Written by Josephine Fagan

Health

Fanny Terrorism

Why, asks Dr Josephine Fagan, are more and more women resorting to surgery in a bid for a so-called ‘designer vagina’?

Illustration by Louise Boulter

Illustration by Louise Boulter

I often discuss current medical issues with colleagues in the UK and abroad and, in the past few years, many of us have been troubled to encounter a significant number of young, female patients who are mistakenly concerned that their genitals are abnormal and require corrective surgery.

These patients aren’t uneducated, or suffering from thought disorders. But the majority do have one thing in common: their anxieties were triggered by cruel comments made on social media, usually by ex-boyfriends. Nowadays, that’s how gossip spreads. It’s not easy keeping private things private.

Obviously, women subjected to such attacks have been left feeling hurt and dismayed. But what made them fear they were also physically flawed? It’s not as if the naked body is a mystery: it’s used to sell everything from shampoo to newspapers. Then again, comparisons with airbrushed photos may only compound the problem, especially when adverts tend to depict a very limited range of physical types.

Take the typical Page Three Girl: on the whole, she has either ‘melon boobs’ or what I call the ‘ski-slope and half-an-apple’ breast profile, which is hardly representative of womankind. Bombarded with such images, many women have resorted to plastic surgery to achieve these supposedly ideal stereotypes.

But the world of advertising doesn’t portray female genitals, even when selling products such tampons. So, where does the notion of what constitutes a ‘normal’ or ‘abnormal’ vagina or vulva come from? For today’s teenagers it may well be from internet pornography, which doesn’t exactly provide a balanced overview.

Of course, there’s nothing new in having a naïve or narrow take on sexual matters. It’s said John Ruskin, the Victorian art critic, was so horrified by the sight of his bride’s pubic hair, he was unable to consummate their marriage. Sadly, the classical nudes Ruskin admired left him unprepared for the hirsute realities of female anatomy. The naked truth may pose a similar shock to today’s inexperienced young men, whose only point of reference is some waxed, buffed, surgically-altered porn starlet.

A male colleague gave me pause for thought when he said: ‘In most porn films, the camera lingers longer on the penis than the vagina. And how many male porn stars do you think have small or average penises?’

So, is the current vicious trolling trend fuelled by male anxiety? And are the increasing numbers of women prepared to undergo purely cosmetic surgery simply a reflection of their partners’ angst?

All I do know is, that one doctor friend now sees so many women with concerns about the appearance of their vulvas, she has resorted to using an anatomy text book, containing photographs of the vast array of normal female genitalia, in order to provide reassurance.

“There’s nothing new in having a naïve or narrow take on sexual matters. It’s said John Ruskin, the Victorian art critic, was so horrified by the sight of his bride’s pubic hair, he was unable to consummate their marriage.”

As for the nitty-gritty of ‘designer vagina procedures’, most involve surgical reduction in the size of the labia minora (so-called labiaplasties). Complications can include wound infection, persistent pain, scar formation and a lack of sensitivity during intercourse.

Despite this, NHS statistics reveal a five-fold increase in the number of labiaplasties from 2003 to 2013. Although many of these were for medical reasons, such as correction of congenital problems), the Royal College of Obstetricians and Gynaecologists, now advises against solely cosmetic labiaplasties being carried out on the NHS, particularly on girls under the age of 18.

The RCOG also expressed concerns that some women seeking labiaplasty may have body dysmorphic disorder, (a condition where sufferers have extreme anxieties about body image), and recommended that such patients be offered counselling and psychological support.

What’s less clear is how many ‘designer vagina’ procedures are being performed outside the NHS. And, with ever more private clinics offering such surgery, it’s hard to say why there has been little in the way of public debate on this issue.

It’s also sobering to think that Germaine Greer wrote her controversial article: ‘Lady, Love Your Cunt…’ in the 1970s, and still, many find even the title shocking. Happily, the intervening decades, have seen many women enjoying greater social, political and sexual freedom.

But let’s not forget the estimated 66,000 women and girls living in the UK who are victims of Female Genital Mutilation, (and the further 24,000 girls feared to be at risk of it). For those of us who continue to campaign against FGM, the current trend towards designer vagina surgery is all the more bewildering.

So, call it what you will – your fanny, your nunnie, your front bottom or your quim (my personal favourite). But if it ain’t broken, why fix it? Instead, to paraphrase Ms Greer, just be chuffed with your chuff!

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Written by Josephine Fagan

Josephine works as a doctor in urgent and primary care. She’s also a bit of a globetrotter, is working on her first novel, and loves the colour purple.