“Wait, Teenagers are Doing What Now?” or, “The Teen Cosmetic Labiaplasty Post You Never Wanted” | Vol. 3 / No. 26.5

This photo is a euphemism | Photo: gudka, CC BY 2.0

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In case being a person on this planet and/or watching movies and television hasn’t informed you of this, let me remind you: being a teenage girl sucks. At roughly the same time that you’re trying to figure out how all of this “being a person” stuff works, you are bombarded more than usual with conflicting messages: Have sex, or else you’re a prude. Don’t have sex, it will ruin your life and also you will be a slut. You won’t get what you want unless you follow your dreams! Give up on your dreams, they’re super unrealistic! Try to be “one of the guys,” or no men will like you. Be “one of the girls,” or else women will hate you and no man will ever talk to you. Your teenage years are filled with hormones and angst no matter what your gender is, but I still feel as if teenage girls get the shortest end of the stick as they are trying to navigate into adulthood and start making decisions that will affect the rest of their lives.

One decision that teenage girls are apparently making (that I had no idea was happening) is to have cosmetic genital surgery. Yeah, you read that right. Between 2014 and 2015, the number of teenage girls who received labiaplasties doubled. (Admittedly, this number is still small, at least on the end of cosmetic surgeons—400 girls had the procedure done last year, though this doesn’t account for any who had the procedure done by a gynecologist instead of a cosmetic surgeon.)

For those of you who don’t regularly read things that horrify you or make you angry as part of your unofficial job, labiaplasty (probably NSFW even if strictly medical) is a surgical procedure in which the labia majora are trimmed, changing the appearance of the vulva. While this can be done for legitimate reasons (for example, chafing or other problems causing women and girls to be unable to play sports) the procedure is mostly cosmetic, and aimed at making the vulva “pleasing” visually. Since most women are not looking at their vulvas unless they have a mirror and a copy of The Vagina Monologues handy, this procedure is usually aimed at making the vulva more visually acceptable to potential sexual partners.

Labiaplasty also rests on some pretty shaky grounds—it’s often referred to by surgeons who want you to have it as part of a “rejuvenation” procedure, as if age has made your vagina saggy and surgery is the fountain of youth that will perk it back up. But labiaplasty and similar “rejuvenation” surgeries aimed at the genital area were basically deemed “a pretty bad idea” by the American College of Obstetricians and Gynecologists in 2014: “Absence of data supporting the safety and efficacy of these procedures makes their recommendation untenable.” Despite this pretty clear warning, “the Aesthetic Plastic Surgery group report[ed] a 49 percent increase from 5,070 in 2013 to 7,535 in 2014” and some doctors say that  yoga pants are to blame. Yoga pants.

Because labiaplasty is still goddamn surgery, it contains a plenitude of risks “including pain, painful scarring, dyspareunia, hematoma, edema, and infection”  and can also “affect sexual sensation and function.” So girls who are just barely old enough to be having sex may be feeling pressured into losing their ability to enjoy it. That’s just so great.

And in today’s entry for “things no one should ever have to say,” Dr. Julie Strickland, who is the chairwoman of the A.C.O.G. told the New York Times  that labiaplasty ‘“should not be entertained until growth and development is complete.”’ The fact that she said that pretty much means that there are at least a few cases where girls tried to have this surgery before they were done growing.

Adolescent girls are already prime targets for body image concerns, and the media is less than helpful in combatting these problems since girls normally only see idealized female forms, and not necessarily the range of body shapes, sizes, and features that normal women inhabit. Girls are even less likely to get a good sense of what a normal vagina “should” look like, since they aren’t exactly going to see a lot of them outside of sex or overly-invasive locker room interactions. Instead they’re left with those good ol’ standbys, porn and Google image searches. And since porn is already made up of women who were partially chosen for their role because they had quote unquote “attractive” vaginal areas (what does that sentence even mean?), girls who look there for guidance are seeing more of the same “ideal” vulvas. Even our good friend Wikipedia is taking part in the perpetuation of the idea that there is only one way for a vagina to look (while reassuring men that their penises are all very, very normal):

Even when a girl looks outside the realm of porn for clues about her place on the labial spectrum, she’ll probably find only a narrow selection of vulvas to compare with her own. In 2014, Slate asked Vagina author Naomi Wolf to analyze the Wikipedia entry for vagina. “Why is there only one image?” she wondered. “I’ve never seen a labia like that. Not outside of porn. It’s not showing a true range.” Indeed, the entry’s featured photo is a completely shaven pubic area with a barely there labia minora and a small clitoris—the size and shape preferred by porn films and increasingly desired by teen girls (many of whose labia are well within the normal range) who ask their doctors for genital modification. (The Wikipedia entry for vulva, a lesser-understood term that gets far fewer views than vagina on the site, features a tremendous collage of labial and clitoral configurations.) Meanwhile, the penis entry features an entire paragraph on size range in the header and a dedicated section further down the page.

So even Wikipedia is letting girls down, and presenting the idea that a range of male sexual organs is totally normal, but that female sexual organs basically only come in one make and model.

I was a teenage girl with a lot of insecurities and angst, and something that makes me very sad is that I now have to be somewhat grateful that “concern about what my vulva looked like” was not on my list of worries. If girls (and boys) lack sexual education and opportunities to learn about what the range of womens’ bodies can look like, they are left with very few models of normal sexual functions. And if unscrupulous cosmetic surgeons capitalize on teenagers’ body insecurity in order to perform unnecessary procedures with potentially sex-killing side effects, it’s going to take more than a few copies of Our Bodies, Ourselves to set things straight.

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Elle Irise is a regular contributor to This Week In Tomorrow. When she’s not completely flabbergasted by the phrase “teen cosmetic labiaplasty,” she studies gender in popular culture.

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