In Muslim societies as well as in a number of other cultures around the world, an intact hymen traditionally acts as a signifier of the virginity of a woman and can be of paramount importance when a girl is married for the first time.

But in Europe and elsewhere, more and more women are undergoing hymenoplasty – the surgical reconstruction of the hymen – for a number of reasons, other than religious and cultural ones.

Some of these include psychological healing, as when a woman has had her hymen torn as a result of sexual assault and rape. In these cases, hymen surgery can repair some of the psychological damage by restoring her both physically and mentally.

There are also instances when the hymen can tear before intercourse. The use of sanitary tampons and some very vigorous exercises for example, can cause tearing of the hymen.

Whatever the reasons, hymenoplasty is on the rise in Europe as well as in some Muslim countries such as Tunisia and Turkey where the procedure is considerably less expensive than in western Europe. The operation is widely advertised on the Internet, and a large choice of medical tourism packages are available.

But the practice is also drawing strong criticism from some quarters.

In a number of European capitals and particularly in London, doctors are earning thousands of euros at a time for hymenoplasty, commonly known as ‘virginity repair’ operations. Patients are mostly young Muslim women and surgeons have been accused of cashing in on their fears as they come under pressure from their traditionalist families to be ‘untouched’ before they marry.

There are no reliable statistics on these operations mainly because these are necessarily performed in private clinics and are therefore not covered by health insurance plans. However, more and more young Muslim women are seeking certificates from gynecologists to prove their virginity.

The Koran forbids Muslims engaging in extramarital sex but according to various Islamic scholars, hymen reconstruction surgery is permissible in certain cases.

Abdallāh al-Najjār, a scholar from Al Azhar University in Cairo is of the opinion that there is nothing in Islamic jurisprudence that forbids the surgery whether the hymen was broken due to an immoral act or a moral cause that excuses the woman.

Other experts such as Dr. Muhammad Bin Yahya al-Nujaymi from the International Islamic Fiqh Academy in Jeddah, Saudi Arabia, say that hymenoplasty is permissible only if it was due to factors outside the woman’s control, such as rape.

In the UK as well as most western countries, the operation is legal. However, bodies such as the British General Medical Council say that doctors must first obtain from the patient an ‘informed consent’ which may be considered invalid if it is given ‘under pressure or duress exerted by another person’.

In any event, critics are of the opinion that hymen repair perpetuates harmful myths about virginity.

The operation itself involves the reconstruction of a layer of skin at the entrance to the vagina that usually tears, accompanied by bleeding when a woman has her first sexual intercourse.

Even though this is a traditional sign of virginity, a great many women do not bleed upon losing their virginity.

Some 22 London clinics – many in Harley Street – have put out advertisements on the internet for the operation that costs around 3,000 euros and is performed under local anaesthetic, in under one hour.

Some private clinics attract potential patients with advertisements saying the surgery can ‘restore your innocence and is 100% safe’. This is of course is a debatable claim.

Others recommend the operation by asserting that the hymen is ‘a sign of virginity and for religious reasons is an important factor in a new marriage…some marriages are even annulled in the event of a torn hymen’.

In any case, there is a degree of anguish involved for many of the young women applying for the operation.  

It is a fact that social and sexual differences between young Muslim and non-Muslim women in Europe are diminishing, including a trend of marrying later in life; and what’s more, that trend has generally reduced the probability of women of any faith marrying as virgins.

Even so, many Muslim women who apply for hymenoplasty still evoke the pressure and intimidation that threaten their physical and psychological well-being as their traditional wedding dates approach.

In France, as long ago as 2008, the College of Gynecologists and Obstetricians had opposed hymenoplasty for cultural, health, as well as moral reasons.

Some physicians were of the opinion that by performing the operation, they were empowering women by giving them a viable future and preventing them from being abused.

But the head of the College, Professor Jacques Lansac had said that “attaching so much importance to the hymen is regression, submission to the intolerance of the past.”

The then French Justice Minister, Rachida Dati who is Muslim faced calls for her resignation after she had upheld a court ruling that annulled the marriage of two French Muslims, on the grounds that the woman’s hymen was not intact.

The court cited a breach of contract because the man had agreed to the marriage after the woman was “presented to him as single and chaste.”

A number of physicians, lawyers and feminists were of the opinion that the court ruling would lead more and more Muslim women in France to seek virginity repair operations.

Their fears were of course justified and the debate is ongoing.

On 23 January 2020, Baroness Thornton,  Parliamentary Under-Secretary for Health in the House of Commons asked Lord Bethell, Government Whip, if Her Majesty’s Government plan to ban repair of hymen surgery.

The answer was : “My Lords, no one should undergo any surgical procedure that they do not want or need. Pressuring a female partner or family member into having an unnecessary surgical procedure is never acceptable. The Government are investigating hymen repair surgery, and we will take all necessary action to ensure that all vulnerable women and girls are protected.”

Whereas Baroness Thornton replied : “I thank the Minister for his reply. As noble Lords will have gathered, hymenoplasty is the so-called restoration of virginity, and it is not illegal in the UK. It is carried out in private clinics, by and large, and apparently costs about £3,000 a go. The Sunday Times revealed that NHS (National Health service) facilities were used to carry out this procedure 82 times in the past eight years. The noble Lord is quite right: clinicians agree that there is no medical reason for the restoration of the hymen, so why is that procedure available on the NHS? No explanation was given to the Sunday Times when it asked why the procedure was delivered. I think the noble Lord and I would agree that the NHS should not be offering a procedure designed to perpetuate harmful myths about virginity and threats to vulnerable women and girls.”

Lord Bethell then answered : “The noble Baroness is absolutely right about harmful myths. The Government are deeply concerned about the climate in which this industry is operating. We will be looking into how the frameworks are being applied by the GMC (General Medical Council), the CQC (Care Quality Commission) and the ASA (Advertising Standards Authority). On her specific question about the NHS, there were around 82 cases according to the records available. Very sadly, there are cases of abuse and rape—and, I am afraid, of fear of death—that may, even with the best counselling available, give a young woman or girl a good reason to ask for this procedure. It is under such circumstances that the NHS provision has been made.”

The “Western” and Islamic bioethical debate on hymenoplasty will likely continue into the future as the critical concepts that underpin ethical and medical justifications for and against the procedure are taken into consideration.

Hossein Sadre