Never on the NHS, and never ever on the young

The motion; Labiaplasty is a form of genital mutilation and should be banned was carried, just, by an audience of  trainee gynaecologists in Nottingham last week (click here). Phew! There is an epidemic of this sort of surgery (figure) and it’s time it ended.

For every NHS operation, there are dozens of private ones.  A recent study (click here) confirmed what any experienced gynaecologist knows; a mix of sexual and psychological insecurity, typically provoked by mother or boyfriend saying “that’s not right” underlie most requests. Folk memories that other ethnic groups have large labia, that enlargement is a sign of excessive masturbation, or desires for a pre-pubertal state remain unspoken, leaving claims of physical discomfort to justify surgery. Demand bears little relation to anatomical variation (see for example the Great Wall of Vagina here).  Poorly documented claims by surgeons fill the scientific literature, while patient tales of cures, botched operations, and ongoing distress fill the internet.

Despite my debate victory, I doubt a ban is justified. We should protect children and the vulnerable from irreversible surgery, but adults do all sorts of things to their bodies in the name of sex. Good luck to them. It’s just not something for the NHS. Two recent reports agree.  The Royal College of Obstetricians and Gynaecologists (RCOG click here) said in October 2013:

“[…] providing labiaplasty for cosmetic reasons alone is not a proper use of public resources and should not
be provided by the NHS.”

and the Society for Paediatric and Adolescent Gynaecology (SPAG click here) said:

“Labiaplasty does not tackle the cultural and economic factors that are giving rise to vulval appearance distress. There is no scientific evidence to support the practice […]” and “[…] labiaplasty should not be performed on girls under the age of 18 years.”

Well said.

Jim Thornton