Thursday, 20 December 2012

FGM and Labiaplasty: What’s the Difference?

Over the past four months, I have been working alongside a couple of UK organisations that aim to research and campaign against Female Genital Mutilation (FGM). Recently, a friend who is training to be a midwife sent me an article on labiaplasty and FGM, written by a practicing midwife in the UK. This gist of this article was that women such as myself campaign against FGM from a poor standpoint, as we come from a society in which labiaplasty is becoming increasingly common; this therefore (apparently) makes us hypocrites.
For those who are not aware, labiaplasty—also known as ‘designer vagina surgery’—involves surgically ‘perfecting’ labia minora and majora. It is the latest, in an ever growing list, of cosmetic procedures chosen by women who want to enhance their image. While some women may seek this as a result of large labia (which can make sex painful), others do so because of the growing pressure to meet society’s expectations of what constitutes an attractive female form.

According to some doctors and midwives, there is little difference between FGM and labiaplasty. Those same individuals feel that Western societies should remove the plank of wood from their own eyes, before attempting to remove the speck from others. I have to strongly disagree with this. 

First of all, I will examine the pressures exerted on those who have undergone FGM and labiaplasty. To an extent, there are similarities. I have come across stories of FGM victims who were told their clitoris would grow extensively should they not have it removed, that men would not want to marry them, and that they could not fulfil their duties as a woman. Similarly, some women who undergo labiaplasty do so due to the images of perfection imposed by the pornographic material industry; these images of women with perfect labia suggest that is ‘normal’. However, that is where my agreement ends.

Any woman (at least in the UK), who seeks labiaplasty will be fully informed of what she is electing to do. Under British law, surgeons are duty bound to inform their clients of the risks involved. These women will then have their labia adjusted in a clean, surgical environment. Similarly, the element of consent involved is different. In the UK, consent by coercion is not consent at all. A person who consents to a medical procedure must have done so as a result of their own motivations. This consent in the absence of coercion is closely related to autonomy. Suggesting that a woman who chooses labiaplasty has not done so as a result of her own autonomous decision making process is patronising.

In contrast, a woman who undergoes FGM will be told that it is necessary for a host of reasons that are untrue. She will not be informed of the risks associated, which include an increased chance of dying as a result of pregnancy or childbirth, painful menstruation, infection, and an increased risk of AIDS. FGM is usually performed in unsanitary conditions, with no pain relief, no medical assistance, and as a result is dangerous and frightening. As FGM is often performed on young girls who are not capable of understanding these risks, it cannot be argued that they are fully informed—that is assuming there are informed of any risks, at all. These girls will be coerced by their parents, and other members of their communities. They don’t seek FGM, they are forced into it. Their autonomy is not used, it is taken away from them. 

Attempting to draw parallels between FGM and labiaplasty is not only ridiculous, it is thoroughly unhelpful. Each person who does this arms the individuals who campaign to maintain the practice of FGM with ammo, which they will then use against us. Meanwhile, the real issues surrounding FGM campaigns will be ignored; these issues are that young girls are being subjected to a procedure that is inherently violent, in conditions that are unsafe, without their full consent. Until we stop trying to draw such petty comparisons, the real issues will be overlooked, and women worldwide will continue to suffer.

So to those who would like to argue that we cannot campaign against FGM while labiaplasty is practiced in Western society, yes we can. I am by no means an individual who would undergo unnecessary cosmetic surgery, but if others do, then so be it. Tarring myself and my fellow campaigners with the same brush as those 

who inflict FGM will not help anyone.

Laura Mc Keever


  1. Thank you for this incisive argument. It is really incredible that anyone would equate the two, just because the same body parts are involved. Iam particularly shocked that it the comparison is coming from trained professionals. The issue of consent and the reasons for performing FGM and labioplasty cannot be compared.

  2. What you need to understand is that some women believe that FGM is more aesthetic, the same as someone who undergoes labioplasty without medical indiciation. When you explain to a Somali woman that she is not allowed to cut off her labia, despite the fact that she thinks it is more attractive, because it doesn't represent what we see as attractive hut her white neighbour can cut hers off because she has the right and ability to consent, it becomes a little hard to justify without sounding like a bigoted cunt who is dismissive to the cultural beliefs of others. Also, many people from the Middle East who are in support of FGM have their surgery done in hospital in sterile conditions. Admittedly they usually have Type 1 or Type 2 FGM, but still, it's very hard to use the whole argument about hygiene and medical expertise. This is why we need a blanket rule. This is why we don't offer Jews and Muslims routine elective male circumcision on the NHS. It's bad for everyone and a blanket ruling must be made. Not one that is biased against cultures different to our own.

    As someone who has worked in the maternity sector, we are advised to tell women that genital piercing comes under Type 4 FGM. In this country nearly any cosmetic, unnecessary surgery or modification to the female genitalia is covered by the ban on FGM. A good rule of thumb is that if an NHS doctor hasn't referred you for this surgery, it is more than likely cosmetic and only being performed for aesthetic reasons. This is FGM.

  3. It never ceases to amaze me, the amount of ignorance that some people have. The definition of Female Genital Mutilation defined by the World Health Organization is "Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons." Last time I checked "looking prettier" wasn't a necessary medical reason which means that Labiaplasty is a form of FGM because not only does it intentionally alter the female genital organ but it does it for non-medical reasons. Besides the definition that everyone references does not say that consent is part of it at all or where it is done. It just says any alteration. Funny isn't it because Labiaplasty falls into that definition quite well as well as other female genital cosmetic procedures or piercings. I find it hard to believe there is a huge difference. In fact later on the WHO actually defines the four different types of FGM procedures,
    ProceduresFemale genital mutilation is classified into four major types.

    * Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris) *(So clitoral head removal? Sound familiar is also done all the time)*.
    * Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora *(Hmmm, so this is like Labiaplasty which is also done on a frequent basis in order to increase sexual pleasure? Also totally legal)* (the labia are "the lips" that surround the vagina).
    * Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
    * Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing *(Piercing is done every year in the US. In fact the tattoo parlor who did my tattoo actually had genital piercings)*, incising, scraping and cauterizing the genital area.

    *My additional comments.*

    FGM and Labiaplasty aren't that different especially according to the WHO because they both fall under the rather vague definition that has nothing to with where the procedure is held or the consent by the person that it is being done to. It just says that it is an unnecessary procedure that intentionally alters the female genital area and both surgeries do that. Labiaplasty is FGM only with a much prettier name.