Labia Surgery is Increasingly Popular, But Most People Aren't Getting it Because of 'Idealized' Genitals Seen in Porn (Insider)

Read the full article by Lux Alptraum at Insider.com

The vaginal labia come in a variety of shapes and sizes. The inner labia, in particular, can range from nearly invisible to bountiful and overflowing. For those who'd prefer smaller inner lips, a procedure known as labiaplasty can surgically reduce their size.

Not everyone thinks labiaplasty is a beneficial procedure.

In 2017, the American College of Obstetricians and Gynecology (ACOG) sounded the alarm about labiaplasty, noting that the procedure, which had been on the rise since 2011, saw a sharp increase in cases in 2016.

In a statement, ACOG explicitly expressed concern about increased teen interest in the procedure, cautioning its members against surgically altering young patients' labia in most cases and noting that many adolescent labiaplasties could be in violation of laws against female genital mutilation (FGM).

ACOG's discussion of labiaplasty also offered a few possible reasons for why the procedure was growing in popularity. The increased demand could merely be a product of increased awareness of the procedure, or, the statement suggested, a byproduct of the pubic hair removal trend. 

But it was the third rationale ACOG presented that really took hold in the conversation around labiaplasty: "Exposure to idealized images of genital anatomy," or, more colloquially, porn.

That's now being challenged by a new study suggesting pornography is, at best, a minor influence in the decision to seek labiaplasty.

Porn usually isn't the motivating factor when people pursue labiaplasty

When Dr. Heather Furnas, Clinical Assistant Professor at Stanford University, broached the topic with her own labiaplasty patients, porn was rarely offered up as a primary motivating factor. Her recent study of 124 women (about 1% of annual labiaplasty cases) found that, while pornography can't be eliminated as an influence, its role is minor when compared to other factors.

Furnas believes the answer is much simpler: more labiaplasties are being performed because people who've long struggled with labial pain are now aware that labiaplasty is an option, thanks to the internet.

In the twenty years that she's been performing the procedure, Furnas has met many women who seek it out after years of pain, irritation, and physically uncomfortable intercourse — women like the writer Morgan Jerkins, who wrote about her own labiaplasty in 2016.

Dr. Furnas, who likens labiaplasty to the significantly less controversial breast reduction, explains that while some people have aesthetic concerns, many of her patients are more focused on being able to ride a bike without pain, or get through a day without having to carefully position their labia lest they experience excruciating chafing.

All of us could use a more expansive education when it comes to vulval diversity. And patients whose requests for labiaplasty are motivated more by body dysmorphia than physical discomfort are more likely to benefit from counseling than surgery.

But rather than blithely assuming that people who pursue labiaplasty are insecure, ill-informed, and image- obsessed, it's worth following in Dr. Furnas's footsteps and asking more patients what is motivating their decision.