Genitoplasty :: Cosmetic genital surgery rising in UK

Demand for cosmetic genitoplasty or vaginoplasty is increasing. Lih Mei Liao, consultant clinical psychologist, and Sarah M Creighton, consultant gynaecologist, argue that surgery carries risks and that alternative solutions to women’s concerns about the appearance of their genitals should be developed.

The paper published in this week’s BMJ medical journal.

Vaginoplasty, a medical procedure involves the creation or reshaping of the vagina. Vaginoplasty is sometimes performed to revise vaginal anomalies and congenital conditions such as absence of a vagina at birth, as well as to repair the area following disease or injury. Vaginoplasty may be undertaken for functional reasons, aesthetic reasons, or a combination of the two.

Women’s concerns about their appearance, fuelled by commercial pressure for surgical fixes, now include the genitalia.

A share of this consumer demand is being absorbed by National Health Service specialists. This article was prompted by the increased numbers of women asking for labial reduction and the concerns of clinicians about the rising number of referrals for cosmetic genital surgery.

More and more women are said to be troubled by the shape, size, or proportions of their vulvas, so that elective genitoplasty is apparently a “booming business.” Advertisements for cosmetic genitoplasty are common, often including before and after images and life changing narratives.

Google produced around 490 000 (464 000 on May 27) results when we entered “labial reduction”. Forty seven of the first 50 results were advertisements from clinics in the United Kingdom and United States offering cosmetic genital surgery.

Television programmes and articles in women’s magazines on “designer vaginas” may also fuel desire for better appearance.

But decisions about surgically altering the genitalia may be based on misguided assumptions about normal dimensions, they warn. Surgery carries risk, such as loss of sensitivity and the long term benefits are unclear, they say. Some doctors even align the practice with “female genital mutilation.” So what makes women take such risks when their genital characteristics fall within typical ranges?

The increased demand for cosmetic genitoplasty may reflect a narrowing social definition of normal, or a confusion of what is normal and what is idealised. And the provision of genitoplasty could narrow acceptable ranges further and increase the demand for surgery even more. Surgery is an extreme and unproved intervention in this instance, and it should be thought of as the last resort, not the first port of call, they argue.


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