Recommendations for primary care physicians who may encounter requests for virginity testing

Virginity testing is a complex, culturally mediated practice that is poorly understood by Western clinicians. Although there is published literature on the ethics of 'virginity' testing and on the lack of reliability of a hymen examination to determine 'virginity', little practical guidance has been published for clinicians who may encounter requests for virginity testing in the clinical setting.

Now, a researcher from Boston University School of Medicine (BUSM) is providing recommendations for primary care physicians who are asked to perform this procedure.

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, the clinician must act in the best interest of the patient which might include performing an evaluation. Upholding human rights does not have to be incompatible with providing a needed service to a patient, even if the practice does not fit into our social norm."

Sondra Crosby, MD, associate professor of medicine at BUSM, author of the article

According to Crosby changing social norms, attitudes and practices about 'virginity' testing will not occur easily and change must come from within the culture and be spearheaded by members of the community. "Engagement with religious and community leaders is crucial for enacting change," adds Crosby, who also is an associate professor of Health Law, Ethics & Human Rights at Boston University School of Public Health and a physician at Boston Medical Center.

She believes education about the lack of reliability and the possible harms of virginity testing should be provided in communities who follow this practice, through training community members, reading materials and inclusion in other reproductive health discussions. "Simply condemning the practice is not sufficient to successfully promote change, nor does it help the women we are obligated to protect."

Crosby recommends if a physician has a large population of patients from countries or communities where 'virginity' testing is practiced, they should use routine or other visits to discuss this issue and provide education on the matter. "While it is not possible to determine if someone is a "virgin" based on examination of the hymen, 'virginity' testing can be discussed as part of comprehensive sexual education and counselling during well-visits for all genders, adults and adolescents, as well as during pediatric and teenage preventive exams. Such conversations can help build trust; assess knowledge, attitudes and practice of at-risk patients; and allow the physician to anticipate future requests."