The government has made it illegal to carry out, offer or aid and abet virginity testing or hymenoplasty in any part of the UK, as part of the Health and Care Act 2022. It is also illegal for UK nationals and residents to do these things outside the UK. The Department of Health and Social Care (DHSC) has subsequently published non-statutory guidance for those who may come in to contact with people affected by virginity testing and hymenoplasty. Content Warning:This article includes references to abuse that some readers may find distressing – discretion is advised. This article breaks down the key points that schools need to be aware of.

Schools should read and follow the guidance
Defining virginity testing and hymenoplasty
Understanding the procedures are forms of violence and ‘honour-based’ abuse
Understanding the procedures may cause or link to other safeguarding concerns
Tackling barriers to victims coming forward
Recognising the indicators that someone may be at risk
Responding to pupils at risk and not involving families and community members
Managing disclosures
Implementing appropriate training and working with organisations

Read on to learn more about each point.

Schools should read and follow the guidance

The DHSC says that the multi-agency guidance should be read and followed by all persons and organisations across the UK who have a duty and due regard to the safeguarding of children in their care – this includes governing boards of maintained schools and trust boards of academies.

It should be ensured that:

The school has a lead person, e.g. the DSL, whose role includes responding to concerns about virginity testing and hymenoplasty.
The school has a staff member, e.g. the DSL, who has undertaken additional training and can be approached to discuss and direct difficult cases.
All staff understand their role in protecting pupils who have undergone or are at risk of abuse, know to whom they should refer cases and understand the importance of timely information sharing.
Policies and procedures are in place that cover how to protect pupils who have undergone or are at risk of virginity testing and hymenoplasty.

Defining virginity testing and hymenoplasty

The Health and Care Act 2022 considers virginity testing, also known as hymen, ‘2-finger’ or vaginal examination as any examination (with or without contact) of the female genitalia intended to establish if vaginal intercourse has taken place. This is irrespective of whether consent has been given. Vaginal examination has no established scientific merit or clinical indication.

Hymenoplasty is a procedure, which can involve a number of different techniques, undertaken to reconstruct a hymen. Typically, it involves stitching or surgically reconstructing a hymen. The aim of the procedure is to ensure that the person bleeds the next time they have vaginal intercourse to indicate they are a virgin. Hymenoplasty is different to procedures that may be performed for clinical reasons, e.g. surgery to address discomfort or menstrual complications.

Understanding the procedures are forms of violence and ‘honour-based’ abuse

Virginity testing and hymenoplasty are forms of violence against women and girls and are part of the cycle of ‘honour-based’ abuse. Victims are coerced, forced and shamed into undergoing these procedures, often pressurised by family members or their intended husbands’ family in the name of supposedly upholding honour and to fulfil the requirement that a woman remains ‘pure’ before marriage. Those who ‘fail’ to meet this requirement are likely to suffer further abuse, including emotional and physical abuse, disownment and even honour killings.

Understanding the procedures may cause or link to other safeguarding concerns

The procedures are degrading and intrusive, and can result in extreme psychological trauma, provoking conditions such as anxiety, depression and PTSD, as well as physical harm and medical complications. Both virginity testing and hymenoplasty can be precursors to child or forced marriage and other forms of family and/or community coercive behaviours, including physical and emotional control.

Tackling barriers to victims coming forward

As with all forms of ‘honour-based’ abuse, and abuse in general, there are many barriers to victims disclosing information and reporting what has happened to them. It is, therefore, important that, if information regarding either settings or individuals involved in these practices is obtained, this intelligence is shared either with police, or anonymously through Crimestoppers.

Victims may also take years to come forward, e.g. they may not know that the abuse was abnormal or wrong at the time, and may feel shame about their sexual experiences or sexual abuse, having been taught that speaking out against family and/or the community is wrong, or being scared about the repercussions of speaking out. As such, the physical signs of abuse may not be present at the time of disclosure, but psychological damage is likely to remain. It is important, therefore, that schools educate pupils about the harms of these practices and dispel myths, and establish an environment where pupils feel safe enough to make a disclosure.

Recognising the indicators that someone may be at risk

Those aged 13-30 are considered to be most at risk, but it can affect girls as young as 8, and anyone can be subject to a virginity test or hymenoplasty regardless of age, ethnicity, sexuality, religion, disability or socioeconomic status. While physical signs of a procedure may be absent and highly unlikely to be identified in school, staff should be alert to the possible presence of stress, anxiety and other psychological or behavioural signs.

The guidance lists the following as indicators as that a person is at risk of or has been subjected to a virginity test and/or hymenoplasty:

A pupil is known to have requested either procedure or asks for help
Family members disclose that the pupil has already undergone the practices
Pain and discomfort after the procedures, e.g. difficulty in walking or sitting for a long period of time which was not a problem previously
Concern from family members that the pupil is in a relationship, or plans for them to be married
A close relative has been threatened with either procedure or has already been subjected to one
A pupil has already experienced or is at risk of other forms of ‘honour-based’ abuse
A pupil is already known to social services in relation to other safeguarding issues
A pupil discloses other concerns that could be an indication of abuse, e.g they may state that they do not feel safe at home, that family members will not let them out the house and/or that family members are controlling
A pupil displays signs of trauma and an increase in emotional and psychological needs, e.g. withdrawal, anxiety, depression, or significant change in behaviour
A pupil appears fearful of their family or a particular family member
Unexplained absence from school, potentially to go abroad
Changes in behaviour, e.g. a deterioration in schoolwork, attendance, or attainment

The above list is not exhaustive, but if any of these indicators are identified, staff members should follow the school’s safeguarding policy – this should mean raising concerns with the DSL who will then activate local safeguarding procedures. A referral should also be made to children’s social care services (CSCS) where there are concerns about a pupil’s welfare.

Responding to pupils at risk and not involving families and community members

Schools should ensure they follow their safeguarding procedures and adhere to their statutory duties immediately where there are signs that that a pupil’s welfare is being or may be threatened. An assessment of the risk they face should be undertaken. If there is believed to be immediate danger, the police should be contacted straight away.

Schools should not involve families and community members in cases involving virginity testing and hymenoplasty, including trying to mediate with family or using a community member as an interpreter. Such involvement may increase the risk of harm to the pupil, including expediting arrangements for the procedure. The risk of the pupil suffering from trauma and psychological damage is high and mental health support should be made available.

Managing disclosures

Staff working at schools should be mindful of the importance of good communication when talking to a pupil who has undergone or is at risk of virginity testing and/or hymenoplasty. The guidance provides broad principles on how to approach these conversations, which include:

Responding sensitively – acknowledge the disclosure, being aware of its sensitivity and the likely discomfort pupils will feel in discussing their sexual experiences and their fears of judgement and repercussions from their family and/or community for speaking out.
Assuring the pupil’s immediate safety – ensure the pupil is in a safe place away from the perpetrator(s). Where a disclosure takes place over the phone, ask closed questions and try and determine if the pupil is alone and it is safe for them to talk; consider using code words if possible. If the pupil is in immediate danger, contact the police straight away.
Being honest – explain to the pupil that while information will only be shared with those who need to know to be able to keep them safe and respond appropriately, confidentiality is limited and certain information may have to be passed on to others
Providing reassurance – ensure the pupil is aware that they are being taken seriously, and they will be supported and kept safe, and they should not feel ashamed or bad for making a report.
Gathering information – in order to fully understand the situation, sensitively try to collect as much information as possible, e.g. what procedures have taken place or are being requested, whether the pupil is at risk of other forms of abuse, coercion and control. If the pupil’s immediate safety is assured, open and non-leading questions can be asked. Keep a record of what is said.
Advise on the law – inform the pupil of the law to let them know that they are protected and that virginity testing and hymenoplasty is illegal. It may also be helpful to dispel myths and prejudices around virginity testing, e.g. the belief that virginity determines the worth of a woman.

Being involved in such discussions can also be difficult for members of staff, and schools should ensure support is available for those who are affected by what they have heard.

Implementing appropriate training and working with organisations

As with all forms of abuse, training on virginity testing and hymenoplasty should be appropriate and complement the school’s existing safeguarding training and duties. The DHSC suggests training for staff could include:

An overview of virginity testing and hymenoplasty, including definitions of and education on the hymen and virginity.
The risks and harms associated with virginity testing and hymenoplasty, including long-term health consequences.
Details of the UK law on virginity testing and hymenoplasty.
What to do when someone makes a disclosure and/or is at risk of or has undergone a virginity test or hymenoplasty.
The importance of multi-agency working and sharing information confidentially, and not discussing it with family or community members.
Tools to support sensitive conversations and disclosures.

Community organisations play a vital role in protecting and supporting those at risk of virginity testing and hymenoplasty. Schools should consider, where appropriate, working with relevant community groups and those with personal experiences to help make sure that they meet the needs of pupils and that their staff understand the issues related to virginity testing and hymenoplasty. Schools should, however, remain confident in their training and expertise of staff to be able to take action to protect pupils. Schools should check that any community groups they work with have robust child protection and general safeguarding policies that cover the sharing of information with statutory agencies.

What’s next:

You can read the guidance in full here, including Annex B which provides contact details for organisations who can offer tailored support.