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A Young Woman Asking for Labia Reduction Surgery: A Plea for “Vulvar Literacy”

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Bio-Psycho-Social Obstetrics and Gynecology


In the last decades, the demand for genital cosmetic surgery and, more specifically, labia reduction surgery has increased. Labia reduction surgery means that parts of the labia minora are surgically removed. Several reasons for this increased demand for labia reduction surgery have been suggested, such as the trend to shave pubic hair resulting in more visible genitals, an increased exposure in public media of digitally altered images of the female genital suggesting an “ideal female genital,” and the advertising of labia reduction surgery by aesthetic surgeons and clinics as a way to rejuvenate and to regain (sexual) attractivity [1, 2]. An explanation we would like to add here is that there is a growing intolerance toward any kind of (physical) imperfection—for instance, like children’s teeth—which could be seen as a side effect of medical technological progress. Interestingly, in several African countries, it is common to elongate the labia minora by teaching adolescent girls to stretch them manually, suggesting that this would increase male and female sexual pleasure [3, 4].

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  1. Bramwell R, Morland C, Garden A. Expectations and experience of labial reduction: a qualitative study. BJOG. 2007;114(12):1493–9.

    Article  CAS  PubMed  Google Scholar 

  2. Liao LM, Creighton SM. Requests for cosmetic genitoplasty: how should healthcare providers respond? BMJ. 2007;334(7603):1090–2.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bagnol B, Mariano E. Vaginal practices: eroticism and implications for women's health and condom use in Mozambique. Cult Health Sex. 2008;10(6):573–85.

    Article  PubMed  Google Scholar 

  4. Koster M, Price LL. Rwandan female genital modification: elongation of the labia minora and the use of botanical species. Cult Health Sex. 2008;10(2):191–204.

    Article  PubMed  Google Scholar 

  5. Lloyd J, Crouch NS, Minto CL, Liao LM, Creighton SM. Female genital appearance: “normality” unfolds. BJOG. 2005;112(5):643–6.

    Article  PubMed  Google Scholar 

  6. Crouch NS, Deans R, Michala L, Liao LM, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG. 2011;118:1507–10.

    Article  CAS  PubMed  Google Scholar 

  7. Women’s Health Victoria. Women and genital cosmetic surgery. Women’s Health Issues Paper; 2013. Report No: 9.

    Google Scholar 

  8. Koning M, Zeijlmans IA, Bouman TK, van der Lei B. Female attitudes regarding labia minora appearance and reduction with consideration of media influence. Aesthetic Surg J. 2009;29:65–71.

    Article  Google Scholar 

  9. Rouzier R, Louis-Sylvestre C, Paniel BJ, Haddad B. Hypertrophy of labia minora: experience with 163 reductions. Am J Obstet Gynecol. 2000;182(1 Pt 1):35–40.

    Article  CAS  PubMed  Google Scholar 

  10. Veale D, Eshkevari E, Ellison N, Costa A, Robinson D, Kavouni A, et al. Psychological characteristics and motivation of women seeking labiaplasty. Psychol Med. 2014;44(3):555–66.

    Article  CAS  PubMed  Google Scholar 

  11. Onden-Lim M, Wu R, Grisham JR. Body image concern and selective attention to disgusting and non-self appearance-related stimuli. Body Image. 2012;9(4):535–8.

    Article  PubMed  Google Scholar 

  12. American Psychiatric Association. Desk reference to the diagnostic criteria from DSM-5. Arlington: American Psychiatric Publishing; 2013.

    Google Scholar 

  13. Barrett MM, Carlson JA. A clinicopathologic study of labia minora hypertrophy: signs of localized lymphedema were universal. J Low Genit Tract Dis. 2014;18(1):13–20.

    Article  PubMed  Google Scholar 

  14. Kato K, Kondo A, Gotoh M, Tanaka J, Saitoh M, Namiki Y. Hypertrophy of labia minora in myelodysplastic women. Labioplasty to ease clean intermittent catheterization. Urology. 1988;31(4):294–9.

    Article  CAS  PubMed  Google Scholar 

  15. Reitsma W, Mourits MJE, Koning M, Pascal A, van der Lei B. No (Wo)man is an island – the influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making: a cross-sectional study. J Sex Med. 2011;8:2377–85.

    Article  PubMed  Google Scholar 

  16. Veale D, Eshkevari E, Ellison N, Costa A, Robinson D, Kavouni A, et al. A comparison of risk factors for women seeking labiaplasty compared to those not seeking labiaplasty. Body Image. 2014;11(1):57–62.

    Article  PubMed  Google Scholar 

  17. Wilson EO. Sociobiology: the new synthesis. Boston: Harvard University Press; 1975.

    Google Scholar 

  18. Paarlberg KM, Weijenborg PTM. Request for operative reduction of the labia minora; a proposal for a practical guideline for gynecologists. J Psychosom Obstet Gynaecol. 2008;29(4):230–4.

    Article  PubMed  Google Scholar 

  19. Martoredjo D, Laan E. De invloed van blootstelling aan foto’s van ongewijzigde vulva’s op het genitale zelfbeeld van vrouwen. Tijdschrift voor Seksuologie. 2015;39:1–6.

    Google Scholar 

  20. Hage JJ, Maas SM. Aesthetic reduction of labia minora – oral presentation at the 10th annual meeting of the European Association of Plastic Surgeons (EURAPS). Madrid, Spain; 1999.

    Google Scholar 

  21. Ostrzenski A. Cosmetic gynecology in the view of evidence-based medicine and ACOG recommendations: a review. Arch Gynecol Obstet. 2011;284:617–30.

    Article  PubMed  Google Scholar 

  22. Veale D, Naismith I, Eskevari E, Ellison N, Costa A, Robinson D, et al. Psychosexual outcome after labiaplasty: a prospective case-comparison study. Int Urogynecol J. 2014;25(6):831–9.

    Article  PubMed  Google Scholar 

  23. Hamori CA. Postoperative clitoral hood deformity after labiaplasty. Aesthet Surg J. 2013;33(7):1030–6.

    Article  PubMed  Google Scholar 

  24. Blanks J. Femalia. San Francisco: Down There Press; 1993.

    Google Scholar 

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Correspondence to K. Marieke Paarlberg MD, PhD .

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Paarlberg, K.M., van de Wiel, H.B.M. (2017). A Young Woman Asking for Labia Reduction Surgery: A Plea for “Vulvar Literacy”. In: Paarlberg, K., van de Wiel, H. (eds) Bio-Psycho-Social Obstetrics and Gynecology. Springer, Cham.

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