These Doctors are More Likely to Suggest Labiaplasty to Patients

A new study published in the Journal of Sexual Medicine has found that male physicians are more likely than female physicians to say that they would recommend labiaplasty (surgery to reduce the size, or reshape the appearance, of women’s labia minora). Also, plastic surgeons were more likely to jump on board with labiaplasty than gynecologists or general practitioners. The take-home? If you’re worried about your labia minora, ask your female gynecologist or general practitioner – or at the very least, get a second and even third opinion.

In the study, researchers surveyed 210 physicians in the Netherlands – a country that already has more comprehensive and widely available sex education than the US. Why remark on this? Because in the US, most Americans don’t get much sex education in school – not even medical school – which means that many physicians may be uncomfortable talking about sexuality with patients or may be ill prepared to talk about sex-related medical topics, including what your labia minora look like and how you feel about your labia.

But let’s get back to the study. A total of 164 of the 210 physicians completed the survey, in which they were shown images of 4 different vulvas (shown above, from the JSM article). The vulva photos were from two women, ages 35 and 40; two photos were before surgery and two photos were taken 6 months following surgery. This was likely done to experimentally control for other features of the vulva, such as skin color or the symmetry of other features, that might otherwise influence ratings of the vulva’s appearance. The physicians generally indicated (about 90% of them) that the vulva with very small labia was perceived to be close to society’s ideal.

Interestingly, gynecologists and general practitioners tended to rate all 4 vulvas as “natural” and “attractive” even though two of the four were post-operative vulvas (though they were not told this). However, plastic surgeons were more likely to rate the two surgically altered vulvas as “natural” and “attractive” – even though they weren’t in their “natural” state at all! The plastic surgeons less often rated the two “before” surgery photos as “natural” or “attractive.”

And then there’s this from the study abstract:

“More plastic surgeons regarded the picture with the largest labia minora as distasteful and unnatural, compared with general practitioners and gynecologists (P < 0.01), and regarded such a woman as a candidate for a labia minora reduction procedure (P < 0.001). Irrespective of the woman’s labia minora size and the absence of physical complaints, plastic surgeons were significantly more open to performing a labia minora reduction procedure than gynecologists (P < 0.001). Male physicians were more inclined to opt for a surgical reduction procedure than their female colleagues (P < 0.01).”

Overall, male physicians were more willing to operate on women’s labia for reasons related to appearance or physical discomfort (the original article can be found on the JSM web site).

As regular readers know, I care deeply about women’s sexual health and a significant portion of my days are spent studying how women feel about their genitals and how they experience them. A colleague (Dr. Vanessa Schick) and I currently conducting a study related to labiaplasty and other elective genital surgeries, such as vaginal rejuvenation. She and I also recently wrote a book called Read My Lips: A Complete Guide to the Vagina and Vulva (available on Amazon). Now, I believe in medical care being offered to those who want it and can benefit from it and I certainly don’t think elective genital surgeries should be banned. There are good reasons why some women want to have labiaplasty or vaginal tightening procedures and sometimes women benefit from these procedures. However, such procedures are often marketed to women in ways that make them feel bad about their natural bodies. In addition, this study raises significant concerns about how some physicians may be more biased to recommend surgery to women. Given the choice between a physician who could help me to feel better about my natural body and one that might rush to tell me how I could surgically fix it, I’d rather be a patient of the first one.

What do you think about this study, and genital surgeries more generally?

Learn more about vulva and labia diversity, these types of surgeries, and much more about vaginal/vulvar health, sex issues, pleasure, and even some arts and crafts activities in our book, Read My Lips: A Complete Guide to the Vagina and Vulva.

Follow us on Twitter @mysexprofessor

About Dr. Debby Herbenick

Dr. Debby Herbenick

Dr. Debby Herbenick is a sex researcher at Indiana University, sexual health educator at The Kinsey Institute, columnist, and author of five books about sex and love. Learn more about her work at www.sexualhealth.indiana.edu.

  • http://badassbard.blogspot.com Thomas

    First, it should come as no surprise that plastic surgeons tend towards this set of opinions. Just as one is unlikely to find a beautician that will say, “You don’t need any makeup at all.” One is unlikely to find a plastic surgeon who sees no room for ‘improvement’ in a would-be patient. I’m not so cynical as to insist that this is because of an economic motive, though there is one, but rather that these attitudes are the result of a certain aesthetic sense born of professional necessity.

    Second, provided the patient in question doesn’t consider themself to be disfigured, elective, aesthetic surgery is something that one should always get a sheaf of opinions on. Any doctor who doesn’t insist so should be suspect. It’s one thing to go under the knife to save one’s life or to correct an appearance issue that could exclude someone from normal participation in society. It’s quite another to do so to meet an arbitrary standard or to try and correct for minor, and often irrelevant, shortcomings.   

  • Kathryn Rebecca42

    I think it’s interesting that GPs and GYNs rated all vulvas as natural-looking.  I think that speaks to the variety found nature; no two women’s vulvas are the same, and everything’s ok.  I find it frustrating that male enhancement surgery is marketed to men as a way to increase their masculinity, or their ability to obtain sex from more women, yet female enhancement surgery is marketed to women as a way to please men (“surprise your lover by getting a hymenoplasty,” “heighten his pleasure by getting vaginal rejuvenation”).  Really, why would a woman want to replace her hymen, if not for someone else?

    I don’t understand cosmetic genital surgery at all.

  • Debby Herbenick

    Fascinating – thanks for sharing your experiences.