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.
Gender divisions in sports have primarily served to keep women out of what has always been believed to be a male domain. The idea of women participating alongside men has been regarded with contempt under the belief that women were made physically inferior.
Within their own division, women have reached new heights, received accolades for outstanding physical performance and endurance, and have proven themselves to be as capable of athletic excellence as men. In spite of women's collective fight to be recognized as equals to their male counterparts, female athletes must now prove their womanhood in order to compete alongside their own gender.
That has been the reality for Caster Semenya, a South African Olympic champion, who has been at the center of the latest gender discrimination debate across the world. After crushing her competition in the women's 800-meter dash in 2016, Semenya was subjected to scrutiny from her peers based upon her physical appearance, calling her gender into question. Despite setting a new national record for South Africa and attaining the title of fifth fastest woman in Olympic history, Semenya's success was quickly brushed aside as she became a spectacle for all the wrong reasons.
Semenya's gender became a hot topic among reporters as the Olympic champion was subjected to sex testing by the International Association of Athletics Federations (IAAF). According to Ruth Padawer from the New York Times, Semenya was forced to undergo relentless examination by gender experts to determine whether or not she was woman enough to compete as one. While the IAAF has never released the results of their testing, that did not stop the media from making irreverent speculations about the athlete's gender.
Moments after winning the Berlin World Athletics Championship in 2009, Semenya was faced with immediate backlash from fellow runners. Elisa Cusma who suffered a whopping defeat after finishing in sixth place, felt as though Semenya was too masculine to compete in a women's race. Cusma stated, "These kind of people should not run with us. For me, she is not a woman. She's a man." While her statement proved insensitive enough, her perspective was acknowledged and appeared to be a mutually belief among the other white female competitors.
Fast forward to 2018, the IAAF issued new Eligibility Regulations for Female Classification (Athlete with Differences of Sexual Development) that apply to events from 400m to the mile, including 400m hurdles races, 800m, and 1500m. The regulations created by the IAAF state that an athlete must be recognized at law as either female or intersex, she must reduce her testosterone level to below 5 nmol/L continuously for the duration of six months, and she must maintain her testosterone levels to remain below 5 nmol/L during and after competing so long as she wishes to be eligible to compete in any future events. It is believed that these new rules have been put into effect to specifically target Semenya given her history of being the most recent athlete to face this sort of discrimination.
With these regulations put into effect, in combination with the lack of information about whether or not Semenya is biologically a female of male, society has seemed to come to the conclusion that Semenya is intersex, meaning she was born with any variation of characteristics, chromosomes, gonads, sex hormones, or genitals. After her initial testing, there had been alleged leaks to media outlets such as Australia's Daily Telegraph newspaper which stated that Semenya's results proved that her testosterone levels were too high. This information, while not credible, has been widely accepted as fact. Whether or not Semenya is intersex, society appears to be missing the point that no one is entitled to this information. Running off their newfound acceptance that the Olympic champion is intersex, it calls into question whether her elevated levels of testosterone makes her a man.
The IAAF published a study concluding that higher levels of testosterone do, in fact, contribute to the level of performance in track and field. However, higher testosterone levels have never been the sole determining factor for sex or gender. There are conditions that affect women, such as PCOS, in which the ovaries produce extra amounts of testosterone. However, those women never have their womanhood called into question, nor should they—and neither should Semenya.
Every aspect of the issue surrounding Semenya's body has been deplorable, to say the least. However, there has not been enough recognition as to how invasive and degrading sex testing actually is. For any woman, at any age, to have her body forcibly examined and studied like a science project by "experts" is humiliating and unethical. Under no circumstances have Semenya's health or well-being been considered upon discovering that her body allegedly produces an excessive amount of testosterone. For the sake of an organization, for the comfort of white female athletes who felt as though Semenya's gender was an unfair advantage against them, Semenya and other women like her, must undergo hormone treatment to reduce their performance to that of which women are expected to perform at. Yet some women within the athletic community are unphased by this direct attempt to further prove women as inferior athletes.
As difficult as this global invasion of privacy has been for the athlete, the humiliation and sense of violation is felt by her people in South Africa. Writer and activist, Kari, reported that Semenya has had the country's undying support since her first global appearance in 2009. Even after the IAAF released their new regulations, South Africans have refuted their accusations. Kari stated, "The Minister of Sports and Recreation and the Africa National Congress, South Africa's ruling party labeled the decision as anti-sport, racist, and homophobic." It is no secret that the build and appearance of Black women have always been met with racist and sexist commentary. Because Black women have never managed to fit into the European standard of beauty catered to and in favor of white women, the accusations of Semenya appearing too masculine were unsurprising.
Despite the countless injustices Semenya has faced over the years, she remains as determined as ever to return to track and field and compete amongst women as the woman she is. Her fight against the IAAF's regulations continues as the Olympic champion has been receiving and outpour of support in wake of the Association's decision. Semenya is determined to run again, win again, and set new and inclusive standards for women's sports.