Hymen Repair Surgery in Macedonia: A Virgin Again for 400 Euros

by Natasha Dokovska
– Macedonia –

In the past, if a woman wasn’t a virgin, she would surreptitiously pour animal blood on the bed after consummating her marriage. Today, this tradition has been replaced in Macedonia with a more sophisticated ruse – hymen repair surgery. This procedure is recognized medically as plastic surgery and is easily performed, taking only thirty minutes to one hour to repair a broken hymen.

Thinner than skin, the hymen is a fibrous, elastic membrane covering the vagina – one so delicate that it can be ruptured from vigorous physical exercise or even a fall, as well as by sexual intercourse.

“I’m at this clinic for the second time. I have to have hymen repair surgery because if I’m not a virgin I can’t be married again. I don’t feel any pain, it’s not difficult – it’s just expensive!” – says Esma, a 19 year-old Romani girl explaining that after two previous marriages, she now wants to marry again. But the family of her third husband doesn’t want a bride who is not a virgin. After the wedding, they will wait outside the bedroom all night and ask to see if there is blood on the bed sheet. If no blood is found, the husband’s family will return the disgraced bride to her family’s home. To avoid this grave situation, a virginity test is often conducted by a doctor on the engaged woman at the request of the fiancé’s family.

Esma will pay 400 euros ($550 USD) to repair her hymen – the equivalent of two months salary for average Macedonians – even though this procedure is forbidden by law.

Her 16 year-old cousin Lina, has five marriages behind her, having had hymen repair surgery twice. The first surgery was performed before her first marriage, the second was done for her current marriage.

“When I went to the gynaecologist for the first time, I was only 13 years old. The mother of my husband was with me to ask the gynaecologist if I’m a virgin or not. Because I wasn’t, she paid for the surgery. I was afraid, but I didn’t feel anything,” explains Lina. She says that she decided to get the surgery again because her new husband promised to be a good lover if she is a virgin.

Both Esma and Lina are Romani Muslims, and while the majority of women in Macedonia who pursue hymen repair surgery are Muslim, young women from both of the country’s main religions (Muslim and Macedonian Orthodox) decide to have the procedure done. Muslim women are particularly pressured to have the surgery because of their religious beliefs: a woman who is not a virgin, faces potential violence and can even be in danger of being killed by her male family members in an attempt to restore the family’s honor. While Islamic law requires chastity before marriage for both men and women, men are never required to “prove” their chastity. But the practice of honor killing is determined by culture, not by religion. Because hymen plastic surgery re-establishes the appearance of virginity, these young women can potentially avoid the threat of physical violence that might otherwise occur.

Over the last five years, large numbers of young Orthodox women in Macedonia have also begun pursuing this surgery, but for a much different reason: their lovers think that sex is better with a virgin. And while Muslim women secretly opt for the surgery, Orthodox women do so usually after discussing it with their sexual partners. This trend began when private gynaecological clinics were established in Macedonia. Before that, neither Orthodox Macedonians nor Muslims could readily have the surgery as state medical clinics strictly forbade it.

Gynaecologists and plastic surgeons worldwide report that an increasing number of women are seeking hymen repair plastic surgery. Other religious groups such as Orthodox Jews and fundamentalist Christians are fueling an increased demand for this procedure. In the US, there is a similar demand with some women simply doing it as a way to “restore” their sex lives.

According to June Reinisch, former director of the Kinsey Institute for Research in Sexuality, Gender and Reproduction, there is a long history of hymen repair, including using a needle and thread and membrane material from goats. But there are also more modern methods, the simplest of which is done by stitching together the remnants of the ruptured hymen with sutures that dissolve, and inserting gelatin capsules with fake blood that rupture during intercourse.

In Macedonia, doctors often perform the surgery at night and their patients typically give false names, arrive in disguise and pay in cash to ensure the necessary secrecy that will save some of these women’s lives. Some travel from as far as Turkey and Western Europe to have the procedure done.

“[A] lot of women come from Kosovo and Albania to repair the hymen and their husband or their fiancé pay without to ask for the price. They pay in cash and in euros, but they ask us for discretion,” says one gynaecologist from Skopje, the capital of Macedonia, who insists on anonymity. He says that over the last three years the number of women seeking hymen repair has skyrocketed from 10 surgeries per year to approximately 15-17 per week.

“After the war in Kosovo women and girls came [to] Skopje and asked for fast and quality surgery. They didn’t ask [about the price]. This is the reason why the price is going down. If in the past we ask[ed] 2000 marks, today the price is between 300-400 euros ($412-550 USD),” says one Albanian gynaecologist who confirms that all the women who come to his clinic are Muslim. He explains that the price depends on the damage done to the broken hymen. A woman seeking her first surgery pays the least, but the second or third time the price is more expensive because the hymen is more damaged. One gynaecologist from Bitola, a town in western Macedonia, has repaired one woman’s hymen one hundred times! Unlike most women who seek this surgery, the woman was a Romani prostitute who always wants to be “new” for her wealthy clients.

But even the surgery doesn’t guarantee a woman’s safety. If her partner discovers that she’s had the procedure, her safety and possibly her life can be in jeopardy. Doctors who openly advertise the procedure are receiving death threats but they continue to offer the surgery to save the lives of these women. And yet despite the good intentions of some doctors, the fact that the surgery is illegal means that many girls are putting themselves at risk. Some of the cheaper clinics that offer the procedure are not up to medical standards and their doctors often use un-sterilized equipment that leads to infection. Last year, three Romani girls who could not afford to pay top dollar at a good clinic, died after surgery.

About the Author

Natasha Dokovska has been a journalist for 23 years, covering social issues and human rights in Macedonia. She has been an editor for international policy, an advocate for human rights as a NGO activist and publisher, and has edited books related to peace journalism and other topics. She currently is the editor for the first internet alternative radio in Macedonia and is also the Executive Director of Journalists for Children and Women’s Rights and Protection of the Environment in Macedonia.