An Investigation Into The Disturbing Rise of Labiaplasty in Young Girls

A distressing trend is on the rise for girls as young as nine years old. Labiaplasty, a risky procedure that involves shortening or reshaping the labia alters the appearance for cosmetic reasons. I know what you're thinking, why in the hell would a nine-year-old need to cosmetically shape their labia?

The American Society of Plastic Surgeons found that labiaplasty is on the rise with over 12,000 procedures performed in 2016. The most disturbing part is that five percent of those procedures were patients who were under the age of 16. While that may not seem like a large percentage, that's over 500 young girls who believe that their body looks disgusting.

Moreover, labiaplasty isn't typically done out of medical necessity. Aesthetics are at the forefront of the popularity of the procedure.

In a BBC article, Paquita de Zulueta, a General Practitioner said that the numbers of patients coming in for labiaplasty have risen only in the past few years. She writes, “I'm seeing young girls around 11, 12, 13…" and they come to Zulueta thinking there is something wrong with their body—it's the wrong size, it doesn't look normal, it's the wrong shape. She says they are “really expressing almost disgust."

You may have heard of labiaplasty before—it's a non-uncommon procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva.. It's marketed towards older women or women who have given birth. But trimming and tucking the labia for younger women is on the rise.

“The big thing I tell patients about labiaplasty is that there are a lot of unknowns. The labia have a lot of nerve endings in them," says Dr. Julie Strickland, the chairwoman of the American College of Obstetricians and Gynecologistscommittee on adolescent health care. That means that numbness, sexual sensation, pain, or scarring could be a side effect of the surgery.

When a patient has a previous injury, ongoing pain, or discomfort, labiaplasty can be considered as a pertinent medical procedure. Some patients will often insist that their labia is interfering with sports, daily activities, or sex.

How can we avoid this rise in numbers? How can we encourage young children that their body is still growing, changing and that there is no one singular vision of what a body looks like?

Renee Engeln, Ph.D. and award-winning professor at Northwestern University tells me that the answer isn't telling children and young adults that they are simply “beautiful" to improve their self-esteem. Instead, there should be an emphasis on “teaching girls that their bodies are tools." She continues, “Bodies are meant for doing things. They're meant to help you explore your world and communicate with others. Their primary purpose isn't to be evaluated by others. We should model for young girls what it looks like to care for your body and treat it with respect, and make it clear that your body deserves respect no matter what it looks like."

Where are young people getting information on what a so-called “normal" labia look like? First, sex education still actively abandons any mention of sexual pleasure for women. We discuss erections and penis-in-vagina sex, but never the specifics of what happens to a person with a cervix when they are turned on. Because of this, young children are often at a loss of understanding their own genitals. This body image issue can be carried well into adulthood without a complete understanding of how accurate body functions. Engeln says that because young adults aren't given any reference for pleasure, “it's no surprise that some young girls already view their genitals in an objectified way, that is, in terms of how they might look to other people."

I've heard certain people compare the surgery to creating the lips of a Barbie doll—completely invisible with no protrusion. Another influence on young people (no surprise) is pornography, which young people are viewing more than ever at a younger age. In mainstream pornography, actors are fitting a certain mold that is following a trend—it's not the reality of sex.

Moreover, genital aesthetics and comparisons are more prevalent now that so many young women wax or shave their pubic area. Their genitals are exposed; however, there is a recent surge in body hair being included in the mainstream, and in porn. The internet, and mainstream pornography, introduces a body that is airbrushed and false inaccuracy.

Shape, color, size, and asymmetry come in all varieties, for everybody. Just like the freckles on your back or the shape of your fingernails—we are all uniquely made up of our characteristics, labia included.

But people are fighting back. The Labia Library in Australia is a non-profit organization that focuses on teaching women what a healthy body looks like, no matter how diverse. Their photo gallery features a large selection of images of real labia so that women seeking genital cosmetic surgery are properly informed.

Engeln advises parents to look at what types of messages they are sending their children. If a guardian is vocally stating that they hate their body, or certain types of bodies, then their child will receive this message and internalize it negatively. “These kinds of comments also reinforce the truly destructive notion that feeling shame about your body is just a normal and expected part of being a woman," says Engeln.

It's imperative for guardians—of all kinds—(be that a teacher, guidance counselor, babysitter, coach, etc.) to teach all children about body positivity and to eradicate any notion of objectifying a woman's body.

“It's never too early to instill some activism in your daughters. I'm angry that we live in a culture that teaches young girls there's something wrong with how their labia looks. I want girls (and their parents) to join me in that anger. Let's raise girls who want to change this part of our culture instead of changing their bodies," says Engeln.

The labia is still growing during adolescence and the appearance will change over time. By the age of 18, the outer labia will have grown, making the inner labia not as prominent (which is typically what concerns most patients). According to the American Board of Cosmetic Surgery, if a young person decides to go through with the surgery, there could be potential scarring which could lead to an asymmetrical labia.

It's clearly important to note, shout, scream, yelp, and repeat that “All vaginas are different" and diverse, and unique, and beautiful. No one labia is the same.

“It's essential that parents push back against the cultural narrative that teaches young girls their bodies are problems to be solved," says Engeln.