Aussie Girls As Young As 11 Seeking Genital Cosmetic Surgery
Why are more and more Australian girls putting their vaginas under the knife? And why are their parents letting them?
What you need to know
- New University of Melbourne study investigating sharp rise in young girls and women seeking out cosmetic genital surgery
- Average age of referred patients concerned over the appearance of their vaginas was just 14-and-a-half
- Researchers say girls don't understand what a "normal" vagina looks like, due to airbrushed and stylised images online, on social media and in text books
When Kathy* was only 13, she began to feel anxious her genitals weren’t normal.
When she compared her vulva to the pictures she saw in class textbooks, depicting a smooth mound and slit, hers, which had some of the inner labia protruding, didn’t look the same at all.
Becoming more and more convinced that something was seriously wrong, she forced her mother to take her to a doctor. She wanted to ask about surgery.
She had no idea her genitals were actually perfectly normal, despite not looking like the pictures she’d seen in books and online. A specialist at the Royal Children’s Hospital in Melbourne assured her she had nothing to worry about, and that when it comes to the appearance of the labia, there is a wide range of “normal.”
In fact, about half of women have their inner labia protrude beyond their outer labia. But images in media almost always depict stylised or airbrushed genitalia, which can send girls idealised and unrealistic messages about how their bodies should look.
In a disturbing trend, Australian girls as young as 11 are seeking out cosmetic surgery on their genitals, and doctors have recorded a huge spike in cases over the last decade.
Of the 41 girls and women referred to Melbourne’s Royal Children’s Hospital between 2000 and 2012 over concerns about how their labia looked, the average age was 14-and-a-half.
In nearly a quarter of those cases, the concern was coming directly from the girls’ mothers.
Researchers from the University of Melbourne have launched a new pilot study to discover why children and young women are increasingly going under the knife, often at the urging of a parent.
"From my research it is clear that young women and girls (and sometimes parents!) often won't have an understanding of what the range of "normal" is for female genitals – that there really is no such thing as normal," researcher Emma Barnard told ten daily.
“For nearly all the women I spoke to, this experience of having concerns is happening from around 13 to 16. It is a very specific and fraught time when they are trying to figure out who they are and how their bodies work."
Medicare statistics show claims for labiaplasty, where the edges of the inner labia are cut away so they doesn’t extend beyond the outer labia, and vulvoplasty, referring to surgeries on the outside of a female’s genitals, more than doubled, from 707 claims in 2002-2003, to 1,584 claims in 2013-2014.
Since then, the surgery has gone into the private sector, as Medicare no longer provides rebates for some cases. Between 2003 and 2013, a total of 12,190 girls and women lodged claims for genital surgery, and of those, nearly a quarter were aged between five and 25.
However the actual numbers are estimated to be much higher, as data for privately performed surgery isn't routinely collected. In a recent survey published by the British Journal of Medicine, more than a third of Australian GPs reported female patients under the age of 18 requesting genital surgery. Similar research suggests it is a growing trend internationally.
"We live in a very visual and virtual culture, so it isn’t surprising that young people and adolescents experience appearance concerns – this is very normal," Barnard told ten daily.
"[These] concerns are very real and can cause an enormous amount of distress for young women during their adolescence and should be taken seriously. Girls can often be reluctant to talk openly about their concerns due to a sense of embarrassment and shame, so it is very important to be able to access good information in a timely manner."
The women Barnard spoke to reported a lack of knowledge, understanding and exposure to female anatomy as teenagers, and said the only images they’d seen came from text books, magazines, social media and online.
"These sorts of images are very often stylised or airbrushed, so what you see won’t be an accurate representation of the true range of diversity," Barnard said.
Tight fitting clothing and personal grooming trends, like shaving and Brazilian waxing, also drove girl's concerns over how their genitals looked, but surprisingly, researchers found, pornography did not have a major influence.
"There is a lot of stigma around vaginas and genitalia and it’s very ‘hush hush’," study participant Kathy* said.
"You don’t really talk about it much because when you are in your teens that’s kind of the time where you are thinking about your body more – things are changing, there’s hair and stuff like that – so it was good to have that experience [of seeing a doctor] and to know there was nothing wrong."
Barnard hopes her study can shine a light on the motivations of young women, improve education and reduce unnecessary surgeries.
"We know that this is happening, but we don't really know why, as there is very little existing research about the reasons why young women are considering these procedures," she said. "This is not surprising, given the difficulties of doing research on such a sensitive topic (especially with young people).
"If we have a better idea of how girls experience genital appearance concerns, then we can potentially improve clinical practice."
In a world first, The Royal Australian College of General Practitioners (RACGP) introduced guidelines in 2016, stressing to doctors that they should thoroughly investigate women’s motivations behind seeking cosmetic genital surgery, inform them of the risks, and educate them on the “normal range” of the appearance of the labia.
Girls under the age of 18 must undergo an evaluation by a GP, psychologist or psychiatrist , and wait for a three-month cooling-off period, before going through with the surgery.
Doctors say girls, patients and parents should be aware going under the knife isn’t risk-free, and complications can include infection, scarring, bleeding, loss of lubrication, loss of sensation, psychological stress, and tearing of scar tissue during childbirth.
"Destigmatising the issue will make it easier for young women and girls to articulate their concerns and to seek help when they need it. This is certainly something I hope this research can contribute."
For more information on the labia, and to see a gallery of images depicting the range normal female genitalia, visit the Labia Library.