Female Genital Cosmetic Surgery (FGCS) refers to non-medically indicated cosmetic surgical procedures that change the structure and appearance of the healthy external genitalia of women, or internally in the case of vaginal tightening.Labiaplasty is the most common form of FGCS requested and performed. This involves trimming of the labia minora, and accounts for almost half of the procedures performed. Criteria that measure and describe female genital anatomy are sparse and vary, whilst medical textbooks continue to lack detail regarding range of diversity and measurements. No formal training is required to perform these procedures and in Australia, they can be performed by anyone with a medical degree despite a lack of clinical safety guidelines.
Social perception of beauty is ever changing and influenced by socio-cultural norms. These in turn are believed to influence women’s perceptions of ‘normal’ or 'desirable' and popularise certain appearances, which correlate with increased requests for this group of procedures. There is little firm knowledge regarding female genital structure, function and vocabulary within the community. Digitally modified images found on the internet, the removal of pubic hair, fashion trends which outline genital contour are believed to influence women’s attitudes to their genital region. Skewed perceptions or anxiety around appearance may result from a general lack of knowledge around the range of genital diversity. These factors collectively have contributed to the rise in FGCS requests in most developed countries, which raises issues around claiming autonomy of choice to modify genital anatomy to achieve a more desirable or aesthetically acceptable appearance.
Societal forces in modern society which influence a woman’s decision to undertake FGCS may not be very different to sociocultural forces used to justify Female Genital Mutilation/Cutting (FGM/C), as necessary for social inclusion. Consequently, ethical issues associated with the practice of FGCS must not be overlooked by clinicians.
