Teenage Girls Do Not Need Genital Cosmetic Surgery

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Vaginas come in all shapes and sizes, and there’s a wide range of what’s considered “normal.”

This is the message that the American College of Obstetricians and Gynecologists’ (ACOG) Committee on Adolescent Healthcare wants to send to teenage girls, so it recently issued a press release offering guidance to doctors on how to talk to young patients about the appearance of their genitalia.

Parents — and teens themselves — might want to listen up, too.

During puberty, girls’ bodies develop — and that includes labia growing to adult size. This drastic change can be a shock to a teenage girl’s self-image. And with the proliferation of waxing and shaving, it’s much easier for girls to see — and criticize — what’s between their legs. 

To make matters worse, our culture’s instant accessibility to online porn may be be presenting a distorted and unrealistic standard of comparison. Adult film stars are paid to have so-called “picture-perfect” vaginas — an idea that may be hard for the average teenage girl to grasp.

“Adolescent years are normally a turbulent time when girls are searching for their identities,” says psychiatrist Gail Saltz, Ph.D.. “It’s a vulnerable period with a potential for great insecurity.“ Saltz adds that teen boys, who are also exposed to pornography, might react negatively when they see an actual vulva — leading a girl who’s just becoming sexually active to question her worthiness.

Last year, about 400 teens had labiaplasty, the cosmetic surgery to “fix” the appearance of their genitals by trimming and shaping the outer labia. According to the American Society for Aesthetic Plastic Surgery, that’s about an 80 percent increase from the year before, when 222 girls went under the knife, reported the New York Times.

Dove’s recent body-image campaign, Legacy, points out that mothers play an important role in reinforcing a positive sense of self. “A girl’s beauty confidence starts with you,” the campaign states, reminding moms to set a good precedent and teach their daughters to think positively about the bodies they were born into. This includes embracing the vaginal variations that teens may perceive as imperfections. 

Much research has supported the assertion that moms have a deep-rooted influence on the way their daughters feel about their own bodies — and that the seeds of dissatisfaction are planted even before puberty. “A lot of grown women are equally insecure about their bodies,” says Saltz. “So if you have a mother daughter dyad operating in a vacuum of lack of knowledge and reasonable expectation, things could get dangerous.” Ultimately, she says it should be a gynecologist’s or pediatrician’s call as to whether surgery is necessary — and it rarely is.

But it’s not just vanity that’s leading teenage girls to seek genital reconstruction. Some teens have legitimate discomfort, says ACOG. Irritation caused by tightly-fitting clothes like skinny jeans, exercise, menstruation, and even sex have been reported by patients. But that still doesn’t mean surgery is the go-to solution. In fact, it should be a last resort.

ACOG suggests that girls learn to reposition their outer labia before exercise and even use emollients before getting dressed to reduce friction. In extreme cases, labia compression garments can provide extra support. Many compression briefs are lightweight and breathable — far more comfortable than, say, shape wear. All of these options should be given a chance before any kind of cosmetic procedure is considered for discomfort.

It’s important to note that, according to ACOG, genital cosmetic surgery is a major procedure that comes with the chance of serious side effects, such as pain, scarring, painful sex (dyspareunia), hematoma, edema, and infection. 

So before deciding to change yourself — or if you’re a mom, allowing your adolescent daughter to correct her “imperfections” surgically — consider the consequences of such a life-changing operation, and whether it might be better to work on embracing your uniquely beautiful body as is.

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