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Eliminating Virginity Testing:

An Interagency Statement

SUU, Alm.del - 2020-21 - Endeligt svar på spørgsmål 1670: MFU spm., om regeringen opretholder dialogen med WHO om de massive problemer det giver kvinder, at myten om jomfruhinden stadig er udbredt, til sundhedsministeren SUU, Alm.del - 2020-21 - Endeligt svar på spørgsmål 1670: MFU spm., om regeringen opretholder dialogen med WHO om de massive problemer det giver kvinder, at myten om jomfruhinden stadig er udbredt, til sundhedsministeren

Eliminating Virginity Testing:

An Interagency Statement

Eliminating virginity testing: an interagency statement

WHO/RHR/18.15

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CONTENTS

Acknowledgements

Executive summary

Background

Root causes of virginity testing

Where is virginity testing practised?

Specific populations at risk

Victims of sexual violence

Political activists, detainees, and prisoners

Virginity testing is a violation of human rights

The rights to privacy and physical integrity

The right to the highest attainable standard of health

The right to be protected from discrimination based on sex

The right to life

The right to be free from torture or cruel, inhuman or degrading treatment

The rights of the child

Review of the scientific evidence

Lack of medical utility of virginity testing

Hymen examination

The “two-finger” test

Harmful consequences of virginity testing

Perceived benefits of virginity testing

Global strategies to eliminate virginity testing

Strengthen the knowledge and training of health-care providers

Build supportive legislative and policy frameworks

Empower and mobilize communities

Conclusion

References

ACKNOWLEDGEMENTS

This statement draws upon the work of many people around the world dedicated

to preventing and responding to all forms of violence against women and girls

and all harmful practices against women and girls.

Claudia García-Moreno in the World Health Organization Department of Reproductive

Health and Research (RHR) led the preparation of this statement and provided oversight

to the development of the final text. Rose McKeon Olson prepared the initial draft and

provided inputs and Ian Askew, Rajat Khosla, Lucinda O’Hanlon, Megin Reijnders and

Lale Say from RHR reviewed and also provided useful inputs throughout the process.

We gratefully acknowledge the valuable inputs provided by OHCHR and UN Women, and

external reviewers: Aaron Miller, Karen Morris, Shelley Ross and Paul Van Look.

Penny Howes was responsible for technical editing.

Eliminating Virginity Testing: An Interagency Statement

EXECUTIVE SUMMARY

irginity testing

, also referred to as hymen, “two-finger” or per vaginal examination, is an

inspection of the female genitalia meant to determine whether a woman or girl has had

vaginal intercourse. As shown in a systematic review on virginity testing, the examination has

no scientific merit or clinical indication – the appearance of a hymen is not a reliable indication of

intercourse and there is no known examination that can prove a history of vaginal intercourse (1).

Furthermore, the practice is a violation of the victim’s human rights and is associated with both

immediate and long-term consequences that are detrimental to her physical, psychological and social

well-being

(1).

The harmful practice of virginity testing is a social, cultural and political issue, and its

elimination will require a comprehensive societal response supported by the public health community

and health professionals.

Throughout the text the terms

virginity testing, virginity examination

and

virginity

are used, with full awareness that there is no scientific merit to, or

clinical indication for “virginity testing” or to a “virginity examination”, and that the term “virginity” is a social, cultural and religious construct with neither

medical nor scientific basis.

Eliminating Virginity Testing: An Interagency Statement

Traditionally, the virginity examination is performed

on unmarried women and girls, often under force,

threat or coercion, to assess their virtue, honour

or social value

(2).

In numerous countries, it is also

included as part of the medical assessment of rape

(3).

The practice of virginity testing has been reported in countries

from several regions of the world. It appears to be most

established in Asia and the Middle East; countries in

northern and southern Africa; and, more recently, among

some immigrant groups in Europe and North America,

forcing communities, societies and countries to make

decisions regarding its use

(3–20).

The growing attention

to eliminating sexual violence has raised awareness of

the routine use of virginity testing in some settings

(21).

Virginity testing is rooted in entrenched systems of

discrimination against women and girls

(i.e. gender

discrimination). It further reinforces socio-cultural norms that

perpetuate women’s inequality, including stereotyped views of

female morality and sexuality, and serves to exercise control

over women and girls. Virginity testing violates well-established

human rights

(22),

such as the right to be protected from

discrimination based on sex; the right to life, liberty and security

of person [including physical integrity]; the right to the highest

attainable standard of health; and the rights of the child (when

performed on a girl aged under 18 years).

The virginity examination itself can be painful, humiliating

and traumatic.

It is associated with a range of physical, mental

and sexual and reproductive health problems

(1, 2, 3, 8, 16).

extreme cases, women or girls may attempt suicide or be killed

in the name of “honour”

(10, 16, 23).

Effects on an individual’s

social well-being can also be devastating; women and girls

may be ostracized, stigmatized and denied employment and

educational opportunities

(24, 25).

Those who seek redress

after virginity testing often face re-stigmatization and retribution.

When done in the context of examination for sexual assault, it

can lead to re-victimization and re-traumatization

(2, 22).

A number of medical professionals, health-care

associations and human rights organizations have

explicitly condemned virginity testing as unscientific

and harmful

(2, 3, 8, 27–30, 88).

In addition, some local and

national governments have banned virginity testing and enacted

laws that criminally punish those who perform the examination

(31, 32).

Despite some limited progress, virginity testing

continues to be performed by health professionals around the

world. More work is urgently needed to increase awareness

of its detrimental effects on the health of women and girls,

and the imperative to eliminate its use.

This statement establishes that virginity testing is

unscientific, medically unnecessary and unreliable; it

is associated with short- and long-term adverse health

outcomes.

The statement expresses a commitment to support

efforts to eradicate all forms of virginity testing, thereby upholding

the human rights of women and girls across the globe. The

statement calls on governments; health professionals and their

associations; international, regional and national health agencies;

and communities at large to take the initiative to ban virginity

testing and create national guidelines for health professionals,

public officials and community members, particularly in countries

where virginity testing is widely practised. It calls for the following

specific strategies to eliminate virginity testing from medical

practice:

•

Medical providers and their professional associations should

be aware of the research that shows that virginity testing

has no scientific merit and cannot determine past vaginal

penetration or virginity. They should also know the health and

human rights consequences of trying to establish virginity

and never perform or support the practice.

•

Governments and health authorities should enact supportive

legislative and policy frameworks for the sustained elimination

of virginity testing.

•

Communities should lead in awareness campaigns that

According to the 1964 World Medical Association’s

Declaration of Helsinki, it is the physician’s duty to

safeguard the health of the people

(26).

Health

professionals who perform virginity testing are violating

the fundamental ethical principle: “first, do no harm”.

challenge myths related to virginity, and harmful social norms

that perpetuate the practice of so-called virginity testing.

The World Health Organization and endorsing

agencies confirm their commitment to supporting all

women and girls, communities, organizations and

national governments in the elimination of virginity

testing.

Eliminating Virginity Testing: An Interagency Statement

BACKGROUND

ROOT CAUSES OF VIRGINITY TESTING

here is no universal definition of the term virginity – its meaning varies by era, region, culture

and religion. The word “virgin” comes from the Latin root virgo, literally meaning “maiden”

– interpreted as a young woman who has not had vaginal intercourse

(33).

The concept of

virginity is not a medical or scientific term; rather, it is a social, cultural and religious construct

(34).

The disproportionate social expectation that girls and women should remain “virgins” (i.e. without

having sexual intercourse) until marriage is rooted in stereotyped notions of female sexuality that have

been harmful to women and girls globally

(34, 35).

In many societies, women are considered property of

their fathers or husbands; their bodies are considered

objects of male dominance; and their value is quantifiable

by their “purity” (35).

These social norms are perpetuated

by systems of rewards and punishments; historical examples

include higher dowries for virgins and the medieval era’s use

of the chastity belt

(36).

They also perpetuate stereotypical

perspectives of women either as “tempters” of men, which

unfairly assigns women as fully responsible for all sexual acts and

consequences, or as vulnerable and in need of protection from

men, who have uncontrollable sexual appetites. Furthermore,

they drive the unequal social expectation for women and girls to

remain “virgins” until they marry.

These attitudes create a framework for men to feel entitled

to control female sexual behaviour, mandate obedience and

warrant punishment, which in some cases includes murder.

These deep-seated, discriminatory beliefs and attitudes have led

to violence against women, and perpetuate harmful practices like

virginity testing that fundamentally violate international standards

of human rights. Given that health-care providers are often

asked to perform this testing, and viewed as experts by those

requesting it, health-care workers can have a major impact as

advocates against use of this practice. The medicalization of this

harmful practice risks continued social acceptability and further

institutionalization of this testing

(10, 34).

Eliminating Virginity Testing: An Interagency Statement

WHERE IS VIRGINITY TESTING PRACTISED?

Virginity testing is a long-standing practice in several

regions of the world.

Countries where this practice has been

documented include Afghanistan, Brazil, Egypt, India, Indonesia,

Iran, Iraq, Jamaica, Jordan, Libya, Malawi, Morocco, Occupied

Palestinian Territories, South Africa, Sri Lanka, Swaziland,

Turkey, the United Kingdom of Great Britain and Northern Ireland

and Zimbabwe

(3–16, 18).

Owing to increased globalization

in the last century, requests for and cases of virginity testing

are emerging in countries that have no known previous history

of the practice, including Belgium, Canada, the Netherlands,

Spain and Sweden

(17, 19, 20).

It is likely that virginity testing is

underreported, particularly in settings where this practice is not

seen as desirable.

SPECIFIC POPULATIONS AT RISK

VICTIMS OF SEXUAL VIOLENCE

Medical providers are often asked to perform virginity

testing, also known as hymen, “two-finger” or per vaginal

examination, on victims of rape

(3, 8, 37–39, 88).

Despite

it having neither scientific basis nor clinical utility, doctors

and medical personnel continue to perform the examination,

supposedly to ascertain whether or not rape occurred

(5, 8,

14, 38, 40).

In this context, the examination is likely to cause

pain and mimic the original act of sexual violence, leading to

re-experience, re-traumatization and re-victimization

(16, 41).

Performing this potentially harmful and medically unnecessary

test violates several ethical standards of the medical profession

(28, 29).

According to the 1964 World Medical Association’s

Declaration of Helsinki, it is the physician’s duty to safeguard

the health of the people

(26).

Health professionals who perform

virginity testing are violating the fundamental ethical principle:

“first, do no harm”. Furthermore, in many situations, it is

performed without the consent of the victim, thus constituting

a form of sexual violence; by standards of international legal

jurisprudence, this could amount to rape or torture, depending

on the context

(2, 3, 5, 42).

The distinct human rights considerations of women prisoners

were prominently recognized during the adoption of the United

Nations Rules on the Treatment of Women Prisoners and

Non-custodial Measures for Women Offenders (the Bangkok

Rules)

(45).

The Bangkok Rules specifically declare that

women prisoners have the right to refuse medical examinations

related to their sexual and reproductive health history, such

as virginity tests

(45).

Additionally, the United Nations Special

Rapporteurs on Violence against Women and its Causes and

Consequences, and on Torture and other Cruel, Inhuman or

Degrading Treatment or Punishment have stated specifically

that forced gynaecological examinations of women prisoners

In the evaluation of victims of rape, the examinee’s virginity

has no bearing on whether or not rape occurred,

nor does it

predict how traumatic or severe the effects of rape will be on an

individual

(3, 4, 8, 38, 55, 62).

The result of this

unscientific test has an impact on judicial proceedings, often

to the detriment of victims and in favour of perpetrators,

which results in victims losing court cases and perpetrators

being acquitted. This situation exacerbates victims’ sense of

disempowerment and re-victimizes them

(3, 4, 14, 43).

constitute a particularly egregious form of mistreatment,

discrimination and sexual violence

(25, 46, 47).

POLITICAL ACTIVISTS, DETAINEES, & PRISONERS

Women prisoners and those in detention facilities are at

heightened risk of abuse and mistreatment, including

forced virginity examinations.

Virginity tests on women

prisoners are common, intimidating and humiliating; they violate

women’s rights to privacy and physical integrity, and further

disempower them

(3, 44).

When performed on women arrested

for protesting or other forms of political activism, forced virginity

examinations perpetuate a climate of fear and intimidation that

prevents women from exercising their civil rights.

Eliminating Virginity Testing: An Interagency Statement

VIRGINITY TESTING

IS A VIOLATION OF

HUMAN RIGHTS

nternational treaties, statements, conferences

and agreements, such as those held by the

United Nations, have declared that certain

traditional practices are harmful and detrimental to

the health of women and girls globally and violate

a series of international human rights standards.

Virginity testing has been recognized by a number

of human rights agencies and treaty bodies as a

harmful practice.

The 1993 Vienna World Conference on Human Rights, and

the Convention on the Elimination of All Forms of Discrimination

Against Women (CEDAW) in the same year

(49, 50),

declared

that all states must modify discriminatory social and cultural

patterns of conduct:

. . . with a view to achieving the elimination of prejudices

and customary . . . practices which are based on the idea

of inferiority or the superiority of either of the sexes or on

stereotyped roles for men and women (49).

The International Conference on Population and Development

(ICPD) in 1994

(51)

and the Fourth World Conference on Women

in 1995

(52)

caused a pivotal shift from population-control

policies to programmes that promote women’s sexual and

reproductive health, reproductive rights, and the advancement

and empowerment of women. The ICPD in 1994 issued a call for:

Eliminating all practices that discriminate against

women; assisting women to establish and realize

their rights, including those that relate to

reproductive and sexual health (51).

Additionally, the 1995 Beijing Declaration and Platform for Action

of the Fourth World Conference on Women

(52)

called upon

all states to ensure women are fully informed and autonomous

regarding decisions concerning their bodies and reproductive

and sexual well-being, obligating states to:

. . . take all appropriate measures to eliminate harmful,

medically unnecessary or coercive medical interventions

. . . and ensure that all women are fully informed of their

options, including likely benefits and potential side-

effects, by properly trained personnel (52).

Since then, numerous international human rights treaties and

treaty-monitoring bodies have shifted to recognize harmful

traditional and medically unnecessary practices based on

discrimination against women as incompatible with the

international advancement of all people

(53–55).

The specific human rights violated by virginity testing are discussed next.

The United Nations Committee on the Elimination of All Forms of Discrimination against Women and the United Nations Committee on the

Rights of the Child

(48),

the United Nations Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment

(46, 47)

and the United Nations Special Rapporteur on Violence Against Women, its Causes and Consequences

(25)

have all declared

virginity testing to be a harmful practice.

Special care and attention should be paid to a child’s or adolescent’s evolving capacity to make their own decisions regarding their

health. The opinion of a child or adolescent should always be asked and taken into account before any physical examination, and age-

appropriate information should be provided. For additional information, refer to the 2017

WHO clinical guidelines: responding to children

and adolescents who have been sexually abused

(64).

Eliminating Virginity Testing: An Interagency Statement

The right to be protected from discrimination based on sex

Multiple international human rights agreements have widely recognized women’s historical oppression and lack

of personal autonomy as central barriers to their overall health, especially in matters of sexual and reproductive

health and rights

(51).

Virginity testing violates the right to be protected from discrimination based on sex, as its

harmful consequences are almost exclusively experienced by women and girls. The origins of virginity testing

are based in patriarchal systems of gender discrimination and violence against women

(22, 49–51).

The right to life

In extreme cases, some women and girls have been murdered or attempted suicide

in the name of “honour” after undergoing virginity examinations. In such cases, the practice

violates an individual’s right to life

(22, 51).

The rights to privacy and physical integrity

The practice of virginity testing violates the principle of human dignity, as well as the rights to privacy and

physical integrity, as it infringes an individual’s control in making an independent decision about an examination

that is known to have long-lasting physical, psychological and socioeconomic consequences

(1, 22, 49, 51, 52).

The practice is routinely performed on victims of rape and sexual assault, a group of individuals who have

already been deprived of physical integrity and autonomy, resulting in yet another violation of their human rights

(46).

The right to be free from torture or cruel,

inhuman or degrading treatment or punishment

Virginity testing violates the right to be free from torture or cruel, inhuman or degrading treatment or punishment,

as the examination is often humiliating, degrading and conducted in a manner to intimidate and punish

(22, 47).

The United Nations Special Rapporteurs on Violence against Women, its Causes and Consequences, and on Torture

and other Cruel, Inhuman or Degrading Treatment or Punishment, have stated that virginity testing is a form of sexual

violence, and moreover constitutes a particularly gross form of ill-treatment, and custodial violence

(25, 46, 47).

The right to the highest attainable standard of health

As virginity testing is an invasive examination of the female genitalia that has no evidentiary value

or scientific merit, and is likely to result in a series of adverse health outcomes. It is a violation of the

right to the highest attainable standard of health

(1, 22, 56, 57).

The rights of the child

Virginity testing violates the rights of children, a group that experiences exceptional vulnerability, as school-aged children have been

subjected to forced examinations

(6, 9, 16, 37, 55, 58–63).

In 1994, the ICPD stated that gender discrimination often begins at the earliest

stages of life, and declared an end to all forms of discrimination that violate the rights of girls

(51).

The Committee on the Rights of the Child

(CRC) of 1990 called upon states to uphold the civil, political, economic, social, health and cultural rights of all children

(57).

Performing

virginity testing on children violates their international rights to non-discrimination, protection and participation

(58).

A child consenting to a

virginity test is unlikely to be informed, free or without coercion, as their decision-making capacity is still developing

(55).

In addition, they are

particularly vulnerable to familial and societal expectations and pressures

(55, 58).

In 2014, CRC joined with CEDAW to endorse provisions

that called upon states to end traditional practices that harm girls, including elimination of virginity examinations

(55).

Eliminating Virginity Testing: An Interagency Statement

REVIEW OF THE

SCIENTIFIC EVIDENCE

LACK OF MEDICAL UTILITY

OF VIRGINITY TESTING

The two most common techniques for virginity testing are:

(i) inspection of the hymen for tears or the size of opening;

(ii) insertion of fingers into the vagina (the “two-finger” test).

Both are performed under the belief that the appearance of

the female genitalia can indicate a girl’s or woman’s history of

sexual activity. Neither version of virginity testing

is supported by scientific evidence.

There is consensus among scientific and medical communities

that the appearance of the female genitalia does not provide

evidence of prior sexual history

(1, 2, 28).

Moreover, searching for

objective measures to determine female virginity undermines women’s

decision-making capabilities and presumes a lack of credibility.

Despite this, virginity testing continues to be practised in clinical

settings, and is still included in some medical training and textbooks

as part of the assessment to determine whether or not a rape took

place

(75–77).

A recent systematic review on virginity testing confirmed

that there is no scientific evidence to support a belief that

the appearance of the hymen is a reliable indicator of vaginal

intercourse

(1).

The appearance of the hymen varies widely,

according to individual exposure to estrogen, age, pubertal status

and method of examination

(1, 63).

One of the most widespread

myths about virginity is that it can be proven by the presence of an

“intact hymen”. The term “intact hymen” has no anatomical correlate

and should not be used. As shown in the systematic review

(1),

a so-called “normal” finding on hymen examination is likely to occur

in those with and without a history of even recent vaginal penetration,

owing to wide variation and because injuries to the hymen often heal

rapidly

(22, 65–73).

“Abnormal” hymen findings are extremely difficult

to differentiate from normally occurring anatomical variations

(30).

Like all human tissue, vaginal and hymenal tissue can be injured

during trauma. In the specific context of recent sexual assault

or rape, trained medical providers who have obtained informed

consent may examine the female genitalia for signs of trauma;

however, the purpose of the examination for sexual assault is to

evaluate for and treat injuries, and to assess for sexually transmitted

infections (STIs). The purpose is not to assess “virginity status”.

The examination for sexual assault does not require insertion of

fingers or anything else into the vagina.

The threat of virginity testing can also lead some individuals to

engage in oral and/or anal sex, in order to “preserve” virginity,

which can be risky when practised without protection

(9, 60).

Some girls have resorted to inserting unhygienic material into the

vagina, such as toothpaste or freshly cut meat, to resemble a hymen-

like “white veil”, which can lead to local trauma, bleeding and infection

(9, 78).

The discriminatory and stigmatizing nature of the virginity

examination also results in a series of adverse psychological

The “two-finger” test is performed by inserting two fingers

into the vaginal cavity in an attempt to assess “laxity of the

vaginal wall” – a supposed marker of previous sexual history

(3, 7).

The vagina is a dynamic muscular canal that varies widely in

size and shape, depending on individual, pubertal or developmental

stage, physical position and various hormonal factors such as sexual

arousal and stress

(74).

Additionally, normal individual variability,

and social traumas.

The examination violates the victim’s physical

integrity, autonomy and privacy, especially when practised without

consent. Studies show that documented harms of virginity testing

include intense anxiety, panic, depression, guilt, feelings of self-

disgust, loss of self-esteem, worsened self-respect and body image,

a dysfunctional sex life, isolation from family and society, and fear of

death

(1, 6, 16, 37).

Virginity testing artificially assigns often undesired

irginity testing has been shown to be associated with a

series of adverse physical and psychosocial effects, with both

short- and long-term consequences

(1).

Firstly, the examination

itself is often painful and traumatic (6, 16). Owing to its invasive and

forcible nature, the examination can damage the genitalia and lead

to bleeding and infection. On occasion, virginity testing is performed

on many girls at once, often by untrained individuals or in unhygienic

settings or in an unhygienic manner, such as repetitive use of the

same gloves; this could potentially increase the risk of STIs and HIV

(9, 78).

inconsistent examination techniques and innumerable other causes

for differences in the musculature of the vaginal wall further contribute

to the test’s futility. There is no scientific basis to support the validity

of the “two-finger” or any other form of virginity test.

HYMEN EXAMINATION

HARMFUL CONSEQUENCES OF

VIRGINITY TESTING

THE “TWO-FINGER” TEST

Eliminating Virginity Testing: An Interagency Statement

M E N T A L

•

Violation of physical integrity, autonomy, and privacy

Anxiety, panic, depression, guilt

Feelings of self-disgust and rejection

Loss of self-esteem

Worsened self-respect and body image

Dysfunctional sex life

T E R M

•

Trauma

Educational, marriage and employment discrimination

Isolation from or punishment by family and society

Fear of death

Suicide

L O N G

S H O R T

T E R M

• Bleeding and infection from damage

to genitalia during examination

• Bleeding and infection from unhygienic attempts

to feign the existence of a hymen

• Payment of a fine, if “failed” test

• Murder, if “failed” test

• STIs

• Unprotected and risky sexual

behaviour to “preserve” virginity

• Higher risk of sexual violence

P H Y S I C A L

labels as “virgin” or “non-virgin”, and leads to harmful psychosocial

consequences. In-depth interviews with medical professionals who

perform virginity examinations revealed that the virginity test can

cause feelings of rejection, weakened self-confidence and depression

in their “patients”

(9).

Women and girls have been reported to

experience severe fear and mental torment as a result of the vaginal

examination, and have even resorted to suicide

(10, 16, 44, 79).

Virginity examinations are also likely to have long-lasting

harmful effects on individuals’ physical, sexual and

reproductive, and social well-being.

In some settings, “failing”

a virginity test is perceived to bring dishonour and shame to the

individual’s family and community, and may result in punishment.

Documented forms of punishment include being beaten, starved

or sexually assaulted, including by gang rape, or even murdered

(9, 16, 44, 63).

Murders are known as “honour killings”, and are

often carried out by male relatives who believe the girl or woman

who failed the virginity test brought shame to their family

(10, 16,

23).

An unfavourable result may also lead to familial and societal

condemnation and banishment from the community. Isolated,

and without family and community support, these women are

at heightened risk of certain forms of violence, including forced

prostitution

(16, 60, 80).

Additional socioeconomic consequences

include educational, marriage and employment discrimination –

several schools and universities, as well as several employers, only

enrol or hire “certified virgins”

(9, 10, 25, 38, 44, 81, 82).

In some

communities, those who fail virginity tests can be expected to pay

a fine for tainting the community

(9).

“Certified virgins” may also

experience adverse effects, including increased risk of sexual violence,

owing to beliefs prevalent in some communities that sexual intercourse

with a “virgin” is more desirable, or can cure HIV/AIDS

(9, 80).

PERCEIVED BENEFITS

OF VIRGINITY TESTING

There are many social and cultural reasons put forward for why

a person may desire or request a virginity test. Many perceived

benefits are based on false understandings of virginity testing.

For example, some communities believe virginity examinations will

reduce the spread of STIs like HIV, while data shows the practice

may increase the risk of STIs

(1, 9, 25, 60, 62, 78).

Others believe

the practice will reduce the prevalence of premarital sex and prevent

unwanted pregnancies, but this is not supported by evidence;

the results of a virginity test are not an indicator of prior or future

sexual activity

(1, 25, 62, 78).

As a long-standing practice in

some communities, some regard virginity testing as a meaningful

communal tradition and celebration of cultural values

(9, 60).

However, a person’s human rights are absolute – they may not be

limited by invoking cultural or religious justifications for practices that

violate international standards of human rights: virginity testing is no

exception

(83).

Finally, since no physical examination can confirm

or deny virginity, performing such a “test” does

not clarify who

is a “virgin” and who is not. There are no benefits to doing it.

Ultimately, virginity testing is a way to maintain power and control

over women and girls.

In summary, available research indicates that the

virginity test is detrimental to a woman’s or girl’s

physical integrity and psychosocial well-being and is

likely to cause long-lasting damage.

Eliminating Virginity Testing: An Interagency Statement

GLOBAL STRATEGIES

TO ELIMINATE

VIRGINITY TESTING

number of medical professionals, health-care associations and human rights organizations

have explicitly condemned virginity testing as unscientific and harmful

(2, 3, 8, 27–30, 88).

In addition, some local and national governments have banned virginity testing and enacted

laws that criminally punish those who perform the examination

(31, 32).

Despite some limited

progress, virginity testing continues to be performed by health professionals around the world.

More work is urgently needed to increase awareness of its lack of clinical value and detrimental

effects on the health of women and girls, and the imperative to eliminate its use.

Elimination of virginity testing will require long-term commitment and unified action at local,

national, regional and international levels. Health-care providers and national authorities have

a responsibility to eliminate practices that are harmful to girls’ and women’s health.

This section provides recommendations for global strategies

to end all forms of virginity testing.

Eliminating Virginity Testing: An Interagency Statement

STR ATE GIES F O R P ROVID ERS

Strengthen the knowledge & training

of health-care providers

A gap exists between current scientific evidence and medical education

and training

(7, 37, 59, 75–77, 84).

Health-care providers, especially those

who work in family practice, obstetrics, gynaecology, sexual health and

paediatrics, have a critical role to play in the elimination of virginity testing

from medical practice. In order for long-term abandonment of the practice,

health-care providers must be knowledgeable about the virginity/“two-finger”

test, including reasons why it must not be performed; its lack of scientific

merit or clinical utility, and associated health risks and consequences; how to

decline requests to perform the examination; how to prevent, recognize and

manage complications; and how to counsel women and their families about

the test.

NECESSARY ACTIONS INCLUDE THE FOLLOWING:

•

Health professionals should be informed of the latest evidence

that virginity tests have no clinical value and can have harmful

health consequences. They must never perform or recommend

the practice.

Health-professional training must be provided on the

recognition, management and sensitive care of patients

subjected to virginity testing.

Health educators should update medical education

and textbooks to reflect this evidence, work to dispel

myths and misconceptions about virginity, and provide

medically accurate information that does not reinforce

harmful practices like virginity testing.

Health professionals must first and foremost “do no harm”

(26),

which includes treating all patients with respect.

In the case of survivors of sexual assault, this requires

ensuring that they are not re-victimized in the process

of care. The role of health professionals is not to determine

whether or not rape occurred, but to provide compassionate,

sensitive, confidential and effective clinical care, and

document findings, according to best practices.

Health professionals should respectfully counsel the

families of women/girls who request it, and inform them that

virginity testing is medically unnecessary, unscientific and

potentially harmful, and work to dispel myths

and misconceptions about virginity.

•

Health professionals should counsel or refer women, and their

families, who suffer physical and mental health consequences

and complications from virginity testing.

Health professionals and educators should provide medically

accurate information to patients and caregivers, educate women

and girls on the anatomy and physiology of their sexual organs,

and reaffirm their rights to the safety and integrity of their bodies.

Health professionals and educators should promote provision

of comprehensive sexual and reproductive health information,

education and services and adolescent sexual and reproductive

education programmes that include accurate messages about

virginity tests and associated myths.

Boys and men should be educated to respect women’s

and girls’ physical autonomy, practise informed sexual

consent, and join the movement to end all forms of

violence against women and girls.

Health professionals should advocate for the community

at large to abandon virginity testing.

•

Eliminating Virginity Testing: An Interagency Statement

STRATE G IE S F O R P OL ICYMA KERS

Build supportive legislative

& policy frameworks

It is the responsibility of the state to uphold, respect,

protect and monitor the human rights of all its citizens,

including those violated by virginity testing

(22).

States

and all concerned regulatory bodies should develop

plans of action and set milestones to encourage the

elimination of this harmful practice.

NECESSARY ACTIONS INCLUDE THE FOLLOWING:

•

Governments should enact and implement laws to ban virginity

testing and prosecute those who violate the law, in order to

make the government’s position explicit; prevent and deter its

use across all regions; and support and protect those who have

abandoned the practice.

Legislation must prohibit all forms and methods of virginity

testing.

All possible risks, misinterpretations and means of evasion

should be analysed, to avoid unintended consequences, such

as the practice “going underground”.

Input should be sought from human rights organizations,

feminist and women’s health and rights advocacy groups,

health-care providers and community leaders.

National authorities must effectively monitor and regulate

practices by public and private actors in health-care and

community settings, to ensure sustained eradication of

virginity testing.

Authorities should sponsor nationwide education campaigns

to inform health-care providers and communities at large that

virginity tests are unreliable and do not determine past vaginal

penetration, and can have harmful health consequences

as well as human rights implications.

•

Health-professional organizations, including physician,

midwifery and nursing associations and their respective

councils, should adopt policies to condemn all forms of

virginity testing and mobilize their members to agree not to

perform or support any form of virginity testing.

Medical professionals who perform virginity testing should

be disciplined and subject to legislative action.

Policies must be enacted that ensure no employer,

educational facility, detention centre or any other institution

requires or requests virginity tests and that training is

provided to staff who come into regular contact with those

subjected to virginity examinations. This may include

juridical staff, law-enforcement personnel, social workers

and teachers.

National authorities must invest in matters that are

fundamental to the prevention and sustainable elimination

of virginity testing, including provision of universal sexual

and reproductive health care and education.

•

Eliminating Virginity Testing: An Interagency Statement

STRATE G IE S F OR COMMUN ITIE S

Empower & mobilize communities

As virginity testing is often community led, community action will

be critical to its elimination. Confrontation of cultural or social

norms has diverse and unique challenges; interventions must be

tailored to specific populations and population subgroups (11, 78,

85–87). With sustained, community-led agreements to eliminate

virginity testing, new social standards will emerge that challenge

long-standing, harmful social norms (87).

NECESSARY ACTIONS INCLUDE THE FOLLOWING:

•

Communities should lead in identifying problems and solutions

regarding the practice of virginity testing. Discussions should

examine community beliefs, behaviour, attitudes and systems

of power. Trained facilitators should guide the discussion.

It is important to be creative: community discussion

can take the form of classes, debates, and workshops,

storytelling, art, music and dance.

Local advocacy, social justice and women’s rights groups

should be consulted, to assist in the vision and

implementation of community programming and training.

Community-based education materials that engage and

respect local beliefs, attitudes and perceptions should be

produced and distributed. Education strategies should be

adapted in light of any new knowledge of the community’s

understanding of virginity testing.

•

A public, community-wide joint agreement

to ban virginity testing should be considered.

This can take the form of a public pledge,

where community, religious and political figures

can attend to pledge their commitment.

Community, religious, customary and tribal

leaders should advocate for the required

change in societal practices. Societal leaders

have great influence in the perceived morality

or permissibility of harmful practices

like virginity testing.

The media should be utilized to educate, spark dialogue

and begin to normalize taboo topics among households

and communities, through local radio broadcasting,

television commercials and programming, social media

campaigns, and endorsement by public figures.

•

Eliminating Virginity Testing: An Interagency Statement

CONCLUSION

his statement establishes that virginity testing is unscientific, medically unnecessary and

unreliable; it violates a woman’s human rights and is associated with short- and long-term

adverse health outcomes. The statement expresses a commitment to support efforts to

eradicate all forms of virginity testing, thereby upholding the human rights of women and girls

across the globe.

The statement calls on governments; health professionals and their associations; international,

regional and national health agencies; and communities at large to take the initiative to ban virginity

testing and create national guidelines for health professionals, public officials and community

members, particularly in countries where virginity testing is widely practised.

Medical providers and their

associations should

be aware

of the research

that shows that

virginity testing has no scientific

merit and cannot determine

past vaginal penetration or

virginity. They should also

know

the health and human rights

consequences of virginity

testing,

and never perform

or support the practice.

Specific

strategies

to eliminate

virginity testing

from medical

practice

Governments and health

authorities should

enact

supportive legislative and

policy frameworks

for the

sustained elimination of

virginity testing.

Communities should

lead in

awareness campaigns

that

challenge myths related to

virginity, and harmful social

norms that perpetuate the

practice of virginity testing.

The World Health Organization and endorsing agencies confirm their commitment to supporting

all women and girls, communities, organizations and national governments in the elimination

of virginity testing.

Eliminating Virginity Testing: An Interagency Statement

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