Taken from the November/December 2012 issue of the Women's Health Activist Newsletter.

Take to the Internet and you’ll find both discussion and debate about these practices. The discussion includes pros and cons of various techniques; reviews of, shall we say, stylists and practitioners in your area; and DIY (do-it-yourself) instructions and tips. The debate often comes down to two questions: is it feminist? And, is it harmful to your health?

Feminists of every era have challenged traditional notions of beauty. The suffragists scandalized their contemporaries by wearing bloomers. Second-wave feminists broke free from the constraints of girdles and binding brassieres and popularized the clean-faced, no-makeup look. Feminists today wear skirts and dresses when they want to, but, with the exception of presidential candidates, we can also wear pants without exciting much public comment. Many of us wear lipstick at times, but we can leave the house without makeup and not risk starting neighborhood rumors.

In recent years, however, feminists have been grappling with a new class of beauty regimens: products and services to change the appearance of women’s genitals. When it comes to these genital beauty regimens, feminist opinions range across a wide spectrum. There are well-developed critiques of how air-brushed pornography has set unrealistic expectations that risk leaving real women, who can’t bring Photoshop into the bedroom, feeling inadequate. There are sincere and passionate descriptions of the sensual pleasure some women take in hairlessness and the light-hearted fun of vajazzling — defined by the Urban Dictionary as “decorating your vagina with sequin"¹ (although what’s being decorated is technically the vulva). As with many debates about feminist behavior, part of it does come down to choice. We don’t just swing from one constrained path to another — from only skirts to only pants. Feminism has opened up a greater range of choices for women, and we embrace that range.

But as the feminist health movement has revealed in case after case, the rhetoric of choice can be co-opted to present harmful and dangerous practices as tools of empowerment. Whether it’s breast implants, contraception, or vaginal beautification, a woman needs full information about the benefits and risks of the options she’s choosing between, including what is not known, so that she can make a real choice about what’s best for her.

This article explores the known and unknown health consequences of a range of products and services that claim to improve the appearance of women’s genitals. To do this, we sorted the practices into three general categories: hair removal, including shaving, waxing, and laser hair removal; scent and color modification, which includes douching, deodorant sprays, bleaching and coloring; and a cosmetic surgery called labiaplasty.

Hair Removal

It is not uncommon today for women to shave their pubic hair. And, in the last few years, additional methods for removing hair have grown in popularity, such as waxing and laser hair removal. Although some doctors have expressed concerns about the risks of shaving and waxing — such as a potential increased likelihood of infection due to the small open wounds that can be caused by hair removal — there isn’t evidence to support this opinion. There’s more reason to question the safety and effectiveness of laser hair removal, however.

Laser hair removal is widely advertised and, like many products and treatments that straddle the medical-cosmetics line, the advertisements over-estimate its benefits and under-estimate its risks. On the website for Laser Cosmetica, for example, laser hair removal is described as a “permanent alternative to waxing, shaving, and electrolysis;"² Capital Laser similarly describes the procedure as “safe, painless, and effective.³ The Food and Drug Administration (FDA), however, warns that laser treatment does not result in permanent hair removal,⁴ and the Mayo Clinic — a respected leader in medical care, research, and education — cautions that the procedure is less effective for people with darker skin and those with light skin and light hair because the laser technology works by differentiating the color of the hair from the skin.⁵

You won’t learn that from the ads! Laser Cosmetica also claims that “there are no long term health hazards” – but the fact is there are no long-term health studies.⁶ Some women find that the treatment causes short-term redness on their skin, or longer-term problems like discoloration and scarring.⁷ The claim that the treatment is painless is also misleading, which is why the FDA has specifically ruled that manufacturers cannot make this claim.⁸ The Mayo Clinic also warns that laser hair removal can cause blistering and swelling.⁹ Finally, in 2009, the FDA issued a warning about potentially serious and life-threatening side effects from misuse of the numbing agents used in laser hair removal procedures.¹⁰

Scent & Color Modification

The products and practices in this category are intended to improve the scent and color of your vagina. Although this topic certainly raises worthwhile questions about whether and why the scent and color of your vagina need improving, it also raises questions about the health effects of the products that claim to do it. Unfortunately, because the FDA doesn’t regulate cosmetics the way it does drugs and devices, women can’t always get answers to these questions and may not be clearly warned about these products’ potential health risks.

If you weren’t already familiar with vaginal “cleansing” products like deodorant sprays and douches, Stephen Colbert may have brought them to your attention with his parody critiquing the sexism inherent in last year’s outrageous Summer’s Eve commercials. Colbert complained about how marketing that focuses only on women, “telling them that their bodies aren’t good enough the way they are,” shortchanges men and asked why men aren’t “encouraged to purchase products to make [their] groins acceptable in polite company.”¹¹

While Colbert addressed the racism of the controversial ads for the vaginal cleansing products, he didn’t provide a health-based challenge to the company’s claim that “these are products that every v[agina] needs.”¹² The American College of Obstetricians and Gynecologists (ACOG) and U.S. Department of Health and Human Services (HHS) Office of Women’s Health, have, however. These respected health authorities advise women to avoid deodorant sprays and douching completely, because these products can cause urinary tract infections (UTIs).¹³ HHS also warns that douching can cause vaginosis (a bacterial infection) and pelvic inflammatory disease (PID), which can lead to infertility, and notes that “women douche because they mistakenly believe it gives many benefits.”¹⁴ These warnings send a clear message that, from a health perspective, the risks associated with use of these products outweigh any benefits.

But, according to the cosmetics industry, it’s not just the smell of your genitals you need to change — it’s the color too. Fortunately, they can help you with bleaches and temporary dyes. Creams like Bleach Babe promise to get rid of the natural coloration of the skin around the vagina,¹⁵ while products like My New Pink Button promise to “restore the youthful pink color back to your labia.”¹⁶ My New Pink Button is a temporary vaginal dye that comes in four shades of pink and is applied to the inner labia using an applicator like one you use to apply eye shadow. While the company’s website doesn’t make it clear exactly how the product works (and they didn’t respond to our queries), it does imply that using My New Pink Button will improve your sex life, claiming “it will bring out that sexy, hot pink I am fired up look,” “it will bring out the animal in you,”¹⁷ and “tonight it’s show time.”¹⁸

Many of the advertisements for changing the color of your genitals also carry an overt racial message that lighter skin is more attractive, which could be the subject of an entire article by itself. And no matter what your skin color, you might agree with blogger Heidi Ferrer, who questions the benefit of having a vagina that is painted “Barbie dream house” pink.¹⁹ Read enough of these ads and you’re likely to be left with the sense that somehow the vagina you were born with isn’t quite right. What you won’t get is any reliable information about whether these bleaches or temporary dyes work the way the manufacturers claim they do and whether they pose any risk to your health.

Cosmetic Surgery

Lastly, we come to surgical ways you can “greatly enhance the cosmetic appearance of the outer vagina.” We don’t have space here to address all of the many elective vaginal surgeries available today,²⁰  so we are focusing on the specific type of surgery, labiaplasty, which is promoted primarily for its ability to change the appearance of your genitals. Labiaplasty is surgery that removes part of the labia to reduce its size or change its shape.

As with many cosmetic procedures, advertisements promoting labiaplasty overstate the benefits and understate the risks. The Cosmetic Surgery Center of Maryland, for example, claims that having large labia can cause “distancing in relationships” and that having a labiaplasty “boosts self confidence.”²¹ The Manhattan Center for Vaginal Surgery’s ads promoting labiaplasty claim it will make you feel “prettier” and give you “greater confidence and self esteem.²²  But, you won’t be surprised to learn, the surgeons can only back up those claims with anecdotal testimony from satisfied patients, because there’s no actual research that supports them.

Promotional materials for labiaplasty also fail to acknowledge how little is known about possible risks. For instance, there are no data on how having a labiaplasty might affect a woman’s ability to have a vaginal birth. Nonetheless, in an FAQ on the Manhattan Center for Vaginal Surgery’s website, the response to a question about whether a woman can have a labiaplasty if she hasn’t already had children reads: “Yes. Whether you have had children or not is not the issue.”²³

The Women’s Health Activist has covered this issue before (“Made-to-Order Vaginas,” July/August 2007), describing the labiaplasty procedure and the lack of evidence supporting its safety. The Network is not alone in raising these concerns. The New View Campaign, www.newviewcampaign.org, led the way in raising the alarm and organized protests as early as 2008 to demand that medical professionals and government regulators ensure that women considering this surgery are given full information about possible risks.²⁴

It’s not just activists who are concerned about labiaplasty. Today, medical professional associations like ACOG agree that “women should be warned about the lack of data supporting the efficacy of these procedures and their potential complications, including infection, altered sensation, dyspareunia [painful sexual intercourse], adhesions, and scarring.”²⁵ In addition to the lack of evidence about the health effects of labiaplasty, as New View points out, there is a lack of training, oversight, and accountability for doctors performing labiaplasty procedures. Women know that medical training takes years and years of hard work, and few realize that most surgeons performing labiaplasty don’t go through any additional training to do these surgeries. Even fewer are aware that there’s no medical authority monitoring the safety of the practice and no data on the safety of the procedures in the first place.

Conclusion

Andy Wright, a San Francisco-based blogger, framed her critique of the beauty industry’s products for vaginas by pointing out, tongue in cheek, that if you think there’s nothing wrong with your vagina, “you’re probably wrong.”²⁶ But she quickly reassures readers, “Don’t worry — there’s nothing that money can’t fix.” In this consumer culture, why should our vaginas be different from any other aspect of our lives?  But whether you think a little vajazzle will add sparkle to your life or not — and whether you want to spend money changing the look, smell or color of your genitals — you should have a reliable source of information about the health consequences of these practices and products. And today, that just isn’t available for many of the products the ads encourage us to use.

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Amy Allina is the NWHN Program & Policy Director.

Kate Ryan is the NWHN Senior Program Coordinator.

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