Australian GPs are receiving genital cosmetic surgery requests from girls as young as 15

A world-first survey exploring GP experiences of cosmetic female genital surgery reveals girls as young as 15 are requesting and undergoing labiaplasties and other procedures in Australia.

Of 443 GPs who took part in the study, more than a third said they had received requests for labiaplasty – the removal of tissue from the labia minora – from girls under 18, mostly due to concerns about its size, appearance and/or visibility.

Lead author Dr Magdalena Simonis, from the University of Melbourne’s Department of General Practice, says the results are concerning.

“The fact that surgery rates for 15-24 year olds are the same for 25-45 year olds is especially worrying, because female genitalia don’t reach maturity until around age 18,” says Dr Simonis.

“There’s an epidemic of anxiety about normality.”

The study also found that at least half of all requests came from girls and women whom GPs considered emotionally vulnerable – suffering from anxiety, depression, relationship difficulties, or body dysmorphic disorder.

According to figures from Medicare, the number of women who accessed Medicare benefits for vulvoplasty or labiaplasty in Australia increased from 640 in 2001 to more than 1500 in 2013 – an increase of 140%. This number does not include surgeries accessed via the private sector, which is not required to publish data.

There was no concomitant rise in the incidence of congenital or acquired disease conditions to warrant the increase in surgeries, Dr Simonis points out.

Reasons for surgery requests as cited by GPs included: fashion (comfort in clothes); perception of beauty; pornography; perception of normality; Brazilian hair removal, which exposes previously hidden genital tissue; spouse/partner comments; physical discomfort; media and websites; and peer pressure.

Other Australian studies have found that media and peer influence can predict attitudes towards cosmetic surgery, while education regarding digital alteration of women’s genitals in media images can positively impact people’s perception of ‘normality’.

Dr Simonis argues the cosmetic surgery industry is exploitative of women’s ignorance of their own bodies.

“The industry is brilliant at using social media to convince women and girls that they have ‘redundant’ or ‘excess’ tissue, when in fact we know that the labia are rich with nerve fibres,” she says.

“Surgery to ‘trim’ the labia can affect sexual response, because the clitoris is not just a ‘pea’ as described in textbooks, but is a larger organ, most of it not visible to the eye.”

As of the 1 October this year, the Medical Board of Australia has begun advising that girls under 18 who are requesting the surgery should receive mandatory counselling and a three-month cooling-off period.

See the study results published last week in BMJ Open here.