While we are naturally appalled by reports of female genital mutilation in other cultures, cosmetic vaginal surgeries continue in the UK and US

When it comes to designer vaginas, professional gynaecologists and their ilk are like buses. You wait and you wait for one of them to speak out against the madness of radical bikini waxes and vaginal cosmetic surgery - and then three come along all at once.

So, for instance, in June the journal Clinical Infectious Diseases ran an article describing the case of a 20-year-old Australian woman with type 1 diabetes who had experienced bleeding during a bikini wax. Over the following two weeks, the pain became so severe that when she finally sought help from doctors, they were initially unable to carry out a full internal examination. A rash and high fever were among symptoms that led doctors to suspect that she had the flesh-eating disease necrotising fasciitis.

In fact, she had another strain of Streptococcus pyogenes infection and Herpes simplex, and if she hadn't sought help she would have died. The report's authors noted that complications of waxing "include burns, mech anical folliculitis, infectious folliculitis, other infections of skin and soft tissues, and contact dermatitis and/or vulvitis". The risk of infection in an area where bacteria breed easily can be especially dangerous for immunosuppressed people - such as those with diabetes or HIV/Aids, or those undergoing cancer treatment. After ten days in hospital (and three weeks off work), the woman recovered.

Perhaps the most depressing part of the report, though, is what happened next. Six months later, she decided to shave off her pubic hair - leading to a hospital readmission.

Over the past decade the trend for bald, or nearly bald, vaginas has become entirely mainstream. (I know one senior citizen who has regular Brazilian waxes, even though she has been celibate for 20 years, doesn't swim and says she finds the process excruciating.) And this trend has been linked, repeatedly, to another - the rise and rise of vaginal cosmetic surgery.

Back when women had pubic hair, there was little notion of beauty standards for vaginas. But lately a huge range of surgeries has developed for women who think their labia and pubic area could do with being trimmed, plumped up or thinned out. There have been articles about a woman who had hymenoplasty (creating a new hymen) and vaginal tightening as an anniversary gift for her husband.

This month, the American College of Obstetricians and Gynaecologists advised strongly against such cosmetic interventions, saying that the absence of any data "supporting the safety and efficacy of these procedures makes their recommendation untenable". And also this year, an article in the British Medical Journal considered how doctors should respond to requests for cosmetic genital surgery, noting that the number of labial reductions performed on the NHS has doubled in the past five years.

"Surgical incision carries risks," the authors of the article noted, as it affects "many nerve fibres that are highly sensitive and . . . contribute to erotic sensation and pleasure". Cut through those nerve fibres, and the patient risks a major loss of sensation.

Which illustrates that, in many cases, these surgeries don't seem to be about sexual pleasure so much as aesthetics - about sex as a performance, rather than a sensory experience. The authors of the BMJ report point out that many women seeking surgery bring along illustrations from pornography, "not unlike presenting for a haircut at a salon". The porn aesthetic - in which women perform sexual pleasure for men, rather than actually experience it - has become a dominant sexual narrative.

Of course, men have been known to indulge in risky genital surgery, too: sexual hang-ups are far from being a female preserve. But what's interesting is that while male genital surgery tends to revolve around the wish to be bigger and more "manly", female genital surgery is all about becoming smaller, tighter, hairless, virginal - more childlike, essentially. The BMJ authors reported that the patients whom they spoke to uniformly wanted to achieve an effect that was "similar to the prepubescent aesthetic featured in advertisements".

There's no need to spell out how horrific this is. And all that cutting away doesn't - surprise! - seem to be making patients any happier. One woman to whom the BMJ authors spoke had chosen to have surgery "to stop her feeling anxious. However, she was still sexually anxious and avoided sex."

While we are naturally appalled by reports of female genital mutilation in other cultures, cosmetic vaginal surgeries continue in the UK and US, under the all-encompassing banner of "choice". It's amazing what a capitalist system - with its mantra that you're never quite good enough, but you can always be fixed - can make you choose to do, isn't it?

Kira Cochrane is women's editor of the Guardian

Post your comment

Please note: you will need to login or register before you can comment on the website