Addressing Conceptions of Hymenoplasty Among Healthcare Providers

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Survey responses highlight a lack of consensus among Flemish gynecologists regarding the ethics and safety of hymen reconstruction.
Survey responses highlight a lack of consensus among Flemish gynecologists regarding the ethics and safety of hymen reconstruction.

According to survey results published in BMC Women's Health,1 many Flemish gynecologists encounter at least 1 request to perform hymenoplasty during their career, and most would welcome published professional guidelines to navigate the social and ethical dimensions of hymen reconstructions. 

Previous studies2-4 have indicated that in some communities, hymenoplasty is seen as a “pragmatic choice” for women to conform to societal conceptions of virginity and to avoid violence if they are perceived not to be virgins when they marry. However, the procedure itself is not medically indicated, may result in complications, and to many, reinforces misogynistic notions of virginity and marriageability. Seeking to elucidate the prevalence of hymen reconstruction requests in Flanders, researchers surveyed healthcare providers in the region for their experiences with hymenoplasty. Online self-administered questionnaires regarding hymenoplasty were completed by 109 gynecologists and trainees in the Flemish region of Belgium.

Of 109 respondents, 45% answered that they would perform hymen reconstruction if requested, whereas 49% indicated that they would reject a hymenoplasty request. A total of 73% respondents had received a request for hymenoplasty at some point in their career. Among those who would perform the surgery, 65% reasoned that the procedure is the “patient's decision,” independent of the provider's opinion. An additional 45% indicated that the “risk situation” of the patient would be a motivating factor in performing hymenoplasty. The most commonly cited reasons for rejecting a hymenoplasty request were that the procedure is medically unnecessary (42%), the provider did not have the required technical skills (28%), and that such practice “[deceives]…future husbands and families” (19%). Most (70%) providers were not in favor of social security reimbursement for the surgery, regardless of whether or not they would perform it. In terms of clinical guidance, 81% of respondents had no knowledge of guidelines for hymenoplasty in Belgium or abroad, and 72% would “welcome” an official guideline by the Flemish Society of Obstetrics and Gynaecology.

These survey responses highlight a lack of consensus among Flemish gynecologists regarding the ethics and safety of hymen reconstruction. A published guideline on how to respond to hymenoplasty may help providers in decide the best option for the patient, regardless of personal opinion. Above all, the health and safety of the woman requesting hymen reconstruction should be of utmost concern to the provider, and a standardized guideline may assist in carrying out that concern.

References

  1. Leye E, Ogbe E, Heyerick M. ‘Doing hymen reconstruction': an analysis of perceptions and experiences of Flemish gynaecologists. BMC Womens Health. 2018;18(1):91.
  2. Wild V, Poulin H, McDougall CW, Stockl A, Biller-Andorno N. Hymen reconstruction as pragmatic empowerment? Results of a qualitative study from Tunisia. Soc Sci Med. 2015;147:54-61.
  3. Loeber O. Wrestling with the hymen: consultations and practical solutions. Eur J Contracept Reprod Health Care. 2015;20(2):128-135.
  4. Van Moorst BR, van Lunsen RHW, van Dijken DKE, Salvatore CM. Backgrounds of women applying for hymen reconstruction, the effects of counselling on myths and misunderstandings about virginity, and the results of hymen reconstruction. Eur J Contracept Reprod Health Care. 2012;17(2):93-105.

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