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The brutal gang rape of a student in Delhi in December 2012 triggered international outrage and catalysed progressive legal amendments in India, including harsher punishments for perpetrators and a wider definition of sexual assault. 1 However, necessary changes to the health system have been slower. 2 Despite doctors' responsibility to provide medical and psychological help, some in India have been criticised for providing insensitive care to victims of rape. 3 In particular, attention has focused on the "two finger test," a disturbing practice conducted by some doctors during medical examinations.
This test, which originated in the 18th century, involves examining the hymen and the laxity of the vagina to ascertain information about the victim's sexual history. 4 Insertion of one finger into the vagina with difficulty is interpreted as meaning that the victim was a virgin, whereas easy insertion of two fingers suggests that she is "habituated to sexual intercourse." 5 Clearly, this test has no scientific value; the absence of the hymen and laxity of the vaginal orifice may occur for reasons unrelated to sex. 6 And even if the woman has had previous sexual experience, this is irrelevant to whether she consented to an assault.
The two finger test violates a rape victim's physical and mental health: it is painful and mimics the original penetrative assault, causing trauma through "re-rape." 4 7 Moreover, doctors' interpretations of the test can frame whether the woman's complaint is considered true or false in court. 4 Biases in the judicial system can portray a "habituated" woman as one who would not refuse sex, or who could falsely accuse a man of rape. 7 Consequently, defence lawyers use an "affirmative" two finger test to question a woman's character and to refute allegations that sex was non-consensual. 4 Such patriarchal assumptions have contributed to victims losing cases. 4 5 7
Many doctors...