BJOG Release: Expectations And Experience Of Labial Reduction

Main Category: Women's Health / Gynecology
Also Included In: Pregnancy / Obstetrics
Article Date: 13 Dec 2007 - 5:00 PDT

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New research published inBJOG: An International Journal of Obstetrics and Gynaecology has found that women seeking labial reduction opt for the procedure because they feel stigmatised by social norms about how they should look and may have unrealistic expectations of the surgery.

The incidence of labial reduction in the NHS has doubled in recent years and the study, from the University of Liverpool, looked at why women underwent the surgery, what they hoped to get out of the operation and their experiences afterwards.

The study took place in an NHS hospital setting and identified women who had undergone labia reduction surgery over a two year period, 17 women were invited to take part and six accepted.

The study found that the main reason the women requested surgery was because they viewed their pre-surgery appearance as 'defective' and sought a 'normal' genital look. The women tended to base their view of 'normal' on social norms projected in the media that female genitalia should be 'invisible', with no protruding labia, and they requested the operation because they found their situation stigmatising.

Clinicians may have a very different view of normality, based on healthiness and incorporating the natural variations that occur among women. However, the study highlighted that health professionals are delivering mixed messages about what is 'normal'. The women's perception of being 'abnormal' were inadvertently reinforced by being given reassurance of normality, alongside referral to a specialist for further investigation or surgical intervention.

Another common theme was that the women felt their appearance impacted negatively on their sex lives and relationships. Those in the group that were sexually active found that their dislike of the way they looked created anxiety about having sex with their partner or starting a new relationship. By having the operation the women expected to see an improvement in their sex lives and, for some, there was also the hope that it would improve or save a relationship.

Although the operation did have the effect of making the women less self-conscious, expectations of improved sex-life and relationships were not met for all women.

Dr Ros Bramwell, of the Liverpool University research team, said "I think a key issue here is what is meant by 'normal'. Health professionals may understand 'normal' as meaning healthy or within the average range. But knowing that there are other women who look like you do doesn't help if you still feel that the way you look is somehow abnormal and wrong."

"The problem is that clinical time is usually limited and we are dealing here with what are probably long-held attitudes and issues of self-esteem which are quite difficult to change. Further research is needed into potential psycho-educational interventions to help change women's perception of their need for surgery."

Professor Philip Steer, BJOG editor-in-chief, said "There is an growing demand for labia reduction and it is increasingly important for clinicians to understand the reasons why women believe they need this surgery. Often these reasons go beyond the realm of the gynaecologist to wider social and cultural norms reflected in the popular media."

"Thus the suggestion that improved communication about 'normal' genital appearance should begin at an earlier stage has merit as does the proposal that psychosocial elements be introduced to the referral process - both certainly warrant further investigation."

Notes

BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal.

Reference

Bramwell R, Morland C, Garden A. Expectations and experience of labial reduction: a qualitative study. BJOG 2007; 114:1493-1499.

Royal College of Obstetricians and Gynaecologists