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.
With so many groundbreaking medical advances being revealed to the world every single day, you would imagine there would be some advancement on the plethora of many female-prevalent diseases (think female cancers, Alzheimer's, depression, heart conditions etc.) that women are fighting every single day.
For Anna Villarreal and her team, there frankly wasn't enough being done. In turn, she developed a method that diagnoses these diseases earlier than traditional methods, using a pretty untraditional method in itself: through your menstrual blood.
Getting from point A to point B wasn't so easy though. Villarreal was battling a disease herself and through that experience. “I wondered if there was a way to test menstrual blood for female specific diseases," she says. "Perhaps my situation could have been prevented or at least better managed. This led me to begin researching menstrual blood as a diagnostic source. For reasons the scientific and medical community do not fully understand, certain diseases impact women differently than men. The research shows that clinical trials have a disproportionate focus on male research subjects despite clear evidence that many diseases impact more women than men."
There's also no denying that gap in women's healthcare in clinical research involving female subjects - which is exactly what inspired Villarreal to launch her company, LifeStory Health. She says that, “with my personal experience everything was brought full circle."
“There is a challenge and a need in the medical community for more sex-specific research. I believe the omission of females as research subjects is putting women's health at risk and we need to fuel a conversation that will improve women's healthcare.,"
Her brand new biotech company is committed to changing the women's healthcare market through technology, innovation and vocalization and through extensive research and testing. She is working to develop the first ever, non-invasive, menstrual blood diagnostic and has partnered with a top Boston-area University on research and has won awards from The International Society for Pharmaceutical Engineering and Northeastern University's RISE.
How does it work exactly? Proteins are discovered in menstrual blood that can quickly and easily detect, manage and track diseases in women, resulting in diseases that can be earlier detected, treated and even prevented in the first place. The menstrual blood is easy to collect and since it's a relatively unexplored diagnostic it's honestly a really revolutionary concept, too.
So far, the reactions of this innovative research has been nothing but excitement. “The reactions have been incredibly positive." she shares with SWAAY. “Currently, menstrual blood is discarded as bio waste, but it could carry the potential for new breakthroughs in diagnosis. When I educate women on the lack of female subjects used in research and clinical trials, they are surprised and very excited at the prospect that LifeStory Health may provide a solution and the key to early detection."
To give a doctor's input, and a little bit more of an explanation as to why this really works, Dr. Pat Salber, MD, and Founder of The Doctor Weighs In comments: “researchers have been studying stem cells derived from menstrual blood for more than a decade. Stem cells are cells that have the capability of differentiating into different types of tissues. There are two major types of stem cells, embryonic and adult. Adult stem cells have a more limited differentiation potential, but avoid the ethical issues that have surrounded research with embryonic stem cells. Stem cells from menstrual blood are adult stem cells."
These stem cells are so important when it comes to new findings. “Stem cells serve as the backbone of research in the field of regenerative medicine – the focus which is to grow tissues, such as skin, to repair burn and other types of serious skin wounds.
A certain type of stem cell, known as mesenchymal stem cells (MenSCs) derived from menstrual blood has been found to both grow well in the lab and have the capability to differentiate in various cell types, including skin. In addition to being used to grow tissues, their properties can be studied that will elucidate many different aspects of cell function," Dr. Salber explains.
To show the outpour of support for her efforts and this major girl power research, Villarreal remarks, “women are volunteering their samples happily report the arrival of their periods by giving samples to our lab announcing “de-identified sample number XXX arrived today!" It's a far cry from the stereotype of when “it's that time of the month."
How are these collections being done? “Although it might sound odd to collect menstrual blood, plastic cups have been developed to use in the collection process. This is similar to menstrual products, called menstrual cups, that have been on the market for many years," Dr. Salber says.
Equally shocking and innovative, this might be something that becomes more common practice in the future. And according to Dr. Salber, women may be able to not only use the menstrual blood for early detection, but be able to store the stem cells from it to help treat future diseases. “Companies are working to commercialize the use of menstrual blood stem cells. One company, for example, is offering a patented service to store menstrual blood stem cells for use in tissue generation if the need arises."