Trigger Warning: This article contains discussion of a range of gender-based violence, mental health issues and medical procedures
Hymenoplasty and virginity-testing procedures are to be banned across the United Kingdom. The legislation is part of the government’s wider Tackling Violence Against Women and Girls Strategy. The move will criminalise the procedures on the grounds that they are never medically indicated but rather are based on false cultural myths about female virginity, and often result from coercive pressure by family. This change is backed by women’s rights campaigners as well as many doctors, though some express concerns it increases potential risks by forcing the procedures "underground".
Hymenoplasty is a surgical procedure which reconstructs a woman’s hymen usually with the aim to make a woman or girl bleed when they next have intercourse. In contrast, virginity testing is a procedure which tests whether a woman’s hymen has been torn. The rationale for the procedures is often based upon myths surrounding virginity and women’s sexual status including that virgin women have intact hymens and will bleed during their first sexual intercourse.
The myths that intact hymens or blood are reliable indicators of virginity are contradicted by substantial medical evidence. In addition, both procedures are associated with physical risks and psychological harm including depression, low self-esteem and suicide.
The Royal College of Obstetricians and Gynaecologists (RCOG) report that it is unknown how prevalent these procedures are as they are often done privately and very little data is available. However, charity Karma Nirvana worked with the BBC in a joint investigation and found that hymenoplasty is offered by at least 21 clinics in the UK and the procedure has been carried out 69 times in the last 5 years.
The myths about virginity are significant because they are embedded in many patriarchal cultural norms. For instance, the Iranian and Kurdish Women’s Rights Organisation (IKWRO) describes that many women and girls are expected to demonstrate their virginity on their wedding night by bleeding onto a sheet, with even the sheet being used as "proof" of virginity.
If girls and women fail to live up to these myths, they can be subject to huge amounts of shame. Middle Eastern Women’s Society Organisation (MEWSO) emphasises that in some communities, it is the father’s "honour" to ensure his daughter is "untouched" and the responsibility for a daughter's virginity is placed on her mother. As a result, many of the patients who undergo these procedures do so as a result of pressure from close family. They may be subject to coercive control and may not give consent themselves. These procedures are a form of “honour” based abuse which is defined as controlling behaviour within families or other groups to protect honour or other cultural beliefs.
RCOG reports that many women and girls may not be aware that hymenoplasty procedures do not guarantee bleeding which can leave them at even greater risk of their wedding night. Moreover, the IKWRO suggests the patients may also be at risk of related harmful practices such as female genital mutilation and forced marriages.
Forced hymen examinations are a form of inhuman, cruel or degrading treatment according to the Universal Declaration of Human Rights (UDHR, and in some circumstances are thought to amount to torture. The European Court of Human Rights (ECHR) found that virginity tests on detained women in the case of Salmanoglu and Polattas v Turkey breached the prohibition of torture and inhuman or degrading treatment or punishment as defined by the European Convention on Human Rights. However, these pertain to cases where the procedure is a result of force and do not preclude the procedures being done with the patient’s consent.
New Recommendations For Legislative Ban
The report by the Home Office highlighted that extensive pressure from families makes it difficult for clinicians to assess whether consent is freely given and not a result of coercion. As a result, it concludes a legal requirement for consent would be an insufficient way of protecting girls and children.
The recommendations outlined in the report include making the performance of a hymenoplasty a criminal offence as well as prohibiting virginity testing. Alongside, they recommend investment in training, guidance and resources for organisations and charities which support and safeguard women and girls who are victims of coercion. The panel drew on evidence from the criminalisation of Female Genital Mutilation (FGM) and how it challenged cultures and myths which regard it as acceptable.
The legislation will also include that the arrangement of a hymenoplasty on behalf of another person will be criminalised. This applies extraterritorially meaning that women and girls could not be taken to other countries to have the procedures. Furthermore, the laws will protect the women or girls subject to these procedures so they would not be liable to criminal offences.
Opposition to New Legislation
Dr Dheeraj Bhar, a cosmetic surgeon, disagrees with the ban. He highlights that a ban rather than an increase in regulation may increase the risks patients face because it drives them "underground" to "back alley" doctors. A similar issue is often discussed with regard to abortion whereby making the procedure illegal does not stop people seeking it, rather they continue to do so at a greater risk to themselves. The report acknowledges this risk but the only suggestion it offers for mitigating it is to review the impact of the ban after a short period.
The report recommends against any exemptions to the new legislation. This is in contrast to the prohibition on abortion after 24 weeks, where exemptions are permitted when it is strongly in the patient’s interest (e.g. if the mother’s life is at risk). Some clinicians argue hymenoplasty exemptions should be permitted because they can protect women against honour-based abuse by producing results which meet the expectations of the cultural beliefs. However, the government’s report dismissed this rationale on the grounds that it is not a reliable form of protection. Hymenoplasty is often ineffective at making women bleed during intercourse and it is argued women and girls are at further risk if it is discovered they underwent the procedure.