Source: Reproductive Health Matters
They are being advertised in women’s and youth magazines, via e-mail and on the web. They range from penis enlargement to hymen repair, vaginal tightening, and labia and clitoral “trimming” (termed “labiaplasty” and “genitoplasty”). This is in a context of other forms of cosmetic surgery already long being used by large numbers of people, including breast enlargement (and reduction), face lifts, tattooing, plumper lips, and liposuction to remove body fat. People may have only a vague notion of any health risks from some of these procedures, which may be downplayed.
The Department of Health in Britain has a page on their website about genitoplasty, which treats it as legitimate. A recent article by several psychologists (Liao and Creighton, BMJ 2007;334:1090-92) reported that young women’s fears about whether their bodies were sexually desirable were the reason they sought genitoplasty. The article describes an advertisement in a women’s magazine with a silhouette of a woman with no visible labia. Letters from several male physicians in response to a letter I wrote to the BMJ condemning it as a new form of FGM disagreed that it was comparable; colleagues at WHO also said it was “tricky” as there is consent. An RHM board member called this the age of “body-changing”. US historian Joan Brumberg called it “the body project” in a 1998 book of that title.
Not all forms of body-changing surgery are simply cosmetic, e.g. following disfiguring illness, such as breast reconstruction after mastectomy, or filling in hollow cheeks caused by AIDS. People can now change their sex surgically as well, making this is a complex subject. This journal issue asks:
* Whether and when is body-changing surgery on sexual and reproductive body parts legitimate – and is it sometimes a form of self-harm? What distinguishes it as such one way or the other?
* What is driving so many women and men, especially young people, to seek these procedures for so-called cosmetic reasons? Is it fashion? Body art? Is this OK, no problem, or what?
* Have feminist perspectives about bodily autonomy and body image − accepting our bodies as they are, without seeking or expecting “perfection” − been a failure from this point of view? Are partner expectations driving some of this? What are the gender and sexuality-related issues?
* Who are the providers of these types of surgery? What training and skills are they required to have, if any? Do public medical schools teach this form of surgery? If not, who does? Should they? Is this an ethical form of medical practice?
* Who is behind these services and driving them commercially? What relationship do they have to the public health services, including in poor countries?
* Should this industry, its advertisements and the procedures themselves be regulated? If so, how?
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