Designer Genitals or Mutilation?

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The Designer Vagina

Given the current fashion emphasis on genitals completely stripped of any view-obstructing hair, many women have become increasingly concerned about the appearance of their vaginas. Thanks to a thriving online porn industry, close up images of vaginas are abundant, which has led many women to compare the appearance of their own to those of others. There is certainly a preferred streamlined, smooth, Hollywood “look” to those lady parts, but in reality there is wide variation in the appearance of the normal vagina in terms of size, symmetry, and coloration.

Most women don’t have occasion to carefully inspect the vaginas of a large variety of regular women, and so they may come to believe that their own anatomy is somehow deficient and aesthetically displeasing. This perception can have additional grounding in their own reality, as the many men who consume pornographic images may also come to believe their partner’s vaginas do not meet the typical standards of feminine beauty. Thus woman may experience distress and a desire to change the look of their vaginas to feel more attractive for themselves and their partners.

“Designer Vaginas” have become an option for these dissatisfied women, whereby surgery is used to change the appearance of the vagina. The most popular procedure is probably labiaplasty (also called female genital rejuvenation surgery), a surgical procedure to trim and shape the vagina's inner lips (labia minora), outer lips (labia majora) or both. For between $3000-$8000, affluent women can have their private parts made to look just about any way they and their partners prefer.

Culture and vaginal alteration.

As a cultural psychologist, I noticed a disturbing similarity to the designer vagina phenomenon and the traditional practice of female genital alteration (FGA), also known as female circumcision, female genital cutting, and female genital mutilation. The World Health Organization (WHO) defines this as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” They further maintain that FGA is a “violation of the human rights of girls and women.” At least 200 million girls and women alive today have been subjected to this practice. It happens generally before age 5, but can be done during adolescence, before marriage, or even after the birth of a woman’s first child. FGA has been going on for thousands of years, with procedures described in ancient Egyptian and Greek texts. It is prevalent in many African countries, as well as part of the Middle East, Indonesia, and Asia. In some countries it is more prevalent than others, for example almost all Egyptian women have experienced FGA.

There are four different categories of FGA, and some are quite minor (a ceremonial nick) and others quite severe (clitoris and labia completely removed and vagina sewn shut). Most procedures are somewhere in between. The process is generally painful and can cause serious long and short-term medical and psychological difficulties. Western reaction to FGA tends to be overwhelmingly negative, leading to well-intentioned governmental and NGO efforts to stop these procedures, but these efforts have mostly failed.

Why haven’t we been able to stop female circumcision?

There are many complicated layers surrounding the practice of FGA. In Western culture we tend to have a negative visceral reaction to anyone taking a sharp knife to a girl's delicate private parts, and thus we conclude that the practice must be bad. We then try to find reasons to justify our aversion. Research shows that people’s emotional reactions tend to precede their rational thoughts, and when we feel distressed about something our brain tries to figure out logical reasons why that thing must be wrong. If we can’t find any logical reasons, we make them up.

The typical ethical reasons advanced against FGA include:

1. It’s usually done during childhood, so there is no choice or autonomy for the person getting the procedure
2. It is can be dangerous, especially when under unhygienic conditions or when the FGA procedure is extreme
3. It may be traumatizing and result in psychological harm

These supposed ethical reasons are actually rather thin and could be considered judgmental, patriarchal, and lacking in cultural sensitivity. Arguments against FGA do not hold up when compared to similar socially acceptable Western procedures done on children, such as infant male genital alteration (circumcision), intersex surgery, and removal of benign growths or extra fingers. The rationale that the procedure is unnecessary and constitutes discrimination against women is most interesting in an era of unopposed designer vagina surgery. In fact, many women with FGA are quite happy with it and are the driving force behind the continuation of the practice.

There are many reasons people practice FGA, including tradition, cultural standards of beauty, religion, and (presumed) health benefits. Many women in these cultures like the way the results look. They tend to use words like “clean” and “pure” to refer to the results of their FGA, and may feel disgust toward women who have not undergone the procedure. They may feel proud for having traversed a cultural rite of passage.

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Western perspectives forced on these communities may be undermining the liberty and autonomy of such women. The process of outlawing FGA has mostly forced the procedure underground, increasing the medical risks. Further, discussions of danger do not separate the risks of unhygienic practices versus the dangers of the actual procedures themselves. Health risks imposed by the actual procedures, when performed by medical professionals under hygienic conditions, would be few if the safety records of the designer vagina industry are any indication. Arguments about psychological harm do not balance this with the harm that can be caused by social stigma, shame, and ostracization that can occur toward families who do not participate in FGA.

WHO opposes medicalized FGA. Feminist arguments against medicalized FGA posit that no woman should have her genitals cut to fit into a patriarchal society. The result is that women and girls are denied safe, legal procedures, leading to a loss of autonomy as they are forced into a clandestine, health-jeopardizing situation to meet their sociocultural needs. In the US, it is common for families to travel abroad to have the FGA conducted in their countries of origin, and in many cases the procedure is done by traditional circumcisers without medical qualifications.

What is a proper response to female genital alteration?

It is that undeniable FGA carries some amount of health risk with no clear health benefits. The more extreme but less common types of FGA are quite dangerous and disfiguring. A harm reduction approach has been suggested as a respectful alternative to curb the practice, toward an eventual goal of preventing the pain, complications, and potential disability imposed by FGA. Efforts to educate Western women to prevent them from getting designer vaginas put an emphasis on the natural beauty and differences of a normal vagina. These are non-coercive techniques at harm reduction that can be modified for use with women from cultural groups that value FGA. The notion that Western women should be "educated" while women from other cultural traditions should be forced into compliance is racist and paternalistic.

In the Journal of Medical Ethics, Drs. Arora and Jacobs (2016) advanced a compromise surgery that would provide the appearance of circumcision with minimal health risks. This compromise was denounced by some as an avenue to potentially increasing the incidence of the problem. I would argue that opposition has more to do with our own prejudice and discomfort with these cultural traditions than the actual well-being of girls and women. Consider the corresponding lack of outrage over traditional Western infant genital cutting (male circumcision), which is widespread and largely non-therapeutic, and the lack of debate over the booming designer vagina industry.

The fact of the matter is that people have been surgically altering themselves and their children since the beginning of time. A better approach is understanding, education, and harm reduction — and recognizing that in many intimate ways our cultures aren’t so different.

Related Link

The women having their clitorises reconstructed: Surgeon performing the operation describes how it helps victims of female genital mutilation.