I will never forget the first time I was asked to perform a "virginity exam."
I was a rather new doctor when a woman I knew from the community brought her teenage daughter in for a "checkup." I naively assumed they were there to discuss a topic like birth control, acne, or menstrual cramps. But the mother quickly informed me she was concerned that her daughter had become sexually active, and wanted me to "check her down there and tell me what was going on."
The mortified daughter sat glaring at her mother on the brink of tears, and I began to panic internally. How was I going to handle this moment? (They don’t teach you things like that in med school.) I took an extra deep breath and calmly explained to the mother that this was not possible physically or ethically. The mother's anger began to escalate as the daughter's anxiety began to dissipate. I eventually got everyone settled down and was able to provide the daughter with some appropriate medical care, but the entire interaction disturbed me. Sadly, it turned out to be the first of many times it has happened over the years.
Since the days of the chastity belt, society has placed a misguided emphasis on a young women’s purity (yet, rarely a young man’s – but that’s a different post all together). Many people believed (and still do) that an "unbroken" hymen was proof a woman had not had sexual intercourse. But what exactly is a hymen and does it really mean anything for it to be “intact”?
What is a hymen?
The hymen is a thin membrane or fold of tissue at the vaginal opening between the labia and the vagina. It has a central opening, but it is narrower than the diameter of the vagina. The hymen serves no medical purpose; it is simply a remnant from embryological development of the vagina.
Much like labia, there is a wide variation in hymen thickness and shape, with up to 10% of girls born with some type of abnormality. Some women are born with no hymen at all. Others have no opening at all or such a small opening that only menstrual blood can escape. If a teenager is unable to insert a tampon, they should be brought to a gynecologist for an exam. If the hymen is too narrow, sometimes it can be treated with a vaginal dilator to help slowly stretch it to a normal size. If there is no opening at all or the opening is too small, it may need surgery to repair it. Some women can also have a hymenal band, where the tissue forms two small openings with a thicker band of tissue that separates them. These hymenal bands can cause problems if a teen uses tampons, but are fairly easy to remove surgically.
Does an intact hymen make you a virgin?
None of the gynecology textbooks I have list a medical definition of “virginity.” Much like sex, the definition can be subjective. If the hymen is intact, it is unlikely that a woman has had vaginal intercourse with a penis. But if it’s not intact, there can be multiple other reasons. The most common one is from tampon use. Over time, especially in girls with heavier flow, the hymen can be slowly stretched from inserting and removing tampons. Self-stimulation, which is a normal part of sexual development, can lead to a stretched hymen. And as mentioned earlier, some girls are born without a hymen.
I am a parent of a teenager myself. I understand the desire to protect and monitor our children. In our safety conscious society, we keep apps on their phones that tell us where they are at all times, we check their social media to make sure they aren't being bullied (or bullying) and we can even randomly drug test them if we have suspicions; but we really can’t “vagina check them” for virginity. It’s demeaning, inaccurate, and unethical.