The taboo around female genitalia has grave consequences for women

An opinion piece by Cat Rodie published this week in Fairfax media suggests that the social and cultural taboos around female genitalia are contributing to young women and girls both not knowing about what their genitals should look like and being dissatisfied with their genital appearance.

“Girls get socialised not to talk about their genitalia. And then, when they need to talk about it (because they have a weird symptom or something has changed) they find that it’s too embarrassing… We need to normalise conversations about female genitalia so that we can start smashing through taboos”

You can read the article in full HERE

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So what is a vulva anyway?

UK young people’s sexual health organisation Brook together with the British Society for Paediatric and Adolescent Gynaecology (BritSPAG), co-produced a new resource aimed at educating young people about genital diversity.

Titled, “So What is a Vulva Anyway?”, the online booklet was developed in response to an increasing number of young women and girls in the UK having concerns about their genital appearance and requesting female cosmetic genital surgeries.

Commenting on the launch of the booklet, Brook participation and volunteering manager  Ms Laura West said:  

All young people deserve education, support and advice about anatomy, but unfortunately there is a lack of accurate and sensitive information available as part of the school curriculum and on the internet. This new booklet will help to address this need and will inform doctors, girls, young women and their families, as to what is normal and where to seek further help and support if required.”

Dr Naomi Crouch, GP, researcher on FGCS, and chair of BritSPAG said: “We hope this resource will provide information for girls and young women that their vulva is unique and will change throughout their life, and that this is entirely normal and healthy.”

You can access the resource which is free to download here.

Different doctors, different opinions?

When was the last time you googled a health issue looking for information? Or went looking for a health practitioner for a specific medical issue?

Since 2000, the Pew Research Centre in the US has been researching something they call The Social Life of Health Information. This project examines how people use the internet to look for and communicate about health information and medical issues. They estimate that about 7 out of 10 adults have searched online for information about a health issue.

The Australian Bureau of Statistics (ABS) reports that as recently as 2014 – 2015, 86% of all households in Australia had access to the internet at home. This report confirms that young people (aged 15 -17) are the biggest users of the internet in Australia (out of all internet users).

I think it is safe to suggest (without conducting an extensive literature review), that 1) people feel comfortable to look for health-related information online, and 2) that if most adults do this, then young people will also be doing this.

I spend a LOT of my PhD time looking at health-related information on the internet. One thing that has struck me as I have been researching female cosmetic genital surgery, are the differences you see between different sources of information online about the topic. You might expect to see differences in the quality of information you find, but what about differences in expert opinion on the subject?

Consider the following – a google search for female cosmetic genital surgery can net the following two webpages, one from the American Society of Plastic Surgeons, and one from the American Congress of Obstetricians and Gynecologists (ACOG). I chose these two pages from the US because the professional associations are equivalent in nature and both consider themselves to be opinion leaders about FGCS.

Both pages are provided by the leading specialist medical membership organisations that provide training and accreditation to plastic surgeons and gynaecologists in the United States. Both organisations make a claim about having particular expertise about FGCS, but as you can see each offer startlingly different takes on the merits of these types of surgeries.

My point here, is that these two different medical specialities have very different opinions about FGCS and offer different (and sometimes conflicting) advice about these procedures, even when both specialities are considered experts and leaders in their field. I wonder how people (especially young people) negotiate such different expert opinions on the same topic? What does it mean for people when they are looking for health information or medical advice and the expert opinion is conflicting?

This example gets more interesting in relation to the difference in opinion between the two disciplines when it comes to teens and adolescents seeking FGCS. In response to an ACOG position statement released in 2016 which counsels doctors to take a very conservative and cautious approach to young women asking for FGCS, the American Society for Aesthetic Plastic Surgeons released a statement which asserts that aesthetic plastic surgeons “should be at the forefront in developing recommendations… in regard to adolescents inquiring about labiaplasty”, and assert their claim to expertise and opinion with regard to FGCS.

In this instance, is the wellbeing of young people caught up in a disciplinary difference of opinion?