November 2011


The prepubertal hymen

Volume 40, No.11, November 2011 Pages 873-875

Anne Smith

Not so long ago, some doctors believed that they could determine, on the basis of examination of a girl's genitals, whether or not the girl had engaged in sexual intercourse. Even today, 'virginity checks' are conducted by doctors in some countries. Some Australian doctors still believe that it should be possible to determine, on the basis of examination findings, whether a child has been sexually abused. This article sets out to describe some of the common variations in hymenal anatomy in order to dispel myths and misperceptions surrounding genital examination findings in young girls.

Most general practitioners would immediately refer any prepubertal child who they suspected may be the victim of sexual abuse to a specialist centre for assessment and support. Given the consequences for doctors and patients when mistakes occur in the medicolegal arena and the potential risk of secondary trauma, this cautious approach seems wise. However, there are several other presentations in young girls that would appropriately prompt the GP to conduct a genital examination. For example, in the absence of an allegation or suspicion of sexual abuse, symptoms of genital itch, redness, pain or discharge would usually warrant examination.

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