Extreme Makeover: Vagina Edition

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Last fall, a group of activists from New View Campaign staged a protest outside the office of the Manhattan Center for Vaginal Surgery. According to Time Magazine:

Appalled at the popularity of so-called designer vaginas, a grass-roots organization called the New View Campaign staged its first-ever protest on Monday outside New York City’s Manhattan Center for Vaginal Surgery. Two dozen women … handed out index cards and held up orange poster boards with the message “No Two Alike,” while two members of the group donned giant cloth vulva costumes. New View, which was created in 2000 … is trying to fight what it calls “the medicalization of sex,”…Says the group’s leader Leonore Tiefer, a sexologist and psychologist at New York University: “Promoting a very narrow definition of what women’s genitals ought to look like — even for those women who don’t want surgery, it harms them.”

I was unable to find picture of the cloth vulva costumes (and believe me, I tried), but I did find the group’s website with an extensive and thoughtful exposition of their philosophy. I was intrigued by their response to arguments about a woman’s right to choose genital plastic surgery:

The focus of our concern is on the cosmetic surgical procedures and the promotion of these by some doctors. Real choice is important, but choice does not exist in a cultural vacuum. In campaigning against genital cosmetic surgery we are calling for critical attention to the cultural conditions that lead women to choose these operations. We want to encourage debate about what is going on in contemporary western society that could produce a woman’s desire to surgically alter her genitals? We see the scene being set by trends such as the medicalization of women’s sexuality and the way women’s bodies continue to be objectified… [A]ggressive marketing … enlarges the market by normalizing and expanding women’s dissatisfaction with their bodies.

Although individual choice is an important cultural value that we endorse, the ethics of this issue cannot be reduced to ‘an individual’s right to choose.’ This is because the promotion and normalization of these practices has implications for all women. The business opportunity afforded by genital cosmetic surgery rests on creating, inflaming and inflating genital discontent among the wider population of women…

I am very wary of any argument that claims that an issue of choice cannot be reduced to an individual’s right to choose. That is nothing more than excuse to value some people’s choices (like the women of the New View) over the choices of other women with whom they disagree. The members of the New View may not like the fact that women choose genital plastic surgery, but they have no philosophic basis for interfering with that right.

The New View is correct, though, in its assertion that marketing and cultural values profoundly influence a woman’s desire to have genital cosmetic surgery. Here’s the marketing message of the Manhattan Center for Vaginal Surgery:

Labia Reduction & Cosmetic Enhancement: Labiaplasty is a cosmetic genital surgical procedure that will reduce the size or change the shape of the small lips on the outside of the vagina (the labia minora).

Many women are born with large or irregular labia. Others develop this condition after childbirth or with aging. The appearance of the enlarged labia can cause embarrassment with a sexual partner or loss of self esteem. Some women just want to look “prettier” like the women they see in magazines or in films.

They want to look “prettier” like the women they see in magazines or in films? Just what magazines and films offer up-close views of women’s labia?

If anyone is in doubt about the impact of cultural values, consider this scientific paper on the practice of labial elongation among Rwandan women. According to Rwandan female genital modification:

…In Rwanda, the elongation of the labia minora and the use of botanicals to do so is meant to increase male and female pleasure. Women regard these practices as a positive force in their lives… Research was carried out in the northeast of Rwanda over the course of 13 months. Semi-structured interviews were conducted with thirteen informants. Two botanicals applied during stretching sessions were identified as Solanum aculeastrum Dunal and Bidens pilosa L. Both have wide medicinal use and contain demonstrated beneficial bioactive compounds…

While there is extensive natural variation in the appearance of female genitalia, individual cultures have created appearance “norms,” and women within those cultures attempt to modify themselves to achieve these “norms.”

Is genital surgery the inevitable result of cultural values that create “norms” for sexuality and objectification of women’s bodies? Or are groups like the New View over-reacting? Can they really argue that genital cosmetic surgery is qualitatively different from other forms of cosmetic surgery in allowing women to take control of their appearance and enhance their self esteem?

These are difficult ethical questions without easy answers. I just hope there is no reality show in our future entitled Extreme Makeover: Vagina Edition. I’m not willing to rule that unfortunate possibility just yet.