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Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

Labiaplasty in Australia

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2.  Tuesday 7th

Labiaplasty: factors leading to increased requests among women from a survey of GP experience.

Magdalena Simonis

This talk was really very sad in many respects.  In my own practice I have experience of young women (as young as 15yrs) wanting to have their labia modified, often without ever seeing other labia to know how normal they are.  With the adolescent body changing so dramatically at 15 it isn’t hard to understand the horror some young women must feel when they notice the changes to their genitals-  looks, skin, hair, discharge etc. Luckily these concerns can be addressed and reduce the health anxieties of the client with correct information.  Unfortunately, many young women in our society are not given any information about this – and certainly in my practice many women have no idea that they need a vaginal discharge every day for example.

Some of the concerns raised included the lack of knowledge of how these surgeries when done are going to affect the women as she ages – with atrophying of the labia during menopause.  There is now knowledge however on how it may cause considerable distress and discomfort if the surgery is not performed correctly or if there is some complication – bleeding, infection and pain etc. 

Some of the long-term effects may be hypersensitivity – especially if the clitoral hood is shortened to expose the clitoral bud. When even the wearing of clothes may be painful. There may be decreased sexual sensitivity if the edges of the labia minora are removed (there is a technique where the body of the labia is ‘wedge-resected” to avoid the more sensitive edges of the labia.) 

This procedure is the 4th most common cosmetic surgery after the nose, liposuction and breast augmentation in Australia, the surgeon does not have to be a registered cosmetic surgeon and the client over 18 years does not have to have counseling or a cooling off period.  Women under the age of 18 have to have a 3-week cooling off period just in case they change their mind.

I have heard some arguments that this surgery is no different than having other parts of the body being modified  - the women's reasons for having their labia reduced is because of the physical look (aesthetics) or a functional concern but this talk that gave examples of the research around the psycosexual distress, relationship concerns and sexual assault that women have experienced when counselled. 

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