Health care providers conduct and make conclusions about whether or not a woman or girl has had sexual intercourse based on these examinations. This is frequently done prior to marriage.

The sociocultural significance of the hymen in certain communities as “proof” of the absence of sexual activity has even led to an intersection of culture, religion, politics, law, economics, and medicine in the form of “virginity testing,” which involves the use of a vaginal examination to evaluate whether or not a woman’s hymen is “intact,” in an attempt to ascertain whether a woman has had sexual intercourse. Frequently, conclusions about sexual history are made based on assumptions about the hymen, a small membranous tissue with no known biological function, which typically occupies a portion of the external vaginal opening in females. In many patriarchal cultures, the sexual history of girls and women is used as a significant determinant of their societal, community, family, and individual status. We call on clinicians to: 1) avoid relying solely on the status of the hymen in sexual assault examinations and reporting 2) help raise awareness of this issue among their peers and counterparts in law enforcement and the judicial system and 3) promote fact-based discussions about the limitations of hymenal examinations with their colleagues and health professional students from all specialties that address the sexual or reproductive health of women and girls. We recommend that clinicians take into consideration that a hymen examination does not generally offer a high degree of certainty about sexual activity, with or without consent. Clinicians who perform forensic sexual assault examinations should avoid descriptions such as “intact hymen” or “broken hymen” in all cases, and describe specific clinical findings using specific medical terminology. We concluded that an examination of the hymen is not an accurate or reliable test of sexual activity, including sexual assault, except in very specific situations. We reviewed published studies about the hymen to help guide clinicians in evaluating whether or not a hymen examination would be a valuable practice. The hymen is a small membranous tissue outside of the vaginal canal that has no known biological function. In some settings, clinicians who evaluate women and girls suspected of being victims of sexual assault, or suspected of having engaged in intercourse (with or without consent), rely on an examination of the hymen for their assessments. We call on clinicians to consider the low predictive value of a hymen examination and to: 1) avoid relying solely on the status of the hymen in sexual assault examinations and reporting 2) help raise awareness of this issue among their peers and counterparts in law enforcement and the judicial system and 3) promote fact-based discussions about the limitations of hymenal examinations as part of clinical education for all specialties that address the sexual or reproductive health of women and girls. Clinicians tasked with performing forensic sexual assault examinations should avoid descriptions such as “intact hymen” or “broken hymen” in all cases, and describe specific findings using international standards and terminology of morphological features. We reviewed published evidence to dispel commonly held myths about the hymen and its morphology, function, and use as evidence in cases of sexual violence.Īn examination of the hymen is not an accurate or reliable test of a previous history of sexual activity, including sexual assault.

Clinicians, however, continue to refer to changes in the hymen to assess for a history of consensual or nonconsensual sexual intercourse. Conclusions about women’s and girls’ sexual history are made in some settings based on assumptions about the hymen, a small membranous tissue with no known biological function, which typically occupies a portion of the external vaginal opening in females.

Photos of hymenal skin tags