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The myth of the hymen
Abstract
The hymen can be ruptured during sexual intercourse, but also in many different, non-sexual ways. In cultures where female virginity is highly valued, premarital defloration is a source of shame for both the girl and her family. Thus, these young women, including brides whose virginity cannot be demonstrated at their wedding, run the risk of public humiliation, repudiation, violence, etc. Considering these sanctions, some girls feel forced to request a surgical repair of their hymen. Nevertheless, gynaecologists may refuse to comply with requests to undertake a hymen reconstruction. To justify this point of view, they esteem that this type of medical surgery is misleading and not medically indicated. Furthermore, a double moral standard is maintained: young women - but not men - are expected to remain virgins until their marriage. On the contrary, hymen (re)constructions are justifiable when considered as procedures improving the mental and social well-being, and consequently the overall health of the patient. Moreover, the decisions taken by competent women concerning their own body should be respected. Hymen (re)constructions are in many ways distinguishable from female genital mutilation (FGM).
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Defenders of multiculturalism have been recently criticized for failing to address gender inequality in minority cultures. Multiculturalism would seem incompatible with a commitment to feminism. This article discusses two empirical cases that pose a problem for public policy in the Netherlands: a conflict over wearing headscarves (hijab) and requests for surgical hymen repair. These cases evoke widespread public controversy, in part because they are presumed to express or accommodate traditions in violation of women's rights and thus raise the question of tolerance. While recognizing the potential discrepancies between feminism and multiculturalism, the author argues that committed feminists can be multiculturalists as well, and that good feminism might well require acts of multiculturalism. In addition, she advocates a contextual approach to tolerance. Her argument is that general justice arguments are too indeterminate to make for good judgement in concrete cases. The national political culture and institutional setting in which multicultural conflicts take place should be considered as morally relevant factors and co-determine our moral considerations. The dispute over feminism and multiculturalism cannot be settled in abstracto. Using a contextual approach, the author argues that wearing a headscarf and hymen repair are justifiable and consonant with feminist concerns in the Dutch educational and medical contexts.
Curiosity provoked by the hymen among laity and learned, is disproportionate to its dimensions. Embryologically, it is a membranous remnant at the junction of sino-vaginal bulb and mullerian ducts. Although originally it was considered as a vestigial structure, its evolutionary role in protecting female infants from pelvic infections has recently been pos-tulated [1]. Until now, surgery of hymen is largely limited to ‘hymenotomy’ when it is congenitally imperforated. In this issue of Indian Journal of Surgery (2009; 71:221–223) Vishwa Prakash has described his technique of hymeno-plasty (more correctly hymenorrhaphy). This unusual paper provokes several scientifi c, ethical and social concerns. First of all, why would somebody seek reconstruction of torn hymen? Intact hymen is long held as a sign of virginity. Blood stained bed-sheets are expected on nuptial nights and they are vividly portrayed in popular cinema to represent bleeding from ruptured hymen on defl oration. Deviation from this hegemonic, religious expectation has harmful repercussion on the woman which ranges from shame to ‘honour killing’ [2]. This misconception must have origi-nated probably because of phonetic resemblance between the two Greek words “Hymen” and “Hymn”. The word “hymen” means “membrane” as evident from terms such as “hymenology” (anatomical study of membranes), “hyme-nopterons” (insects with membranous wings) and “hyme-nolepis” (tapeworms with membrane suckers). According to some etymologists, even the word “human” originated from the root word “hymen” because human fetus is cov-ered with amniotic membrane during gestation. Appropri-ately, membranous remnant of vagina is termed as “
This paper addresses modern Turkish medicine as arbitrator of two modern medical practices: virginity surgery and virginity tests. These medical procedures are currently practiced by medical doctors [obstetrician-gynecologists (ob/gyns)] in modern Turkish society. The virginity of unmarried women has had a great significance for many cultures. The taboos on pre-marital sexual relationships contribute to this social anxiety over the hymen of women. In this respect, in contemporary Turkish society medicine plays a significant role in controlling and reconstructing women's bodies through virginity tests and virginity surgery. The aim of this paper is to contextualize these medical practices within liberal gender ideology and discuss the connection between patriarchal expectations about the virginity of the bride and medicine as an institution. In order to assess the perspectives of the physicians, thirteen in-depth interviews were conducted with Turkish ob/gyns.
Female genital mutilation (FGM)--previously known as female circumcision--was criminalised in many countries in the 1990s. This occurred mainly in Western nations and responded to the perception that FGM was intended to subjugate women and was an abuse of human rights. However, other female genital surgical procedures have a totally different intent and are designed to restore the integrity of the hymen, correct deformity or simply enhance the appearance of the female genitalia. Such procedures, unlike FGM, are performed on women who have reached the age of consent and who request the surgery themselves. Restoring the integrity of the hymen (so-called "hymenoplasty") can erase evidence of the sexual history of a woman. "Revirgination" may have particular importance to women contemplating marriage in cultures where a high value is placed on virginity Some commentators have equated hymenoplasty with corrective surgery intended to restore the condition of female circumcision--techniques which are prohibited by most Australian criminal statutes. However, the medical, ethical and human rights arguments against FGM are not easily extended to revirgination and other cosmetic genital surgery. This article examines whether revirgination surgery has effectively been criminalised in Australia and whether this is appropriate from a medical and ethical perspective.
The increase in migrant populations in western Europe has led to specific problems and dilemmas in the area of sexual and reproductive health and service provision. In general, these problems and dilemmas can be divided into four categories: (1) epidemiology of diseases and risk factors; (2) psychosocial and cultural aspects; (3) communication; and (4) moral and ethical dilemmas. Regarding epidemiology, there is an increased prevalence in migrant groups of unwanted pregnancy and abortion, HIV/STDs, and sexual violence. Effective contraceptive use is hampered by knowledge deficits, uncertain living conditions, ambivalence regarding the use of contraceptives, and problems accessing (information on) contraception. Psychosocial and cultural aspects relate to the norms and attitudes individuals and groups have regarding the family, social relationships, sexuality, and gender. These norms and attitudes have an impact on the sexual and reproductive choices people make and the possibilities and restrictions they feel in this respect. Problems in communication concern not only language but also communication styles, the way patients present their problems, and the expectations they have from the service provider. Communication problems inevitably lead to a lower quality of care. Moral and ethical dilemmas arise where cultures collide, for example regarding sexuality education and virginity problems. Two examples of practical situations in which migrant patients ask for help with sexual or reproductive health problems will be described.
Charged with personal, societal and legal significance, the hymen, as a fold of flesh, has the power to rule the sexual identities of unmarried women in Turkey. This article examines the forms and associated meanings of contemporary challenges to virginity rules among educationally advantaged, upwardly mobile young women. The article demonstrates that in the process of negotiating often contradictory expectations of their sexual behavior, young women cultivate purposefully ambiguous identities related to their state of virginhood. The author calls these identities ` virginal facades' and explores their complex and contradictory implications. The author highlights an important normative shift from a focus on the physical reality of virginity to a focus on the moral expression of virginity, and emphasizes the intricate connection between social class and women's sexuality experienced by some young women as sexual guilt.
Introduction
During this century many immigrants from Mediterranean and African countries have moved to western Europe.1 Second and third generations often face a conflict. They may follow the lifestyle of the new country and friends but have to remain mindful of the original traditions and attitudes of their families.
Many immigrant groups hold strongly with the tradition that girls must be virgins when they marry. If the bride cannot show her bloody sheet after the wedding night, her family are shamed. Her new husband's family may exact revenge in the form of violent reprisals and banishment of the bride. Because of these far reaching consequences, many gynaecologists in the Netherlands are willing to …
In Islamic culture, there is an imperative demand that women should be virgins on their wedding night. Service providers in The Netherlands are increasingly confronted by Islamic young women who find themselves in serious difficulties because they are no longer virgins, and are about to enter a forced or arranged marriage. These young women report a diversity of problems such as loneliness, social isolation, depression, despair, suicidal feelings, identity problems and serious conflicts with parents. In this article we focus attention on the circumstances that can result in these types of difficulties, and also critically consider the kinds of help that young Islamic women are given. Attention is paid to the question of whether existing forms of service provision, especially surgical reconstruction of the hymen, take sexual and other inequalities into account.
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, midwives, youth welfare and social officers, and school nurses and doctors in four Swedish cities. Of the 507 who returned the questionnaire, 271 had seen patients seeking virginity-related care. Of these, 14 had turned the patients away; 221 had made 429 referrals, mostly to a welfare officer or a gynaecologist; and 26 had referred patients to a plastic surgeon. Nine gynaecologists had carried out such surgery themselves. Swedish authorities have to date focused on this issue primarily from a social and legal perspective. No guidelines exist on how health professionals should deal with requests for surgery to restore virginity. Further research is needed on how best to meet the needs of this group of patients in a multi-ethnic society and how to address requests for hymen repair. Without this, medical practitioners and counsellors will remain uncertain and ambivalent, and a variety of approaches will persist.
Résumé
Dans bien des cultures, la chasteté des femmes est un déterminant essentiel de l'honneur familial, la virginité jusqu'au mariage revêtant une grande importance. La preuve traditionnelle de la virginité est le saignement lors de la rupture de l'hymen, ce qui incite certaines femmes à demander une chirurgie génitale pour « restaurer » la virginité, ou reconstruire l'hymen. Le but de cette étude était de déterminer si les soignants suédois avaient rencontré des patientes souhaitant cette intervention. Des questionnaires ont été envoyés à 1086 gynécologues, travailleurs sociaux et agents de protection de la jeunesse, infirmières et médecins scolaires dans quatre villes suédoises. Des 507 soignants ayant retourné le questionnaire, 271 avaient eu des patientes recherchant des soins liés à la virginité : 14 d'entre eux avaient éconduit les patientes, 221 les avaient orientées, principalement vers un travailleur social ou un gynécologue, et 26 avaient adressé les patientes à un chirurgien esthétique. Neuf gynécologues avaient pratiqué eux-mêmes l'intervention. Jusqu'à présent, les autorités suédoises se sont penchées sur cette question uniquement dans une perspective juridique et sociale. Il n'existe pas de directives sur la manière dont les soignants doivent traiter les demandes de restauration de la virginité. Les recherches doivent se poursuivre pour mieux satisfaire les besoins de ce groupe de patientes dans une société multiethnique et décider comment répondre aux demandes de reconstruction de l'hymen. Faute de quoi, les médecins et les conseillers demeureront dans l'incertitude et l'ambivalence, et des approches diverses perdureront.
Resumen
Un importante determinante del honor de la familia en muchas culturas es la castidad de las mujeres; se atribuye gran relevancia a la virginidad hasta el matrimonio. La prueba tradicional de la virginidad es el sangrado cuando se rompe el himen, por lo cual algunas mujeres solicitan cirugía genital para “restaurar” su virginidad, o reparación del himen. El objetivo de este estudio fue investigar si los prestadores de servicios de salud suecos han atendido pacientes que solicitaron esta cirugía. Se enviaron cuestionarios a 1086 ginecólogos, funcionarios de protección y asistencia social a la juventud, y enfermeras y médicos escolares en cuatro ciudades suecas. De las 507 personas que contestaron el cuestionario, 271 habían atendido pacientes que buscaban servicios relacionados con la virginidad. De éstas, 14 habían rechazado a las pacientes; 221 habían proporcionado 429 referencias, la mayoría a un funcionario de protección y asistencia social o a un ginecólogo; y 26 habían remitido a las pacientes a un cirujano plástico. Nueve ginecólogos habían efectuado la cirugía por sí solos. Hasta la fecha, las autoridades suecas han tratado este asunto principalmente desde un punto de vista social y jurídico. No existen guías sobre cómo los profesionales de la salud deben tratar las solicitudes de cirugía para restaurar la virginidad. Aún es necesario realizar más investigaciones sobre la mejor manera de atender las necesidades de este grupo de pacientes en una sociedad multiétnica y de atender las solicitudes de reparación del himen. De lo contrario, los profesionales médicos y consejeros continuarán con dudas y ambivalencia, y una variedad de enfoques persistirá.