Female Genital Cosmetic Surgery

The surge in requests for Female Genital Cosmetic Surgery (FGCS) has occurred in the context of broader sociocultural developments that endorse the appearance of the single hairless slit as the standard or ideal genital appearance. Online marketing reclassifies labia minora that extends beyond the margin of the labia majora as an unusual variant warranting labiaplasty. Skewed information provided on consumer websites supports unrealistic notions of genital normality and lacks robust evidence for long term sexual and aesthetic satisfaction outcomes. It is vital that a doctor who sees women with concerns about their genital appearance knows to examine the patient respectfully and provide education regarding genital anatomy function and diversity with confidence. Health professionals need to manage genital anatomy anxiety and the subsequent rise in requests for labiaplasty from a biopsychosocial perspective, with women of all ages. The VMWS continues to be a great resource for health professionals who seek to learn more.

The Rise of Female Genital Cosmetic Surgery

In 2013, Dr Magdalena Simonis, GP and researcher with the Department of General Practice at University of Melbourne, noted that there was a rise in concern amongst women she saw regarding the appearance of their genitalia and her experiences were being echoed by other GPs who worked in women’s health. The quest for more information about this relatively unknown procedure resulted in the discovery of the skewed online marketing that women were being exposed to. There was little or no information around genital diversity and the normality of this amongst women, while there was active online encouragement of the quest for the ‘youthful, hairless, single slit’.

Education and information for doctors around labiaplasty and the suite of FGCS procedures was also lacking, and doctors could only glean from the websites what the procedures entail. Labiaplasty was being described as ‘simply trimming off undesirable excess skin’, sometimes to ‘enhance sexual attractiveness and confidence’, sometimes to improve ‘women’s hygiene’ or for reasons of ‘comfort’ for the active, sporty woman.

There was also a lack of research, which prompted Dr Simonis to write an essay. She then shared it with researchers, including Women’s Health Victoria (WHV), who was then exploring the topic and developing a policy paper, which she reviewed. Dr Simonis recommended that an online website be designed to help women who were seeking information online and WHV developed Labia Library.

At that point, there had been no research conducted in primary care exploring what GPs were experiencing and being asked about. Dr Simonis instigated the first 3 Australian studies, one of which was the first largest GP study worldwide. In 2015, Dr Simonis authored the only FGCS guide for GPs and health professionals, published by the RACGP: “Female Genital Cosmetic Surgery: A resource for general practitioners and other health professionals”. She also recently authored a chapter for the first textbook on the topic of female genital cosmetic surgery entitled “Female Genital Cosmetic Surgery: Solution to What Problem?”.

Further Reading