characteristics of the respondents. Results Overall, 288 o...
Source
#1Amirhossein Moaddab (BCM: Baylor College of Medicine)H-Index: 8
#2Laurence B. McCullough (BCM: Baylor College of Medicine)H-Index: 47
Last. Alireza A. Shamshirsaz (BCM: Baylor College of Medicine)H-Index: 20
view all 5 authors...
Introduction Doctors around the world might be asked to provide virginity testing. The ethical framework for the assessment of the physician’s role in virginity testing is based on the professional responsibility model of ethics in obstetrics and gynaecology and its three core ethical principles: benefi cence, respect for autonomy, and justice. Benefi cence-based objections are that virginity testing has no clinical indications and has substantial biopsychosocial risks. Autonomy-based objections...
3 CitationsSource
#1Mehri Robatjazi (Shahid Beheshti University)H-Index: 1
#2M SimbarH-Index: 16
Last. Hamid Alavi MajdH-Index: 17
view all 7 authors...
Apart from religious values, virginity is important in different communities because of its prominent role in reducing sexually transmitted diseases and teen pregnancies. Even though virginity testing has been proclaimed an example of violence against women by the World Health Organization, it is still conducted in many countries, including Iran. 16 in-depth, semi-structured interviews were conducted with participants aged 32 to 60 years to elucidate the perceptions and experiences of Iranian ex...
2 CitationsSource
#1Kevin Gary Behrens (University of the Witwatersrand)H-Index: 4
1 CitationsSource
#2Sylvie SchusterH-Index: 1
Last. Pd Brigitte Leeners Md (UZH: University of Zurich)H-Index: 1
view all 6 authors...
Introduction As a result of transnational migration, health institutions are faced with growing demand for “restoration” of virginity. The practice of hymen reconstruction constitutes a challenge for health care providers in medical, ethical, judicial, social, and cultural dimensions, for which they are not well prepared. Aim The aim of the presented nationwide survey was to investigate the experience of Swiss gynecologists with women requesting hymen reconstruction. Methods A questionnaire spec...
7 CitationsSource
#1Birgitta Essén (Uppsala University)H-Index: 28
#2Anna BlomkvistH-Index: 1
Last. Sara Johnsdotter (Malmö University)H-Index: 19
view all 4 authors...
An important determinant of family honour in many cultures is the chastity of women, with much importance attributed to virginity until marriage. The traditional proof of virginity is bleeding from the ruptured hymen, which has led some women to request genital surgery to “restore” virginity, or hymen repair. The aim of this study was to investigate whether Swedish health care providers have had experience of patients requesting this surgery. Questionnaires were sent to 1,086 gynaecologists, mid...
32 CitationsSource
#1Jim Anderst (UMKC: University of Missouri–Kansas City)H-Index: 4
#2Nancy D. Kellogg (UMKC: University of Missouri–Kansas City)H-Index: 23
Last. Inkyung Jung (University of Texas Health Science Center at San Antonio)H-Index: 11
view all 3 authors...
Objectives: The goals were to evaluate the association of definitive hymenal findings with the number of reported episodes of penile-genital penetration, pain, bleeding, dysuria, and time since assault for girls presenting for nonacute, sexual assault examinations. Methods: Charts of all girls 5 to 17 of age who provided a history of nonacute, penile-genital, penetrative abuse were reviewed. Interviews and examinations occurred over a 4-year period at a children's advocacy center. Characteristic...
32 CitationsSource
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