Hymenoplasty in Lebanon: Social Pressure, Tradition, and Freedom

 
“In some cultures, the woman's hymen is believed to impact her marriage prospects, her family's reputation, and even her private life." Accompanied by images of flowers symbolizing the female genitals, this phrase, found on the website of a Lebanese plastic surgery specialist, promotes hymenoplasty, a surgical procedure aimed at reconstructing the hymen or 'restoring a patient's maidenhood,' as described on the site.
This seemingly antiquated phrase reflects the reality of a widespread practice in Lebanon, rooted in the collective myth of feminine purity. It creates a divide among physicians: some exploit it, some want to “do a favor," while others refuse to perform hymenoplasty for ethical reasons.
This legal surgical intervention, practiced in both the Arab world and Europe, restores the hymen by stitching together the torn parts of the membrane caused by initial sexual intercourse. It is performed within 15 to 30 minutes under local anesthesia or sedation, with minimal risks to the patient's health. According to Alain Daher, a gynecologist-obstetrician with a decade of experience in Beirut, it is “an easy, quick, and painless surgical technique.”
Once done, the pain is minimal, allowing women to resume work the following day. However, they must wait two to three weeks for the sutures to resorb before engaging in sexual intercourse to avoid arousing their partners’ suspicions about their maidenhood.
A Relatively Minor Surgical Procedure, or Nearly So
Maria*, 24 years old, underwent the surgery a few months ago. “My lover’s Muslim, whereas I’m Christian,” she confides. We both knew that we could never have a future together or get married. He supported my decision to break up and undergo the surgery.”
She described the doubts that overwhelmed her before deciding on the matter. “I spent nights researching every little detail,” Maria recalled. “I had sleepless nights.” Once the decision was made, the young woman described the surgical intervention as “straightforward.” She noted, “The first day, I had a bit of trouble walking, and then nothing."
This surgical procedure comes at a cost, with prices starting at $500 and soaring to over $1,000 in some clinics, where practitioners take advantage of women's distress and urgency. “They know very well that these women will get it done at any cost," observes Dr. Daher. "They can thus impose any price they desire.”
When contacted by This is Beirut posing as a potential patient, a clinic specializing in intimate surgery revealed that the procedure would cost $1,600. At least for this price, “there is a 100% chance that you will be tight,” guarantees the gynecologist over the phone. How reassured we are!
Medical Tourism
“Contrary to what one might think, women from all communities and social classes seek hymenoplasty” to restore their maidenhood, notes gynecologist Farid Bedran. A significant number of patients are women from Gulf countries who come to the country for a discreet procedure during their stay. Doctor Daher estimates that about half of his patients originate from Gulf nations. These visits align with the trend of medical tourism, an industry in which Lebanon, once hailed as the “Middle East's hospital,” was a major player in the region before facing economic and political crises.
A Regained Purity

Physicians unanimously agree that there has been a decline in the demand for hymenoplasty over the past decade, with statistics showing an average of one procedure every two to three months, compared to one per week ten years ago. However, the imperative of maidenhood before marriage remains prevalent in Lebanon.
“Having an intact hymen remains highly important for many women,” asserts Gaëlle Abou Ghannam, gynecologist and co-founder of Métlé Métlik (literally, 'we are alike'), an online program dedicated to women's sexual and reproductive health.
In fact, in her testimony, Maria often repeats the word “mistake” to describe premarital sexual intercourse. “We are not supposed to engage in intimate relations with just anyone,” she says. “This should be reserved for marriage. I will never again repeat this mistake.”
She expresses the guilt that haunted her after each intimate moment with her lover. “Having sexual intercourse felt like betraying my father's trust, even if he didn't know,” she indicates. It is a sense of guilt directed inward.” However, this seemed to dissipate once her hymen was restored. “Now, it's like I'm starting afresh, beginning a new journey,” Maria asserts with enthusiasm. Purity is regained.
The Bloodstained Bridal Sheet
The bloodstained wedding sheet, symbolizing the purity of the young bride, remains in the collective imagination of certain traditional milieux. Yet, it's worth noting that “about 50% of women do not experience bleeding during their first intercourse,” according to Doctor Daher.
Indeed, the hymen is weak evidence of female maidenhood. While some women are born without a hymen, others may rupture it while working out. Furthermore, even when the hymen is intact, its rupture does not systematically result in bleeding.
Doctor Bedran, however, asserts having “a technique that ensures 100% bleeding.” Nonetheless, he acknowledges that “it's a bit more painful and requires more time.”
To guarantee this bleeding, some gynecologists “tighten the hymen and a part of the vagina more than necessary,” explains Dr. Abou Ghannam, who refuses, out of conviction, to perform hymenoplasties. “The tear will be more severe than that resulting from a first sexual intercourse," she continues. "It will certainly be more painful; hence, bleeding is highly probable."
Educate Men
Originating from a middle-class background, Maria grapples now with this secret. “I would never reveal it to anyone,” she asserts. She sheds light on the hypocrisy of men concerning women’s maidenhood. She says that her former lover, the one with whom she “lost her maidenhood,” deemed it important for his future wife to be a virgin.
She is not naive. Maria acknowledges that despite the apparent liberalization of societal mores, female purity is still glorified, if not required. “I believe even men who claim not to care about your past attach importance to maidenhood,” she asserts.
While accompanying women, Gaëlle Abou Gannam makes sure not to blame them. “We raise the topic of maidenhood and the hymen with the hope of empowering women to break free from this societal myth," she emphasizes. "However, we ensure not to be confrontational on this issue. We indicate that we understand the importance of maidenhood in certain milieux."
Abou Ghannam concludes, "The most important aspect is to educate men, as they are the ones to perpetuate this myth and are the driving force behind women resorting to this procedure."
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