An unkind cut

The Guardian newspaper ran an article in November about the alarming rise in labiaplasty.  I had read that anecdotally, requests for cosmetic surgery to correct ‘problems’ with one’s vulva have increased exponentially in tandem with the pornification of our culture – the British figures would appear to support that assertion.

A study published in the British Journal of Obstetrics and Gynaecology last week revealed that, over the last year, there has been an increase of almost 70% in the number of women having labiaplasty on the NHS. There were 1,118 in 2008, compared with 669 in 2007 and 404 in 2006.

There is no way to know how many girls and women had the procedure performed privately – but presumably the total figures are considerably higher. In Australia, the figures are also in the thousands. Thousands of women and girls who have subjected their most tender parts to slicing and trimming for mostly cosmetic reasons.

There are some women who suffer physical pain and discomfort because of the shape of their vulva (generally the length of their inner labia), and this can at times be quite severe. The fact that there are surgeons skilled in genital surgery is a boon to many of those women, and I certainly don’t begrudge them the chance to improve their quality of life.

But the reality is that the majority of labiaplasties are performed purely for cosmetic reasons. Yes, even our ‘private parts’ are meant to live up to the airbrushed standard.

And that ‘standard’ is indeed airbrushed. As Mia Freedman discussed in her recent blog post on this issue, even magazines targeting women routinely airbrush female genitals. And not just because they want to, either. Freedman explains

When I worked in magazines I got worked up for quite some time about the censorship requirements around vaginas. Unless anything has changed since then, the basic situation is that any magazine featuring a picture of a naked woman, had to digitally remove anything visible outside the ‘single slit’ of the vaginal lips. So any stray bits of labia or clitoris had to be airbrushed out. Because it was deemed OFFENSIVE …

The now defunct magazine Women’s Forum first brought the issue to my attention years ago and Cosmo then took up the cause with a campaign protesting it. What a shocker. And nothing changed.

To this day, any magazine showing any ‘genital detail’ must be sold in a sealed plastic bag. Like pornography. And I’m not talking about explicit legs akimbo shots, just shots of a normal girl standing up with her legs closed. She must look like Barbie or the airbrush will be deployed to make the censors happy and protect our sensitive eyes from OFFENSIVE VISIBLE LADY PARTS.

Many Australian women are unaware that these censorship guidelines even exist. I certainly was.

Like most straight women in our society, I’m not in the habit of looking at other vulvas. We don’t do much communal bathing in our country, so unless I do become a birth doula one day, chances are I won’t be getting acquainted with too many examples other than my own. And I’m not alone in that. So is it any wonder that girls and young women increasingly consider the bodies they see in pornography to be ‘normal’? Is it any wonder that their own genitals, if they differ markedly from that version of ‘normal’, seem somehow wrong? Compounding this phenomenon is the popularity of waxing – another legacy of pornification which means that genital variations are now more noticable than in more hirsute times.

There are a number of Australian cosmetic surgeons who advertise genital surgery services online. Their websites promised enhanced comfort and self esteem. Conversely, my googling didn’t lead me to any surgeons openly touting penis enlargement surgery – on the contrary, it is very easy to find sites decrying the practice as unnecessary, unreliable – and of course, reassuring men that a satisfying sex life is not dependent on their genitals living up to a porn-star standard. I’m not claiming that penis enlargement isn’t big business (pardon the pun) but the drastic option of surgery is something that is falling out of favour, right at a time when more and more cosmetic surgeons are acquainting their scalpels with women’s genitals.

Aside from the obvious pain and discomfort immediately resulting from surgery, women having labiaplasty do run the risk of future problems.

As with any surgery, labiaplasty is potentially risky. Dr Sarah Creighton [a consultant gyneacologist in London],says that there have been no studies into the after-effects or possible complications of labiaplasty, nor has there been any research into the impact on childbirth: she suggests that women who opt for this procedure might experience the same problems while giving birth as women who have undergone ritualistic female genital mutilations.

I can’t help but wonder how many women who opt for this procedure are fully aware of the implications for childbirth. Presumably, many of them are young and have not yet embarked on motherhood, or indeed decided whether or not they even wish to. In any case, the reality is that should they give birth in the future, a scarred labia will probably not stretch and open in the same way as undamaged tissue will. This is likely to impact on (or even destroy) their ability to birth without significant medical intervention. To me, that seems high price to pay – and a cost that I hope cosmetic surgeons are disclosing along with their $4000-$10 000 invoice.

Despite perhaps having some shared origins in the pathologising and commodification of female bodies, I don’t think we should conflate labiaplasty procedures with ritualistic female genital mutilations much further. These are obviously very different experiences and issues.

But what is very clear is that girls and women need us to teach them more about themselves. Generations on from women first being urged to examine themselves with a hand mirror, we’re still not getting it right. Body diversity extends beyond skin colour and weight, and body image concerns can be found below the belt.