Last November, the X Factor judge and TV personality Sharon Osbourne caused quite a stir by revealing the latest in her long string of cosmetic surgeries. Deviating from the Botox injections, skin peels, tummy tucks and rhinoplasties favoured by her peers, Mrs Osbourne instead chose to undergo an altogether more intimate procedure: labiaplasty, or vulval reconstructive surgery. This case highlights a startling trend in modern medicine – the inexorable rise of cosmetic genital surgery.
The number of labiaplasties performed on the NHS has increased fivefold in the past decade, with more than 2,000 taking place in 2010. Far more procedures are thought to be performed each year in the private sector. Most reconstructive vulval surgery is undertaken to address long-term problems such as discomfort during sex or exercise and hygiene issues. Nonetheless, there is growing concern amongst practitioners that crushing social pressures and perverse expectations of “normality” are driving young girls to request surgery on aesthetic grounds alone. Many doctors and social commentators have now broken silence on this issue, declaring that the rise of the designer vagina may reflect an unhealthy negative bias amongst women towards their genitalia, fuelled by an internet porn boom and emerging fads such as “vaginal steaming” and the infamous “vajazzle”.
The burgeoning status of this issue has led the Royal College of Obstetricians and Gynaecologists (RCOG) to publish a paper clarifying best practice guidelines for doctors and surgeons in this field. Perhaps the most striking point raised by the authors was the fact that cosmetic genital surgery is ultimately performed blind; the evidence for the efficacy of labiaplasty and its long-term consequences is scant at best. Women concerned by the appearance of their genitalia may therefore be electing to go under the knife despite the medical professionʼs profound ignorance of likely post-operative outcomes.
The report provided by RCOG also recommends that labiaplasty should not be offered as an NHS service in the absence of legitimate medical grounds for intervention. The authors instead advocate psychiatric treatment for patients with significant concerns about the appearance of their genitalia. This may go some way towards addressing the problem, but several concerns remain, not least the risk that patients might simply be shunted into private healthcare, exposing themselves up to an utterly opaque and poorly regulated industry. Ultimately, if we are to truly understand the rise of the designer vagina at home and abroad, we must first ask uncomfortable and probing questions about the central involvement of society. Could our fascination with internet pornography, and our bizarre obsession with achieving “normality”, be driving young girls to request risky, life-changing surgery?
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