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Vagina Diaries draws attention to hidden cost of labiaplasty

ABC TV’s The Vagina Diaries investigates the worrying trend for increasing numbers of labiaplasty procedures being performed in Australia. Labiaplasty is a surgical procedure to remove or reduce the labia…

Most people haven’t actually seen many vulvas up close, and don’t know about the vast anatomical range of normality. Philippa Willitts

ABC TV’s The Vagina Diaries investigates the worrying trend for increasing numbers of labiaplasty procedures being performed in Australia. Labiaplasty is a surgical procedure to remove or reduce the labia minora, the inner lips of the vagina.

Presenter Natalie Harris interviews a number of doctors, patients, and sex industry professionals in the documentary. She even asks random men on the street about what they think about vaginas and the reasons that women might choose to “go under the knife” to have their labia reduced.

The documentary explores the core issues at the heart of labiaplasty – female self-esteem and confidence. The common thread among the women who have labial reduction surgery is the feeling that they’re abnormal and somehow unattractive to their sexual partner.

Why so worried?

We don’t know why a woman may feel unappealing to her sexual partner. But the reasons for this distress are complex and part of a psychological spectrum of body image disorders.

Women’s distress may be influenced by current grooming trends, especially pubic hair removal, which renders the labia more exposed, and may irritate sensitive skin.

And concerns about labial appearance are unsurprising when one looks at advertising sites for labiaplasty on the internet. Given the intention of these sites is to generate a demand for surgery, they don’t tend to celebrate diversity.

Rather, the image of a smooth exterior with the labia minora tucked inside the labia majora is idealised – and negative comparisons are encouraged.

The fact of the matter is that most women (indeed, most people) haven’t actually seen many vulvas up close, and don’t know about the vast anatomical range of normality.

And, interestingly, Australian censorship laws prohibit the publication of illustrations of the labia minora and the clitoris. So vulvas are invariably made to resemble that of prepubescent girls, with pubic hair removed and a single crease placed between the labia major (external lips of the vagina).

This contributes to the general lack of knowledge and understanding about female genital diversity.

The consequences of this are distorted views of genital normality, leading to insecurities in women whose genitals don’t mirror this idealised image.

Confidence and consequences

In the documentary, a sexual health advocate identified as Danni who has had labiaplasty says that if you ask a surgeon whether an operation should be performed, they’re likely to say yes.

She says although she didn’t regret her operation, in hindsight, she wouldn’t have undergone her labiaplasty procedure and considered it largely unnecessary if she’d been more self assured and mature. And particularly if she’d had the benefit of more information on genital diversity.

But a labiaplasty procedure may precede more then just regret.

Women can experience complications such as bleeding, infection and scarring. And the long-term complications of labial reduction surgery are unknown.

What we do know is that women experience sensation from labia minora that contributes to sexual function. In fact, after the clitoris, the labia minora are regarded the most sensitive part of the female genitalia, helping stimulation and lubrication during sex.

Cutting and burning this delicate tissue causes scar tissue, and interferes with the blood and nerve supply making the labia less sensitive to touch. This may have a negative impact on sexual sensation.

So why would a woman want labiaplasty? Women rate confidence as the big driver for undergoing surgery.

One interviewee, identified as Louise in the documentary, says, despite the pain and illness she suffered as a result of surgery, she felt more confident after her procedure.

But the presenter points out that the surgery seemed to fulfil a space in her mind rather than body; that it seemed to have less of a physical impact than a psychological one.

A much-needed backlash

Medicare’s schedule of pharmaceutical benefits items reports the number of labioplasty procedures has doubled in the last ten years in Australia. And a similar trend is occurring throughout the developed world.

A recently released “ethical opinion paper” by the UK’s Royal College of Obstetricians and Gynaecologists says women should be given accurate information about normal variations in female genitalia. And that those requesting labiaplasty should be offered counselling and psychological treatments for problems such as body image distress.

Knowledge is power, and a recent backlash against genital insecurities has prompted the launch of “labia library” by Women’s Health Victoria. The website contains information, advice and a photo gallery of 20 normal labia.

Sites such as these may help prevent the harm caused by unnecessary, and often expensive, surgery.

Congratulations to the makers of this documentary for what they have achieved in this documentary. This is an important issue that needs attention, you should watch it.

The Vagina Diaries screens at 9:30 pm tonight on ABC2.

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13 Comments sorted by

  1. Mariel Castro

    Product Manager at Trigger

    Thanks for the interesting article, I did go on a bit of a rant wondering why women do this kind of thing. Are they talking to their partners before doing this kind of thing? And what kind of partner would let their lady go through this sort of thing?

    So many questions.. :)

    1. Rebecca Deans

      Paediatric and adolescent gynaecologist at Royal Hospital for Women and Sydney Children's Hospital at UNSW Australia

      In reply to Mariel Castro

      Thanks Mariel,

      it is a shame that women can feel this way! It's interesting that most men don't really seem to worry much about it. Many of the women seeking this procedure seem to be single. Of the ones that have a partner I find the man sees it as an issue that the woman has and usually leaves it up to her. I have seen a few women who have told me that a former partner had commented on the labia giving her a 'complex'. How can we help empower women?

  2. Veronica McGowan

    logged in via Facebook

    Why is there no feminist /health push to change these stupid and discriminatory censorship laws? It is really outrageous that women's genitals are air brushed to imply that regular genitals are somehow offensive and need pictorial alteration! I find this really offensive. Why can't we just get over the 'shock horror' of seeing real genitals... in their natural state.

    The Labia Library is a good start, but again, most images are de-haired.

    1. Rebecca Deans

      Paediatric and adolescent gynaecologist at Royal Hospital for Women and Sydney Children's Hospital at UNSW Australia

      In reply to Veronica McGowan

      Agreed. We need more infomation out there about the 'normal' state...

    2. Vicki High

      company director

      In reply to Veronica McGowan

      I agree 100% - our censorship laws are out of date! Why is it okay for bare breasts and women front on but not men...why does a natural part of sexual diversity (in the physical sense) have to be censored? Are some of "women's bits" really that offensive that they need to be hidden from the general public?

      I purchased a copy of Penthouse for a gender studies assignment which had a question from a (male) reader complaining about the "nude" (ie hairless) pictures of women's genitals - the response…

      Read more
    3. Pat Moore


      In reply to Vicki High

      Yes Vicki, I've heard this adjective "neat" (nip and tuck?) used in praise of the 'perfect' vulva before. The airbrushing is compulsory from top to toe to gain that perfection of Barbi doll plasticity? SexY (as in what is commonly and currently thought of as being maximally desirable via the paragon/standard of pornographic fictions) without being sexUAL (raw, cosmetic-free, on the ground female human animal)? In other words this is about the old chestnut of the "male gaze"? Now the camera's gaze…

      Read more
    4. Vicki High

      company director

      In reply to Pat Moore

      I actually agree with you re women being 'clean' - assuming they have showered recently - the smell of a sexually aroused woman is totally different to one who IS unclean! I probably should have mentioned that I asked many more women re being 'nude' than men - mainly because a lot of them were (and are!) lesbians. To my surprise a lot of the lesbian women said they preferred to shave down below as they felt they were then 'clean' - when I raised the same issue as above re stale smell or sex smell some of them were adamant that women who had hair below were "unclean" even after showering! Personally I agree with the men - and I'm a lesbian - showering together is both relaxing and arousing and I actually like the scent of my partner when she's aroused...

      As to your comment re 'bald' women not looking prepubescent - I'll beg to differ on that - some of the women in the Penthouse I got looked underage - perhaps it was due to airbrushing as well as hairlessness...

  3. Matty Silver
    Matty Silver is a Friend of The Conversation.

    Sex Therapist / Sex Commentator at Self Em

    To prevent unnecessary surgery it is important to educate health professionals and the public about the anatomy and physiology of the vulva. The labia minora is a highly sensitive sexual organ and plays an important role for sexual response. It is dense with nerve endings and sensory receptors, which are highly sensitive to light touch.

    The main function of the vulva is to give pleasure and labiaplasty has the obvious potential to destroy an erogenous zone and can lead to lack of arousal and impede orgasmic responses.

    This information is hardly ever provided. One of my clients wished now she never had the operation or at least be warned.

    1. Rebecca Deans

      Paediatric and adolescent gynaecologist at Royal Hospital for Women and Sydney Children's Hospital at UNSW Australia

      In reply to Matty Silver

      Couldn't agree more. You can't go back once you've had it done. We also don't know the risks for delivery of a baby. Is tearing / episotomy more likely?? Yes, women need to be given the real risks.

  4. Linden Roberts

    logged in via Facebook

    The key thing that came out of that documentary was the censorship, making the normal, "abnormal".

  5. Evelyn Haskins


    Utterly silly.

    All they need to do is wait for menopuase and the labia return to prebuscent size -- or even less.

    There is something rather sick in the modern trent to pressure woment into thinkind that they must look pre-pubertal to be 'sexy'.

    And then we worry about paedophilia, though our men are being bombarded with the idea that pre-pubertal female are sexy.

  6. Janeen Harris


    I've never heard of anyone being turned off by the appearance of genitalia. This is worse than low self esteem. Men just aren't that fussy, ladies.

  7. linda chalmers
    linda chalmers is a Friend of The Conversation.

    Delivery systems

    I get so sad when I read and hear about women having unnecessary surgery on their vulva. I have known women who have had cancer on their labia and needed surgery. The distress and fear they felt was understandable, the fear of disfigurement of that precious part of themselves,they would have made bargains with whatever god there is, to be able to be cancer free. I have worked in a feminist women's health centre, an abortion clinic & I was a nurse. I have seen many many vulvas and they are all beautiful so beautiful and so individual it is a real liberation to see how all the parts are there but in many different variations. We need to do real work to talk to women considering this surgery.