Historical and Ethical Perspectives on Vulvoplasty

Sex Med Rev. 2020 Oct;8(4):542-547. doi: 10.1016/j.sxmr.2020.06.002. Epub 2020 Jul 18.

Abstract

Introduction: Surgical and other procedures to alter the shape of the female external genitalia, especially the labia minora, are increasingly popular and controversial worldwide.

Objectives: This article aims to delineate and complicate the medical and moral controversy around these vulvoplasty procedures, by describing how female genital aesthetics, their interpretation, and alteration vary over time, space, and culture.

Methods: The history of the Hottentot Venus is used as a pivot about which to consider current biomedical, anthropological, and ethical literatures regarding female genital appearance and its manipulation. Intersectionality describes how different systems influence each other to affect the agency of certain individuals or groups, and is therefore an ideal analytic method for biopsychosocial concerns of sex and informed consent.

Results: The 19th century anatomic study and display of Sarah "Saartjie" Baartman, the Hottentot Venus, defined a European vulvar ideal by demonstrating its opposite. Today, the ideal appearance of the labia minora is variable across cultures and nationalities, and various mechanical and surgical manipulations are sought or imposed upon women to bring their bodies into conformity with these ideals.

Conclusion: For European audiences, Baartman exemplified a stereotypical association between genital appearance, sexual availability, and accessibility as a biomedical subject. These logical linkages were a by-product of sexist, racist, and colonial ideologies that have since fallen out of favor. However, their genital effects continue to influence bioethical considerations of genitoplasty into the present day. Chubak B. Historical and Ethical Perspectives on Vulvoplasty. Sex Med Rev 2020;8:542-547.

Keywords: Bioethics; Body Dismorphic Disorder; Female Genital Cosmetic Surgery; Female Genital Mutilation; Labiaplasty; Vulvoplasty.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Body Image*
  • Cultural Characteristics*
  • Female
  • Gynecologic Surgical Procedures / ethics*
  • Gynecologic Surgical Procedures / history
  • Gynecologic Surgical Procedures / legislation & jurisprudence
  • Gynecologic Surgical Procedures / trends
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Internationality*
  • Vulva / anatomy & histology
  • Vulva / surgery*