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 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.