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An Investigation Into The Disturbing Rise of Labiaplasty in Young Girls

Health

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.

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Fresh Voices

My Unfiltered Struggle of Introducing a Product to a Neglected Market

Sweaty Palms & Weak Responses

Early spring 2018, I walked into the building of a startup accelerator program I had been accepted into. Armed with only confidence and a genius idea, I was eager to start level one. I had no idea of what to expect, but I knew I needed help. Somehow with life's journey of twists and turns, this former successful event planner was now about to blindly walk into the tech industry and tackle on a problem that too many women entrepreneurs had faced.


I sat directly across from the program founders, smiling ear to ear as I explained the then concept for HerHeadquarters. Underneath the table, I rubbed my sweaty palms on my pants, the anxiousness and excitement was getting the best of me. I rambled on and on about the future collaborating app for women entrepreneurs and all the features it would have. They finally stopped me, asking the one question I had never been asked before, "how do you know your target audience even wants this product?".

Taken back by the question, I responded, "I just know". The question was powerful, but my response was weak. While passionate and eager, I was unprepared and naively ready to commit to building a platform when I had no idea if anyone wanted it. They assigned me with the task of validating the need for the platform first. The months to follow were eye-opening and frustrating, but planted seeds for the knowledge that would later build the foundation for HerHeadquarters. I spent months researching and validating through hundreds of surveys, interviews, and focus groups.

I was dedicated to knowing and understanding the needs and challenges of my audience. I knew early on that having a national collaborating app for women entrepreneurs would mean that I'd need to get feedback from women all across the country. I repeatedly put myself on the line by reaching out to strangers, asking them to speak with me. While many took the time to complete a survey and participate in a phone interview, there were some who ignored me, some asked what was in it for them, and a few suggested that I was wasting my time in general. They didn't need another "just for women" platform just because it was trending.

I hadn't expected pushback, specifically from the women I genuinely wanted to serve. I became irritated. Just because HerHeadquarters didn't resonate with them, doesn't mean that another woman wouldn't find value in the platform and love it. I felt frustrated that the very women I was trying to support were the ones telling me to quit. I struggled with not taking things personally.

I hadn't expected pushback, specifically from the women I genuinely wanted to serve.

The Validation, The Neglect, The Data, and The Irony

The more women I talked to, the more the need for my product was validated. The majority of women entrepreneurs in the industries I was targeting did collaborate. An even higher number of women experienced several obstacles in securing those collaborations and yes, they wanted easier access to high quality brand partnerships.

I didn't just want to launch an app. I wanted to change the image of women who collaborated and adjust the narrative of these women. I was excited to introduce a new technology product that would change the way women secured valuable, rewarding products. I couldn't believe that despite that rising number of women-owned businesses launching, there was no tool catered to them allowing them to grow their business even faster. This demographic had been neglected for too long.

I hadn't just validated the need for the future platform, but I gained valuable data that could be used as leverage. Ironically, armed with confidence, a genius idea, and data to support the need for the platform, I felt stuck. The next steps were to begin designing a prototype, I lacked the skillsets to do it myself and the funding to hire someone else to do it.

I Desperately Need You and Your services, but I'm Broke

I found myself having to put myself out there again, allowing myself to be vulnerable and ask for help. I eventually stumbled across Bianca, a talented UX/UI designer. After coming across her profile online and reaching out, we agreed to meet for a happy hour. The question I had been asked months prior by the founders of my accelerator program came up again, "how do you know your target audience even wants this product?".

It was like déjà vu, the sweaty palms under the table reemerged and the ear to ear smile as I talked about HerHeadquarters, only this time, I had data. I proudly showed Bianca my research: the list of women from across the country I talked to that supported that not only was this platform solving a problem they had, but it's a product that they'd use and pay for.

I remember my confidence dropping as my transparency came into the conversation. How do you tell someone "I desperately need you and your services, but I'm broke?". I told her that I was stuck, that I needed to move forward with design, but that I didn't have the money to make it happen. Bianca respected my honesty, loved the vision of HerHeadquarters, but mostly importantly the data sold her. She believed in me, she believed in the product, and knew that it would attract investors.

From Paper to Digital

We reached a payment agreed where Bianca would be paid in full once HerHeadquarters received its first investment deal. The next few months were an all-time high for me. Seeing an idea that once floated around in my head make its way to paper, then transform into a digital prototype is was one of the highlights of this journey. Shortly after, we began user testing, making further adjustments based off of feedback.

The further along HerHeadquarters became, the more traction we made. Women entrepreneurs across the U.S. were signing up for early access to the app, we were catching investor's attention, and securing brand partnerships all before we had a launched product. The closer we got to launching, the scarier it was. People who only had a surface value introduction to HerHeadquarters put us in the same category of other platforms or brands catering to women, even if we were completely unrelated, they just heard "for women". I felt consistent pressure, most of which was self-applied, but I still felt it.

I became obsessed with all things HerHeadquarters. My biggest fear was launching and disappointing my users. With a national target audience, a nonexistent marketing budget, and many misconceptions regarding collaborating, I didn't know how to introduce this new brand in a way that distinctly made it clear who were targeting and who we were different from.

I second guessed myself all the time.

A 'Submit' button has never in life been more intimidating. In May 2019, HerHeadquarters was submitted to the Apple and Google play stores and released to women entrepreneurs in select U.S. cities. We've consistently grown our user base and seen amazing collaborations take place. I've grow and learned valuable lessons about myself personally and as a leader. This experience has taught me to trust my journey, trust my hard work, and always let honesty and integrity lead me. I had to give myself permission to make mistakes and not beat myself up about it.

I learned that a hundred "no's" is better than one "yes" from an unfit partner. The most valuable thing that I've learned is keeping my users first. Their feedback, their challenges, and suggestions are valuable and set the pace for the future of HerHeadquarters, as a product and a company. I consider it an honor to serve and cater to one of the most neglected markets in the industry.