Why Are More and More Teen Girls Getting Cosmetic Genital Surgery?
An increasing number of American teen girls are asking their doctors for cosmetic genital surgery, according to a new paper from the American College of Obstetricians and Gynecologists. Between 2014 and 2015, the number of girls age 18 and under who received labiaplasties—procedures that alter the external appearance of the vulva—almost doubled.
To be fair, that number is still small: The American Society for Aesthetic Plastic Surgery reports that 400 girls got the procedure last year, though there are probably more that obtained labiaplasties from gynecologists, which wouldn’t figure into the data. Julie Strickland, who heads ACOG’s committee on adolescent health care, told the New York Times she was “sort of baffled” by the fast-growing count. Most of these patients are girls who want their labia minora shortened for aesthetic reasons, though some cite discomfort during sports as the impetus for their surgeries.
ACOG’s opinion on teen labiaplasty, released last week, states that young women are particularly vulnerable to body anxieties that may lead to a request for cosmetic surgery:
Adolescents, under the influence of pubertal hormones, undergo rapid transformation and growth of their breasts and genital tissues. This can lead an adolescent to question whether her body is normal and to express occasional dissatisfaction with her body’s appearance, size, symmetry, or function. … This age group may be under particular stress regarding these issues because of societal conceptions of the ideal female body and parental concerns for body perfection.
Labiaplasty may affect sexual sensation and function—a concerning prospect for doctors with patients at the very beginning of their sexual lives. ACOG says doctors should screen teen girls for body dysmorphic disorder before performing any genital modification (since surgery could worsen bodily dissatisfaction spurred by a mental health issue) and suggest counseling and nonsurgical alternatives.
The Times reports that girls age 18 and under receive fewer than 2 percent of all cosmetic surgeries—they’re mostly ear surgeries, nose jobs, and breast reductions—but nearly 5 percent of all labia surgeries. The body insecurities that come along with puberty are nothing new, of course. But adolescent girls didn’t always seek surgical alterations for body parts usually only seen by locker room cohabitants and sexual partners. Most young women don’t see many other girls’ labia in person, so they don’t learn of the wide range of sizes, shapes, and colors of women’s vulvas. Today’s teen girls have grown up with easy access to photos and videos of genitals porn, which are often already surgically modified or chosen for their slight, monochrome appearance.
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.
Teenage boys are notorious propagators of the myth that women’s vaginas change shape—and their labia change size and color—depending on how many men they’ve had sex with. The internet teems with accounts of self-conscious women convinced that their labias look like “roast beef.” Without easily available, medically accurate sex education, girls don’t have the resources to resist these unrealistic ideals. In a climate that prizes a specific kind of vulvar perfection, it’s no wonder teens questioning their changing bodies look to surgery for an answer.
This is ridiculous! How many more ways will Americans torture themselves in order to be “sexy,” “beautiful” or “cool”?
I’m not talking about piercings, tattoos or fake nails. I’m talking about self-starvation in order to conform to the Barbie/Ken body ideals and hacking off parts of their bodies and faces in order to achieve same.
In Africa, India and the Middle East there are people fighting to protect women from “socially correct” genital mutilation. But in America we do it to be cool… Ai yi yi!
Fighting Female Genital Mutilation
The NY Times By MONA ELTAHAWYNOV. 16, 2014
CAIRO — I AM a 47-year-old Egyptian woman. And I am among the fortunate few of my countrywomen whose genitals have not been cut in the name of “purity” and the control of our sexuality.
Egyptian government figures put the rate of female genital mutilation among women ages 15 to 49 at 91 percent. Among teenagers 15 to 17, it is 74 percent. Unicef estimates that of the 125 million women worldwide who have undergone genital cutting in the 29 countries where it is most prevalent — mostly in Africa and the Middle East — one in five lives in Egypt.
Other than the tireless Egyptian activists who for years have fought to eradicate it, very few talk about a practice that brings nothing but harm to so many girls and women. In her books, the feminist Nawal El Saadawi has long documented her own cutting at the age of 6 and her tenacious campaign against a practice that is carried out by both Muslims and Christians in Egypt. But why aren’t other prominent women speaking out by sharing their own experience of surviving genital cutting? The silence comes at a great cost.
Many international treaties designate female genital mutilation a violation of the human rights of girls and women. On Oct. 30, the United Nations secretary general, Ban Ki-moon, announced a global campaign to end it within a generation.
Egypt first banned the practice in 1959, and then permitted it again in some forms. When Egypt hosted the 1994 United Nations Population Conference, it was embarrassed by a CNN report that showed a cutting procedure, despite official claims that it was no longer practiced. The government then allowed “medical” genital cutting — in which the procedure is carried out in a medical environment or by a medical professional — until 2008, when a universal ban was imposed after a 12-year-old girl died the previous year during a procedure in a clinic.
Next week, in the first trial since that law was passed, the father of a 13-year-old girl, Soheir al-Batea — who died during the procedure after an allergic reaction to penicillin — and the doctor who performed the surgery will be sentenced on Nov. 20. It seems we pay attention only when female genital mutilation kills a girl. Otherwise, we quietly ignore it.
The practice is sometimes erroneously referred to as circumcision. According to the World Health Organization, it “comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for nonmedical reasons.” The procedure has no health benefits. We hack away at perfectly healthy parts of our girls’ genitals because we’re obsessed with female virginity and because women’s sexuality is a taboo. This cutting is believed to reduce a girl’s sex drive. And families believe their daughters are unmarriageable unless they are cut.
An Egyptian gynecologist I interviewed told me that all of her patients at a university hospital clinic were survivors of female genital mutilation; 70 percent of those at a private practice were. Anecdotal evidence suggests that the more educated a woman is, the less likely her daughters will be cut.
In a BBC report broadcast to coincide with the current trial in Egypt, a traditional midwife boasted that despite the ban, she had a waiting list of mothers who wanted their daughters to be cut. The Guardian reported that many in the village where Soheir al-Batea lived believed that genital cutting was prescribed by Islam. The grand mufti of Egypt pronounced it un-Islamic in 2007, but some local imams persist in attributing the practice to a saying of the Prophet Muhammad. Across Africa, Christians and animists follow the custom as well.
The 2008 Egyptian ban, which imposes sentences of up to two years in prison or fines of up to 5,000 Egyptian pounds (about $700), has done little to curb the practice.
“Medicalized” cutting is at 77 percent — up from 55 percent 20 years ago. When I interviewed a 53-year-old survivor of the practice in Cairo for a BBC radio documentary about women in the Middle East, she told me, “It must be carried out, because that’s the way to maintain the purity of girls, to make sure that the girl is not out of control. We don’t care if it’s against the law or if they’re trying to stop it. We know doctors who are willing to continue and have done so.”
Laws are not enough. Countries that have succeeded in lowering the rate of female genital mutilation, like Senegal, have used varied methods: alternative rites of passage into womanhood, campaigns in which brides and bridegrooms state that they both reject the custom, and the involvement of clerics and priests. Higher education levels, family relocation to big cities and sometimes the death of the family patriarch can make a difference. Some of these factors helped my own extended family end the practice.
Mothers must not bear the blame alone. They subject their daughters to the same harm and pain that they themselves experienced because they understand what is required of their daughters in order to be married. Our society must learn to stop brutalizing girls in the name of controlling their sex drive.
We need nothing short of a recognition that ending female genital mutilation is part of the “social justice and human dignity” revolution that we began in Egypt in January 2011. We can better protect our girls when we recognize that those chants of our revolution are essentially demands for autonomy and consent — for all.
Mona Eltahawy is the author of a forthcoming book on the fight for gender equality in the Arab world.