growingpains
t is late — nearly 10 pm — and I am teaching first-year medical students how to perform a speculum exam (a word and concept so foreboding that the red squiggle of death appears under it, which means that Medium refuses to admit it’s a real word).
It’s the exam that students are, without fail, the most anxious about performing. In no small part, I suspect, because specula look not unlike metal pterodactyls — when plural are spelled like “Dracula” — and because even in this day and age, we don’t have anything better than what essentially amounts to a medical oven mitt for visualizing a patient’s cervix.
Without fail, I explain to them that the speculum exam is actually my favorite part of a routine pelvic. It is precisely the anxiety — both the fear on the part of the patient and provider alike — that allows for the greatest transformational experience. Meaning, if a provider knows how to perform the exam well (with cultural competency, trans competency, trauma competency, and clinical skill) then they have the greatest opportunity to really challenge and change the trauma of said exam on a cellular and neurological level.
In the midst of this speech, in which I’m often rhapsodizing, I invariably receive the question I hate the most:
“What if the patient is a virgin? What if the hymen prevents insertion?”
Dear reader, it’s worth saying that right now I am writing this essay in the time of November, nearing the end of 2019, and that the news—as always—is a hot damn mess, but that the hymen, or rather, the insidious idea of the hymen, is rather unfortunately all over the press.
Here is the order of news titles in my Google search at this exact moment:
“Yes, I go with her,” T.I. said. After Deyjah’s 16th birthday party, he said he “put a sticky note” on her door that read, “Gyno. Tomorrow. 9:30.” He then recounted a typical gynecologist visit.
“So we’ll go and sit down and the doctor will come and talk, and the doctor’s maintaining a high level of professionalism,” T.I. said. “He’s like, ‘Well, you know, sir, I have to, in order to share information’ — I’m like, ‘Deyjah, they want you to sign this, so we can share information. Is there anything you would not want me to know? Oh OK. See, doc? Ain’t no problem.’”
2. Outrage As US Rapper T.I. Says He Has Daughter’s Hymen Checked Annually — The Guardian
“In 2018, virginity tests like these were condemned by three United Nations agencies: the World Health Organization (WHO), UN Human Rights and UN Women. A statement reads:
“This medically unnecessary, and often times painful, humiliating and traumatic practice must end … WHO states that there is no evidence that either method can prove whether a woman or girl has had vaginal intercourse or not.”
Last month, a spokesperson for the New York State Department of Health described the tests as “an assault on young women with no scientific or medical basis”.
3. Rapper T.I. Faces Major Backlash For ‘Hymen’ Comments — WVLT Channel 8
Planned Parenthood posted a series of clapback tweets Wednesday, starting with: “Idk who needs to hear this but virginity is a made-up social construct, and it has absolutely nothing to do with your hymen.”
A few things here bear clarification if you aren’t terribly familiar with this seismic cesspool of a news story by now. The first is that the majority of articles utilize gendered language when we all in this century know that not everyone who has a hymen identifies as a woman. So, that.
The second is that the medical provider in question, did, in fact, do his job to attempt to dispel the myth T.I. was laying out, saying “Well, I just want you to know that there are other ways besides sex that the hymen can be broken like bike riding, athletics, horseback riding and just other forms of athletic physical activity.”
To which T.I. responded: “Look, Doc, she don’t ride no horses, she don’t ride no bike, she don’t play no sports. Just check the hymen, please, and give me back my results expeditiously.”
It is also rather unfortunately mentioned in several news sources the state of Deyjah’s hymen at the time she turned 18, which shows that even in the midst of conveying incredulity at the subject, the bullshit notion of hymen and virginity is still, pun intended, intact.
Cool. So, then, why all this hype about the hymen?
It turns out that even in November of 2019, we still don’t know very much about this elusive expanse of skin; it may or may not be flat and may or may not cover not the opening of the vagina (as is widely believed), but rather the skin around the introitus, or entrance, to the vagina.
The hymen may or may not denote whether or not someone is a virgin (whatever that means), it may or not denote that someone has ridden a bike or worn a tampon or inserted anything into their vagina — but most likely, it won’t denote anything at all.
Here’s something from Psychology Today (let’s pretend it isn’t gender essentialist, shall we?):
“For reasons that remain unclear, female babies are born with membranes surrounding their vaginal openings. Most hymens are doughnut-shaped and open in the center. Newborns’ hymens tend to be prominent and thick. But as the years pass, most hymenal tissue thins and the opening widens. During childhood, most hymenal tissue wears away as a result of washing, walking, athletics, self-exploration, and masturbation, though little bits may remain around the vaginal opening, particularly in the area closest to the anus (hymenal tags).
The intact hymen almost never covers the entire vagina. If it did, virgin girls could not menstruate. However, the opening may not look like a doughnut hole. In some women, it has a ladder-like appearance with bands of tissue extending from one side to the other. In others, it resembles a honeycomb with multiple small openings. And in rare cases, an estimated one in 200, the hymen’s single opening is so small that fingers, tampons, and erections may not be able to enter comfortably or at all (imperforate hymen).”
The reason that the breaking of the hymen appears to have been linked with virginity seems to stem from etymology: the Greek word for “hymen” and the Greek word for “marriage” share a root. But so do “prize” and “prison”, “impale” and “travel”, and “sever” and “co-emperor” (whatever that means), and we aren’t creating any kind of social construction involving skewering people on Amtrak trips to see Vermont foliage, now are we?
We also know that humans aren’t the only ones with hymens.
“A few other mammals are born with hymens, including manatees, whales, elephants, hyenas and our old friends, horses. But their origin and function are a mystery to evolutionary biologists. Although the theories are fun: Desmond Morris reckoned hymens evolved so that first-time sex was painful for girls and they wouldn’t be flippant about it; they would only do it with a bloke they were ‘bonded’ to. Children of pair-bonded parents would have been more likely to survive.
The aquatic ape theory claims that humans lived in water for a few million years, to get out of the heat and away from predators and that hymens evolved to stop stuff going up us, like shells and starfish. Some theorists boringly claim that the hymen may have no adaptive evolutionary purpose, that it’s a byproduct of the way female genitals develop.” — Sara Pascoe from The Guardian
So now that we’ve ruled out science as a determining factor for this supposed importance of the hymen, we can deduce that this conversation is in line with a larger, more problematic schema that posits social constructs such as virginity as moral, and therefore medical, values.
There was a time when virginity had actual, economic worth — fathers who sold the virginity of their female-assigned-at-birth children as property, in exchange for a dowry, and perhaps we can draw parallels there in the way that this concept has bled over into modern medicine. We can, at least, draw a parallel to T.I., who (abusively, and inappropriately, to be sure) clearly placed such high value on the “physical evidence”, erroneous as it may be, of his daughter’s virginity that he not only went with her every year to the OBGYN, but he also broadcast his practice in the media.
But to connect it solely with Greek roots, dowries, and physical ambiguity would be to do a disservice to the fact that we’ve a long history of associating or prioritizing certain bodies over others in medicine, in the name of “health,” and with a very inherently moral message. It is somehow moral to eat broccoli and not oven nachos; it is somehow moral to never have broken a width of skin that may never have been intact in the first place. (As it is somehow moral to place on a certain spectrum on the BMI, which is another bullshit and inherently racist alternative fact to actual health).
In some senses, the nebulous understanding of the hymen itself is actually a perfect metaphor for virginity — but not in the ways one might think. For all intents and purposes, both are social constructs that gets talked and hand-wrung about, but no one actually seems to have much intel on.
Furthermore, what can be said about the “demarcation” of virginity as it shows up on people with vaginas versus people with penises? The cultural traditions surrounding the hymen, as well as the lore, the shitty lack of information, and the ill-informed customs and social values, exist to devalue certain people over others — a concept that is still, to this day, enforced medically.
