As reported by the BBC Victoria Derbyshire show recently, girls as young as nine are seeking surgery on their genitals because they are distressed by the appearance of this intimate area. Several gynaecologists have reported that young girls (under the age of 15) have been increasingly seeking out labiaplasty surgery, which shortens and reforms the labia minor surrounding the vagina, most often because they are concerned by the size or shape of their vulvas.
Naomi Crouch, a gynaecology specialist, told the BBC about the worrying trend, explaining: "Girls will sometimes come out with comments like, 'I just hate it, I just want it removed,' and for a girl to feel that way about any part of her body - especially a part that's intimate - is very upsetting."
Surgeons are also worried that GPs are referring young girls for unnecessary labiaplasty. In 2015-16, more than 200 girls under 18 had labiaplasty on the NHS and more than 150 of those girls were under 15. Some experts fear that pornography and images viewed through social media are leading young girls to have unrealistic perceptions of how their genitals should look.
Paquita de Zulueta, a GP with over 30 years’ experience, told the BBC that it is only in the past few years that young women have been coming to her with concerns about the shape of their genitals. She explained: "There isn't enough education and it should start really quite young, explaining that there is a range and that - just as we all look different in our faces - we all look different down there, and that's OK."
Dr de Zulueta thinks labiaplasty should only be performed on girls who have a medical abnormality, and not for cosmetic reasons. NHS England has denied carrying out the operation for cosmetic reasons, only for clinical conditions and explained that for the past few years clinical commissioning groups have only been able to refer patients who are experiencing physical pain or emotional distress for such procedures. The Royal College of Obstetricians and Gynaecologists said the operation should not be performed until a girl had finished developing, after the age of 18.
Labiaplasty can be conducted for medical reasons, for example if a woman’s anatomy is causing serious discomfort during sport or sex. It is also used as part of the reconstructive process for victims of female genital mutilation. The problem, critics say, is if young women are being driven to seek surgical changes because of negative perceptions of their natural anatomy - which could be being shaped by the ubiquity of hairless, “neat” vulvas in pornography and pop culture.
Elise Bevan, a solicitor in the cosmetic surgery team at Penningtons Manches LLP, said: “We are alarmed and concerned at the reports of young girls seeking genital surgery for cosmetic reasons, and it would appear that these decisions are predominantly influenced by images in popular culture. Performing irreversible cosmetic surgery whilst these girls are still developing carries serious risks of harm. They should instead be offered education, support and advice.”