Reconstructive surgery is a practice that was designed for functional and cosmetic purposes. Time has given rise to a novel practice: female genital cosmetic surgery (FGCS) that has solicited a lot of controversies. Initially, procedures to alter the genital size, appearance, and function were conducted for purely medical reasons, but now, this has changed to alter even that which is considered normal (Goodman, 2011). This has been the reason for contentious debate revolving around FGCS. However, criticism and anti-campaigns against FGCS are increasing amidst an increased use of this surgery and associated procedures. Medicalization of the women’s genitalia exposes photos of pre- and post-surgery that resemble female genital mutilation according to the New View Campaign (2008). Yet, these photos are seen as an ideal representation of the woman’s genital.
Various magazines have articles that indicate the desired or ideal female genitals, and by so doing, these articles result in consumer anxiety. Any woman looking at these articles begins comparing her genitals to those of the woman in a mere photograph, not forgetting that photoshop might have been used to enhance the picture(s). The articles on these new technologies and how the vulva and labia tissues should look like leads to disconcerted women about what is normal, and what is abnormal genitalia. Female genital cosmetic surgery is a term that envisages several procedures.
First, labiaplasty is a novel procedure that entails modification of labia tissue that is considered extremely droopy by making it more firm through injection of fat from other parts of the body. The labia minora is the main target, and it aims at reducing the size of these lips to avoid protruding beyond the labia majora. Also, it entails the correction of labia tissue asymmetry about size and/or length. This is an absolute cosmetic procedure without a single effect on one’s sensations. The ideology of an ideal labia has prompted many women to seek cosmetic surgery. Women undergo these surgeries based on the perception of an ideal labia minor: minimal, unextended, symmetrical, homogeneously pink, and not wavy (Davis 2002, p. 15).
Vaginoplasty, also known as vaginal rejuvenation, is another procedure that entails the tightening of the vagina and vaginal opening. This procedure is done by eliminating tissue deemed excess from the vaginal lining. It is mainly sought by women who have lost their vaginal tone after delivery. Hymenoplasty is yet another FGCS procedure that brings about re-virgination. This procedure entails reconnecting the edges of the hymen, mainly torn during the first sexual activity, so it can tear and bleed during intercourse. This procedure is prevalent in areas where cultural and religious values form the gist of the society, and especially in communities where virginity is highly valued. Labia majora augmentation is a procedure that plumps up the labia major after being injected with fatty tissue from other parts of a woman’s body. Vulval lipoplasty makes use of liposuction and eradicates fat deposits from the area covered by pubic hair: the mons pubis. The result is a less prominent mons pubis (Braun 2013).
G-spot augmentation is a procedure that aims to enhance the size of the G-spot and result in better sexual pleasure. This process entails the injection of substances such as collagen into the g-spot. The procedure should be repeated after every 3-4 months because this is the period that the effects of the procedure are felt. Analogous to various critics of these procedures, there is no indication of the side effects of associated with frequent G-spot augmentation. Perineoplasty “is a reconstruction of the perineum, vulvar vestibule, vaginal introitus, and distal vagina by excising scarred and redundant tissue and opening perineal and levator ani musculature” (Goodman 2008, p.4).
This procedure aims to enhance the strength of the pelvic floor and make it compact. The last procedure highlighted in this paper is a clitoral hood reduction. This procedure is aimed at improving a woman’s sexual pleasure through enhanced stimulation during sexual activities. The procedure reduces the hood of skin surrounding the clitoris and subsequently leaving the glans, which is the head of the clitoris found beneath this skin, exposed (Braun 2013).
The escalating use of FGCS is due to greater awareness and advertisements that create a feeling of self-criticism within an individual. The procedures are enticing, and any woman would be tempted to undergo either one procedure of her choice if only to improve her body and especially concerning sexual organs that seem to give an individual her identity. These procedures have grown over time, but Brazilian waxing seems to have opened the box of panthora. Brazilian waxing is a procedure that removes the pubic hair and leaves the genitals exposed; hence, no camouflaging and women can evaluate the appearance of their genitals. The result has been an increased feeling of self-consciousness and confusion about what is normal and abnormal. Sexuality is a topic that is less discussed; therefore, an individual will only rely on what photographs and surgeons of cosmetic surgery deem normal. Grady (cited in Purdy 2001) states that most women who undergo FGCS have normal organs. There is some misguided information that pushes women to undergo FGCS, yet they may not need it.
FGCS made its first appearance in the news in 1998 when Gary Alter and David Matlock (surgeons in Los Angeles) advertised various genital procedures aimed at adorning the vulva and elevating response to sex. Despite the fact that vaginal tightening had pre-existed, the new surgeries envisaged plastic surgery procedures with a focus on orgasmic function and vulva appearance. These new technologies for enhancing the female genitals were triggered by the increased hairless norm, heightened expectations for pleasure, orgasm, and G-spot response (Tiefer 2008, p. 467).
The quest for FGCS is attributed to psychological distress that comes about due to the appearances of the vulva, which has been pictorially enhanced. According to Grady (cited in Purdy 2001), conditions that were once left alone are now deemed as ailments; hence medicalizing sexuality. Medicalization of sexuality has resulted in the growth of the surgeons at the expense of their patients. Grady (cited in Purdy 2001) highlights that some of these conditions; labeled ‘abnormal’ are merely part of the great diversity within the human race. Notwithstanding that some procedures may be necessary, it would be important for surgeons and associated health professionals to succinctly define what can be deemed as a medical condition that requires medical intervention rather than performing unnecessary procedures on the women’s bodies.
The entire medicalization and franchising of female genitals have engendered scrutiny into one’s genital appearance, response to sexual activities, and one’s sexual behavior. This has led to the insecurity of some sort about their functional abilities regarding sexual intercourse and sexuality regarding clothing. Whereas surgeons and the media promote FGCS procedures, critics claim that the entire process violates important human ethical principles. The credibility of information provided by the media is questionable because surgeons have been cited offering free cosmetic procedures to journalists during interviews (Tiefer 2008, p. 469). FGCS is considered to surgically victimize women because most of them undergo the procedures without a comprehensive informed consent. Despite the fact that these procedures are performed by, other gynecologists are against the practices alleging that there is insufficient evidence to deem these procedures as safe and reliable.
Some women seek FGCS for aesthetic value, but it is difficult to distinguish between functional and aesthetic characteristics of these procedures. FGCS is compared to female genital mutilation (FGM) by some critics, but this has not received much scrutiny because unlike FGM that is coerced, FGCS is taken up by the western women freely. However, in the case of autonomy, full informed consent should be given while highlighting the negative impact of the procedures. Autonomy is questioned because societal and media pressures prevail and push the woman to change her looks, all in a bid to be sexually appealing. FGCS conflicts with ethical principles of autonomy, non-maleficence, and beneficence. Women do not fully understand the repercussions associated with these procedures, and the surgeons performing these procedures are not devoted to delineating such information because it may ruin their business.
Consumer organizations supported the franchising of medical products as a means to promote competition. However, critics such as the New View Campaign argue that this move is aimed at misinforming and misguiding the consumer. The images posted on the internet and showing in pornographic cites indicate an ideal female genital that most women will crave for. This is bizarre because even in facial looks, no one person is identical to another. The New View Campaign deems genital cosmetic surgery as an unregulated, unmonitored, and untested practice that has merely misinformed the public. Women have especially fallen prey to what is deemed “an ideal body image” (2008, p. 1).
There is no scientific backing of the safety and effectiveness of genital cosmetic surgery; hence, the strong opposition by the critics of such kind of surgery. There is a concern that women seeking these services are not fully aware of the consequences of these procedures. There is a major bias towards the positive and desirable outcome in comparison to the negative outcomes. Genital cosmetic surgery is delineated as a flawless process on online photos and videos. Yet, possible adversities such as “scarring, loss of genital sensation, post-operative anxieties, reduced erotic pleasure, obstetric risks and chronic pain” can occur (Tiefer et al., 2008, p. 1).
The New View Campaign advocates transparency, that is, the surgeons should give all the details of the cosmetic procedures. Feminists against FCGS and they have condemned it as a means that aggravates gender inequality. Genital surgery is mainly used to draw an appealing picture of sex work and pornography, which are deemed as avenues for exploitation and oppression. According to Tiefer (2008), feminists assert that women have the right to control their bodies howsoever they chose, even if it means undergoing the FGCS. On the other hand, these feminists argue against myogynists’ influences that push a woman to make fraught decisions that are not autonomous. Interviewees of cosmetic procedures tend to focus less on the adversities of these procedures and focus more on the benefits they have derived from them. It can be summed up from these interviews that women agonize over criticism, comparison, and discontentment.
This paper would not be complete without highlighting the risks associated with the various FGCS procedures, as indicated by Goodman (2011, p. 8). Labiaplasty is associated with the excessive repair, infection, scarring, hyper- or hypo-sensitivity, scalloped labial edges and disfigurement. Clitoral hood size reduction is associated with hypersensitivity, damaged glans, or clitorial body due to frequent operations and scarring. Perineoplasty required vigorous repair that leads to dyspareunia, infection, and damage of organs in close proximity such as rectum and peritoneum. Hymenoplasty is also associated with dyspareunia as well as additional defects on the hymenal ring. Vaginoplasty is associated with incontinence, scarring, infection, dyspareunia, injury to adjacent organs, and poor wound healing.
There are advertisements all-over about FGCS. These advertisements highlight the benefits of these procedures; apparently, these benefits are short-term. There is no indication of what these procedures can do over a long term and especially for those requiring repetition such as the G-spot augmentation. There is a need for studies to show long-term effects of FGCS because any woman who seeks the magical effects of FGCS would inarguably take up the procedure. It is important to understand whether the risks discussed above are emanated in all individuals who undergo the procedure, or are there particular predisposing factors to such risks.
References
Braun, K 2013, ‘What is genital cosmetic surgery (GCS)?’ Health Journey, issue 3. Web.
Goodman, M 2011, ‘Female Genital Cosmetic and Plastic Surgery: A Review’, Journal of Sexual Medicine, vol. 8, no. 6, pp. 1813-1825.
New View campaign. (2008). Research and Monitoring Needed for Female Genital Cosmetic Surgery– NYC protest set for November 17, 2008, 12-2PM, Final Press Release. Web.
Purdy, L 2001, ‘Medicalization, Medical Necessity, and Feminist Medicine’, Bioethics, vol. 15, no. 3, pp. 248-261.
Tiefer, L 2008, ‘Female Genital Cosmetic Surgery: Freakish or Inevitable? Analysis from Medical Marketing, Bioethics, and Feminist Theory,” Feminism & Psychology, vol. 18, no. 4, pp. 466 – 479.
Davis, S 2002, ‘Loose Lips Sink Ships (Labia Cosmetic Surgery),’ Feminist Studies, vol. 28, no. 1, pp. 7–37.