Table 2.

Summary of included studies reporting on impact on examinee

Author, Year	Study design and population	Results	Quality of evidence
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