New Zealanders are said to be enthusiastic adopters of new technology and processes related to grooming and there appears to be no exception when it comes to female cosmetic genital surgery.

Female cosmetic genital surgery is an overarching term which can relate to a number of different procedures performed on the female genitalia.The practice is thought to be on the rise in New Zealand based on statistics collected in countries similar to ours; however, substantial local research is yet to be conducted.

According to DermNet NZ, the incidence of vulvoplasty (augmentation or, more frequently, reduction of the external female genitalia) has increased dramatically over the last two decades in high-income Western countries. Statistics released by the Australian Government in 2014 reported a 105% increase in Medicare claims for vulvoplasty and labiaplasty from 2008 to 2013.

Dr Hera Cook, a senior lecturer at University of Otago’s public health department, says research conducted in America indicates early adopters of other grooming practices, such as pubic hair removal, are more likely to have cosmetic genital surgery.

“What we’re finding is that the number of cosmetic surgeries that white women are getting is disproportionate to the percentage of white women in the population as a whole. The research on pubic hair grooming shows that is more popular with more highly educated, higher income, white women and that is what it seems is happening with cosmetic genital surgery – looking at the higher number of white women and the cost.”

While there has been some research into the prevalence and effects of female cosmetic genital surgery conducted in New Zealand, this research has only involved small groups of women and has been conducted by cosmetic surgeons and women’s advocacy groups,  both with a vested interest in the outcomes of their research.

“The problem is really that we’ve either got research by the cosmetic surgeons who clearly have an interest or we’ve got feminists, which may be and often is very good research, but it’s based on the women who are prepared to talk to them.”

Female cosmetic genital surgery is not illegal in New Zealand, though another branch of surgical genital alteration, female genital mutilation or FGM, is. FGM became a crime in 1996, roughly around the same time that women began opting to have cosmetic genital surgeries, and is illegal regardless of the patient’s age and whether she elects to have the procedure herself.

There are several lines between the two subsections of genital alteration, Cook says, the clearest of which is that female genital mutilation is often performed on children, while cosmetic surgery is usually performed on adults.

“The other thing about FGM is it encompasses a very wide spectrum of operations. Sometimes it’s really quite small alterations and sometimes it’s alterations that make it difficult for the women to menstruate, or not possible for her to have a child without having the scarring that resulted from the FGM cut open. When we look at labiaplasties we’re looking at something that would be at the very mild end of female genital circumcision,” she says.

“The problem with FGM is obviously we want to respect other cultures and in our own culture the difficulty is we want to respect women’s choices.

“I think though that where we would see there being a similarity is these operations are being performed because society tells women that their sexuality isn’t acceptable. What we want is a society in which women feel comfortable and can enjoy their sexuality and their bodies and in both cases you’ve got incorrect information given to women about their bodies.”

Cook believes the rise in prevalence of female cosmetic genital surgery represents a rising number of women who see their genitals as an object for other people to look at, rather than a part of their body which they experience sexual responses through.

“We know that this relates to other kinds of body disorders, from anorexia to all the kinds of issues around body dysmorphic disorder,” she says.

“Concern and anxiety about appearance affects cognitive function, it affects women’s academic achievement, it affects women’s confidence – and confidence affects a whole lot of aspects of life.”

Cook would like to see a reduction in the numbers of female cosmetic genital surgeries performed, but says this would require a significant shift in society’s views on female sexuality. While she believes we need to challenge the practice, she does not see any practical need of making these operations illegal.

However, whilst we may challenge or reject the practice of female cosmetic genital surgery, Cook says it is important not to reject the women who have elected to undertake these operations.

“I think really we need to look at is as a structural problem and think about what the solutions are at that level. I certainly don’t think we should be condoning any individuals for their choices,” she says.

“Women are not saying they’re having cosmetic surgery because they want their bodies to look like Kim Kardashian or they want their body to be perfect. They’re saying actually that they have parts of their body that they’re uncomfortable about, that they think there’s something wrong with them and they’re just trying to get their body back to a point where they see their body as normal.”

Dr Hera Cook is a historian of sexuality and sexual practices and is a senior lecturer at the University of Otago, Wellington. Her interest in female cosmetic genital surgery is based on her research area of women’s attitudes and experiences of sexuality, and the causes of radical changes in sexual, emotional and reproductive practices and cultures over the past 200 years.


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