The BMJ article suggests that the surgery is a classic example of commercial, media and social pressures artificially creating a problem, building concern over it and then offering a solution.
The "designer vagina" surgery, technically called elective genitoplasty, can shorten or change the shape of the outer labia, reduce the size of the clitoral hood, or shorten the vagina itself. A new procedure, a collagen injection to enlarge the G-spot, is being offered by a Los Angeles clinic specializing in vaginal plastic surgery.
In 2004-2005, Britain's National Health Service conducted 800 "labial reductions," more than twice the number of surgeries six years earlier. The number of private surgeries is unknown.
A spokeswoman for Dr. David Matlock. the surgeon who founded the Los Angeles-based Laser Vaginal Rejuvenation Institute specializing in vaginal plastic surgery, told XBIZ that Matlock had performed 600 surgeries in the last year alone.
The authors found that patients who sought genitoplasty "uniformly" wanted their vulvas to be flat and with no protrusion, similar to the prepubescent look of girls in Western fashion ads.
"Not unlike presenting for a haircut at a salon, women often brought along images to illustrate the desired appearance," the article said. "The illustrations, usually from advertisements or pornography, are always selective and possibly digitally altered."
"There is nothing unusual about protrusion of the labia," the article reads. "It is the negative meaning that makes it into a problem — meanings that can give rise to physical, emotional and behavioral reactions, such as discomfort, self-disgust, perhaps avoidance of some activities and a desire for a surgical fix."
The article, titled "Sexual Behaviour and its Medicalisation: In Sickness and In Health" and available at the BMJ website, also touches on 19th century attempts to curb masturbation, changing attitudes toward sex in society and how the practice of medicine reflects these changing attitudes. The article was written by London gynecologist Sarah Creighton and clinical psychologist Lih Mei Liao.
"Relatively recently, the imperative was for restraint and moderation in sexual matters; now it is for more and better sexual gratification," the article says. "We can see this as the replacement of one orthodoxy by another as an overmedicalization of sex. Celibacy is the new deviance."
To read the article, visit the British Medical Journal website.
