Hymen reconstruction surgery
(HR), while ethically controversial, is now available in many countries. Little
clinical evidence and hardly any surgical standards support the intervention.
Nearly as scarce is social science research exploring women's motivations for
the intervention, and health care professionals' justifications for its
provision.
In order to better understand decision-making processes, we
conducted semi-structured interviews in metropolitan Tunis, in 2009, with six
women seeking the procedure, four friends who supported such women, four physicians
who perform the operation, and one midwife.
Health care professionals and
patient companions expressed moral ambivalence about HR: although they could
comprehend the individual situation of the women, they expressed concern that
availability of the procedure might further entrench the patriarchal norms that
compel the motivation for seeking HR in the first place. Some women seeking HR
shared this concern, but felt it was not outweighed by their personal aims,
which were to marry and become mothers, or to overcome past violent sexual
experiences.
The women felt HR to be uniquely helpful in achieving these aims;
all made pragmatic decisions about their bodies in a social environment
dominated by patriarchal norms. The link between HR and pervasive gender
injustice, including the credible threat of serious social and physical harm to
women perceived to have failed to uphold the norm of virginity before marriage,
raises questions about health care professionals' responsibility while facing
requests for HR.
Meaningful regulatory guidance must acknowledge that these
genuine harms are at stake; it must do so, however, without resorting to moral
double standards. We recommend a reframing of HR as a temporary resource for
some women making pragmatic choices in a context of structural gender
injustice. We reconfirm the importance of factual sexual and reproductive
education, most importantly to counter distorted beliefs that conflate an
"intact hymen" with virginity.
Purchase full article at: http://goo.gl/1SKxgI
By: Wild V1, Poulin H2, McDougall CW3, Stöckl A4, Biller-Andorno N5.
- 1University of Zurich, Switzerland; Ludwig-Maximilians-University, Munich, Germany. Electronic address: wild@ethik.uzh.ch.
- 2EHESS, Paris, France.
- 3University of Toronto, Canada.
- 4University of East Anglia, Norwich, Great Britain, United Kingdom.
- 5University of Zurich, Switzerland.
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