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Vulva anxiety and the rise of labiaplasty

Nov 1, 2021 | featured five, Health | 0 comments

//Illustration by Madison Lauterbach | mlauterbach@msmayhem.com

Editor’s note: The author has a personal relationship with the anonymous source in this article. 

 

What do a so-called normal labia look like? Labia, which is Latin for lips, protect the vaginal opening—they can be dark or light, wrinkled or smooth, long or short, or something in between. Just like the labia, clitoral hoods, a covering of skin that protects the clitoris, come in all shapes and sizes. So why is it that so many young women are turning to often unnecessary surgical alterations to permanently change the look of their vulvas? 

The rise of labiaplasty, the cosmetic shaping of the labia, is widely prevalent among teenagers in the United States—and yet it often goes unspoken. According to The American College of Obstetricians and Gynecologists, labiaplasty rates increased more than 50% between 2014 and 2018. This is attributed not only to pornography and other media fetishizing the look of prepubescent-looking vulvas, but the lack of accessible information to illustrate normal variations in genital anatomy. Rather than embracing how the vulva ages as people do, female external genitalia is almost erased with smooth curves and nothing being allowed to “protrude out.”

Shortly after shaving her pubic hair for the first time, a young teenager, who wishes to remain anonymous, became acutely aware of her asymmetrical labia—which is entirely common. She was just a freshman in high school when she first visited her gynecologist to discuss her options. 

“I wanted to get it fixed as soon as possible, but my doctor made me wait a year,” she said. “I’m happy I had time to think on it, but now [after the surgery] I truly feel so much better about myself.”

The ACOG released a statement in 2020 to warn physicians that the surgical alteration of the labia in patients under 18 when it is not medically necessary is a violation of federal criminal law. 

The 2020 Aesthetic Plastic Surgery National Databank reported $42,113,789 in annual revenue from labiaplasty surgeries, with the average charge being $3,022.

However, this now 19-year-old didn’t undergo a labiaplasty at the ripe age of 15 solely for aesthetics. While cosmetics undoubtedly played a role, she felt physical discomfort during sports from persistent inflammation and irritation due to the inner labia rubbing against skin. Her insurance covered the procedure for this reason. 

“We need to teach young girls what ‘normal’ looks like so people can tell the difference between actual pain versus insecurity,” she said. 

VulvaLove was formed to do just that. Created by sex educator Elizabeth Wood and women’s health physical therapist Dee Hartmann, the brand believes that understanding genital diversity is a key component of body positivity. Outside of providing private consultations, the duo wrote the book “The Pleasure Prescription: A Surprising Approach to Healing Sexual Pain” to help educate vulva-bodied people on how to get to know themselves in a more intimate way. 

“With the rise in pornography and availability of pornography, the bodies that are portrayed, but in this case, the vulvas specifically that are portrayed, have been airbrushed and edited to meet a societal norm of small, neat and tidy—and that’s just not the way we are,” Wood said. “VulvaLove was also started to normalize that genitals are genitals are genitals are genitals. They come in all shapes and sizes and all different colors.”

Wood has dedicated her career to researching vulva diversity and empowering people with vulvas to embrace their anatomy. She even collaborated with Vagina China, a Boulder-led, large-scale community art project, when she participated in a vulva casting ceremony in Longmont to help celebrate labia diversity. There she created a physical cast of her vulva that is anonymously displayed at the art exhibition. 

“Labiaplasty was and still is the fastest-growing elective cosmetic surgery in the world,” Wood said. “This procedure is being performed on girls as young as nine in the U.K., in Australia. The body isn’t fully developed, the labia aren’t fully formed in a girl as young as nine.”

However, Hartmann admits there are times where it appears a labia reduction is advised, especially when it comes to disease or severe discomfort.  

“We certainly recognize that there are medical reasons to have the reduction done,” Hartmann said. “It’s just how much happens and how it’s done and who does it.”

The young woman, who is now based in Colorado, chose her gynecologist to perform the procedure rather than a plastic surgeon for her doctor’s extensive knowledge of female anatomy and nerve density. Today, she says she experiences zero issues during intimacy. According to a 2016 study, most labiaplasty techniques can be performed safely and are unlikely to cause loss of sensation from nerve damage. 

“I’m still not perfect—my gynecologist made sure to only cut what was necessary to avoid causing nerve damage,” she said, adding that she has kept her procedure a secret from those closest to her. “If you’re worried it doesn’t look ‘normal’ down there, it could be a self-esteem issue and a procedure won’t fix that.” 

Vulva Love’s message is clear: Vulvas aren’t supposed to be like a Barbie doll, every body is a “normal” body and knowledge is power.

 

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