Girls as young as nine are seeking surgery to alter the appearance of their genitals, the BBC has reported.
Gynaecologist Dr Naomi Crouch aired concerns over doctors referring an increasing number of young girls for labiaplasty, which involves reducing the size of the labia minora (the flaps of skin on either side of the vaginal opening).
She told the Victoria Derbyshire show: “Girls will sometimes come out with comments like, ‘I just hate it, I just want it removed,’ and for a girl to feel that way about any part of her body - especially a part that’s intimate - is very upsetting.”
Here, we explain what labiaplasty is and talk to experts about what could be influencing the rise in young women opting for this type of surgery.
What Is Labiaplasty?
Labiaplasty is the name for surgery carried out to alter the shape or size of the labia minora, also known as the “inner lips”.
According to the Harley Medical Group the procedure takes about 60 minutes and involves a cosmetic surgeon making small incisions to the tissue.
Women opt to have labiaplasty for both medical and cosmetic reasons.
“For some women with longer labia minora (the inside lips), they can be very irritating when they rub on jeans or trousers and in some cases an operation may be warranted,” Dr Helen Webberley, a GP running the online healthcare service My Web Doctor, told HuffPost UK.
“However, in modern society, where many feel a need to look and be perfect, and where plastic surgery and other beauty modifications are so easily accessible, younger and younger people are seeking intervention.”
If the vaginal lips are obviously abnormal and causing distress or harming health, the procedure can be carried out on the NHS. However the health service doesn’t routinely provide the operation.
As a result, it can prove expensive (it costs anywhere between £1,000 and £3,000) and the operation carries a number of risks. There’s also no guarantee that someone will get the result they expected and it won’t necessarily make them feel better about their body.
Underage Procedures
Official advice is that labiaplasty should not be carried out on those younger than 18 on the NHS. Despite this, more than 200 girls under the age of 18 had labiaplasty on the NHS between 2015 and 2016, the BBC reported. More than 150 of these girls were under 15 years of age.
Changes in the labia minora are a normal part of development during puberty, therefore performing surgery on a young person isn’t even guaranteed to have the desired effect - and may cause needless harm.
“Performing irreversible cosmetic surgery, while physical and psychological development are still evolving, will risk harm and lead to further dissatisfaction,” Professor Janice Rymer, consultant gynaecologist and vice president for Education at the Royal College of Obstetricians and Gynaecologists (RCOG), told HuffPost UK.
“Due to the lack of evidence concerning the effects of labiaplasty, if this procedure is to be undertaken, it is strongly desirable that the procedure is performed only once development has been complete, usually after the age of 18 years.”
Influences
Experts agree that lack of education surrounding what a ‘normal’ vagina should look like, as well as narrow beauty ideals presented in pornography and the media, is to blame for increased interest in surgery among young girls.
“These paint a false picture of the female anatomy which many younger girls wrongly believe to be the ‘norm’,” explained Dr Webberley.
Emma Soos, managing director of The Women’s Health Clinic, said memes and societal expectations for women to remove their body hair are also adding fuel to the fire.
“The likes of Embarrassing Bodies and naked TV shows have not done us any favours - the female anatomy is often sensationalised,” she said.
“I’ve also seen some really awful memes on social media comparing women’s body parts to baguettes. It’s not helpful. Nor is the pre-disposition to shave parts which then put everything on show - if you are quite skinny, you do often notice the labia more.”
Body image pressures aside, the surgery may be necessary for women who experience issues such as getting their labia caught in their underwear or pain and chafing when doing things such as riding a bike or horse.
Dr Webberley has advised patients considering surgery for medical reasons to “very carefully weigh up risks and benefits and not to make quick decisions”.
Tackling The Problem
Most experts agree we need to better educate young women about the female anatomy, in order to deter them from unnecessary surgery.
A study published in the BJOG: An International Journal of Obstetrics & Gynaecology discovered that female genitalia varies hugely in size and shape - yet many women still question whether their vagina looks normal.
“We need to address the issue of ‘are they normal?’,” said Soos. “The answer is usually, ‘yes’. Our bodies change so much up until we’re 25. In fact, the age for having smear tests was increased for that very reason.
“No nurse should be exploring that area of a woman under 25 unless she’s having a baby or worried about an STI.”
The Women’s Health Clinic - which recently stopped offering the surgery after receiving “too many phone calls from worried young women with cosmetic, not medical, issues” - has launched a series of sex positive events shouting about women-led services in a bid to address the issue.
Meanwhile Rymer believes a mix of education, support and advice should be at the heart of clinical practice in this area.
She added: “For significant distress, these girls should receive psychological assessment and counselling.”