Skip to main content
Top
Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

The contribution of online content to the promotion and normalisation of female genital cosmetic surgery: a systematic review of the literature

Authors: Hayley Mowat, Karalyn McDonald, Amy Shields Dobson, Jane Fisher, Maggie Kirkman

Published in: BMC Women's Health | Issue 1/2015

Login to get access

Abstract

Background

Women considering female genital cosmetic surgery (FGCS) are likely to use the internet as a key source of information during the decision-making process. The aim of this systematic review was to determine what is known about the role of the internet in the promotion and normalisation of female genital cosmetic surgery and to identify areas for future research.

Methods

Eight social science, medical, and communication databases and Google Scholar were searched for peer-reviewed papers published in English. Results from all papers were analysed to identify recurring and unique themes.

Results

Five papers met inclusion criteria. Three of the papers reported investigations of website content of FGCS providers, a fourth compared motivations for labiaplasty publicised on provider websites with those disclosed by women in online communities, and the fifth analysed visual depictions of female genitalia in online pornography. Analysis yielded five significant and interrelated patterns of representation, each functioning to promote and normalise the practice of FGCS: pathologisation of genital diversity; female genital appearance as important to wellbeing; characteristics of women’s genitals are important for sex life; female body as degenerative and improvable through surgery; and FGCS as safe, easy, and effective. A significant gap was identified in the literature: the ways in which user-generated content might function to perpetuate, challenge, or subvert the normative discourses prevalent in online pornography and surgical websites.

Conclusions

Further research is needed to contribute to knowledge of the role played by the internet in the promotion and normalisation of female genital cosmetic surgery.
Literature
1.
go back to reference American College of Obstetrics and Gynecology. ACOG committee opinion No. 378: vaginal “rejuvenation” and cosmetic vaginal procedures. Obstet Gynecol. 2007;110(3):737–8. American College of Obstetrics and Gynecology. ACOG committee opinion No. 378: vaginal “rejuvenation” and cosmetic vaginal procedures. Obstet Gynecol. 2007;110(3):737–8.
2.
go back to reference Michala L, Liao L-M, Creighton SM. Female genital cosmetic surgery: how can clinicians act in women’s best interests? Obstet Gynaecol. 2012;14(3):203–6. Michala L, Liao L-M, Creighton SM. Female genital cosmetic surgery: how can clinicians act in women’s best interests? Obstet Gynaecol. 2012;14(3):203–6.
4.
go back to reference Renganathan A, Cartwright R, Cardozo L. Gynecological cosmetic surgery. Exp Rev Obstet Gynecol. 2009;4:101–4. Renganathan A, Cartwright R, Cardozo L. Gynecological cosmetic surgery. Exp Rev Obstet Gynecol. 2009;4:101–4.
5.
go back to reference Crouch NS, Deans R, Michala L, Liao LM, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG Int J Obstet Gynaecol. 2012;119(4):504–5. Crouch NS, Deans R, Michala L, Liao LM, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG Int J Obstet Gynaecol. 2012;119(4):504–5.
6.
go back to reference Bramwell R. Invisible labia: The representation of female external genitals in women’s magazines. Sexual Relation Therapy. 2002;17(2):187–90. Bramwell R. Invisible labia: The representation of female external genitals in women’s magazines. Sexual Relation Therapy. 2002;17(2):187–90.
7.
go back to reference Schick VR, Rima BN, Calabrese SK. Evulvalution: the portrayal of women’s external genitalia and physique across time and the current Barbie doll ideals. J Sex Res. 2010;48(1):74–81. Schick VR, Rima BN, Calabrese SK. Evulvalution: the portrayal of women’s external genitalia and physique across time and the current Barbie doll ideals. J Sex Res. 2010;48(1):74–81.
8.
go back to reference Cain JM, Iglesia CB, Dickens B, Montgomery O. Body enhancement through female genital cosmetic surgery creates ethical and rights dilemmas. Int J Gynecol Obstet. 2013;122(2):169–72. Cain JM, Iglesia CB, Dickens B, Montgomery O. Body enhancement through female genital cosmetic surgery creates ethical and rights dilemmas. Int J Gynecol Obstet. 2013;122(2):169–72.
9.
go back to reference Johnsdotter S, Essén B. Genitals and ethnicity: the politics of genital modifications. Reprod Health Matters. 2010;18(35):29–37.PubMed Johnsdotter S, Essén B. Genitals and ethnicity: the politics of genital modifications. Reprod Health Matters. 2010;18(35):29–37.PubMed
10.
go back to reference Sheldon S, Wilkinson S. Female genital mutilation and cosmetic surgery: Regulating non-therapeutic body modification. Bioethics. 1998;12(4):263–85.PubMed Sheldon S, Wilkinson S. Female genital mutilation and cosmetic surgery: Regulating non-therapeutic body modification. Bioethics. 1998;12(4):263–85.PubMed
11.
go back to reference Braun V. Female genital cosmetic surgery: a critical review of current knowledge and contemporary debates. J Women’s Health. 2010;19(7):1393–407. Braun V. Female genital cosmetic surgery: a critical review of current knowledge and contemporary debates. J Women’s Health. 2010;19(7):1393–407.
12.
go back to reference Reitsma W, Mourits MJE, Koning M, Pascal A, van der Lei B. No (wo)man is an island—The influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making: A cross-sectional survey. J Sexual Med. 2011;8(8):2377–85. Reitsma W, Mourits MJE, Koning M, Pascal A, van der Lei B. No (wo)man is an island—The influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making: A cross-sectional survey. J Sexual Med. 2011;8(8):2377–85.
13.
go back to reference Lloyd J, Crouch NS, Minto CL, Liao LM, Creighton SM. Female genital appearance: “normality” unfolds. BJOG Int J Obstet Gynaecol. 2005;112(5):643–6. Lloyd J, Crouch NS, Minto CL, Liao LM, Creighton SM. Female genital appearance: “normality” unfolds. BJOG Int J Obstet Gynaecol. 2005;112(5):643–6.
14.
go back to reference Braun V, Kitzinger C. The perfectible vagina: Size matters. Culture Health Sexual. 2001;3(3):263–77. Braun V, Kitzinger C. The perfectible vagina: Size matters. Culture Health Sexual. 2001;3(3):263–77.
15.
go back to reference McDougall LJ. Towards a clean slit: how medicine and notions of normality are shaping female genital aesthetics. Culture Health Sexual. 2013;15(7):774–87. McDougall LJ. Towards a clean slit: how medicine and notions of normality are shaping female genital aesthetics. Culture Health Sexual. 2013;15(7):774–87.
16.
go back to reference Davis SW. Loose lips sink ships. Fem Stud. 2002;28(1):7–35. Davis SW. Loose lips sink ships. Fem Stud. 2002;28(1):7–35.
17.
go back to reference Tiefer L. Female genital cosmetic surgery: Freakish or inevitable? Analysis from medical marketing, bioethics, and feminist theory. Feminism Psychol. 2008;18(4):466–79. Tiefer L. Female genital cosmetic surgery: Freakish or inevitable? Analysis from medical marketing, bioethics, and feminist theory. Feminism Psychol. 2008;18(4):466–79.
18.
go back to reference Braun V, Wilkinson S. Socio-cultural representations of the vagina. J Reprod Infant Psychol. 2001;19(1):17–32. Braun V, Wilkinson S. Socio-cultural representations of the vagina. J Reprod Infant Psychol. 2001;19(1):17–32.
19.
go back to reference Braun V. In search of (better) sexual pleasure: female genital ‘cosmetic’ surgery. Sexualities. 2005;8(4):407–24. Braun V. In search of (better) sexual pleasure: female genital ‘cosmetic’ surgery. Sexualities. 2005;8(4):407–24.
20.
go back to reference Wolf N. The beauty myth: How images of beauty are used against women. New York: William Morrow and Company Inc.; 1991. Wolf N. The beauty myth: How images of beauty are used against women. New York: William Morrow and Company Inc.; 1991.
21.
go back to reference Sarwer DB, Cash TF, Magee L, Williams EF, Thompson JK, Roehrig M, et al. Female college students and cosmetic surgery: An investigation of experiences, attitudes, and body image. Plast Reconstr Surg. 2005;115(3):931–8. 910.1097/1001.PRS.0000153204.0000137065.D0000153203.PubMed Sarwer DB, Cash TF, Magee L, Williams EF, Thompson JK, Roehrig M, et al. Female college students and cosmetic surgery: An investigation of experiences, attitudes, and body image. Plast Reconstr Surg. 2005;115(3):931–8. 910.1097/1001.PRS.0000153204.0000137065.D0000153203.PubMed
22.
go back to reference Walden JL, Panagopoulous G, Shrader SW. Contemporary decision making and perception in patients undergoing cosmetic breast augmentation. Aesthet Surg J. 2010;30(3):395–403.PubMed Walden JL, Panagopoulous G, Shrader SW. Contemporary decision making and perception in patients undergoing cosmetic breast augmentation. Aesthet Surg J. 2010;30(3):395–403.PubMed
23.
go back to reference Berman L, Berman J, Felder S, Pollets D, Chhabra S, Miles M, et al. Seeking help for sexual function complaints: what gynecologists need to know about the female patient’s experience. Fertil Steril. 2003;79(3):572–6.PubMed Berman L, Berman J, Felder S, Pollets D, Chhabra S, Miles M, et al. Seeking help for sexual function complaints: what gynecologists need to know about the female patient’s experience. Fertil Steril. 2003;79(3):572–6.PubMed
24.
go back to reference Nappi RE, Liekens G, Brandenburg U. Attitudes, perceptions and knowledge about the vagina: the international vagina dialogue survey. Contraception. 2006;73(5):493–500.PubMed Nappi RE, Liekens G, Brandenburg U. Attitudes, perceptions and knowledge about the vagina: the international vagina dialogue survey. Contraception. 2006;73(5):493–500.PubMed
25.
go back to reference Sharp G, Tiggemann M, Mattiske J. Predictors of consideration of labiaplasty: an extension of the tripartite influence model of beauty ideals. Psychol Women Q. 2014;00:1–12. accessed September 14 2014. Sharp G, Tiggemann M, Mattiske J. Predictors of consideration of labiaplasty: an extension of the tripartite influence model of beauty ideals. Psychol Women Q. 2014;00:1–12. accessed September 14 2014.
26.
go back to reference Michala L, Koliantzaki S, Antsaklis A. Protruding labia minora: abnormal or just uncool? J Psychosomatic Obstet Gynecol. 2011;32(3):154–6. Michala L, Koliantzaki S, Antsaklis A. Protruding labia minora: abnormal or just uncool? J Psychosomatic Obstet Gynecol. 2011;32(3):154–6.
27.
go back to reference Koning M, Zeijlmans IA, Bouman TK, van der Lei B. Female attitudes regarding labia minora appearance and reduction with consideration of media influence. Aesthet Surg J. 2009;29(1):65–71.PubMed Koning M, Zeijlmans IA, Bouman TK, van der Lei B. Female attitudes regarding labia minora appearance and reduction with consideration of media influence. Aesthet Surg J. 2009;29(1):65–71.PubMed
28.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA StatementThe PRISMA statement. Ann Intern Med. 2009;151(4):264–9.PubMed Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA StatementThe PRISMA statement. Ann Intern Med. 2009;151(4):264–9.PubMed
29.
go back to reference Kmet LM, Lee RC, Cook LS: Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Alberta Heritage Foundation for Medical Research, 2004. Kmet LM, Lee RC, Cook LS: Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Alberta Heritage Foundation for Medical Research, 2004.
30.
go back to reference Zwier S. “What motivates Her”: motivations for considering labial reduction surgery as recounted on Women’s online communities and Surgeons’ websites. Sexual Med. 2014;2(1):16–23. Zwier S. “What motivates Her”: motivations for considering labial reduction surgery as recounted on Women’s online communities and Surgeons’ websites. Sexual Med. 2014;2(1):16–23.
31.
go back to reference Howarth H, Sommer V, Jordan FM. Visual depictions of female genitalia differ depending on source. Med Human. 2010;36(2):75–9. Howarth H, Sommer V, Jordan FM. Visual depictions of female genitalia differ depending on source. Med Human. 2010;36(2):75–9.
32.
go back to reference Liao L-M, Taghinejadi N, Creighton SM. An analysis of the content and clinical implications of online advertisements for female genital cosmetic surgery. BMJ Open. 2012;2:e001908. doi:10.1136/bmjopen-2012-001908. Liao L-M, Taghinejadi N, Creighton SM. An analysis of the content and clinical implications of online advertisements for female genital cosmetic surgery. BMJ Open. 2012;2:e001908. doi:10.​1136/​bmjopen-2012-001908.
33.
go back to reference Moran C, Lee C. Selling genital cosmetic surgery to healthy women: A multimodal discourse analysis of Australian surgery websites. Critical Discourse Stud. 2013;10(4):373–91. Moran C, Lee C. Selling genital cosmetic surgery to healthy women: A multimodal discourse analysis of Australian surgery websites. Critical Discourse Stud. 2013;10(4):373–91.
34.
go back to reference Ashong AC, Batta HE. Sensationalising the female pudenda: an examination of public communication of aesthetic genital surgery. Global J Health Sci. 2012;5(2):153. Ashong AC, Batta HE. Sensationalising the female pudenda: an examination of public communication of aesthetic genital surgery. Global J Health Sci. 2012;5(2):153.
35.
go back to reference Bartky SL. Foucault, femininity, and the modernization of patriarchal power. In: Diamond I, Quinby L, editors. Feminism and Foucault: reflections on resistance. USA: Northeastern University Press; 1997. Bartky SL. Foucault, femininity, and the modernization of patriarchal power. In: Diamond I, Quinby L, editors. Feminism and Foucault: reflections on resistance. USA: Northeastern University Press; 1997.
36.
go back to reference Tincknell E. Scourging the abject body: Ten years younger and fragmented femininity under neoliberalism. In: Gill R, Scharff C, editors. New femininities: Postfeminism, neoliberalism and subjectivity. Basingstoke: Palgrave; 2011. p. 83–98. Tincknell E. Scourging the abject body: Ten years younger and fragmented femininity under neoliberalism. In: Gill R, Scharff C, editors. New femininities: Postfeminism, neoliberalism and subjectivity. Basingstoke: Palgrave; 2011. p. 83–98.
37.
go back to reference Braun V. The women are doing it for themselves’: The rhetoric of choice and agency around female genital ’cosmetic surgery. Aust Fem Stud. 2009;24(60):233–49. Braun V. The women are doing it for themselves’: The rhetoric of choice and agency around female genital ’cosmetic surgery. Aust Fem Stud. 2009;24(60):233–49.
38.
go back to reference Woodstock L. Skin deep, soul deep: Mass mediating cosmetic surgery in popular magazines, 1968–1998. Commun Rev. 2001;4(3):421–42. Woodstock L. Skin deep, soul deep: Mass mediating cosmetic surgery in popular magazines, 1968–1998. Commun Rev. 2001;4(3):421–42.
39.
go back to reference Braun V. Selling the “perfect” vulva. In: Heyes CJ, Jones MR, editors. Cosmetic surgery: a feminist primer. Farnham: Ashgate; 2009. p. 133–49. Braun V. Selling the “perfect” vulva. In: Heyes CJ, Jones MR, editors. Cosmetic surgery: a feminist primer. Farnham: Ashgate; 2009. p. 133–49.
40.
go back to reference Jackson S. Sexual skirmishes and feminist factions: twenty-five years of debate on women and sexuality. In: Jackson S, Scott S, editors. Feminism and sexuality: A reader. Edinburgh: Edinburgh University Press; 1996. p. 1–31. Jackson S. Sexual skirmishes and feminist factions: twenty-five years of debate on women and sexuality. In: Jackson S, Scott S, editors. Feminism and sexuality: A reader. Edinburgh: Edinburgh University Press; 1996. p. 1–31.
41.
go back to reference Goodman MP. Female cosmetic genital surgery. Obstet Gynecol. 2009;113(1):154–9.PubMed Goodman MP. Female cosmetic genital surgery. Obstet Gynecol. 2009;113(1):154–9.PubMed
42.
go back to reference Iglesia C, Yurteri-Kaplan L, Alinsod R. Female genital cosmetic surgery: a review of techniques and outcomes. Int Urogynecol J. 2013;24(12):1997–2009.PubMed Iglesia C, Yurteri-Kaplan L, Alinsod R. Female genital cosmetic surgery: a review of techniques and outcomes. Int Urogynecol J. 2013;24(12):1997–2009.PubMed
Metadata
Title
The contribution of online content to the promotion and normalisation of female genital cosmetic surgery: a systematic review of the literature
Authors
Hayley Mowat
Karalyn McDonald
Amy Shields Dobson
Jane Fisher
Maggie Kirkman
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0271-5

Other articles of this Issue 1/2015

BMC Women's Health 1/2015 Go to the issue