When I first started writing about ‘virginity testing’ and hymenoplasty, many people simply didn’t believe me. Sewing stitches in a woman’s vagina so that she bleeds on her wedding night – how could something so inhumane take place in modern-day Europe?

Not being able to ‘prove’ their virginity is a fear for millions of women and girls across the world, including in Europe. Having followed the debate here in Europe and read recent comprehensive studies on the subject, I have found that fighting the myth of virginity is an extremely difficult and complex process.

But criminalising virginity testing and hymen repair surgery is not necessarily the answer. Banning such practices in a country that is not fully prepared might create more problems than solutions for the women that these laws are intended to protect.

Blood on the sheet is the expectation

Female virginity has controlled the lives of women for centuries. It is based on the hard-wired myth that the hymen is a ‘seal’ covering the vaginal opening, which will break and cause bleeding when a woman first has intercourse. Most women don’t bleed, but a blood stain on the sheet is still the expectation in many cultures and many countries.

This includes Kosovo. A teenage girl from Kosovo told me: “If you tell a guy you are a virgin and you have sex, but he sees no blood, he will send you to doctors to check if you are a real virgin or if you are lying.

“If a girl wants to have sex, but doesn’t want to lose her virginity, she will let her partner have anal sex with her. Or [doctors will] stitch her vagina – they can make you a virgin again.”

“Stitching” is slang for hymenoplasty, or surgery to reconstruct the hymen. It’s actually a relatively accurate term as it describes a doctor making stitches in the hymen in order to cause bleeding during sex.

After sharing these girls’ stories anonymously on my blog and on one of Kosovo’s largest news websites, I started looking for more stories. I also interviewed experts and activists in the country – all of them confirmed the existence of the problem.

The result: an extensive report about hymenoplasty and virginity testing in Kosovo was published last year in Swedish national media. The day of publication, I received thousands of hate comments on social media. I was accused of having a hidden agenda, of “dragging Kosovo in the mud”, of “being a whore” or a “Serbian spy”.

However, while all this was going on, more women were reaching out to me to share their personal stories. About what happened if you failed to bleed on your wedding night; about the opposite experience of bloody sheets; and about psychological and physical abuse from their families and in-laws as a result of the ‘honour’ system of which the virginity myth is such an important part.

‘Violation of human rights’ and ‘torture’

Human Rights Watch and other organisations have long reported on women who were abused and even murdered when they failed to prove their virginity. One woman committed suicide after failing to convince her husband that she was a virgin.

For many women across the world, their virginity is so strongly associated with their family’s honour that they are forced to undergo a virginity test. This usually involves checking that the hymen is still intact – even though modern science clearly states that virginity is a myth and that it’s impossible to verify a woman’s sexual history by examining her hymen.

The test is often done by inserting two fingers into the vagina. It is usually performed by a doctor, who then provides a certificate stating that the girl or woman is a virgin. The whole experience, often done without the patient’s consent, can be painful, humiliating and deeply traumatic.

The certificate is often a requirement for marriage. Failing the test is a secret fear for women all over the world, even those who’ve never had sex before.

I interviewed Fatima (not her real name), a Swedish woman who was forced to undergo a virginity test when she was 17. Lying in the chair, she begged the doctor not to examine her, but her mother intervened and explained how many problems the family would face if she didn’t have the test.

Fatima endured this traumatic experience so that her family could prove her virginity to her prospective groom's family. She said that afterwards she felt as if she had been raped, and that she tried to take her own life. Today, she is divorced and has a secret identity, but still suffers from anxiety and nightmares.

The World Health Organization and UN agencies have denounced virginity testing as “a violation of the human rights of girls and women,” while Amnesty International has described it as a “form of sexual violence and […] torture under international law”.

It is truly a worldwide problem. Regions where virginity testing and hymenoplasty are common include parts of the Middle East, the Balkans, the Caucasus, North Africa, central and south Asia and, as a result of immigration, some Western countries.

The reasons why women are forced to undergo virginity tests are also many and varied. They include dispelling rumours, proving rape, as part of school, joining the army, during imprisonment or when getting married. A journalist in Tajikistan took the test herself when writing about the subject. She even had her vagina photographed by the nurse.

In Europe, the most common reason for virginity testing or hymenoplasty is the need to prove one’s virginity before marriage. In many cases, it’s related to forced or child marriages.

A 16-year-old Swedish girl told me that her mother made her have a virginity test because she was about to be married off to a cousin. Another Swedish teenager had a test because she was threatened with being kidnapped and taken out of the country, which had happened to her cousin a few years before.

Last year, France banned virginity certificates. The UK government recently promised to ban both virginity testing and hymenoplasty, while in Sweden an inquiry is currently investigating how to best legislate against the practices.

Ban or educate?

If we ban virginity testing, virginity certificates and hymen repair surgeries, we will address the supply side of the problem. But what about the demand side? According to some doctors and experts, If we implement bans without addressing the expectation of virginity, there is a risk that women will find themselves in an even more dangerous situation.

We need to change cultural views, through conversation, education and social intervention programmes. Social services, schools, police, medical professionals, women’s shelters, women’s organisations and charities – all need to work together to eradicate the misogynistic attitudes upholding these harmful practices experienced by women.

Virginity norms and myths also need to be a mandatory part of sex education in schools.

And, of course, it’s not just about girls and women. We need to involve boys and men too and also change their minds – if we are really going to promote gender equality and human rights.