It’s not difficult to see why female genital cosmetic surgery (FGCS) is often drawn into comparisons with female genital mutilation/cutting (FGM/C). The World Health Organisation defines FGM/C as all procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. So a procedure such as labiaplasty, for example, which is designed to reduce the size of the inner lips (labia minora) of the vulva could theoretically be included in the WHO definition.
But like almost all things theoretical, the issue of both FGCS and FGM/C are far more complex in practice. Unlike FGCS, FGM/C is recognised internationally as a serious violation of the human rights of women and girls. However, this is not the same thing as saying that FGCS is not just as harmful. Rather, it highlights that FGM/C has proven harmful enough to women and girls to warrant an international and legal response.
The global efforts to combat FGM/C should give us all pause for reflection on all practices that aim to alter any part of a women’s body. While it’s important to focus on what’s being physically done to women’s genitals, it’s just as important to consider the context in which any procedure is being conducted. If we’re talking about labias especially, it’s not only a matter of the medical and cultural (and let’s not forget, Australians have a culture too), it’s also about what’s gendered.
What is driving the increasing number of women in Western countries, including Australia, to choose to have FCGS? If women are unhappy with how their vagina looks, we to need to examine the factors that have given rise to women not feeling ‘normal’. While pornography, fashion and the media have been cited as the main culprits, there has been little discussion about how to prevent women feeling anxious and abnormal about their genitals in the first place. This is where a comparison with FGM/C is helpful: there is already much we know about best practice in FGM/C education and prevention that can contribute to all women and girls feeling empowered.
As the evidence on FGM/C prevention programs have shown, educating women and girls about anatomy and genital diversity is a good place to begin. Health professionals also have a responsibility to educate themselves about the issues that may impact women and girls feeling anxious about their bodies, including issues affecting immigrant and refugee women and those who have undergone or at risk of FGM/C.
As we know from our work in women’s health, unhealthy, risky and harmful practices that primarily affect women can be prevented by acknowledging the diversity of women’s experiences. Any comparison of different ‘cultural’ practices should begin from this common understanding.