A distressing trend is on the rise for girls as young as nine years old. Labiaplasty, a risky procedure that involves shortening or reshaping the labia alters the appearance for cosmetic reasons. I know what you're thinking, why in the hell would a nine-year-old need to cosmetically shape their labia?
The American Society of Plastic Surgeons found that labiaplasty is on the rise with over 12,000 procedures performed in 2016. The most disturbing part is that five percent of those procedures were patients who were under the age of 16. While that may not seem like a large percentage, that's over 500 young girls who believe that their body looks disgusting.
Moreover, labiaplasty isn't typically done out of medical necessity. Aesthetics are at the forefront of the popularity of the procedure.
In a BBC article, Paquita de Zulueta, a General Practitioner said that the numbers of patients coming in for labiaplasty have risen only in the past few years. She writes, “I'm seeing young girls around 11, 12, 13…" and they come to Zulueta thinking there is something wrong with their body—it's the wrong size, it doesn't look normal, it's the wrong shape. She says they are “really expressing almost disgust."
You may have heard of labiaplasty before—it's a non-uncommon procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva.. It's marketed towards older women or women who have given birth. But trimming and tucking the labia for younger women is on the rise.
“The big thing I tell patients about labiaplasty is that there are a lot of unknowns. The labia have a lot of nerve endings in them," says Dr. Julie Strickland, the chairwoman of the American College of Obstetricians and Gynecologists committee on adolescent health care. That means that numbness, sexual sensation, pain, or scarring could be a side effect of the surgery.
When a patient has a previous injury, ongoing pain, or discomfort, labiaplasty can be considered as a pertinent medical procedure. Some patients will often insist that their labia is interfering with sports, daily activities, or sex.
How can we avoid this rise in numbers? How can we encourage young children that their body is still growing, changing and that there is no one singular vision of what a body looks like?
Renee Engeln, Ph.D. and award-winning professor at Northwestern University tells me that the answer isn't telling children and young adults that they are simply “beautiful" to improve their self-esteem. Instead, there should be an emphasis on “teaching girls that their bodies are tools." She continues, “Bodies are meant for doing things. They're meant to help you explore your world and communicate with others. Their primary purpose isn't to be evaluated by others. We should model for young girls what it looks like to care for your body and treat it with respect, and make it clear that your body deserves respect no matter what it looks like."
Where are young people getting information on what a so-called “normal" labia look like? First, sex education still actively abandons any mention of sexual pleasure for women. We discuss erections and penis-in-vagina sex, but never the specifics of what happens to a person with a cervix when they are turned on. Because of this, young children are often at a loss of understanding their own genitals. This body image issue can be carried well into adulthood without a complete understanding of how accurate body functions. Engeln says that because young adults aren't given any reference for pleasure, “it's no surprise that some young girls already view their genitals in an objectified way, that is, in terms of how they might look to other people."
I've heard certain people compare the surgery to creating the lips of a Barbie doll—completely invisible with no protrusion. Another influence on young people (no surprise) is pornography, which young people are viewing more than ever at a younger age. In mainstream pornography, actors are fitting a certain mold that is following a trend—it's not the reality of sex.
Moreover, genital aesthetics and comparisons are more prevalent now that so many young women wax or shave their pubic area. Their genitals are exposed; however, there is a recent surge in body hair being included in the mainstream, and in porn. The internet, and mainstream pornography, introduces a body that is airbrushed and false inaccuracy.
Shape, color, size, and asymmetry come in all varieties, for everybody. Just like the freckles on your back or the shape of your fingernails—we are all uniquely made up of our characteristics, labia included.
But people are fighting back. The Labia Library in Australia is a non-profit organization that focuses on teaching women what a healthy body looks like, no matter how diverse. Their photo gallery features a large selection of images of real labia so that women seeking genital cosmetic surgery are properly informed.
Engeln advises parents to look at what types of messages they are sending their children. If a guardian is vocally stating that they hate their body, or certain types of bodies, then their child will receive this message and internalize it negatively. “These kinds of comments also reinforce the truly destructive notion that feeling shame about your body is just a normal and expected part of being a woman," says Engeln.
It's imperative for guardians—of all kinds—(be that a teacher, guidance counselor, babysitter, coach, etc.) to teach all children about body positivity and to eradicate any notion of objectifying a woman's body.
“It's never too early to instill some activism in your daughters. I'm angry that we live in a culture that teaches young girls there's something wrong with how their labia looks. I want girls (and their parents) to join me in that anger. Let's raise girls who want to change this part of our culture instead of changing their bodies," says Engeln.
The labia is still growing during adolescence and the appearance will change over time. By the age of 18, the outer labia will have grown, making the inner labia not as prominent (which is typically what concerns most patients). According to the American Board of Cosmetic Surgery, if a young person decides to go through with the surgery, there could be potential scarring which could lead to an asymmetrical labia.
It's clearly important to note, shout, scream, yelp, and repeat that “All vaginas are different" and diverse, and unique, and beautiful. No one labia is the same.
“It's essential that parents push back against the cultural narrative that teaches young girls their bodies are problems to be solved," says Engeln.
Women have come a long way in redefining beauty to be more inclusive of different body types, skin colors and hair styles, but society's beauty standards still remain as high as we have always known them to be. In the workplace, professionalism is directly linked to the appearance of both men and women, but for women, the expectations and requirements needed to fit the part are far stricter. Unlike men, there exists a direct correlation between beauty and respect that women are forced to acknowledge, and in turn comply with, in order to succeed.
Before stepping foot into the workforce, women who choose to opt out of conventional beauty and grooming regiments are immediately at a disadvantage. A recent Forbes article analyzing the attractiveness bias at work cited a comprehensive academic review for its study on the benefits attractive adults receive in the labor market. A summary of the review stated, "'Physically attractive individuals are more likely to be interviewed for jobs and hired, they are more likely to advance rapidly in their careers through frequent promotions, and they earn higher wages than unattractive individuals.'" With attractiveness and success so tightly woven together, women often find themselves adhering to beauty standards they don't agree with in order to secure their careers.
Complying with modern beauty standards may be what gets your foot in the door in the corporate world, but once you're in, you are expected to maintain your appearance or risk being perceived as unprofessional. While it may not seem like a big deal, this double standard has become a hurdle for businesswomen who are forced to fit this mold in order to earn respect that men receive regardless of their grooming habits. Liz Elting, Founder and CEO of the Elizabeth Elting Foundation, is all too familiar with conforming to the beauty culture in order to command respect, and has fought throughout the course of her entrepreneurial journey to override this gender bias.
As an internationally-recognized women's advocate, Elting has made it her mission to help women succeed on their own, but she admits that little progress can be made until women reclaim their power and change the narrative surrounding beauty and success. In 2016, sociologists Jaclyn Wong and Andrew Penner conducted a study on the positive association between physical attractiveness and income. Their results concluded that "attractive individuals earn roughly 20 percent more than people of average attractiveness," not including controlling for grooming. The data also proves that grooming accounts entirely for the attractiveness premium for women as opposed to only half for men. With empirical proof that financial success in directly linked to women's' appearance, Elting's desire to have women regain control and put an end to beauty standards in the workplace is necessary now more than ever.
Although the concepts of beauty and attractiveness are subjective, the consensus as to what is deemed beautiful, for women, is heavily dependent upon how much effort she makes towards looking her best. According to Elting, men do not need to strive to maintain their appearance in order to earn respect like women do, because while we appreciate a sharp-dressed man in an Armani suit who exudes power and influence, that same man can show up to at a casual office in a t-shirt and jeans and still be perceived in the same light, whereas women will not. "Men don't have to demonstrate that they're allowed to be in public the way women do. It's a running joke; show up to work without makeup, and everyone asks if you're sick or have insomnia," says Elting. The pressure to look our best in order to be treated better has also seeped into other areas of women's lives in which we sometimes feel pressured to make ourselves up in situations where it isn't required such as running out to the supermarket.
So, how do women begin the process of overriding this bias? Based on personal experience, Elting believes that women must step up and be forceful. With sexism so rampant in workplace, respect for women is sometimes hard to come across and even harder to earn. "I was frequently assumed to be my co-founder's secretary or assistant instead of the person who owned the other half of the company. And even in business meetings where everyone knew that, I would still be asked to be the one to take notes or get coffee," she recalls. In effort to change this dynamic, Elting was left to claim her authority through self-assertion and powering over her peers when her contributions were being ignored. What she was then faced with was the alternate stereotype of the bitchy executive. She admits that teetering between the caregiver role or the bitch boss on a power trip is frustrating and offensive that these are the two options businesswomen are left with.
Despite the challenges that come with standing your ground, women need to reclaim their power for themselves and each other. "I decided early on that I wanted to focus on being respected rather than being liked. As a boss, as a CEO, and in my personal life, I stuck my feet in the ground, said what I wanted to say, and demanded what I needed – to hell with what people think," said Elting. In order for women to opt out of ridiculous beauty standards, we have to own all the negative responses that come with it and let it make us stronger– and we don't have to do it alone. For men who support our fight, much can be achieved by pushing back and policing themselves and each other when women are being disrespected. It isn't about chivalry, but respecting women's right to advocate for ourselves and take up space.
For Elting, her hope is to see makeup and grooming standards become an optional choice each individual makes rather than a rule imposed on us as a form of control. While she states she would never tell anyone to stop wearing makeup or dressing in a way that makes them feel confident, the slumping shoulders of a woman resigned to being belittled looks far worse than going without under-eye concealer. Her advice to women is, "If you want to navigate beauty culture as an entrepreneur, the best thing you can be is strong in the face of it. It's exactly the thing they don't want you to do. That means not being afraid to be a bossy, bitchy, abrasive, difficult woman – because that's what a leader is."