Table 2 Summary of included studies reporting on impact on examinee

Leclerc-Madlala S 2003 [4]

Focus group interview in Durban, South Africa (n = 14)

Examiner(s): elderly women

Age of examinees: 13–18 years

Study group: girls planning to attend upcoming virginity testing event

Girls reported fear that being “certified” a virgin would result in brothers, friends, or neighbors raping them

Those who fail virginity tests are often expected to pay a fine for tainting the community and are excluded from certain employment

III

Poor

Shalhoub-Kevorkian, N 2005 [6]

Interviews and focus groups in Jordan and Palestine (n = 41)

Examiner(s): forensic medical doctors

Age of Examinees: 21 years and younger

Study group: 7 sexually assaulted women who had virginity testing, 17 police officers, 2 physicians, 7 prosecutors, 4 social workers, and 4 lawyers

5 of 7 interviewees described the harsh trauma and aftermath of the initial sexual assault and virginity exam afterward

Focus group meetings showed women were extremely fearful and felt terrorized by virginity testing

III

Fair

Robatjazi et al. 2015 [14]

In-depth semi-structured interviews in Iran (n = 15)

Examiner(s): physicians and midwives

Age of Examinees: not specified

Study group: 11 physicians and 4 midwives who performed virginity tests

10 out of 11 physicians reported that virginity testing leads to psychological distress

Most participants defined the following consequences of virginity testing: rejection, suicide, depression, weakened self-confidence, run-outs, divorce, and increased risk of diversion and abuse of girls

III

Fair

Frank et al. 1999 [30]

Survey at one center in Turkey (n = 118)

Examiner: forensic physicians

Age of examinees: not specified

Study group: forensic physicians

93% responded that virginity tests are psychologically traumatic for the patient, 64% believed they were a violation of privacy, and 60% believed they result in loss of examinee’s self-esteem

III

Fair

Human Rights Watch 2010 [32]

Interviews in Delhi and Mumbai, India (n = 44)

Examiner(s): gynecologists and forensic doctors

Age of examinees: not specified

Study group: direct contacts with virginity testing examinees including doctors, health rights activists, prosecutors, lawyers, and parents

The report documented the fear and re-traumatization of virginity testing on a rape victim

Doctors were reported to have harmed the examinee during the test by aggravating existing injuries

III

Poor

Human Rights Watch 2001 [33]

Interviews at eight public schools in three provinces of South Africa (n = 36)

Examiner(s): Teachers and older women

Age of examinees: 7–17 years

Study group: girls who reported sexual violence at school, as well as teachers and counselors

Reported on the fear that a failed test will increase risk of abuse and discrimination

In one case, a girl's relatives broke both her arms after she failed a virginity test

III

Poor

Gursoy E, Vural G 2003 [34]

Survey in eight hospitals in Ankara, Turkey (n = 101)

Examiner(s): nurses and midwives

Age of examinees: not specified

Study group: nurses and midwives

90% opposed and 10% supported virginity testing

62% agreed that a forced virginity exam might result in severe negative effects such as anxiety, depression, isolation from society, a dysfunctional sex life, guilt, worsened self-respect, and fear of death

III

Fair

Leclerc-Madlala S. 2001 [35]

Observation, interviews, and focus groups in Durban, South Africa

(sample size not specified)

Examiner(s): elderly female relatives

Age of examinees: 5–22 years

Study group: key informants in virginity testing movement

Those who failed a virginity test were subject to name-calling and social exclusion

Certified non-virgins were socially excluded, reporting that they will “spoil the bunch” and “cause the flowers of the nation to wilt”

III

Poor