Aesthetic labiaplasty is never just a ‘choice’

An ad for vaginoplasty
An ad for a cosmetic surgery centre that performs vaginoplasty.

The latest reports from the American Society for Aesthetic Plastic Surgeries indicate that the number of labiaplasty surgeries performed between 2011 and 2012 increased 64 per cent, and went up again 44 per cent between 2013 and 2014 (ASAPS, 2015). While it might be tempting to dismiss labiaplasty as just another form of plastic surgery, it represents the reality that the objectification of women’s bodies is no longer limited to their most visible parts. There is no longer any aspect of a woman and her body that are safe from scrutiny and appearance standards; even the most private parts are now public. Although the argument has been used before with other forms of plastic surgery, “empowered choice” is not the only thing occurring when women elect to have aesthetic labiaplasty.

Labiaplasty refers to the surgical reduction of what a woman feels like are “enlarged” labia minora. Women undergo this surgery to eliminate skin protruding past the labia majora (the outer ones), reducing the labia minora (the inner ones) to relative invisibility. Interestingly, there is no proven relationship between the size of a woman’s labia and her ability to experience sexual pleasure. In short, this means that neither bigger, nor smaller, is better when it comes to sexual satisfaction.

Unlike other forms of female genital plastic surgery, arguably performed to improve sexual function and health, aesthetic labiaplasty exists for appearance reasons alone. This highlights the hypersexualization of women’s bodies, in which women are electing surgery that in no way benefits the woman herself, sexually (neither increasing pleasure nor functionality). The only conceivable way that aesthetic labiaplasty might benefit a woman, is in how it reduces her experience of internalized shame about her sexualized body — a shame that comes from a (societally-driven) feeling that her vulva doesn’t match cultural expectation. Contrary to what some would have you believe, women aren’t really chopping off their labia to “fit into yoga pants.”

Medically speaking, it is not unusual for women to have labia of different size, colour, or length — in fact, “normal size” labia can range from 2cm to 10cm in length. But, it seems that there is more that shapes women’s feelings about her vulva than what is medically healthy or normal. Not surprisingly, pornography is one of the most significant influences on what women believe to be “normal” when it comes to about vulvas. Recent research indicates that when women actively consume pornography, they are more likely to internalize the appearance ideals communicated through this form of media, which results in dissatisfaction with their vulvas.

In other forms of surgery, two other important psychological steps take place for a woman to consider plastic surgery for appearance reasons alone: appearance-contingent self-worth and self-objectification. Unsurprisingly, both these steps are culturally dependent. The more a woman sees her self-worth as based on appearance, the more likely she is to try to look like the “ideal,” or take measures — even dangerous ones — to reconcile the difference between what she looks like, and what the parts of sexualized women’s bodies look like in the media.

This is also true of labia: if a woman judges her worth based on her appearance, and her vulva is noticeably different than the vulva viewed by herself or her partner in pornography, the more likely she is to try and “do something about it” to feel “good.” Thanks to so-called “feminist” sites like The Frisky, we can all know what it’s like to go from “roast beef” to “pretty down there.”

As if The Frisky weren’t bad enough, pornography is the most powerful influence shaping social norms around genitals, due in large part to its current pandemic use in North America (a problem which demands an article of its own). When most women are going to cosmetic surgeons for labiaplasty, they are doing so because they have come to believe that their labia are “weird” or “odd,” and desire to have a more “normal” looking vulva. We see this trend both in the academic world and in pop culture. Interestingly, and perhaps not shockingly, when they’re presenting an image of their ideal vulva to their surgeon for comparison, women are presenting images ripped from porn, stating that they want one “like that.”

Trends in pornography towards total removal of pubic hair have increased the visibility of the labia. And, in order for female genitalia to meet “soft core” decency standards, most pornographic magazines and sites digitally edit out the visible labia, performing what Lindy Joan McDougall (2013) calls a digital labiaplasty. Even women whose bodies are used for porn have diverse vulvas, but are digitally altered to present a vulva with little to no labia minora. It is worth noting that the digitally-created vulvas men and women are idealizing (and using for comparison), do not exist.

University of Toronto’s Kathryn Pauly Morgan’s words in 1991 about cosmetic surgery and the colonization of women’s bodies remain as salient as ever: “What appears, at first glance, to be instances of choice turn out to be instances of conformity.” While women might label their pursuit of aesthetic labiaplasty (or any other form of aesthetic plastic surgery) as choice or “empowerment,” the reality is that women are putting a new name on age-old oppression which has not only not disappeared, but has become internalized.

We can not simply call the same behavior a different name, when what is driving that behavior is simply internalized oppression, dictated by a misogynist culture. Further, the existing research on what drives women to elect aesthetic labiaplasty indicates poor self-worth, self-objectification, and body shame. Even the creators of the objectification theory have identified that self-objectification is not about choice or empowerment, but rather survival in a context in which women believe that in order to be valued, they need to look a certain way.

If it is as simple as Fredrickson and Roberts suggest, then making a choice between survival and rejection is not much of a choice at all. In light of this, it may be tempting to look at women who self-objectify and elect unnecessary cosmetic surgeries in the name of “choice” and “empowerment” with judgment. Instead, let’s commit to even greater efforts to establish equality, based on valuing women as more than simply sexual objects and where being a women and making choices is about more than just “survival.”

Hillary McBrideHillary McBride is a registered clinical counsellor working in the Vancouver area. She specializes in women’s experiences and feminist therapy. Hillary is currently a PhD student at the University of British Columbia where she is hoping to conduct subversive feminist research to change academia from the inside out. Follow her on twitter @hillarylmcbride.

Hillary McBride
Hillary McBride

Hillary McBride is a registered clinical counsellor working in the Vancouver area. She specializes in women's experiences and feminist therapy. Hillary is a PhD student at the University of British Columbia, where she researches women's experiences using feminist methodologies. She is the author of "Mothers, Daughters, and Body Image: Learning to Love Ourselves as We Are" and recently won the International Young Investigator Award in Human Sexuality from Taylor & Francis for her research and clinical work on sexuality in mothers.

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  • JingFei

    The Frisky is like an online sewer of nonsense and ignorance.

  • Mira

    Wow. That is so sad. 🙁

  • Tera

    Makes me feel sad, just sad.

  • Hierophant2

    That’s because lesbians generally love women as human beings, as whole beings, and hetero men see women as a collection of body parts (if not consciously, then unconsciously). A body part can always be improved upon, but not a human being.

  • Meghan Murphy

    I saw that one a while back too — good recommendation!

  • lagattamontral

    I don’t understand. What is pornographic about oral sex? Even cats do it.

  • Jude

    Century of Self is a great documentary on the subject.

  • Astrid

    Men suffer from that biking problem too but I don’t see them chopping off their balls. They design special saddles for this problem.

    • Rachel

      Ha ha I giggled at this Astrid, not because it’s actually funny but because of the way it was worded so well, and it’s oh so true. It’s ridiculous how much the world will bend over backwards to accommodate men’s tackle, but yet with women, we are actually expected to alter and chop off parts of our bodies to suit inanimate objects which could so easily and painlessly be changed.

  • skilletblonde

    There is a show called “Botched” that comes on the E network in America. I think its proper name is the Entertainment Network. I discovered it while channel surfing. The show is about 2 male plastic surgeons, whose purpose is to correct bad plastic surgery… with more plastic surgery. After viewing it, it should be renamed “Butchers.” I found myself literally turning away in disgust. It was like a horror show where mainly women were being cut up and stuffed. It was Frankenstein/Jack the Ripper. I was reminded of Jane Caputti book, “The Age of Sex Crime.” Here she reveals how Jack the Ripper, who loved to cut up women’s bodies, became the template for other serial killers. Through the sensationalism of these crimes, the butchering and killing of females became entertainment. But it is also science. Doctors have always targeted the female body for unnecessary surgeries. Some of them can be Jack the Ripper with no legal consequences. And when they received the right to advertise in the 1980’s, women were victimized like never before. Now you could not pick up a magazine or a paper without being reminded you had a problem. Of course the question is never asked, who gets to decide what perfection is, and why do we listen to them? Why is their perception of beauty more valid than yours? But, women, unfortunately, sheepishly follow the trend.

    The doctors that star in the TV show Botched are Terry Dubrow and Paul Nassif. Both are no strangers to Reality TV. Dubrow was part of the truly awful show “The Swan.” Ordinary people, (that is, according to the producers), who were deemed unattractive were made over by extreme plastic surgery. Dubrow’s wife is part of another really bad trope in Reality TV, the Real Housewives franchise. A look at his wife, and one can see the overt abuse of plastic surgery. Paul Nassif appeared on one of the Real Housewives franchises with his now ex-wife. And yes, she also had the look of too much plastic surgery.

    I’m afraid that under the system of unrestrained capitalism where nothing is sacred, where women in particular are denied the dignity of self, this kind of butchery will continue. The day may come when the trend will be in order to be beautiful one must cut off their nose, to balance their face. How many women will we see without noses?

    Here is a clip from the Swan. Caution, it will make you mad. Also notice what Dr, Dubrow looks like- while he names what needs to be corrected- on the young woman?

    • Alienigena

      Unfortunately humans can be pretty extreme even in small scale society (pre-Capitalism). I remember taking a course in the anthropology of Oceania and reading about initiation rights and penis splitting amongst Australian indigenous peoples. I am not male, but the accounts and photos made me a bit ill and led me to ponder how they managed to not damage the uretha.

      Neck extending, foot binding, deformation of skull (e,g, flattening), perforation of lip, scarification, piercings, etc.. Unfortunately modern plastic surgery is just one practice in a long line of practices that are pretty inexplicable to me. But I agree modern plastic surgery has some pretty horrific elements and seems mostly targeted at women’s bodies.

  • Melanie

    She mentioned that she experienced pain, but then spent the rest of the article speaking about shame and being ‘pretty down there’. I suspect that maybe the pain comment was thrown in there to rationalize her decision.

  • will

    It’s all SO depressing.

  • JessieR

    I’m throwing myself on a chopping block here…. if my labia were 10cm long, I would consider a reduction due to comfort. Women do report physical discomfort with longer lengths. Sadly, this is probably 0.00025% of the motivations for the surgery.

    A very sad remark in regards to large labia is an association with promiscuity. Boys used to say it in high school, my girlfriends confided in me that they weren’t slutty and didn’t know why they were getting big. It’s an extension of the paedophile culture.

    This is a fantastic article on one of the saddest things women are doing to themselves.

  • Sara Marie

    I agree with much of what you wrote here. I do want to comment that I don’t think lesbians and lesbian relationships are inherently better than heterosexuals and hetersexual ones. I agree that the influence of porn culture, including BDSM, has unfortunately seeped into much of the lesbian community. But as far as the particular subject of this post, I just do not know of lesbians that obsess over having the “right” labia the way some heterosexual women do.

    In regards to oral sex, your comments below focus on hetero relatinships, though some of them could presumably apply to lesbian relationships as well. In reality, though, at least in my experience, lesbians really don’t obsess over having “pleasing” genitalia. I’m not saying no lesbian has ever done this, but the norms among lesbians and self-internalizations tend, in general, to be different in this regard. My guess–and it would be interesting to study this–is that if you look at who is going through labiaplastia, it is almost exclusively heterosexual women.