In a world where girls as young as nine are seeking surgery to alter the appearance of their genitals, parents may be at a loss as to how to reassure their daughters their vulvas are “normal”.
But now, doctors have created an online booklet you can direct young women to so they learn “vulvas come in a variety of shapes and sizes” and every woman’s “normal” is different.
The booklet, created in partnership with with Brook, a young people’s sexual health and wellbeing charity, features a series of illustrations that detail the changes that happen to a woman’s body during puberty and beyond.
Commenting on the launch, Laura West, participation and volunteering manager at Brook, said: “All young people deserve education, support and advice about anatomy, but unfortunately there is a lack of accurate and sensitive information available as part of the school curriculum and on the internet. This new booklet will help to address this need and will inform doctors, girls, young women and their families, as to what is normal and where to seek further help and support if required.”
The resource was commissioned by The British Association of Paediatric and Adolescent Gynaecology (BritsPAG), a specialist society of the Royal College of Obstetricians and Gynaecologists.
According to NHS figures, in 2015-16 more than 200 girls under 18 had labiaplasty and more than 150 of the girls were under 15. These numbers do not include girls and young women having the procedure privately. BritsPAG say these operations do not have a medical justification.
Female genital cosmetic surgery refers to surgical cosmetic procedures that change the structure and appearance of the healthy external genitalia of women. It includes the most common procedure, labiaplasty, which is sometimes referred to as “designer vagina” surgery and involves the lips by the vaginal opening being shortened or reshaped.
As well as including illustrations of vulvas, the booklet, titled ‘So what is a vulva anyway?’, includes information to clear up the names of body parts for young women who may be confused.
“People call vulva lots of different names: fanny, minge, foof, flower,” it says. “Some people say vagina when they are actually talking about their vulva which is fine, but it’s a really good idea to know the proper names to avoid confusion.”
Dr Naomi Crouch, consultant gynaecologist and chair of BritSPAG, told HuffPost UK as well as being useful for teens directly, the new booklet can help parents when talking to young people about normal vulva appearance.
“It provides accurate and sensitive information about the vulva, how it is unique and it is entirely normal and healthy to change throughout life,” she said.
“Parents can play an important role in ensuring young people have access to accurate information and offer reassurance and emotional support to those who may feel concerned or distressed about how they look or feel.”
The team behind the booklet conducted discussion groups with young women in order to gauge their current level of understanding and whether they felt as though this resource would be useful.
These young women felt there is a lack of understanding about the vulva and that they are not taught enough in school. They said they are likely to conduct their own research online.
The booklet provides girls with a reliable resource to counteract the fact they are presented with so many images of vulvas that are digitally manipulated.
“It’s difficult to know what a ‘normal vulva’ is. You don’t really get to see other peoples so it’s difficult to appreciate that labia come in different shapes and sizes,” the booklet says.
“If you have seen any porn you might have seen vulvas looking a particular way (often with no hair and with very tiny labia - so you can’t see them). Lots of images are photoshopped to look like this - as are boobs, legs and various other body parts. This creates a false image of what is considered normal or desirable.”
The resource also aims to tell young women - and their parents - that if a young person does have concerns about their body, a positive thing to do is to reach out and speak to a healthcare professional, such as a GP.
The booklet will be available on the BritsPAG website as a download for clinicians, including GPs, practice nurses and sexual health staff to be able to give out when meeting young people with genital cosmetic concerns and signpost them to further resources that promote healthy body image.
Louise Williams, clinical nurse specialist at University College Hospital and co-lead of the project, said: “We see many patients in our paediatric and adolescent gynaecology clinic who have a poor understanding of the function of parts of the anatomy and also of normal genital variation
“We hope [this booklet] will reassure young people that vulvas come in a variety of shapes and sizes, and if they need advice and support, they can know where to go”
Dr Naomi Crouch, consultant gynaecologist and spokesperson for the RCOG and chair of BritSpag, added: “There is absolutely no scientific evidence to support the practice of labiaplasty and the risk of harm is significant, particularly for teenagers who are still in stages of development both physically and psychologically.
“We hope this resource will provide information for girls and young women that their vulva is unique and will change throughout their life, and that this is entirely normal and healthy.”