The hymen, again
The hymen, again
Updated 06:38am (Mla time) Nov 06, 2004
By Rina Jimenez-David
Inquirer News Service
Editor's Note: Published on page A15 of the November 5, 2004 issue of the Philippine Daily Inquirer
TUESDAY'S column on the hymen, or rather, bleeding as a result of a ruptured hymen, as an "indicator" of virginity drew responses from women working with survivors of sexual abuse. They said a statement I made -- that the hymen may sometimes tear because of vigorous activity like biking or horseback riding -- was inaccurate and might even make their work in prosecuting abusers much more difficult.
Dr. Bernie Madrid of the University of the Philippines-Philippine General Hospital Child Protection Unit called and later sent an e-mail to set the matter straight. While she "totally agrees" that "bleeding is not a proof of virginity," Bernie made clear that "biking, doing vigorous exercise, etc., will not result [in] an injury to the hymen."
"What most people do not know is that majority of hymens already have an opening at birth and that as the child becomes older, the hymen becomes more elastic. This is the effect of the hormone estrogen. A well-estrogenized hymen can be penetrated without resulting in any injury," says Bernie.
While a virgin may not bleed or experience pain during her first sexual intercourse, notes Bernie, neither does the absence of bleeding or of tears, lacerations, abrasions and other signs of injury mean that a woman or girl did not have sexual intercourse, with or without her consent.
"What we emphasize in our training on the medico-legal examination of the sexually abused child is that normal findings do not exclude sexual abuse," Bernie adds. "In 80 percent of sexual abuse cases, physical findings are normal. We do not accept requests to 'find out if the child or woman is still a virgin.' It is a useless exercise. Virginity is not even a medical diagnosis. The hymen is insignificant to the health of a female unless she gets hurt or killed by an ignorant male because of misconceptions over it."
* * *
TWO articles published in CPU-Net Medical Alert, a bi-monthly bulletin of the Child Protection Unit Network, "demystify" the alleged link between injuries to a child's genitalia ("anogenital trauma") and the child's virginity or lack of it, or whether she had consensual sex or not.
A study (Jones and Hartman, 2003) in the publication of the Academy of Emergency Medicine involved 523 female adolescents, between ages 13 and 17, some of whom reported having consensual sex, while the others alleged having been forced into having sex.
The study's findings show that 70 percent of the adolescents who reported consensual sex had "documented anogenital injuries" while 85 percent of those who alleged sex abuse reported similar injuries.
The conclusion: "Injuries are not inevitable consequences of sexual assault, [but] the lack of genital injury does not imply consent by the victim or lack of penetration by the accused."
Another study, discussed in an article entitled "Genital anatomy in pregnant adolescents: Normal does not mean nothing happened," the authors studied the genital examination findings of 36 pregnant adolescents and looked for evidence of "penetrative genital trauma." Of the 36 subjects, only two showed genital changes "that were diagnostic of penetrative trauma," this despite proof (pregnancy) that they had undergone sexual intercourse.
* * *
A POSSIBLE explanation, the authors said, is that "penetration does not result in visible tissue damage or [that] acute injuries occurred but healed completely."
In its conclusion, the study notes that "medical, legal and social professionals as well as lay juries [or even the media] need to understand that, in most cases of childhood sexual abuse, there will be few if any clinical findings that are diagnostic of penetrative trauma." The authors emphasize that "vaginal penetration does not result in observable evidence of healed injury to the hymen." What investigators and legal authorities need to do, notes CPU-Net, is to conduct a "good investigation, including a forensic interview and collection of collaborative evidence in the persecution of child sexual abuse cases."
All too often, the investigation and pursuit of a report of child sexual abuse results in inflicting even more abuse on the young victim. I remember one child advocate complaining that the "usual" procedure in the physical exam of a child reporting sexual abuse (which I hope has already been discarded) was to insert round metal tubes of varied circumferences into the vagina or anus to ascertain whether a child had undergone penetration or not. At the very least this would mean requiring the child to relive the experience, if not inflict even more pain, shame and trauma.
And might I add, as well, a reiteration of an earlier appeal to the media to cease the horrendous practice of interviewing child survivors of sexual abuse (often on-cam), with reporters asking them how they feel (how else are they supposed to feel?) and if they want the abuser, who is sometimes the child's father, to be put to death (go ahead, deepen the pain!).
* * *
INVESTIGATORS and judges, as well as lawyers and even the parents of abused children, should stop relying on physical evidence of forced or consensual sex, or even of virginity at the time of the incident, to prove or disprove a child's allegations of sexual abuse. Instead, authorities can rely on the child's testimony and demeanor, as well as an appraisal of the child's state of mind by professionals, among other evidence to get to the truth of the child's report of sexual abuse.
Meanwhile, those of you who are concerned about the increasing number of child sexual abuse cases may want to learn as much as you can about the issue, as well as approaches to the healing of survivors during the Third Annual Conference of the Child Protection Unit Network on Nov. 8 and 9, at the Traders Hotel.
Updated 06:38am (Mla time) Nov 06, 2004
By Rina Jimenez-David
Inquirer News Service
Editor's Note: Published on page A15 of the November 5, 2004 issue of the Philippine Daily Inquirer
TUESDAY'S column on the hymen, or rather, bleeding as a result of a ruptured hymen, as an "indicator" of virginity drew responses from women working with survivors of sexual abuse. They said a statement I made -- that the hymen may sometimes tear because of vigorous activity like biking or horseback riding -- was inaccurate and might even make their work in prosecuting abusers much more difficult.
Dr. Bernie Madrid of the University of the Philippines-Philippine General Hospital Child Protection Unit called and later sent an e-mail to set the matter straight. While she "totally agrees" that "bleeding is not a proof of virginity," Bernie made clear that "biking, doing vigorous exercise, etc., will not result [in] an injury to the hymen."
"What most people do not know is that majority of hymens already have an opening at birth and that as the child becomes older, the hymen becomes more elastic. This is the effect of the hormone estrogen. A well-estrogenized hymen can be penetrated without resulting in any injury," says Bernie.
While a virgin may not bleed or experience pain during her first sexual intercourse, notes Bernie, neither does the absence of bleeding or of tears, lacerations, abrasions and other signs of injury mean that a woman or girl did not have sexual intercourse, with or without her consent.
"What we emphasize in our training on the medico-legal examination of the sexually abused child is that normal findings do not exclude sexual abuse," Bernie adds. "In 80 percent of sexual abuse cases, physical findings are normal. We do not accept requests to 'find out if the child or woman is still a virgin.' It is a useless exercise. Virginity is not even a medical diagnosis. The hymen is insignificant to the health of a female unless she gets hurt or killed by an ignorant male because of misconceptions over it."
* * *
TWO articles published in CPU-Net Medical Alert, a bi-monthly bulletin of the Child Protection Unit Network, "demystify" the alleged link between injuries to a child's genitalia ("anogenital trauma") and the child's virginity or lack of it, or whether she had consensual sex or not.
A study (Jones and Hartman, 2003) in the publication of the Academy of Emergency Medicine involved 523 female adolescents, between ages 13 and 17, some of whom reported having consensual sex, while the others alleged having been forced into having sex.
The study's findings show that 70 percent of the adolescents who reported consensual sex had "documented anogenital injuries" while 85 percent of those who alleged sex abuse reported similar injuries.
The conclusion: "Injuries are not inevitable consequences of sexual assault, [but] the lack of genital injury does not imply consent by the victim or lack of penetration by the accused."
Another study, discussed in an article entitled "Genital anatomy in pregnant adolescents: Normal does not mean nothing happened," the authors studied the genital examination findings of 36 pregnant adolescents and looked for evidence of "penetrative genital trauma." Of the 36 subjects, only two showed genital changes "that were diagnostic of penetrative trauma," this despite proof (pregnancy) that they had undergone sexual intercourse.
* * *
A POSSIBLE explanation, the authors said, is that "penetration does not result in visible tissue damage or [that] acute injuries occurred but healed completely."
In its conclusion, the study notes that "medical, legal and social professionals as well as lay juries [or even the media] need to understand that, in most cases of childhood sexual abuse, there will be few if any clinical findings that are diagnostic of penetrative trauma." The authors emphasize that "vaginal penetration does not result in observable evidence of healed injury to the hymen." What investigators and legal authorities need to do, notes CPU-Net, is to conduct a "good investigation, including a forensic interview and collection of collaborative evidence in the persecution of child sexual abuse cases."
All too often, the investigation and pursuit of a report of child sexual abuse results in inflicting even more abuse on the young victim. I remember one child advocate complaining that the "usual" procedure in the physical exam of a child reporting sexual abuse (which I hope has already been discarded) was to insert round metal tubes of varied circumferences into the vagina or anus to ascertain whether a child had undergone penetration or not. At the very least this would mean requiring the child to relive the experience, if not inflict even more pain, shame and trauma.
And might I add, as well, a reiteration of an earlier appeal to the media to cease the horrendous practice of interviewing child survivors of sexual abuse (often on-cam), with reporters asking them how they feel (how else are they supposed to feel?) and if they want the abuser, who is sometimes the child's father, to be put to death (go ahead, deepen the pain!).
* * *
INVESTIGATORS and judges, as well as lawyers and even the parents of abused children, should stop relying on physical evidence of forced or consensual sex, or even of virginity at the time of the incident, to prove or disprove a child's allegations of sexual abuse. Instead, authorities can rely on the child's testimony and demeanor, as well as an appraisal of the child's state of mind by professionals, among other evidence to get to the truth of the child's report of sexual abuse.
Meanwhile, those of you who are concerned about the increasing number of child sexual abuse cases may want to learn as much as you can about the issue, as well as approaches to the healing of survivors during the Third Annual Conference of the Child Protection Unit Network on Nov. 8 and 9, at the Traders Hotel.
posted by Dante at 12:00 AM
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