Virginity testing: the evidence behind the 2018 international statement
Virginity testing became the subject of a joint international call for elimination on 17 October 2018. UN Human Rights, UN Women and the World Health Organization stated that a genital examination could not establish whether a woman or girl had previously had vaginal intercourse. Their announcement described a practice documented in at least 20 countries, sometimes imposed for marriage or employment eligibility and sometimes used in investigations of rape. The anatomical claim and the social demand were separate problems: an unreliable examination could still carry powerful consequences when families, employers or authorities treated its result as a verdict.
The scientific synthesis preceding that statement was published in 2017 by Rose McKeon Olson and Claudia García-Moreno. They searched ten electronic databases and additional sources through January 2017, identifying 1,269 records and including 17 studies. Ten addressed medical utility, while eight addressed effects on the person examined; the categories overlapped. The authors did not calculate a pooled estimate of accuracy because the studies differed too much in design, purpose, measurements and outcomes. Their conclusion concerned the consistency of the evidence across those different settings: hymen examination did not accurately or reliably establish the claimed sexual status.
The review's methods also distinguished evidence about physical findings from evidence about harm. The authors used a predesigned extraction form and assessed study quality, rather than simply collecting statements that agreed with one another. Reports of physical, psychological and social consequences were synthesized thematically. An examination's inability to establish sexual history did not imply that undergoing it was inconsequential. The review identified both an absence of demonstrated medical utility and reported harms, supplying two distinct grounds for the later institutional response to virginity testing.
Anatomical variability received a separate treatment in a 2019 narrative review by Ranit Mishori and colleagues. They described a small membranous tissue that commonly occupies part of the external vaginal opening and changes with age and hormonal development. Puberty increases its elasticity; pregnancy, childbirth and menopause bring further changes. The review distinguished these developmental processes from injury and healing. It also noted documented cases of congenital absence alongside newborn studies in which the tissue was present in every child examined. The authors explicitly acknowledged the absence of large cross-cultural population studies on presence at birth, leaving the frequency uncertain. This was a synthesis of earlier research, rather than a new population examination.
WHO's 2018 announcement treated the issue as one of rights as well as measurement. It described virginity as a social, cultural and religious concept without a medical definition. The agencies identified coercion, humiliation and the possibility of further trauma during examinations imposed after sexual violence. Their proposed response extended beyond clinicians to governments and communities, combining changes in professional practice, legislation and public awareness. These were institutional recommendations about ending a practice, built on evidence of its lack of scientific validity and its consequences.
A British expert panel examined a related policy problem in a report published on 23 December 2021. Its subject was hymenoplasty, surgery sought to alter the hymen, in the context of the government's planned prohibition of virginity testing. The panel held two virtual meetings and considered clinical evidence, ethical principles and women's experiences. Its co-chairs, Pallavi Latthe and Jonathan Montgomery, recognized that some women sought the procedure as a way to manage threats or family pressure. The panel nevertheless concluded that permitting the surgery would undermine the proposed prohibition because both practices depended on the same social expectations about anatomy and sexual history.
That conclusion came with acknowledged gaps. The panel said the prevalence of hymenoplasty in Britain could not be assessed precisely and recorded limited evidence about who underwent it. It also recognized possible unintended consequences of criminalization, including unregulated practice and reduced contact with support services. Its recommendations included a later review of implementation, alongside training and resources. The document therefore recorded a policy judgment made under uncertainty, with the uncertainty stated in the recommendation process itself. It did not present the existence of coercion as a measurement of how often every affected person experienced it.
The subsequent government guidance described the Health and Care Act 2022 as prohibiting carrying out, offering, or aiding and abetting virginity testing and hymenoplasty throughout the United Kingdom. In its version updated in August 2025, the guidance defined the prohibited examination by its purpose of determining virginity, whether or not consent was given. It separately recognized normal variation in post-pubertal hymenal tissue, from thin and elastic to thicker and relatively rigid, and stated that neither hymenal size nor opening size reliably indicated past sexual activity. The guidance addressed institutions ranging from healthcare and local authorities to schools and police. The policy record had moved from a scientific review and international statement to a national prohibition, while retaining the underlying distinction between observed anatomy and the sexual history attributed to it.
- World Health Organization, United Nations agencies call for ban on virginity testing, 17 October 2018 — www.who.int
- Olson and García-Moreno, Virginity testing: a systematic review, Reproductive Health, 2017 — pmc.ncbi.nlm.nih.gov
- Mishori and colleagues, The little tissue that couldn’t, Reproductive Health, 2019: narrative review of hymenal anatomy and sexual-history inference — pmc.ncbi.nlm.nih.gov
- UK independent expert panel, Final report on hymenoplasty: ethical, legal and clinical implications, 23 December 2021 — www.gov.uk
- UK government, Virginity testing and hymenoplasty: multi-agency guidance, updated 11 August 2025 — www.gov.uk