Why the rise of Labiaplasty?

With the recent release of Laura Dodsworth’s book, ‘Womanhood; the bare reality’. I thought it would be a good time to talk about Labiaplasty; what it is and why it’s on the rise.

Labiaplasty is the most common form of female genital cosmetic surgery and involves surgical reduction of the Labia minora (the inner lips of the vulva). You may also know it by a few different names: “vulva reshaping”, “vulva and vaginal rejuvenation”, “designer vagina” and “the barbie doll”…yes “the barbie doll!”  

Labia minora surgery was first documented in 1976, but it was not until the 2000s that the surgery gained popularity. In the UK the demand for labiaplasty has increased more than three-fold from 2000 to 2014.

Why is there such demand?

The reason behind the increased demand is a debated and complex one. The reason being is that the private sector is not obliged to share or even capture their data, at times making it hard to pinpoint. However, what we do know is that women request labiaplasty to alleviate problems arising from labia minora which, when large, lead to problems concerning hygiene, difficulties during sexual intercourse and discomfort when wearing tight clothes or exercising. Despite this, the primary motivation for some women requesting labiaplasty is concern about genital appearance.

From my research it appears that there are a few influencing factors as to why there is a demand. Starting with the obvious; porn. There’s the standardisation of vulvas shown in porn, regularly cleanly shaved, with tiny labia. This can perpetuate the idea that this is the only form of “normal”. But this isn’t just internet porn. I found the most amazing research paper that outlines changes from the 1960s to 2013 in playboy magazine centrefolds. They studied over 493 magazines and discovered the vulva was fully exposed increasingly significantly, from 0 instances in the 1950s to 78.6% of images from 2010 through 2013. Alongside this is the grooming, minimal to no hair grew from 11.4% of images from the 1990s to 78.5% of those from 2010 through 2013. Now, there isn’t a write up on what these vulvas look like, apart from bald or minimal hair! But they did say that it seems that Playboy digitally alter the image to fit into the western ideal beauty standard. Cheeky.

Alongside this is the growing conversations about grooming and the pressure women are now put under. Carrie Bradshaw spoke about Brazilian waxing in 2000, The Only Way is Essex carried out vajazzling in 2011. Celebrities from Kim Kardashian to Gemma Collins have  spoken openly about labiaplasty, there have even been treatments carried out on morning TV!

Body image and the vulva.

The most common motivator for surgery is, aesthetic concerns (71%) , followed by physical/functional (63%) and sexual reasons (38%) Furthermore, a significantly higher percentage of women seeking labiaplasty (39%) had experienced teasing in regards to their genital appearance, predominantly from ex-partners. In this piece of research all partners were male. I can’t help wonder; if the partners of women who undergo labia surgery are as concerned about the possibility of reduced sexual pleasure as they were about aesthetics?

“Normal” is one of my least favourite words, but it fits here. As individuals we tend to want to feel “normal”, which ultimately means that we fit in, or are accepted. So in order to know what “normal” is we compare ourselves.  To help understand what women perceive as “normal” when it comes to labias, researchers in Australia evaluated the effect of viewing images of surgically reduced labia on women’s perceptions of “normal” genital appearance. One group of women looked at images of modified genitalia first and another group viewed images of unaltered genitalia first. What they found isn’t surprising, viewing modified genitalia alters the perception of “normal” among women ages 18-30. In addition, all women rated small labia as more desirable

The Royal College of Obstetricians and Gynaecologists actively talk about the lack of data in regards to the surgery and that this has ramifications on understanding the risks.  They also explain in their ethical guidelines, that when dealing with women who request labial surgery whose motivation is primarily anxiety about their appearance, accurate information about what is normal physiology can often provide sufficient reassurance to alleviate their concerns. This is turn could deter them from going ahead with the surgery.

I am not against Labiaplasty, specifically when there is pain, discomfort or functional issues. I am for; informed decisions, accurate information and education and real support (debunking myths and normalising body parts). I believe that accurate information about “normal” female genital physiology should be the first point of call. This could provide sufficient reassurance for women who are requesting surgery because of anxiety about their appearance. Clinicians should discuss other possibilities; offering counselling or psychological treatments for difficulties such as body image distress, sexual difficulties and low self-esteem.

Laura’s book does “normalises” vulvas, reminds us that they are all “normal”. If you see a lot of images of small labia minora you are more likely come to view that as “normal” or desirable. It’s not much different from seeing women with thin bodies on TV or women with immaculate features in magazines due to Photoshop. We need to debunk these myths, educate and talk more openly about the diversity, individuality and uniqueness of vulvas.

Photo by Jan Kleinert on Unsplash

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