Made-to-Order Vaginas
July/August 2007
By Alicia Bell
“A sexy surgery that can make you like a virgin…women all over the world are discovering a new fountain of youth.”1 This is how “vaginoplasty”, a surgical procedure that involves cutting or burning the vaginal wall, is being described in the media. Gynecologists offering the procedure promote the idea that women can get a “designer vagina” by undergoing “vaginal rejuvenation.”
These doctors are telling women that the surgery can make sex more pleasurable for them, though there’s no science or data to back that up. In an Internet YouTube video, one gynecologist claims: “We can enhance sexual gratification because what we are doing is enhancing the muscles of the upper and lower parts of the vagina. We’re decreasing the internal diameter [of the vaginal canal].” This doctor states that vaginoplasty is for women who have experienced “vaginal relaxation as a result of childbirth.”2 He continues, “Our whole mission is to empower women with knowledge, choice, and alternatives.”2 Another doctor says, describing women who undergo this surgery, “Even though nobody sees it, they wear it on their face and they walk down the street self-assured. They feel good about themselves.”1
In a TV interview, one doctor asserted that vaginal rejuvenation will “stimulate your love life” by “restoring, recreating, rebuilding the entire vaginal wall, the vagina itself.” He indicated that women who have the procedure will experience a rejuvenated sex life, commenting that “If at age 20, pre-childbirth, they’ve reached certain levels of sexual excitement, that will come back again.”1 Another doctor solemnly counsels in his YouTube video, “the reality of the matter is this—cosmetic surgery may make you look good. However, laser vaginal rejuvenation will make you feel good. One without the other is like the cake without the icing.”2
Despite this language of sexual and emotional empowerment, the assertion that vaginoplasty leads to a better sex life is completely unproven. No studies on the procedure’s use to enhance sexual pleasure appear in the medical literature and there is no evidence that the procedure is effective for enhancing female sexual pleasure. No bona fide medical journals or societies even discuss vaginoplasty as a way to enhance sexual pleasure. (Medical literature, in fact, uses the term “vaginoplasty” only to describe the creation of a vagina in women born without one and for male-to-female sex reassignment surgery.)3,4
The underlying logic for doing this surgery is the assumption that vaginal diameter is a determining factor in women’s sexual pleasure. But there is no evidence either that vaginoplasty increases sensation or that vaginal tightness is proportional to sexual pleasure; this is a myth that stems from associating enhanced sexual pleasure with virginity and youthfulness. In fact, the surgery traumatizes the vaginal walls and any scarring that results can decrease sensitivity to sexual stimulation: not exactly a recipe for better sex. These doctors are playing on the cultural biases that already undermine women’s confidence in sexuality as they age to encourage them to undergo an expensive, risky surgical procedure. (Cosmetic vaginoplasty costs about $6,500 and is not covered by health insurance.)5,6
Promoting surgery as a solution to bad sex or poor self-image is dangerous and perpetuates myths about women’s psychosocial health and sexuality. Feminist sexologists have pointed out that: “there are no magic bullets for the socio-cultural, political, psychological, social or relational bases of women's sexual problems.”7 Even sex therapists who promote medical solutions to women’s sexual concerns have been critical of this procedure, pointing out the serious risks that it will make an existing problem worse or create a problem where none existed.8
Why have professional medical associations not stepped up to tell women that there is no evidence to support vaginoplasty for enhanced sexual pleasure? Why are they not chastising doctors who promote and perform this pointless surgery? In response to these questions, Anthony Scialli, MD, Professor of Obstetrics and Gynecology at Georgetown University School of Medicine, said: “ACOG [the American College of Obstetricians and Gynecologists] represents gynecologists, not women.”
Some doctors pushing vaginoplasty admit that it is not for every woman. But without evidence of sexual benefit this surgery should not be performed for any woman. Women with concerns about sexual satisfaction need support and guidance from health care providers who will help them consider the full range of factors that may be affecting their sexual experiences and offer solutions that are responsive to their needs. Vaginoplasty should not be an option since it has potential harm and no evidence of benefit.
Alicia Bell, MS, is the Project Manager of PharmedOut at Georgetown University School of Medicine’s Dept. of Psychology and Biophysics.
REFERENCES
1. ABC Action News WFTS TV. “Like a Virgin”. November 6, 2006. Available at http://cosmeticsurgery2.com/cs2-stern.htm. Accessed July 26, 2007.
2. YouTube. Dr. Matlock Promo. Added to YouTube June 7, 2007. Available at http://www.youtube.com/watch?v=H0kEe7bE7uI&eurl. Accessed July 25, 2007.
3. Selvaggi G, Ceulemans P, De Cuypere G, et. al. Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals. Plastic & Reconstructive Surgery. 116(6):135e-145e, 2005 Nov.
4. Fedele L, Bianchi S, Berlanda N, et. al. Neovaginal mucosa after Vecchietti's laparoscopic operation for Rokitansky syndrome: structural and ultrastructural study. American Journal of Obstetrics & Gynecology. 195(1):56-61, 2006 Jul.
5. No author. “Pricing” on Labiaplasty Surgery.com. Available at http://www.labiaplastysurgeon.com/dr-stern.html. Accessed on July 24, 2007.
6. Navarro M. The Most Private of Makeovers. New York Times. November 28, 2004. Available at http://www.nytimes.com/2004/11/28/fashion/28PLAS.html?pagewanted=1&ei=50.... Accessed on July 25, 2007.
7. The Working Group on a New View of Women's Sexual Problems. The New View Manifesto. Introduction: beyond the medical model of sexuality. Available at http://www.fsd-alert.org/manifesto1.asp. Accessed on July 30, 2007.
8. Sandra G. Boodman, “Cosmetic Surgery’s New Frontier: Procedures Popularized In L.A.'s 90210 Come to D.C.'s 20037”, The Washington Post, March 6 2007, page HE01.
