Virgin: The Untouched History (5 page)

It seems strange, since we think of them as being static unless they are "torn" or "broken," but hymens change shape all by themselves. Between birth and age three, and in some cases again between ages three and
five,
hymens can go through quite a bit of alteration in shape and size. These changes take place painlessly, silently, and virtually unnoticeably, without the girl in question (or anyone else, in all likelihood) being any the wiser or noticing any change. We don't know why the hymen changes shape, and we don't know how it happens, but the phenomenon has been observed many times. The best way to think of it is that like other body parts, the hymen continues to develop after birth, and this means that sexual penetration is absolutely not required for a hymen to be different or look different from one day, one week, or one month to the next. This calls into question the very notion of the "intact" hymen: if the hymen can change all by itself, can we ever accurately call it "intact" or "unaltered"?

In addition to appearing in different shapes, hymens vary in other ways. Hymenal tags, elongated protrusions of tissue that extend from the surface of the hymen, are a fairly common accessory. Hymens can also have bumps, mounds, notches, concavities, and depressions. Although seventeenth-century English midwife and medical writer Jane Sharp described the hymen as looking like a "clove-gilliflower" (a pink, or carnation), in reality hymens are observed in a range of colors along the purple/red spectrum. Likewise, the inner rim of the hymen can be smooth or scalloped, or show evidence of past tearing or stretching in the form of clefts. These can be superficial notches or complete transections. It is less common for women who have not experienced some sort of vaginal penetration to have complete transections in the most substantial portions of their hymens, so in examinations, for instance exams conducted after allegations of child abuse, these are considered a red flag that penetration might have taken place. But not all hymens with complete transections have been penetrated, not all vaginal penetration is sexual, and not all sexual penetration causes a complete transection of the hymen—or indeed any at all.

Resistance and Resilience

The physical appearance and general form of the human hymen runs a wide gamut and is prone to change without either external cause or warning. Much the same is true of the nature of the hymenal tissue itself. Just as we all have different qualities of hair and skin, with some being fine and delicate and others being robust and resilient, the thickness, strength, flexibility, durability, and sturdiness of hymenal tissue varies, too.

Part of this, like the characteristics of any of the other tissues in our bodies, is genetic. We inherit our hair color, eye color, propensity toward certain diseases, and a million other things from our parents—so why not the characteristics of our genital tissues? There is some evidence that imperforate hymens may be inherited matrilineally, so it would make sense if similar things were true of other aspects of the hymen as well.

Hymen tissue is also affected by hormones. Estrogen, to which a female fetus is exposed in utero and which her body will manufacture in increasingly large quantities as she heads into puberty, both thickens the genital mucous membranes and makes them more elastic. Because of their prenatal estrogen bath in the mother's womb, the hymens of very young girls (approximately under the age of two) can in some cases be more elastic than those of girls just a few years older. As the effects of the fetal hormone bath wear off, the elasticity of the vagina can correspondingly decrease and its tissues become more, fragile. Then, as puberty arrives, a girl's own estrogen increases enormously and with it, so does the elasticity of her genital tissues.

Thickness and resilience of hymen tissue also varies. In general, the hymen is thinner than an eyelid. Many are described as being translucent. Some are so thin and fragile that it is impossible for doctors to examine them without damaging them in the process. Others are thicker, even rubbery. Researchers have found that some hymens remain fairly thick, others remain fairly thin, and still other hymens may become thinner over time.

The thickness, thinness, and relative fragility of different hymens often complicate attempts to make virginity diagnoses based on what the hymen looks like. Some more or less disintegrate on their own. Others are quite robust and can be shoved around rather roughly without looking any worse for wear. Nineteenth- and early-twentieth-century gynecologists sometimes explained away women who did not bleed the first time they had intercourse as having "complacent" hymens, meaning that the hymen was so elastic as to simply bend or fold on impact. The knowledge that the female genitalia could simply "give in" to penetration without struggle or damage was itself sometimes used to cast aspersions upon a woman's chastity, on the assumption that any woman who could disguise her sexual indiscretions probably had already done so. Some women who believe that they never had hymens because they did not bleed or feel pain the first time they had sex may simply have hymens that are sufficiently sturdy to bend instead of breaking.

Because we're taught to think of hymens as inherently fragile, the notion of a resilient hymen is especially intriguing. Some hymens are so resilient that they endure years of sexual intercourse quite handily, only to be discovered during prenatal gynecological exams or even in childbirth. In the January 2002 edition of
Midwifery Today E-News,
midwife Brenda Capps reported her attendance of the labor of a young first-time mother who had a thick, very resilient septate hymen that had apparently survived intercourse with no sign of damage and had to be cut to allow the baby to be born.

An even more impressive case is the topic of a 2002
Australian and New
Zealand Journal of Gynecology
report about a Taiwanese woman in her early thirties. Diagnosed with an imperforate hymen at thirteen, this patient had surgery to correct it. Despite the surgery, the hymen grew back, and she underwent a second hymenotomy when she was eighteen. Everything seemed fine for some time, and the woman married and became pregnant, delivering by caesarean section. At the time that she gave birth, doctors noted that her hymenal orifice was quite narrow. The patient admitted that her husband had a problem with premature ejaculation and that she rarely, if ever, felt penetration during their sexual encounters. (The underappreciated fact that lack of penetration is no barrier to pregnancy is certainly one of the morals to this story.) Whatever the nature of this woman's sex life, it must have been sufficient to the task, for the patient soon became pregnant a second time. When she arrived at the hospital to give birth, however, the doctors discovered that her hymen had once again resealed. The baby was delivered successfully by caesarean, and the patient was given a third hymenotomy. One hopes that the old maxim "third time's the charm" held true, and that this woman and her incredible resealing hymen have required no further run-ins with the scalpel.

At the far opposite end of the spectrum are the fragile hymens. Not a lot is known about fragile hymens for the simple reason that they fall apart too easily to ever be noticed. It is probable that some of the women who, due to lack of any evidence to suggest the contrary, thought they must have been born without a hymen have in reality merely had very fragile ones, so slight as to be negligible.

Far from being a uniform bit of female anatomy, hymens prove to be a motley crew indeed. From a practical perspective, this means that merely saying that someone has a hymen is, all by itself, a bit like Saying someone has skin: "knowing that they have it doesn't tell us what it looks like, whether it is rough or soft, scarred or smooth. Certainly knowing that someone has a hymen, as all but a very small percentage of women do, does not tell us whether or not she has had any sexual experiences. All we know, when we know that someone has a hymen, is that it exists . . . although this itself was for centuries a matter of hot debate.

CHAPTER 4

A Desperate and Conflicted Search

In som virgins or maidens in the orifice of the neck of the womb there is found a certain tunicle or membrane called of antient writers Hymen . . . But I could never find it in anie, seeking of all ages from three to twelv, of all that I had under my hands in the Hospital of Paris.

—Ambroise Pare, 1573

I
T IS EASY TO ASSUME that our ancestors understood things sexual in the same way we do today. After all, human sex organs and the range of sexual acts we have at our disposal have been roughly the same since the time the human species began. It simply doesn't occur to us to think that while our predecessors may have had all the same bits and pieces we do, and may have put them to use in substantially identical ways, they may well have thought—and indeed often did think—of them very differently indeed. Sometimes historical conceptions of the body and its parts can be. so different from ours as to seem bizarre. To wit: the saga of the hymen.

Various ancient writings from Egypt, Greece, the Middle East, and Asia Minor make reference to virgins and virginity, yet none of them mention the hymen. We can read what the Talmud has to say about the signs of virginity, consult the Old Testament about virgin brides, and survey the myths and legends of Artemis, Cybele, Athena, and other virgins both earthly and supernatural and find no mention of the hymen anywhere, nor any suggestion of such an anatomical tidbit. Why not?

The answer is so simple that most historians have missed it: for our ancestors in the ancient world, the hymen did not exist. This doesn't mean that women of that era weren't born with hymens as part of their bodies, but rather that neither they nor anyone else knew that they were there.

We might wonder how the physicians of the ancient world could have possibly missed such a thing. In part the answer is that they literally weren't looking. At that time it was strongly taboo for male doctors to examine women's bodies directly. Occasional exceptions did occur, but in all the medical texts attributed to the school of Hippocrates there are only two examples of a physician carrying out a vaginal examination, which gives the impression that these instances were rare indeed. Examinations on women were done by midwives, not physicians.

Even if doctors had performed gynecological exams every day, though, they still probably wouldn't have found a special thing called a hymen inside anyone's vagina. For one thing, they wouldn't have been looking for it. Having no concept that such a thing should be expected, they would have been unlikely to notice it as anything but just another of the various ridges and folds of the female genitals. The second-century physician Galen's exhaustive anatomical treatise
De usupartium,
for example, makes no mention of it, and this from a meticulous observer who identified and explained the foreskin, buttocks, labia, and clitoris—something that a startling number of later anatomists managed somehow to forget was there. But never once does Galen mention anything like the structure many people believe constitutes the physical presence of a woman's virginity.

In the Beginning Was the Word

The other major reason ancient physicians wouldn't have found hymens in women's bodies even had they looked for them is that, for them, at that time, the word "hymen" meant something altogether different than it does today. In the literature of early Greek medicine, the word "hymen" comes up constantly. Aristotle, particularly, is full of them. There is a hymen of the brain, a hymen of the heart, a hymen of the intestines. You can hardly go three pages without a hymen popping up somewhere, because to Aristotle and the rest of the Greek world of his time, the hymen was nothing more or less than a membrane. Any membrane. The thick membrane around the brain that we call the dura was one such hymen. The mesentery, which anchors all of our intestines in place inside the abdominal cavity, was another. So too with the sac around the heart we call the pericardium, the muscular wall between the chest and abdomen that we call the diaphragm, the sac around the lungs that we call the pleura, and virtually every other structure that divides or separates one anatomical feature from another.

Hymens, hymens everywhere, but not the kind you'd think. How, then, did this catch-all term for "membrane" come to mean something so specific? Not every twist and turn of the tale is known—many texts of this period have been lost to us—but virginity researchers including medieval history scholar Kathleen Coyne Kelly and historian of ancient Greece Giulia Sissa have been able to trace the outlines of the transformation.

After Aristotle and the writers of the school of the so-called father of medicine, Hippocrates of Cos, the next major Western writers on medicine are two Greeks, the second-century Galen and the third-century Soranus of Ephesus. Galen uses the term "hymen" to mean "membrane," just as his predecessors did. Soranus does so, too, but interestingly enough, he defines the vagina itself as a hymen, saying that in his eyes it resembles an intestine with an ample interior. The vaginal canal, to him, was a membrane that formed part of the larger structure of the uterus, or matrix, which to Soranus and everyone else of his era was the female genital par excellence. The rest of the female genital anatomy, in texts of this period, is rarely discussed in terms of specific parts. Only the uterus, with its miraculous capacity to turn sperm and blood into babies, was considered truly relevant.

After Soranus, there are a few examples of the Latin word
himen
(again meaning "membrane") in reference to matters gynecological. Often it is used, as in the tenth-century
De viribus herbarum,
to refer to the amniotic sac, the membrane that encloses the fetus while it grows in the womb. Occasionally
himen
is used in ways that seem to allude to a "virginal membrane," but not in ways that identify any particular part of the body. In the medieval era the
himen
of virginity, when the term is even used that way, seems to be more metaphorical—a symbolic boundary between virgin and nonvirgin—than it is something that anyone could point to in a dissection, or a patient's body. For centuries, though physicians clearly understood that there had to be some reason that women often bled when their vaginas were sexually penetrated for the first time, they saw no reason that such bleeding necessarily had to be associated with any specific bit of the genital anatomy.

Kathleen Coyne Kelly has found that usage of the word "hymen" to refer to the same thing we mean when we use the term today did not occur until the fifteenth century, when physician Michael Savonarola used the word in his
Practica
maior.
"The cervix is covered by a subtle membrane called the hymen," Savonarola wrote, "which is broken at the time of deflowering, so that the blood flows." Savonarola's vague placement of the hymen somewhere "in front of the cervix" can perhaps be excused by the tendency, even in the 1400s, to view the uterus as the true womanly genital, and the vagina merely as an accessory passageway. In any case, he seems to have an understanding that this bit of tissue—it is technically something of a misnomer, although a common one, to call it a membrane—is inconspicuous and often not noticed unless it is damaged.

Savonarola's usage of "hymen" to mean the vaginal hymen was rapidly followed by the first such usage in English. The 1538 dictionary produced by Londoner Thomas Elyot cites it thus: "a skinne in the secrete place of a maiden, which whanne she is defloured is broken." From this point on, "hymen" becomes more and more commonly the vaginal hymen and less and less commonly anything else. By the seventeenth century, physicians and midwives writing in the vernacular use the term "hymen" in their discussions with the expectation that readers will automatically know which, out of the many parts of the body that could be called the hymen, they mean.

This chronology leaves no evidence to support the idea that there is a direct connection between Hymenaeus, the Greek god of marriage, and the name we've ended up using for the small bit of genital tissue that bears the name "hymen." While it does indeed seem like a fine bit of poetic justice that the story of Hymenaeus, a tragedy involving the death of a young groom on his wedding night, would come to be associated with a piece of anatomy that traditionally doesn't survive the wedding, the etymological timing simply doesn't make a causal relationship plausible. Had the ancient Greeks used the word "hymen" to mean something more anatomically specific, even if only in the specific sense of meaning a membrane whose functional destiny lay in its being broken (the amniotic sac, for instance), the argument that Hymenaeus lent his name to the hymen might hold a bit more water. As it stands, Greeks of the era during which Hymenaeus was actively worshipped did not, as we've seen, acknowledge the existence of a specific vaginal membrane, much less name it after their patron god of weddings. Just as the hymen itself is vestigial, a remnant of the time in the formation of the female body when the vaginal canal did not yet open into the vulva, so is the term we use to identify it, a throwback to an era where anatomical knowledge was so generalized that every membrane in the body could carry the same name.

Virginity Before the Hymen

The story of the anatomical hymen begins in earnest with the Greek Soranus, practicing and writing in third-century Rome. Soranus's claim to fame is his
Gynecology,
one of the earliest works on the topic that has survived in its entirety, and what Soranus has to say about the physical nature of virginity is very interesting indeed.

In virgins the vagina is depressed and narrower, because it contains ridges that are held down by vessels originating in the uterus; when defloration occurs, these ridges unfold, causing pain; they burst, resulting in the excretion of blood that ordinarily flows. In fact, the belief that a thin membrane grows in the middle of the vagina and that it is this membrane that tears in defloration or when menstruation comes on too quickly, and that this same membrane, by persisting and becoming thicker, causes the malady known as "imperforation," is an error.

This description of the vagina as an expanding vessel with corrugated walls was considered authoritative for centuries due to its combination of intelligent observation and meticulous logic. Soranus refused to believe in the rumors he had heard about some strange membrane in the vagina because, as he wrote in
Gynecology,
he had no evidence that proved it existed. He had never been able to find it in dissection. He had never experienced any barriers to the insertion of probes into the vaginas of virgin patients. It also seemed, to Soranus, that if "the breaking of the membrane during defloration were the cause of pain, there would also have to be pain before defloration, at the time of the menstrual period. During defloration there should no longer be any." Last but not least, he opined that if a vaginal membrane were the cause of the malady of vaginal imperforation, doctors would always find the obstruction in the same place in every patient who suffered from that malady, and this was not the case.

And indeed Soranus is completely correct about all of this. One can insert a slender probe into a virgin's vagina and not encounter an obstacle until the end of the probe hits the cervix. Women do indeed menstruate when they are still virgins without any barrier in the vagina needing to be removed or altered before the flow can begin, and furthermore, virgin women can menstruate without the menstrual flow causing them pain. It is also true that occlusions of the female reproductive tract, what Soranus is calling "imperforations," may occur in a number of locations within the complex of vagina, uterus, and fallopian tubes.

In hindsight, the flaw in Soranus's reasoning is obvious. He is not imagining a membrane that normally has a hole in it, as we now know the typical hymen to be. Soranus is thinking of the hymen as a solid, contiguous, unbroken thing, like the lid of a jar or an oiled bladder stretched tight over the mouth of a wine jug. There was every reason he should have thought of it this way. In the ancient world, the predominant image of the womb, that most important of the female organs, was that of a vessel. Some described it as an upside-down jug with a long neck, others as a bowl in which male and female fluids were mixed and blood added to produce a child, giving the womb a functional resemblance to a
hater,
the cup or jar in which wine was mixed with water before being drunk. A jug without a stopper easily spills. A lid with a hole in its middle is hardly a lid at all. All of which is to say that what we might be tempted to view as a misconception is not ill-conceived at all. Soranus was being rigorously logical.

Not believing in the existence of a vaginal membrane, however, does not mean that Soranus did not believe in virginity. On the contrary, Soranus was, in contrast to Hippocrates and other Greek doctors before him, a proponent of virginity for both men and women.
Gynecology
is unique in the ancient world in that it actually takes seriously the notion of preserving virginity, and discusses the question of how long a girl could remain healthy as a virgin and what sort of lifestyle would best maintain her health. Soranus was a man of his time in this respect. This odd notion of a woman remaining a virgin rather than being married off at puberty was beginning to become a very charged and public issue in the Rome in which Soranus lived and wrote—a place in which a new faith, Christianity, was gradually gaining its feet.

But what of this idea of a membrane inside the vagina? Where did it come from, and if Soranus believed it wasn't true, who believed it was? Unfortunately, Soranus neglected to mention where he heard the concept. We have no idea if the idea came from some now-lost medical tract, from some unusual report given by a woman or midwife, or from some other source entirely. Classicist Aline Rousselle offers the idea that the "sealing membrane" hypothesis may have been a Roman notion that evolved out of the Roman practice of frequently marrying girls off even before they had had their first menstrual. periods, a practice the Greeks did not follow and to which Soranus was opposed. The Romans would have observed, on multiple occasions, young women beginning menstruation only after they had been physically "opened" by intercourse, and they might then have conjectured that this opening of the passages by a penis removed some obstruction, making it possible for the menstrual blood to flow out.
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