What makes the two-finger test so controversial

The highly controversial and scientifically discredited “two-finger test” found spotlight on Monday, when it came to light that the Delhi Government had issued a circular, dated May 31, that permitted its use on sexual assault survivors under certain circumstances. The government was quick to react on Monday as it issued clarifications and withdrew the circular. However, it drew heavy criticism from women’s rights activists, health activists and experts from the medical community.

The carefully-worded guidelines in the government circular, issued by the Delhi health ministry, state that there is a misconception about the finger test in the media and the legal circles, and that this procedure is actually the per vaginum (P/V) examination. This examination is conducted by medical professionals to determine injuries, and should be performed only if “medically indicated”. It states categorically that the test cannot be used to “judge the habituation of the survivor to sexual intercourse”.

The government issued a statement on Monday that these guidelines had been misinterpreted and that “it is now clarified and further reiterated that medical professionals should not perform the ‘finger test’ for ascertaining the habituation of the sexual assault victim/survivor to sexual intercourse. All hospital authorities in NCT of Delhi are advised to properly adhere to the same.”

However, what seems to have caused the umbrage is the conflation of the ‘two-finger test’ and the ‘per vaginum examination’. In 2014, the union health ministry issued Guidelines and Protocols for "medico-legal care of survivors/victims of sexual assault". These clearly state that the “per vaginum examination commonly referred to by lay persons as 'two-finger test', must not be conducted for establishing rape/sexual violence and the size of the vaginal introitus has no bearing on a case of sexual violence. Per vaginum examination can be done only in adult women when medically indicated.”

Padma Deosthali, coordinator for the Mumbai-based Centre for Enquiry into Health and Allied Themes, who was one of the experts working on these guidelines, says that the two-finger test is a forensic examination and the P/V exam is used to determine injuries and infections and is commonly used on pregnant women. The former, by its very definition and origin, is to determine whether the woman is habituated to sexual intercourse. She adds that the Supreme Court banned the test in 2013, because it is a comment on the size of the vagina.

Dr Suneeta Mittal, one of Delhi’s top gynaecologists, who also worked on the union ministry guidelines, corroborates Deosthali’s argument by explaining that the two finger test originated in forensic medicine to judge the habituation of a woman to sexual intercourse by the size of her vagina. She says that no gynaecologist uses that term and it is completely, scientifically unnecessary to determine sexual assault. Which is why the committee she was part of recommended spoke against it while drafting the 2014 guidelines.

There are other, more scientifically accurate methods of determining injury to genitalia and signs of forced penetration, such as vaginal swabs for sperm, all of which have been clarified in the guidelines.

However, Deosthali says that only a handful of Indian states have decided to implement the union ministry guidelines even as other south Asian countries such as Bangladesh are looking to them as a model while fighting to ban the test.

Though the Delhi government circular strictly takes consent into account, and though the P/V examination sometimes becomes necessary for sexual assault survivors, the fear seems to be that even partial leeway would give certain, non sensitised medical staff a free hand in conducting the test, using it to determine or dismiss rape complaints, damaging an already fragile health care system for survivors.