Tuesday 27 July 2010

The Rise of the Intimate Nip/Tuck

Lippy girl is out there! I have a mention in the August edition of Red, which reveals that labiaplasties on the National Health Service have more than doubled in two years.

The article quotes gynaecologist Dr Deborah Boyle who says, "labia is not just additional skin that's redundant". Hurrah for doctors who know about female anatomy!! 

  
Dr Boyle also comments, "it's sensitive, and some people have orgasms which originate in part from the vulva." Again hurrah, but why is this treated as a medical revelation several million years after we first started enjoying our flappy bits...? 

The article also quotes 'Anna', a woman who has undergone labiaplasty because she 'dreaded' sex;  and who is presented as an example of why labiaplasty is a valid choice. Even Dr Boyle comes down for it in the end, implying she sees some strong women who are determined to amputate, some so much that 'they'd consider doing it to themselves'.

I've got some sympathy for the informed choice argument. But Dr Boyle needs a challenge here, in the light of legislation which states labiaplasty may not be performed without medical reason, notwithstanding a woman's desires - or even her threats of DIY. And also because there have been no public sightings of that creature she mentions: the informed assertive women who chooses labiaplasty as a positive option. Show me the evidence!

Anna I'm sorry to say is not the one. 

She begins, quite petulantly, by stating that labiaplasty is not a female circumcision, 'it's just not'. Wrong. The WHO clearly defines removal of the labia minora as a type IIa female genital mutilation (FGM). This surgery forms 8% of FGM in Egypt, where cutting has been dominated by medics since the 1990s or earlier. When finally in 2007 the Egyptian government closed the medical loophole, they banned any "cut of, flattening or modification of any natural part of the female reproductive system". Clearly labiaplasty was in their sights...

Anna's follow up rings equally hollow as a demonstration of knowledge and empowerment. She says that labia are, 'just excess skin that's unsightly'. The first point is not correct, and the second is a scattergun insult. Neither ignorance nor aggression are generally considered hallmarks of empowerment. 

As regards Dr Boyle's position, it should be said that the UK FGM Act 2003 is clear that many women buy into cutting practices (in all their multifarious forms) - Clause 2 explicitly rules out the threat of DIY cutting as a doctor's defence. The Act protects, "any part of .... labia majora, labia minora or clitoris".

However a loophole has been built into our FGM law. It denies women the right to present a belief in 'custom or ritual' as a reason for tissue excision, but fails to legislate against the equally crazy/misogynistic/unscientific Caucasian view that women should just be a neat little hole.... 

As such it seems to have been designed to protect the Western (and mainly white run) labiaplasty industry, rather than female empowerment per se.

The distinctions in the act raise an interesting challenge for doctors. Imagine that the next patient who visits Dr Boyle to demand labial excision is an educated professional of Egyptian origin, and a member of a family in which each generation has undergone automatic excision to be (as she sees it) beautifully smooth, clean and feminine.
 
Where then for autonomy?