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Vaginas are symbolic more than they are real. In art, they’re hints hidden behind innocent masses of hair, while a flaccid phallus remains on full display. In literature, it’s referred to as some sort of mysterious cavern, the purpose of which is merely to be inside. In everyday life, it is not a labia and a vulva and a cervix, but one’s “lady bits” or the even more cringe-worthy “hoo-ha.”

These attitudes, intentional or not, reveal how much we, women included, struggle to believe that vaginas even exist. Various studies from around the world indicate that no insignificant number of women (and men, less surprisingly) struggle to identify a vagina — let alone its moving parts — on a diagram. Another indicated that as many as 50 percent of women haven’t the slightest clue what a “normal” vagina looks like. Though it would be tough to say what percentage of women have yet to look at their own vaginas, judging by the fact that a video of women examining their genitals with a hand mirror for the first time went viral on BuzzFeed, enough people can relate to make the concept revolutionary enough to reach trending status.

This is all to say that the vagina is tenuous territory. It’s a site of ever-shifting anxieties and a forum on which to project one’s larger issues. So, perhaps unsurprisingly, women are doing everything in their power to craft it in the image of their dreams.

Labiaplasty is a cosmetic procedure in which the labia majora and labia minora — the folds of skin on either side of the vaginal opening — are surgically reconstructed. Labiaplasty is not a drastic procedure, taking just a few hours and requiring a simple local anaesthetic. Patients are capable of returning home the same day with dissolvable stitches and pain medication. While patients are told to refrain from strenuous activities like exercise and sex, the overall toll of recovery is truly minimal. Even so, Dr. Harold Wiesenfeld, an ob-gyn at the University of Pittsburgh Medical Center, notes that complications can occur. Among them: “scarring, pain with intercourse, bleeding, and infection.” Wiesenfeld adds that there is potential for patients to be displeased with the visual outcome of their surgery.

Theoretically, aesthetic appeal is not the primary goal of labiaplasty; it was developed to correct physical abnormalities. Wiesenfeld tells me, “Some women have excessive labial tissue, perhaps from birth, as a result of trauma, infection, or other disorders. Sometimes this excessive tissue can cause discomfort with physical activity and intercourse or interfere with menstrual hygiene.” In these scenarios, labiaplasty would be beneficial. Intersex individuals may also choose to undergo labiaplasty to achieve a look that is more in line with their gender expression. Yet, as indicated by research published in the Journal of Sexual Medicine, those who undergo labiaplasty for purely medical purposes are among the minority of patients. Just 31 percent of individuals surveyed underwent labia reconstruction for reasons void of aesthetics.

If the minority of individuals undergo labiaplasty for medical reasons, one can logically assume the remainder choose to have the operation to achieve a desired look. One might find this trend disturbing, considering that many women don’t even know what a “normal” vagina looks like. Though labiaplasty doesn’t pose many particular risks to women’s overall physical health, one could easily argue that it contributes to damaging cultural notions that women’s bodies, as they are, are not enough.

Wiesenfeld tactfully points to social media as being responsible for the recent spike in labiaplasty procedures. It’s not difficult to fathom that the internet has played a large role in disseminating information about the ideal body, with pornography as a primary culprit.

The online pornography industry has completely changed the way both women and men fantasize and anticipate the appearance and act of sexual intercourse. While it’s unclear whether men are actually buying those horse testosterone pills advertised on the sidebars of PornHub, it is clear that women are giving in to the notions projected, as the majority of women report grooming their pubic hair in some form.

“I definitely wouldn’t argue that porn shapes perceptions of desirability with body image for both men and women,” says Kayden, of popular pornography site TrenchcoatX. Still, she explains that the porn industry does not create these standards from thin air. Instead, she says, “We take our cues from mainstream culture, and then inflate them.” Kayden offers the Kardashians as an example, saying their popularity has created a surge of adult performers with long, dark hair and “oversized butts.”

When it comes to something as specific as the labia, however, Kayden tells me that it’s highly unlikely an adult performer would have had such a surgery before entering the industry. Rather, she explains, “What’s happening is that we are filming hordes of women who are in their early twenties and have never borne children, and then women of all ages are watching those videos and assuming that their labia must look that way to be desirable.”

While the basic tenets of pornography have not evolved exponentially in recent years, medical technology certainly has. Perhaps one reason labiaplasty has spiked in popularity is that physicians are more inclined to suggest the surgery. A 2011 survey of plastic surgeons and gynecologists reveals a bias against the female body inherent in, you guessed it, male practitioners. Male doctors were far more likely to recommend surgery to their patients than female doctors. Yet even female doctors were culpable when it came to articulating what they believed to be society’s “ideal” vagina: small, compact, and unobtrusive.

It seems reasonable to suggest that what a woman does with her physical form is not a bone for the picking. Unfortunately, labiaplasty has become the site of yet another senseless “are you feminist enough?” debate. While some perceive those who undergo the cosmetic procedure as falling prey to the evils of the male gaze, others rejoice in the opportunity to sculpt themselves into a form that encourages them to celebrate their bodies all the more.

There is validity to both sides of this argument. It does not make sense to tell another woman how she should or should not transform her body on the grounds that doing so is more or less of a feminist act. With that said, the latter camp must also acknowledge who popularized labiaplasty and why.

Trends in vaginal beauty may ultimately come to be embraced and expanded upon by the target consumers (women), but the primary manufacturers remain a select group of nonwomen who have very strong ideas about what a woman should look like, and they are to be held accountable. A woman, on the other hand, is not to blame for simply wanting to peacefully exist in a world that is constantly inhibiting her from doing so.

It will be worth observing whether the surge in labiaplasty’s popularity is a mere fad or part of the new bodily order. Will it become as commonplace as a Brazilian wax? Advertised on subways and buses like breast augmentation and rhinoplasty? Or will the women of the future tell tales of regret for altering their genitalia? Whether or not one’s labia is medically altered, all in possession of a vagina could perhaps unite over the simple fact that all we want — for once in this life — is for someone to find our G-spot.