Hymenoplasty: a moral dilemma
The New York Times recently published an article on hymenoplasty, a surgery done to create the physical illusion of virginity in women. It has become increasingly common in Europe. Muslim women who have adopted a European attitude towards sex find when they move towards marriage that their intended husband or his family wants to see proof of virginity, and the only way to fake that in a sufficiently believable way is to get this surgery. This of course says a ton about Muslim populations in Europe and the assimilation (or lack thereof) that is occurring. That’s all very interesting to contemplate, and there is much to say about it, but what’s I’ve been thinking about more since reading the article is the decision the doctor faces. Is this a surgery doctors should be willing to perform? It’s clearly a controversial issue — as the article mentions, the French College of Gynecologists and Obstetricians thinks no, for “moral, cultural, and health” reasons. Nevertheless, I’m inclined to say it should be something doctors are willing to do.
I will assume, first of all, that the surgery has some risks, like any other surgery, but that it is not abnormally risky as far as cosmetic surgery goes. Maybe I’m wrong, but I doubt it, and I am frankly just more interested in the moral issues.
It seems to me like the default response should be to perform the surgery, for basically libertarian reasons. These women want the surgery, it doesn’t do any direct harm to others, and it doesn’t seem so idiotic that wanting it is proof of irrationality, so they have a right to get it. Why should the doctor stand in the way? I don’t consider myself a libertarian, but I do have sympathy for the philosophy, and I feel like at the very least the burden of proof should be on those wanting to restrict individual choice.
What reasons might someone give for not performing the surgery? One is that the decision to have this done is coerced, rather than freely made. I agree that it is coerced in some sense, in that a substantial penalty is being attached to the alternative choice. However, we are usually upset in these sorts of circumstances at the coercive act, rather than the victim’s decision to give in. (This is why we punish muggers, but not people who give up their wallets when threatened with a gun.) In this case, the coercive act, while it seems dumb (or worse), is obviously not something that can be regulated. People can choose to marry or not marry someone else for whatever reason they want, even if idiotic. Extended family can choose not to talk to someone, to disinherit them, etc., for whatever stupid reason they want.
So let’s grant that the cultural practice is unfairly coercive. (I believe it’s reasonable for someone to want their spouse to have refrained from premarital sex, but I’d like to see that limited to an issue of trust and understanding between the couple. Extended family demanding the right to inspect the woman’s genitals seems a step too far.) I’m sure one of the common objections to the surgery is that it “cooperates with” or “condones” the underlying cultural expectation. Maybe we should ban people from giving their wallets to muggers — it might reduce the incentive to threaten people. A similar point can be made here. If within European Muslim communities, substantial portions of the female population became ineligible to wed, there would be a serious shortage of potential brides. It seems inevitable that in such a circumstance, in the long-term, more and more men (and their families) would become willing to accept non-virgin brides.
This is not an unreasonable argument, but it’s not an effect that will be incredibly quick. Banning the surgery means the ability to “get away with” premarital sex will be reduced, and so women will be more careful about maintaining virginity. If what you want is to undermine these cultural expectations, this is counterproductive. Even if you care less about the premarital sex prohibition, and just about the extreme inspection/punishment aspect, it will slow down cultural change. It is also a huge sacrifice to ask of the women in question in the name of longer-term progress. More importantly, if this surgery is widely available, women will no longer suffer from what is essentially a double standard with regard to premarital sex and will instead suffer from the need to have a minor cosmetic surgery done before marriage. I for one, think that smaller injustice is substantially better, even if it will take more time to completely get rid of than the larger injustice would.
At the very least, the case on moral/cultural grounds is inconclusive. Given that, I’d say this is a decision that women should make on their own. I don’t see why doctors (or their professional organizations) should be hesitant about performing it when it’s asked for.
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