What are genital cosmetic surgeries?

Genital cosmetic surgery includes, among other procedures, labiaplasty (reductions or restructuring of the labia majora or minora) as well as modifications of the clitoris, including reshaping of the clitoral glans and reduction or removal of the clitoral hood. Additionally, hymenoplasty (the “reconstruction” of the hymen) and vaginal tightening operations are also included.

In the case of reduction of the labia minora, it is referred to as labiaplasty or nymphoplasty. One procedure, called the “Barbie” procedure, named after the famous doll, involves the surgery of the labia minora (sometimes total removal or suturing) to create a vulva completely “smooth” without visible labia minora.

The request for such surgeries can be purely aesthetic, stemming from discomfort (shame, negative comments from partners, etc.), discomfort when wearing tight clothing or engaging in certain activities (sexual, cycling, etc.), or aiming for an increase in sexual pleasure for the woman herself and/or for a partner.

Access to pornography on the internet, consumed by both men and women from a young age, is cited as one of the reasons for the increase in requests for aesthetic surgeries in Western countries. Adolescent girls and adult women come to clinics with images of “ideal vulvas” that are often retouched images from pornographic magazines or the internet, not reflecting real anatomy. Furthermore, the trend of complete genital hair removal makes the anatomy of the vulva more visible, whereas in other periods it was more concealed by hair.

There is still insufficient data on the long-term consequences of genital cosmetic surgeries on health, sexuality, and childbirth. Some research shows relatively low rates of complications, although every surgery carries risks. The identified negative consequences would relate to sexual pleasure, infections, and scarring.

What similarities are there with FGM?

Genital plastic surgeries can be compared to FGM at various levels due to the similarity of certain practices and the fact that they are performed for non-medical reasons.

Both practices are prevalent in different parts of the world: FGM is more common in countries in Africa and Asia (and among diaspora populations), while genital cosmetic surgeries are more frequently practiced in Europe, North America, and Australia. Regarding the age of interventions, FGM is primarily performed on children (sometimes infants or adolescents), whereas genital cosmetic surgeries are more often performed on adults and increasingly on teenagers. Intersex genital surgeries, which are also performed on infants and children, should be noted in this context as well. FGM is carried out by traditional excisors as well as healthcare professionals (midwives, nurses, doctors, etc.), whereas cosmetic surgeries are performed by surgeons and also by professionals in piercing/tattooing.

The demand for cosmetic surgery typically originates from women (and girls) themselves. However, it is fueled by the social norm propagated by the dissemination of the image of the “ideal vulva” or by the pre-marital virginity requirement imposed on women. Both aesthetic reasons and societal pressure can therefore play a role in the practice of cosmetic surgery, much like female genital mutilation.