In this article, originally published by The Sydney Morning Herald, I discuss how publicly funded genital surgery was just “the tip of the iceberg”.
Women are being “upsold” invasive genital surgeries by unscrupulous cosmetic clinics that do not properly inform them about the risks, or whether the surgery is even necessary, health experts say.
While data shows public health authorities have managed to lower rates of publicly funded labiaplasty, which involves cutting away parts of the labia minora, the private sector is still a “wild west”, according to clinicians working in the area.
The Royal College of General Practitioners in July released a new guide for doctors on treating patients who request genital surgery, including recommending that they be directed to images of female genitalia that have not been digitally altered, such as the online database The Labia Library (note: link contains images of labia).
It also warns purely cosmetic female genital surgery could actually fit the legal criteria for female genital mutilation, a religious and cultural practice among some groups that is banned across Australia.
Medicare data shows a 28 per cent decline in the number of subsidised labiaplasties in the past financial year, after new rules were put in place to ensure women were not undergoing the procedure unnecessarily.
Women who apply to have publicly funded labiaplasty must now provide an expert review panel with photographs of their genitalia, so they can be assessed for unusual physical symptoms that need repair, or told that they fall within the range of normal variation.
Magdalena Simonis, who wrote the college guidelines, said publicly funded genital surgery was just “the tip of the iceberg”.
“Private cosmetic surgeons don’t need to list their data and they don’t,” she said. “There are some plastic surgeons who say they see 100 patients a year, but then there are big cosmetic franchises who say they are doing thousands.”
While plastic surgeons must undergo years of training to qualify, cosmetic procures are less regulated and may be done by practitioners with varying levels of training and expertise.
Dr Simonis said it was questionable whether all women undergoing genital surgery were actually being given the information about the range of appearances that were normal, and the risks of surgery, which they needed to give informed consent.
“If she doesn’t get that information from her doctor, she’s going to get it from the internet.”
Some of the clinicians that are performing these surgeries are not acting in the best interests of patients
Dr Magdalena Simonis
In some cases, women were being pressured into more extensive surgery to the clitoral hood because doctors had removed so much of their labia that they needed to “balance” out the other areas.
“Some of the clinicians that are performing these surgeries are not acting in the best interests of patients,” she said.
Frances D’Arcy-Tehan, a counselling psychologist and clinical sexologist who is completing a PhD at the University of Sydney on genital perceptions and surgery among Australian women, said it was strange that female genital mutilation was banned, but genital cutting was OK for “Susie from North Sydney”.
“I don’t think women here are really getting the full story,” she said. “This [surgery] is still for cultural reasons, but it’s just for an ideal image [rather than religion].”
She said many patients were not warned that cutting their labia could reduce sexual functioning.
“The labia minora is a highly erotic and sensitive tissue and it’s important for arousal,” she said. “It’s normal to have protrusion and when you are aroused, it actually gets engorged”.
Ms D’Arcy-Tehan said the surgery industry was a “wild west” and there were anecdotal reports of women seeking repairs for botched treatment.
She said women might seek the surgery so they could participate in transient fashion trends for tight clothes or small bikinis, because they had removed their pubic hair and were uncomfortable with the sight of their labia, or because they or their partner had only seen highly stylised labia depicted in pornography.
“One study found about 30 per cent of women who had labiaplasty were teased by their boyfriend about the appearance of their labia,” she said.
Originally published: www.smh.com.au/healthcare/labiaplasty-like-female-genital-mutilation-doctors-not-upselling-to-more-invasive-surgery-and-not-informing-patients-of-what-is-normal-20150828-gjacjt.html
photo credit:LOUIE DOUVIS
Magdalena is the President of the AFMW (2020-) and former President of VMWS (2013 & 2017-2020).
Magdalena’s deep engagements with the RACGP over many years includes chair of Women in General Practice, is currently on the RACGP Expert Committee Quality Care, prior to that on RACGP eHealth Expert Committee. She is a regular media spokesperson on numerous health issues, being interviewed most weeks by mainstream and medical media. Magdalena has represented the RACGP at senate enquiries and has worked on several National Health Framework reviews.
Both an RACGP examiner and University examiner she supervises medical students and undertakes general practice research. Roles outside of RACGP include the Strategy and Policy Committee for Breast Cancer Network Australia, Board Director of Women’s Health Victoria and Chair of their Strategy and Policy subcommittee and the AMA Victoria GP Network Committee.
Magdalena has presented at the United Nations as part of the Australian Assembly and was recently appointed the Australian representative to the World Health Organisation, World Assembly on COVID 19, by the Medical Women’s International Association (MWIA).