Let’s Talk Labia, Because Nobody Else Is

Image by Yvonne Lin
More and more young women are seeking genital cosmetic surgery because they don’t feel “normal” — Is the vagina taboo to blame?

There’s a running joke about Ms Emma Barnard in The University of Melbourne’s public health building. She will soon be crowned “the lady with the vagina PhD”.

Ms Barnard is currently researching the labiaplasty phenomenon — the rising rates of genital plastic surgery among young Australian women. She is looking into why young women are interested in getting surgery which alters the appearance of what are otherwise healthy external genitalia.

“When people talk about female genital cosmetic surgery they’re mostly talking about a labiaplasty- which is a surgery designed to reduce the size of the labia minora,” Ms Barnard explained.

Image by the Labia Library

“Usually the surgery is performed because [a woman’s labia] can be quite large, visible or asymmetrical, and sometimes people don’t like the way it looks.”

The rate of labiaplasties performed on young women in Australia is on the rise, although the numbers overall are hard to track.

“We don’t have robust data because most genital cosmetic surgeries happen in the private system,” explained Ms Barnard.

“We do know there is a younger cohort of people interested in and accessing this surgery.”

According to a recent survey, one in three GPs have received requests for labiaplasty from girls aged under 18 years.

“The number of labiaplasties performed in Australia has doubled between 2003 and 2013. Of that doubling, we know about a quarter of the labiaplasties that were performed were on girls and women aged 5–25,” she added.

It appears a large part of this story is the fact female genitalia doesn’t make it into conversation very often, outside of Ms Barnard’s office of course.

Why don’t some young women like their lady bits?

Ms Barnard is quick to clarify this is a complex issue, for which we likely won’t ever have a neat, definitive reason as to why. However, a common thread appears to be that many young girls are unsure if their genitals are “normal”.

Side note: A lot of air quotations were used in this discussion of “normal”

“I think it would be difficult if a young woman set out to understand what a normal labia might be and then make that connection as to whether or not they are normal,” said Ms Barnard.

“The women I’ve spoken with in my research, often describe a moment where they saw an image of genitals or a TV show where labiaplasty was being discussed and thought — “oh, I don’t look like that” or “I’ve been worried about this and this show has confirmed for me that I’m not normal”.”

Ms Barnard was anticipating images of genitals in porn might come up as an influence, but it didn’t. The women she interviewed talked more about medical diagrams brought up in settings such as school-based sex education.

“More often than not, those images are medical diagrams that depict very stylised images of vaginas. They are usually line drawings which don’t show the huge range of genital diverseness.”

What is “Normal”?

The natural variation of female genital appearance is indeed vast, although there is limited access to accurate information about what is “normal”.

The Labia Library is a unique online resource with photographs of female genitalia that show this variety. It was designed to address the growing interest in genital cosmetic surgery.

“After seeing media reports about women seeking female genital cosmetic surgery, we became worried that this type of surgery was increasing because many people have no idea what healthy female genitals actually look like,” the Labia Library website states.

Ms Barnard points out “normal” genital is not well defined even within the medical community.

“The opinion of a gynaecologist about what is ostensibly normal could vary very much so from a cosmetic physician because there is no clinically accepted normal range for a labia,” said Ms Barnard.

“My sense is that parents might not know what is “normal” too.”

There are indeed functional reasons why people may get female genital surgery. Ms Barnard explained large labia can interfere with daily functional processes or cause discomfort in some sports, such as horse riding and gymnastics.

However, she offered an interesting counterpoint.

“If you think about boys, their external genitals are far more prominent and in-the-way. It’s worth thinking about that boys don’t get surgery on their genitals for the same sorts of reasons.”

Ms Barnard is currently undertaking research to understand more about how young women with genital appearance concerns approach cosmetic genital surgery. She also runs LabiaTalk, a blog which explores issues about female genital cosmetic surgery.

A version of this story was also published on The Citizen.