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Cory Silverberg

The Labia Library

By September 27, 2013

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I love libraries. I spent a lot of time in them as a kid. I still remember the feel of the carpet and the smell of the stacks in the library that was ten minutes from where I grew up. As an adult there are few people who help me navigate the world with as much consideration and thought as librarians (my therapist is a close second). So when an email arrived in my inbox the other day advertising the Labia Library, there wasn't much question of me clicking through.

The library in an initiative of Women's Health Victoria, a non-profit based in Australian that is focused on "improving the lives of Victorian women." Which might sound funny if you don't live near a place called Victoria. It's not the kind of library you can visit in real life, and I can't speak to the carpet or the smell, but it's a brilliant response to the increasingly aggressive marketing by a small group of plastic surgeons advertising procedures such as vaginal rejuvenation, labiaplasty, vaginoplasty which fall under the umbrella term female genital cosmetic surgery.

It has an activist bent to it, but like any great library, their focus is on making information accessible. I wanted to know more about it so I asked Jessica Malone, a policy officer with Women's Health Victoria a few questions.

Where did the idea for Labia Library come from?

Women who are seeking genital cosmetic surgery often talk about the desire to be "normal". This made us think about where young women get ideas on what normal genitals actually look like. There seem to be a number of sociocultural factors that promote misconceptions about female genital appearance: 

  1. Pornography: Many porn actors have had labioplasties themselves and porn magazines are often airbrushed to remove visible labia minora and clitoris- the look they want is called a 'single crease'.
  2. Classification guidelines: In Australia, there's also an issue with the application of our classification guidelines. Images of vulvas that appear in unrestricted publications (women's magazines as well as soft core porn) are always airbrushed to remove the labia and clitoris before publication. These are important sources of information about what's normal, particularly for young women.
  3. The prevalence of pubic hair removal among young women means that their vulvas are really exposed and a lot more obvious than if they were covered in hair.

We thought it would be great to show the diversity of female genitals in a way that was informative and factual, so women (and men) could draw their own conclusions about what's normal.

Do you know of data that support the idea that more women are seeking out these kinds of surgeries? I sometimes wonder how much of this discussion is driven by the marketing efforts of few plastic surgeons and the media response to their efforts.

There's definitely evidence that more and more women are seeking genital cosmetic surgeries. In Australia, the number of labioplasties performed under Medicare (our publicly funded health care system) increased 240% between 2000 and 2011. There's no corresponding increase in vulval disease which could explain this increase, and it seems that a lot of women who seek surgery have a perception that their genitals are abnormal.

We're hoping that The Labia Library will inform people before they resort to surgery. Genitals are just like any other part of the body and women's vulvas come in all shapes and sizes. We're hoping that photo gallery section of the The Labia Library will reassure women that genital diversity is completely normal and that it will allay their concerns if they're not sure how real genitals actually look.

 

Does the library take a particular position on what people should and shouldn't do with their bodies in terms of cosmetic surgery?

Everyone has the right to choose what they do with their body and we're not trying to stop them from making the decisions that are right for them.

The Labia Library is part of a bigger project that aims to make sure women who are thinking about female genital cosmetic surgery are properly informed and receive care that is safe and based on evidence. We would like women to be informed about the diversity of female genitals before they pursue surgery.

It's also important that women who are seeking genital cosmetic surgery are informed about the risks, efficacy and complications of surgery. The long-term effects of female genital cosmetic surgery on sexual function aren't known, therefore no information about how these surgeries would impact on childbirth, and the documented risks include scarring, unevenness, permanent colour change, nerve damage and loss of sensation.

In its statement on 'Vaginal 'Rejuvenation' and Cosmetic Vaginal Procedures', the Royal Australian and New Zealand College of Obstetricians and Gynaecologists' 'strongly discourages the performance of any surgical procedure that lacks current peer reviewed scientific evidence other than in the context of an appropriately constructed clinical trial'.

 

The American Congress of Obstetricians and Gynecologists' position on female genital cosmetic surgery notes that 'the safety and efficacy of these procedures have not been documented'.    


What's next for the library?

We understand that in order to challenge unrealistic body norms, we need to raise awareness among individual women but also educate health promotion professionals and policy makers for systemic change to occur, so we're hoping to distribute The Labia Library as a resource to health professionals and beauty therapists, who are often the first port of call for women who are concerned about their genitals.

We're going to be doing further advocacy with the Classification Board in Australia, in an attempt to influence the application of the guidelines in Australia. We're hoping that they will cease applying the guidelines by removing the labia minora and clitoris, or that they will start acknowledging that they're doing this with a statement detailing how images have been altered.

We'd also like to genital diversity covered as a topic in both sexuality education and body image education.

We created The Women and Body Image Gender Impact Assessment as a resource for health promotion professionals and policy makers. The paper discusses the factors that contribute to body image dissatisfaction among women, and the impact on women's health through the life cycle. It also explores the influence of mass media on the concept of the ideal woman and on the sexualisation of women and girls. It contains recommendations about the need for initiatives that are both gender and age sensitive to ensure maximum effectiveness in promoting positive body image within the community. It's one of the most downloaded publications on our website.

And we published an Issues Paper on Women and Genital Cosmetic Surgery.

We engage with women directly through our social media health promotion activities, including  regular campaigns which challenge unrealistic beauty norms. People can check out our Facebook page and follow us on Twitter.

Women's Health Victoria: Visit The Labia Library

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