Beyond the hymen

DW: The research on virginity testing you conducted at the University of Montreal has led the Quebec college of physicians to declare that doctors should not perform these "outrageous and repugnant" tests. What prompted this research?

Marie-Eve Bouthillier: We were called by a nurse who works at a school. She said that the family of one of the girls at the school she worked at had taken their daughter to an emergency clinic. They wanted to get the girl a virginity test and a certificate. She had gone to a party where there was alcohol and so the father was afraid that she was not a virgin anymore.

Can you describe the people who came to the hospital for this virginity certificate?

It's all related to honor, honor of the family. We had a second case which was a bit different. It was a woman in her late 20s. She masturbated and she was getting married in two weeks. She was afraid that she wasn't marriageable anymore.

This woman, in her own country, was a dentistry surgeon. She was quite a well-educated woman but she was still worried that she couldn't get married.

How strong is the religious component in all this?

I don't think it is so much to do with religion as with culture. I think these are archaic beliefs, very conservative beliefs of certain more radical groups, but it's not exactly related to religion.

How widespread is this kind of experience in Canada?

We have no quantitative research. I think we need more research to tackle the phenomenon, to see how big it is. Now it is a taboo subject, so when it happens, you need someone to complain about it. Otherwise, if the girls are brought to the clinic, and they don't complain, we never know about it. What we do know for sure is that there is a business related to virginity testing, surgical hymen reconstruction. We found out that in Montreal, this is the second most popular surgery.

Partly as a result of your study, the Quebec college of physicians has come out and said to doctors they should not be carrying out these virginity tests. How much pressure do doctors feel under when a family or a girl, as in the second case you mentioned, comes and asks for such a test?

In the first case, the doctors felt very pressured by the girl's family. Imagine that you are a doctor in an emergency clinic, your emergency clinic is full of people waiting to see a doctor, and then you have this father really [putting pressure on] you to test his daughter - I think the doctor wanted to get rid of the family so he could get back to his clinic.

In the second case, there was still some pressure, because the woman was accompanied by her mother, who was outside the office but she was still around, watching. In this case it was the nurse who called me, because she did the test first, and then they asked the doctor to do it, and he did it. She was very troubled, she said, "Did I really help her, or could she be in danger?" Two years ago, there was an honor killing in Montreal. In the Shafia family, the dad killed three of his daughters, and this is still in the memory of the population. So when the nurse called me, she said, "I was thinking about the Shafia family, after I did it, and I really thought I did something wrong."

From an ethical point of view, what needs to be done to change this? Is a ban enough?

That's a very tough question. For us it was clear that a doctor shouldn't do it, but this is just the beginning. Behind all the demands there is something else. Maybe she [the girl undergoing the test] will have a forced marriage - sometimes the virginity certificate will be the ticket for a forced marriage. So there are safety and protection issues behind it.

For us, the medical part was the easiest, and the first one to resolve. But we also need an education campaign about virginity, because one of the major problems is that when you think that virginity is just a question of a membrane, that's a problem. It's too reductive to think like that. Virginity is not having had sexual intercourse. It's not about the presence or the absence or the rupture of a membrane. We need to provide more education about this, so we are going to do more research on what concretely has to be done to help these girls, and to help change the mentality around this issue.

Marie-Eve Bouthillier is a medical ethicist and researcher at the University of Montreal.