Women with average-sized labia minora seek out labiaplasty simply to "improve appearance," according to new research published in British Journal of Obstetrics and Gynaecology.
The study involved 33 women who had requested labial reduction surgery through their doctors. A gynecologist examined the women and measured their labia minora. The average width was 26.9 millimetres on the right and 24.8 millimetres on the left, sizes that are consistent with "normal values" published in other studies.
Asked why they wanted to make their labia smaller, 60 per cent said they wanted to improve their appearance. Asked why they had become dissatisfied with their genitals, the women spoke of an "increasing self-awareness of the genital area," comments from a partner, TV shows that mentioned the surgery and physical discomfort.
Fifteen per cent of the women first became unhappy with their labia while not yet 10 years old; 30 per cent reported discontent between 11 and 15. While the average age of the group was 23, one of the patients referred was just 11 years old. The figures are troubling given that genitals continue developing throughout adolescence, becoming more symmetrical over time.
The study comes as Britain's National Health Service reports that labial reduction procedures have increased five-fold in the past 10 years.
In the U.S., the number of women paying for genital cosmetic surgery rose 20 per cent between 2005 and 2006, according to Time.
Websites of Canadian plastic surgeons offering the procedure use terms such as "labia beautification" and "female genital refinement," and suggest that patients will experience reduced pain during sex and exercise, increase their self-confidence and even heighten their sexual gratification.
But there may be hazards. "Unnecessary surgery is a dangerous trend," says Leonore Tiefer, clinical associate professor of psychiatry at New York University School of Medicine.
Dr. Tiefer, who also heads up the activist group New View Campaign, says a key concern is that there is little available follow-up data from women who have had the procedure.
"Cosmetic surgeons publish patient satisfaction, but not the facts of complication. We really don't know what we're talking about here in terms of obstetric risk, chronic pain, scarring and loss of genital sensation."
Dr. Tiefer said the push for smaller labia – a.k.a. "designer vaginas" – appeared in the late 1990s. Between the prevalence of waxing and Internet pornography, "There's a whole cascade of events and trends that have made the vulva more visible."
She believes the rise in labioplasty is the latest turn in a "cultural disease of self-consciousness."
"The normal range [of labias] is very broad – that's the key point in this situation. Nature loves diversity. The attempt to create some ideal and then pass it off as normal is anti-normal."
What do you make of the popularity of the procedure?