Image: by Prue Stent for Catalogue.
According to The New York Times, cosmetic vaginal surgery has now become so prevalent among young girls in the US that the American College of Obstetricians and Gynecologists (A.C.O.G.) has been forced to take action. Last week, the nonprofit organisation issued guidance from its Committee on Adolescent Health Care to doctors, urging them to address the recent rise of teenagers seeking cosmetic surgery to trim or shape their external genitalia. The guidance outlines how doctors can teach and reassure their patients by recommending alternatives to surgery that will alleviate discomfort. They also stress the need to screen patients for a psychiatric disorder that causes obsession about perceived physical defects.
Obviously adolescence is a very difficult period in general. But it is just awful to think that vaginas are now the latest in a long list of body parts that teenage girls feel insecure about — so much so that they would seek drastic measures like surgery to address these insecurities. It’s a phenomenon that has left physicians “sort of baffled,” said Dr. Julie Strickland, the chairwoman of A.C.O.G.’s committee on adolescent health care. And one that further underscores the failings of sex education and a culture in which young women simply aren’t encouraged to look at, talk about, or even understand their vaginas.
The New York Times explains that the labia surgery (or labiaplasty) is marketed for adults, as “‘vaginal rejuvenation,’ tightening the inner and outer muscles of the vagina, as well as often shaping the labia; it is geared to older women and women who have given birth.” But now gynecologists who care for teenage girls are reportedly receiving requests every week from patients who want surgery to trim their labia minora. This is primarily for cosmetic reasons, but occasionally for functional reasons too, including discomfort relief.
In response to these reports then, A.C.O.G.’s guidelines don’t completely rule out labiaplasty for teens, but do say that it is rarely appropriate. “It should not be entertained until growth and development is complete,” Dr. Strickland said. “The big thing I tell patients about labiaplasty is that there are a lot of unknowns. The labia have a lot of nerve endings in them, so there could be diminishment of sexual sensation after surgery, or numbness, or pain, or scarring.” These are notions backed up in A.C.O.G.’s 2007 committee opinion on cosmetic vaginal procedures for adults, which was then reaffirmed in 2014 and said the procedures had not been proven safe or effective yet, with the potential to cause serious complications.
Despite this, though, The American Society for Aesthetic Plastic Surgery says that 400 girls 18 and younger had labiaplasty last year, which represents an 80% increase from 2014. And it’s not just in the US, either. A 2013 British report also found the number of labial reductions on girls and women performed by the National Health Service had increased fivefold over a 10-years period. Something that The New York Times suggests could be linked to the prevalence of young women that wax or shave their pubic hair today. As well as the plethora of airbrushed depictions of vaginas that can now be found online. “I think the most important thing to understand is that there’s huge variety in anatomy,” said Dr. Veronica Gomez-Lobo, the director of Pediatric and Adolescent Ob/Gyn at MedStar Washington Hospital Center and the president of the North American Society for Pediatric and Adolescent Gynecology. She often recommends that young women look at unretouched photographs of vulvas, like those in the book Petals by Nick Karras.
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