Read Virgin: The Untouched History Online
Authors: Hanne Blank
At the same time, Pare understands that imperforate hymens do exist. His text cites a rather gruesome case study of a girl whose imperforate hymen, prior to surgery, led to such an extreme case of hematocolpos (backed-up menstrual blood that cannot exit the body) that it was "as if she had beene in travail with child." Later, in his
Des monstres etprodigues,
a 1573 compendium on monstrous births and birth defects, Pare would cite the hymen, along with extra fingers or toes and similar malformations, as an example of a malformation of the body that maims the person unlucky enough to be born with it, but that is not truly monstrous. As if this were not sufficient to clarify Pare's feelings on the matter, he furthermore made it clear in his
De la Generation de
I'Homme
(Concerning the Generation of Man) that the unsupportable myth of the virginal hymen could interfere with the workings of legal justice:
Midwives will certainly affirm that they know a virgin from one that is deflowered by the breach or soundness of that membrane. But by their report credulous Judges are soon brought to commit an error, for that Midwives can speak nothing certainly of this membrane may be proved by this, because that one saith that the situation thereof is in the very entrance of the privy parts, others say it is in the midst of the neck of the womb, and others say it is within at the inner orifice thereof, and some are of the opinion that they say or suppose that it cannot be seen or perceived before the first birth. But truly of a thing so rare, and which is contrary to nature, there cannot be anything spoken for certainty.
For Pare, a hymen was a membrane that sealed the vagina, and nothing else. When he did not find such a thing in the normal women and girls he examined, it was sufficient for him to state that the hymen did not normally exist, and that in cases where it did, it was a serious defect. Anyone who thought otherwise was a fool.
Then and Now
In the end Pare lost his crusade and the essentially Vesalian vision of the hymen promoted by Pineau won out. Seventeenth-century midwife Jane Sharp accepts the existence of the vaginal hymen without a quibble, and by 1668 we find the anatomical diagrams in the
Anatomy
of Thomas Bartholin prominently featuring a relatively accurate and correctly labeled hymen and hymenal orifice. From this point forward, the hymen is anatomical
terra cognita,
acknowledged universally to exist.
Thus the hymen spent a few relatively uneventful centuries in the medical books, a minor anatomical feature of the female genitalia that could typically be found described as existing in two states, "intact" and "ruptured." Canon and secular law both valued the hymen highly as proof of virginity. On the personal level, the hymen mattered to brides and grooms and mothers and fathers. At the same time, in the heady heyday of Enlightenment skepticism, the Chevalier de Jaucourt, in an article composed for the first Western encyclopedia, could archly question the nature of virginity itself:
Men, says M. de Buffon, jealous of privacies in every sphere, have always made much of whatever they believed they possessed exclusively and before anyone else. It is this kind of madness that has made a real entity of the virginity of maidens.
Jaucourt's refreshing cynicism was, however, nowhere near as influential as Pineau or Vesalius. By the nineteenth century, the hymen was more firmly entrenched than ever as material proof of a sexual status that was, more and more frequently, being cast as a matter of inherent virtue. Time marched on, but even as the decades of the twentieth century began to slip past, the fundamentals of the medical understanding of the hymen remained essentially the same. It existed, and while it did and was "intact," a woman was a virgin. Once it wasn't, neither was she, and that was all anybody apparendy felt the need to know.
It was not until the child sex abuse furor of the 1980s that hymens once again became the object of serious medical study. There was a sudden hunt, as researchers Karin Edgardh and Kari Ormstad put it in their overview of contemporary hymen research, "for a 'gold standard' that could substantiate stories and suspicions of sexual assault." Unsurprisingly given its history and the claims made for it, this hunt centered on the hymen.
Most of the efforts to develop a hymenal standard for abuse diagnosis have centered around two types of anatomical evidence. Clefts or transections of the hymen are the evidence of past tissue tears. Clefts can, however, appear independently of penetration or other sexual trauma. A complete posterior tran-section of the hymen is considered a red flag in a diagnostic examination looking for signs of abuse, something that indicates a probability of penetration, but it is not by any means definitive.
The other aspect of the hymen that doctors have repeatedly examined in their search for reliable physical proof of abuse is the diameter of the hymen's orifice or opening. Although there are a number of small studies that appear, at first blush, to indicate a positive correlation between an increased orifice size and sexual abuse, larger studies allowing for greater comparison have concluded otherwise. A team led by Dr. Daniel Ingram of the University of North Carolina School of Medicine in Chapel Hill, North Carolina, looked at 1,975 girls referred to a Raleigh, North Carolina, sexual abuse care team over a ten-year period from May of 1988 to May of 1998 and ultimately came to the conclusion that the size of the hymenal orifice could not provide sufficient evidence from which to conclude that a girl was sexually abused.
Other researchers agree. Ann Botash and Abby Berenson, two leading hymen researchers, have both cautioned against interpreting any hymenal findings in isolation. "Medical records of all female children at all well-child examinations should describe the hymen configuration as well as changes in configuration with time. Physical findings do not usually provide clear evidence of sexual abuse and the history continues to be the most important factor when attempting to conclude whether or not a child has been sexually abused." Perhaps with time and study there will be another Vesalius, another skilled and lucky anatomist who is able to detect something we currently cannot, and reveal to us some of the mysteries of this notoriously inscrutable piece of tissue. Until then, all we can say with certainty about the hymen is that it remains an open book, its diagnostic usefulness as much a puzzle to us now as its very existence was for our ancestors.
* Although it is beyond the scope of this book to discuss the many variants of this belief in depth, this is not as far-fetched an idea as it may seem. Similar notions have arisen in many cultures around the world. Even in the twentieth century, among indigenous Central and South Americans like the Cubeo of the Colombian Amazon, the Kayapo and Bororo of Brazil, and various rural Mexican populations, menstruation is often explained as the moon having sex with a woman, deflowering her so that she bleeds. Unlike a man, the moon only opens a woman partway, so that the moon must return to her and reopen her body each month until she marries. In these cultures it is believed that while the moon only opens the woman temporarily, a man opens her for good.
"I tried to tell her once more," said the grandmother, "that marriage and children would cure her of everything. 'All women of our family are delicate when they are young,' I said. 'Why when I was your age no one expected me to live a year. It was called greensickness, and everybody knew there was only one cure.' 'If I live for a hundred years and turn green as grass,'
said Amy, 'I still shan't want to marry Gabriel.' "
—Katherine Anne Porter, "Old Mortality"
I
HAVE, MORE THAN ONCE, seen young unmarried women, of the middle classes of society, reduced, by the constant use of the speculum, to the mental and moral condition of prostitutes; seeking to give themselves the same indulgence by the practice of solitary vice; and asking every medical practitioner, under whose care they fell, to institute an examination of the sexual organs," wrote physician Robert Brudenell Carter in 1853. The vaginal speculum, the infamous duck-billed contraption that features as best supporting actor in most gynecological exams, has been with us in one form or another since Roman times, holding open the vaginal walls so that physicians can see inside. It took the nineteenth century's sexual paranoia to turn the vaginal speculum into a weapon of mass feminine destruction.
The nineteenth-century controversy over the use of the speculum contains all the classic elements of interactions between virgins and doctors. Medical and moral claims regarding access to the body coexisted uneasily. The act of examining the genitals by touch was only barely acceptable by the mainstream medical standards of the day, and then only when absolutely necessary. It was by no means clear what sorts of medical need could excuse the more invasive speculum examination. Using the speculum was seen as intrusion into the vagina, not only by an object but by the male gaze, making every woman a potential victim not only of the speculum but of the presumably voyeuristic "speculumizer."
The use of the speculum did not, in other words, merely represent the possibility of a physically disrupted hymen, although that fear certainly accounted for some of the controversy. It represented a wholesale breach of the
hortus
clausus,
the "enclosed garden" of the feminine body, the supposedly inherent purity and modesty that tradition generally, and nineteenth-century mores particularly, attributed to women.
As such, the speculum was seen as a first step on a perilously steep slope that could lead straight from purity to perdition. It physically opened a body that was supposed to be closed to all men save a woman's husband. Worse, the insertion of an object into the vagina was thought to give women ideas they shouldn't have. For want of further vaginal stimulation, women who underwent speculum exams—or so argued Carter and some of his colleagues—would begin engaging in the ruinous "solitary vice" of masturbation and perhaps even turn to prostitution. Such fears of uncontrollable transformations set in motion by the use of medical technology, very like the upright Dr. Jekyll's transformation via drug into the murderous Mr. Hyde, were both a fear and a fantasy in a nineteenth century in which genuinely scientific medical practice was just beginning to gain ground.
Both the bodies and chastity of women and the nature and intentions of medical men were at stake in the speculum controversy. Medical examination of women's bodies by men has always been at least somewhat controversial, and particularly so in cases involving virgins. As far back as St. Augustine we can find cautionary tales of virgins whose virginities are accidentally "ruined" by clumsy midwives or physicians. The male gynecological specialist's motivations were suspect because they constituted male intrusion not just into women's bodies, but into a historically all-female realm. For most of recorded history, the treatment of women's sexual and reproductive health was the almost exclusive bailiwick of women, including the "juries of matrons" who performed the genital examinations required in the evaluation of rape and annulment cases and who were among the rare women considered qualified to give testimony in medieval courts of law. Women served as respected and acknowledged medical professionals for other women in evaluating fertility and treating infertility, coping with pregnancy and its complications, delivering babies, and of course in evaluating virginity.
It was not until around 1625 that a term even existed to identify men professionally interested in the health of women and babies. Until the twentieth century, "men-midwives" were often held in disrespect by both women and by other physicians. By crossing over into what had for so long been women's turf, men-midwives crossed not only traditional lines of propriety but also boundaries of class, because midwifery and all it entailed was women's work, a dirty, low trade that could be performed even by those who had not the benefit of a proper, manly Latin education. It was not infrequently presumed that the only interest a man could possibly have in matters gynecological was of the prurient sort. Gynecologists went out of their way to avoid such allegations, frequently conducting examinations by touch alone, perhaps with the patient curtained off by bedsheets, in order to avoid giving the impression of impropriety. It was also not uncommon for doctors conducting gynecological exams to perform palpations of the uterus and ovaries by inserting a finger or fingers into the rectum rather than the vagina, as that was considered less potentially erotic and did not present the problem of possibly damaging the hymen in unmarried women. Men-midwives literally could not afford to be suspected of what was archly termed " * scientific' rascaldom."
As if this did not already form a sufficiently polarized background for trying to introduce the speculum into gynecological practice, the speculum itself had acquired an aura of guilt by association. In her book
The Science of Woman,
historian Ornella Moscucci describes how the age-old medical instrument became tainted, in the early nineteenth century, by a relationship with prostitution, the police, and venereal disease. Speculum exam became routine in France in the wake of the 1810 legalization and regulation of prostitution. New laws required each prostitute who registered to practice her trade to submit to a speculum exam to be checked for evidence of venereal disease. Because these exams were performed in a public health context, by physicians in the public employ, upon "public women," trainee physicians from all over Europe and the British Isles, as well as the United States, were able to observe these exams during studies in Paris. Prostitutes, considered to be already ruined and only marginally human, could not only be forced to undergo a type of exam that would scarcely have been considered a reasonable thing to request of a "normal" woman, but they could be forced to serve as living visual aids as well.
By midcentury, an unprecedented number of physicians had seen the speculum in action, realized that it had a great deal to offer them as diagnosticians, and began to use the instrument in their own practice. Outrage followed, and articles, reports, and vitriolic letters to the editor began to, litter the medical journals. Robert Lee, the professor of midwifery at St. George's Hospital, London, was one of the speculum's most vocal opponents, delivering a May 1850 paper before the Royal Medical and Chirurgical Society that gruesomely detailed his opposition. Lee's examples "gave a medical veneer to arguments that had little to do with science, and everything with morals," Ornella Moscucci writes. Physiologist Marshall Hall similarly spoke of a degrading "dulling of the edge of virgin modesty," and thundered "what father amongst us . . . would allow his virgin daughter to be subjected to this pollution?" One pseudonymous writer to the 1850
Medical Times
suggested facetiously that "speculumizers" might consider renting out an opera house for a season of public exhibition.
Indeed, even today, it is not uncommon for gynecologists to either forgo performing internal exams on virgin patients, or to habitually use smaller and narrower speculums with them. This is often explained as being necessitated by the small size of the virginal vagina, but this is not necessarily physiologically true. Prepubescent girls do typically have smaller and narrower vaginas, just as their bodies are smaller overall, and preadolescent vaginas tend not to be as elastic as postpubertal ones due to lower estrogen levels. It was for these reasons that tools like the Huffman adolescent speculum, a smaller, narrower-bladed version of the standard Graves speculum, were developed.
In women who have gone through puberty, however, the vagina is likely to be estrogenized, elastic, and at its adult size. The dimensions of the vagina itself—like the size of the penis—do not change because someone has become sexually active. It is not, therefore, terribly likely that the issue genuinely is the vagina's ability to accommodate a speculum. It is more likely to be a fear of damaging the hymen, or a lingering if unsubstantiated notion that the first object to penetrate a particular vagina, whether it is a penis or a speculum or something else entirely, has a unique propensity to cause damage and pain. It seems that even the most clinical and mechanical penetration of a virginal vagina still seems to carry the distinct whiff of destruction, a potential that at least some gynecologists still prefer, even in the twenty-first century, to avoid.
The Virgin Cure
A common contention during the heyday of the speculum debate, generally brought up in the attempt to dismiss the usefulness of the speculum, was that virgins did not contract venereal disease. Speculum exams were useful primarily for diagnosing VD, the argument ran, and logically virgins (and all respectable women generally) would not be exposed to VD. Without the possibility of VD, there was little or no natural need for any doctor to inspect the interior of the vagina, and thus no need for the speculum.
It was a fine argument as far as it went, but alas, it didn't go very far. In point of fact, virgins have often been the particular victims of sexually transmitted infections (STIs) due to a pernicious, long-running myth that a person suffering from an STI can be cured by having sexual relations with a virgin. We do not know when or where this myth began. Desperate people do desperate things, though, and as such, the practice has probably been around almost as long as people have recognized the signs of sexually transmitted diseases in their bodies and struggled, horrified, to be rid of them. We have evidence that the use of virgins as a VD remedy has been especially rampant in various places at various times, among them in Scotland in the late nineteenth and early twentieth centuries, in various parts of Eastern Europe in the late eighteenth century, and currently in AIDS-ravaged Africa.
Part of what is behind this practice is a naive and hopeful belief in sympathetic magic. Across cultures and eras, virgins have been perceived as having a particular potent purity that acts as a shield and keeps the virgin from harm. In Christian virgin martyr legends, for instance, virgins often do battle with demons or with Satan himself while protected by virginity. Surely, the thinking goes, something powerful enough to vanquish demons can also cure syphilis. All one has to do is to take that something from the body of someone who still possesses it.
Other explanations have also been advanced. It is, for example, possible that the myth either began with or was corroborated by a coincidence. Many STIs have distinctly different symptom stages. Initial symptoms, like sores, blisters, or discharges, may eventually cease, to be replaced by more systemic, but less immediately noticeable, symptoms. If an infected person had sex with a virgin during a shift between symptom stages, or if a shift in symptom stages took place shortly after the sexual interaction, the infected person could easily (if incorrectly) deduce that having sex with a virgin was what had caused the illness to "disappear." If the former virgin subsequently came down with primary symptoms of the STI, it would appear to provide proof that the illness had been transferred to another person. Prior to the time when scientific medicine was finally able to explain how such illnesses were actually transmitted, the idea that STIs could be given wholesale to another person was as good an explanation as any for the sudden disappearance of symptoms in one person and their equally sudden appearance in another.
Lest this sound so ignorant as to be unbelievable, it should be noted that many pre-twentieth-century doctors believed that it was not only possible but common for venereal infections to be transmitted in ways that did not require sexual or even physical contact with others. (Many infections classed as "venereal" or "sexually transmitted" can in fact be transmitted nonsexually, but generally not in the ways most of these doctors imagined.) In the later eighteenth and nineteenth centuries, for example, venereal diseases were sometimes blamed on masturbation, or on any of a number of conditions strongly associated with poverty, such as dirty rooms, bad air, infrequently changed linens, or shared eating utensils. The morality of parents was also at issue; parents' sexual overindulgence with one another was thought to be a potential cause of venereal disease in their children.
This sort of thinking combined in a most insidious way with the nineteenth-century notion that children and "respectable" females of all ages were essentially nonsexual. In a social climate where it was unthinkable for a "good" female to be sexual outside of marriage, it was equally unthinkable to voice suspicions that the woman or girl had been raped or molested. Any "good" virgin or child who showed symptoms of an STI was likely to find the blame landing squarely on her and on her family's socioeconomic status. If STI cases could be blamed on things like dirty underpants or poor housing conditions, perhaps they could also be avoided by providing cleaner or better ones. This was a tidy, charitable, and easily effected change, and one in keeping with the popular, middle-class philanthropic goals of the day. Furthermore, it allowed both doctors and families to maintain reassuring lies: children had not been violated, virgins had not been despoiled, and men did not stoop to such reprehensible things.