The Roles of the Turkish Government and Medical Profession
The Turkish government participates in and tolerates the subjection of women to unwanted virginity exams. Following the suicides of girls forced to undergo virginity control in Kutahya and Mugla-Ula in the spring of 1992, Minister of Women's Affairs Turkan Akyol denounced virginity control and vowed to punish officials responsible for such abuse. Yet the only action taken against officials responsible for the girls' virginity exams was the temporary suspension of a single school director. To our knowledge, the Turkish government has taken no steps to stop the performance of virginity control by state actors. Nor has it investigated allegations of such abuse by police and state health care providers. Turkish officials deny their participation in this abusive practice and claim that, where virginity control exams are performed, they are not compulsory.
Turkey's then-minister of human rights, Mehmet Kahraman, responded initially to reports of forced virginity exams by denying government involvement in such violations and pledging that any specific complaint about virginity exams would be investigated. Nonetheless, the minister argued that, in certain cases, virginity exams might serve a protective function and thus would be legitimate. He asserted that medical evidence of rape may be required either to help the victim obtain evidence against her attacker or to establish the truth of her claim.96 Although it is accurate to note that medical evidence is important to corroborate reports of sexual assault, this provides no justification for compulsory virginity exams. Nor, as noted above, does virginity per se have any relevance to a finding of sexual assault.
The government's denial of reports of nonconsensual virginity control is inconsistent with testimony of abuse gathered for this report including the statements of female political detainees, women held as suspected illegal prostitutes, female hospital patients and women taken to state hospitals by family members. While we appreciate the Turkish government's stated commitment to stopping such abuse, evidence shows that virginity controlexams continue to be forced on women, and the government must take much more concerted and aggressive action to eliminate the practice.
The participation of medical professionals—whether state or private—in forced virginity exams is also of concern because it violates basic tenets of medical ethics. The Principles of Medical Ethics adopted by the U.N. General Assembly state:
It is a gross contravention of medical ethics as well as an offence under applicable international instruments, for health personnel, particularly physicians, to engage, actively or passively, in acts which constitute participation in, complicity in, incitement to or attempts to commit torture or other cruel, inhuman or degrading treatment or punishment.97
Medical practitioners must do no harm without the expectation of compensating benefit to the patient. "Thus, medical intervention is ethical only when expected benefits outweigh the harm, pain, and risks attendant upon the procedure." Medical intervention also should have the informed consent of the patient. "The patient, except when he or she is reasonably presumed to be mentally incapacitated, determines the applicability of harm and risk and decides whether the expected benefits are worthwhile."98
Forensic medical practitioners are taking some steps to end the participation of state and private doctors in impermissible virginity exams. The state department of forensic medicine plans to increase the number of forensic specialists throughout the country. These doctors would be thoroughly trained in their field as well as educated specifically about where and when to perform gynecological exams.
Many Turkish doctors do oppose virginity exams and refuse to perform any gynecological examination without women's informed consent. Some doctors, appalled by the widespread and frequent use of virginity exams, have organized campaigns to stop the practice. Evidence indicates, however, that, despite growing awareness of virginity exams as an illegitimate practice, many doctors continue to participate in exams, fail to ask women for their consent, and even use the threat of force to compel women to submit.
The Turkish government bears the responsibility for the actions of its agents and for its failure to act against forced virginity exams conducted by non-state actors. Instead of denouncing virginity exams as abuse, however, the government denies or dismisses the problem. Even when government and medical officials acknowledge such abuse, they often blame families for the problem and attribute the abusive practice to traditional cultural norms.
96 Interview, Ankara, July 14, 1993.
97 Principle 2, Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees against Torture, and Other Cruel, Inhuman or Degrading Treatment or Punishment; adopted by the U.N. General Assembly, December 18, 1982. Principle 4 further provides: "It is a contravention of medical ethics for health personnel, particularly physicians: (b) ...to participate in any way in the infliction of any such treatment or punishment which is not in accordance with the relevant international instruments."
98 Albert R. Jonsen and Leonard A. Sagan, "Torture and the Ethics of Medicine," in Eric Stover and Elena O. Nightingale, eds., The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions (New York: W.H. Freeman and Company, 1985), p. 36.
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