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Dr. Yvonne K. Fulbright

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Her Nether Regions: What's Normal?

Posted: 08/25/11 02:18 PM ET

You can rest easy, gals. Turns out there's nothing "wrong" with your vulva after all. A study published in the British Journal of Obstetrics and Gynaecology has declared that most women seeking genital cosmetic surgery to reduce the size of their inner lips do not have oversized or misshapen labia minora.

Such findings feel liberating until you consider that the researchers themselves may be perpetuating the designer vulva problem. While the investigators determined that 30 of the 33 women had labia with dimensions within the normal published limits, the other 3 women's vaginal lips were sized up as having "significant asymmetry," as in a mean (SD) of 26.9 (12.8) mm on the right side of the vulva and 24.8 (13.1) mm on the left side.

This gave them the green light for NHS-covered surgery at the University College London hospital clinic, where the research was based. The clinic can only perform surgeries on females whose genitalia measure outside of what's considered normal.

Yet what is meant by "normal"?

Dr. Sarah Creighton, gynecologist and the study's lead investigator, is quoted as saying "there is little information about what is normal," with her team encouraging the publication of more large-scale data on normal labial measurements. Such commentary indicates that, as depicted in pornography and advertisements, vulvas are indeed supposed to have a certain look. Anything outside of a range would, otherwise, be considered abnormal.

The fact of that matter is that, when it comes to genitalia -- or one's breasts or one's testicles -- what's normal is to have a wide range of sizes. What's normal is for one side of a person's body to be anywhere from a bit to a lot bigger, longer, fatter, smaller ... than the other side. Asymmetry is the norm when it comes to people's body parts!

The main concern with genital cosmetic surgery isn't determining who should and shouldn't be eligible for such services; it's the need to counter the misperceptions of what is normal that ultimately cause distress.

In helping to quell women's aesthetic concerns about their vulva, we need to start by educating them about the human body and the influence of cultural expectations and appeal on what's supposedly desirable. We need to continue the campaign being waged by women around the world that diversity is beauty. And we need to target females when they're young.

The average age of the 33 aforementioned participants was 23, with one-quarter 16 or younger, and the youngest a mere 11-years-old. Forty percent wanted smaller labia "to improve appearance," a stat made even more unnerving when you consider that all participants were referred by general practitioners who felt that surgery was appropriate treatment. Now just how "normal" is that?

 

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03:10 PM on 09/03/2011
If anyone ever needed proof that the western world's obsession with 'beauty' and 'perfection' has long since reached an unhealthy level, they need look no further than the evidence presented in this article. I had not even heard of labiaplasty until I recently read something somewhere about a documentary called "The Perfect V@gina" and I took a look (very hard to watch - be warned!). Ladies, please, take it from an unapologetic man and take it to heart: the only things that a vast majority of men ask of you and your snapper is that you keep it clean and perhaps not excessively hairy. Unless it's for medical reasons, leave the beav alone! If you get involved with a man (or a woman) who is asking for customizations, well that should tell you what you need to know about the future prospects with that person. But let's be real, this objectionable development is just indicative of the mental illness generally described as body dismorphic disorder that pervades our society. Women are the ones holding themselves to these preposterous standards - and only they can chose to break free.
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Tresco
Sistagirl Laughin' Thingy Award Winner!
11:37 PM on 09/02/2011
Why do they think they call it "bumping uglies"? What vanity! Or is it misplaced insecurity? I have never met a person man or woman who thought their genitals looked beautiful.
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07:37 PM on 09/03/2011
Why do they think they call it "bumping uglies"? What vanity! Or is it misplaced insecurity¬? I have never met a person man or woman who thought their genitals looked beautiful.
“What vanity! Or is it misplaced insecurity¬?”
I don’t think you could exclude those traits from each other, or from any person. They are both part of the human condition. They don’t dictate the discussion, but they play a role.
They call it bumping uglies because they lack a better term. Just as the author’s title illustrates, this conversation is usually dumbed down. They don’t say brass balls because testacles resemble brass the more daring a man is. They are simply vulgar terms that arise from adolescence.
BTW
I am a man who shares the word beautiful with my wife as a way to describe each others genitals.
I feel inspired by the simple thought of them together, to go further in describing how much and in what ways I appreciate my wife’s genitals, and how she expresses her appreciation of mine, but I will refrain from elaborating.
I hope that it’s clear enough that you are representing a narrow slice of the spectrum in your assessment.
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ming099
...the same as it ever was.....
07:23 PM on 09/02/2011
...as a man....and speaking purely from a man's point of view.....LADIES....PLEASE....do not surgically alter your bits so they will look like the ones in magazines and movies. Those (in the movies and magazines) are the ones we will never actually get to see...in real life. Personally....I think the mystery of how they appear is most of the allure that those parts of your bodies hold for men.
I am in my sixties and I was a single man from the mid eighties 'til 2010.......when I married my best friend....and I have seen probably more than my share of those beautiful things and each one was unique. Some were compact,some were long and hung out and some were neatly tucked inside....but all were beautiful and special.

PLEASE...PLEASE ....think before you let anyone near them with a scalpel......post op pain has to be off the chart and then there is the damage to the nerves and loss of sensation you KNOW has to follow surgery of that type.

I have NEVER seen an ugly one....just different ones and I thought all of them were beautiful!!!
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amantedelibros
02:43 PM on 09/02/2011
Personally, I feel that unless the labia majora or minora are causing physical or physiological issues (i.e. pain or severe discomfort), leave them alone. We're not meant to be symmetrical, as the article points out. And that's what makes us all unique. If a woman is undergoing this surgery to appear more alluring to a man or to please a man, she's doing herself a great disservice. I think men are just happy to be close enough to see one, let alone explore one. We women need to learn to love ourselves in all of our myriad shapes and sizes and colors.
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06:08 PM on 09/01/2011
"most women seeking surgery to reduce the size of their inner lips do not have oversized or misshapen labia minora"
So, the inner lips are called the Labia Minora
Interesting
I’m sure the figure that educates most (ethnocentric) young people about female anatomy, Barbie, doesn’t have the Labia Minora. In contrast, Ken dolls always wore underwear so you couldn’t really evaluate his nakedness.
It seems childish to refer to dolls, but as I look at the comments and the lack of forward descriptions like "inner lips" or scientific ones like Labia Minora, it seems that a stunted level of understanding is evident.
Some are more poetic in their descriptions; using metaphors like "nether-regions-of-infinite-delight", others are more obscure using words like "stuff" or "parts”. There is no comfortable way to describe what is not fully understood. I am not simply suggesting that anyone who uses these terms personally doesn’t know the actual names of the parts they are describing, but that they also may be assuming that the person they are speaking with doesn’t know the names of the body parts they are discussing.
This leaves resorting to the most generic earliest depiction of the female form they remember, Barbie, and the following description illustrates the related uncertainty of that age.
I believe if children were better educated about their bodies then they wouldn’t resort to dolls for anatomy questions, and as adults would be able to comfortably manage any doubts they may have about their body.
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White Raven
Eyeballs are tasty
01:37 AM on 09/01/2011
This is such a ridiculous concept. Look: Unless your stuff is hanging out and getting uncomfortably caught in your pants or something, or you are physically in pain at how your labia majora are formed or get in the way of day to day functioning, leave it alone.

As a man I tell you simply: We don't care what it looks like. As long as you're an innie and not an outtie who looks like an innie prior to pants-removal, the aesthetic makeup of the window dressing on your happy funtimes lovepocket is not a priority!
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06:58 PM on 09/01/2011
"the aesthetic makeup of the window dressing on your happy funtimes lovepocket is not a priority!"
I just knocked posters for using dumb downed descriptions so....ill respond directly to that.
I don’t think your comment helps anything
It’s like saying "Girly, if you‘re gonna walk in them like that, the color of your shoes doesn’t matter!"
What does matter? What is the priority?
It seems to me that the focus is still centered on approval.
Your post insinuates that any man would be happy with the "window dressing" if they are freely allowed to have "funtimes" with the "lovepocket"
Looking at it that way makes your post seem quite detestable
I think that the motive was seen by you as a need to please a man, when that may have less to do with it than you think. I believe that it is instead social pressure from media, men, and other women that causes this kind of self doubt. If it does stem from the wanted approval of a man, doesn’t that willingness to self mutilate in order to get that approval show that there is a bigger problem than that man’s disapproval? I think that sexual approval is only one aspect of this kind of genital mutilation, and when it is the case, misogyny isn’t the remedy. Fierce feminism should be a remedy for a woman who feels they must change to gain a partner. Not actualized feminism through intercourse, but actualized feminism through self approval.
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White Raven
Eyeballs are tasty
07:31 PM on 09/01/2011
I think you're just looking for a reason to be annoyed at something.
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HelloDollyLlama
04:21 PM on 08/31/2011
Ladies, take it from me. If a man has actually succeeded in getting all the way to the point where he's looking at your Elsewheres, he's not going to suddenly stop on the 1-yard-line and decide that he doesn't like the way the end zone looks. It just isn't going to happen.
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amantedelibros
02:45 PM on 09/02/2011
Ahh men...always a way to slip sports jargon into a conversation. No pun intended, by the way.
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ConfuciusSay-
Aglets: their purpose is sinister.
11:50 AM on 08/31/2011
As a practising doctor, I take an extremely dim view of colleagues that profit from unnecessary and pointless operations. Are there not enough people who need genuine care for us to earn a living from?
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amantedelibros
02:49 PM on 09/02/2011
Finally, a doctor who appears to care more for the best interests of patients, rather than on the size of the bank account. I often wonder how it's possible that plastic surgeons continue to perform countless numbers of procedures (I'm referring to cosmetic/elective procedures) knowing full well that it's not in the patient's best interest. I think of that NY socialite who looks like a lion. Anyway, nice to hear from a practicing physician who's ethical. F&F :)
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amantedelibros
02:59 PM on 09/02/2011
I wrote a comment this post, but apparently it's not been posted for some reason. In any case, I agree and I applaud you on being more concerned with your patients' well being rather than being motivated by the balance in your bank account. Would that all professionals were as caring and as ethical. I also F&F you :)
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ConfuciusSay-
Aglets: their purpose is sinister.
10:37 PM on 09/02/2011
Thanks, though I do find it strange that my position seems not to be the norm.
:-)
06:01 PM on 08/30/2011
An 11 year old girl is not done growing, physically or mentally, and cosmetic procedures expose patients to unnecessary infection and other risks -- how can that be appropriate for children? That a quarter of the participants were 16 or younger is not only appalling, but for me, skews the study completely. High schoolers (and younger) are inexperienced, often insecure, and vulnerable to peer pressure and self-doubt. They don't have a statistical universe by which to judge their privates.

Wondering if their bodies are normal is normal behavior for that age, but unless clinical deformity is a real issue, the proper treatment is reassurance.
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07:14 PM on 09/01/2011
"That a quarter of the participan­ts were 16 or younger is not only appalling, but for me, skews the study completely"
Many people under the age of 16 undergo cosmetic surgery
The question remains
"how can that be appropriate for children?"
I am sure that it has never been appropriate for a parent to support and or allow a child to receive superficial (non-reparative) cosmetic surgery.
I think the fact that they do means that this study should have encompassed that age range, as some kids of that age will get that surgery.
Remember these were all patients who were already referred to a surgeon. Simply take out this study, and they would likely already have the surgery. With that in mind I don’t think the study is skewed, and I think its findings better represent the social condition because of who it included it.
I agree with your post on its other points. Simply working through adolescents with what you have, as you begin to be aware of the endless worldly possibilities, is what I think prepares an adolescent to be limited to who they are and what they do. This growth is what moves someone beyond the need to have cosmetic surgery I think.
01:53 PM on 09/02/2011
You're absolutely right; I was very upset and not thinking about the broader picture. The best case scenario I could project was a girl, with the usual fears about whether she was normal, taking those fears to a mother who wanted a professional to reassure her daughter with medical authority: your body is not done growing, and you are not abnormal. I hated to think any doctor would encourage the worst by proceeding with so-called correction when none was called for.

Thank you for pointing out my error, and doing so with grace.
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amantedelibros
02:52 PM on 09/02/2011
I couldn't agree more :) F&F
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anoise
My micro bio is too small to fit here....
04:05 PM on 08/30/2011
So where do these women get the idea of what is 'normal' down there?
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11:34 PM on 09/01/2011
Guys and porn. Like one of the commenters above pointed out, many men really like stating whether they prefer "innies or outies." All the talk really gives the impression that if you look a certain way you're going to be judged negatively, and it's not really repaired by the fact that as others have stated, men will in almost all cases have sex with you regardless.
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amantedelibros
02:54 PM on 09/02/2011
I read that innie and outtie comment and still have no clue how that relates to the labia majora or minora. I get it as it refers to the belly button, but the labii?
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06:01 PM on 09/02/2011
Let’s take a 20yr old as an example
For half(give/take)their life their "normal", was prepubescent gentiles, and the other half was post pubescent gentiles. So the norm for their personal gentiles is not consistent.
I think you could use the same scenario play at 20, and at 40.
After 20years of having sexual activity, and regular aging, the genitals are again, normally not constant.
I think that the idea of normalcy is perpetuated by the provider of the service. I think that is what the article dances around.
It plays out by the provider asking the 40year old woman if her gentile’s looks like they normally did when she was 20.
NO?
Well the doctor can fix what he convinced the patient is something wrong.
As a man I can only relate to this insecurity, that arises do to the changing of the genitals, by my desire as a child to be a fully matured male. Then I could compare my fully matured genitals to that of the average penis size which I became aware of as early as 9yrs old. Until I was sure my penis wasn’t getting any bigger, or that it was big enough to be happy with, I was very uncertain, and would have been accepting of any quick fix that ensured normalcy. I’m lucky I wasn’t made aware of any that were socially acceptable.
Now that I’ve matured, I hear that I’m just gonna sag like crazy the older I get.
Woohoo that’s life!
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AmericaninIndia
American Capitalist Pursuing the Dream in India.
06:09 AM on 08/29/2011
I'm a straight man who's lived in many countries and I've had relationships with women from many parts of the world (most remain good friends today).

May I just say: Stop the madness. Women's "nether regions" come in many shapes and sizes. Some women have completely hidden inner labia, and others have large ones that have their own character and shape. Some women have larger clitorises, some have smaller. Some have larger labia, some smaller. I suppose it's the same for men in terms of variation in size and shape.

And you know what? It's beautiful just the way it is. In fact, I personally prefer a woman with larger labia. I find it sexy and feminine.

I'd rather focus on intimacy with the person, and enjoy each other in a loving and passionate way, than to find fault in her anatomy. As far as I'm concerned, I'm happy with what I have, and I try my best to make her feel fantastic. I hope more women feel the same as I do.
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GirlUsingBrain
The most dangerous animal in the forest is man.
05:56 PM on 08/29/2011
Can we clone you?
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AmericaninIndia
American Capitalist Pursuing the Dream in India.
02:04 AM on 08/30/2011
Thanks! I think a lot of men think as I do. They're out there.
02:43 PM on 08/30/2011
I'm another straight man for leaving the lady bits as is. Stop the foolishness now.
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tploomis
I am a human bean.
04:49 PM on 08/28/2011
I am skeptical that surgery for this would allay the sense of "something is wrong with my body" that these women have. The concern would just shift to another area of the body.
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freddsky
Thorstein Veblen'd be proud, if only he were alive
02:18 PM on 08/28/2011
I seem to regard a tidbit from "How To Be A Jewish Grandmother," by Sylvia S. Seaman.
A JG should always be truthful but delicate, particularly with grandchildren.
So when a toddler asks, "Have you got a penis down there, grandma?" the correct response is, "Not at the moment, darling." Applying this principle to herself and her own inner child ("truthful but delicate") should allay any nonsense fears a woman might have about "normalcy."
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inmyhumbleopinion
Vote third party.
12:37 PM on 08/28/2011
Women have become addicted to plastic surgery and I think it's criminal that these cosmetic surgeries are performed on anyone younger than 21. It's one thing to repair damage as a result of an accident for someone that young; quite another to go under the knife voluntarily.

What is wrong with us? What is making us feel so inferior that we have to take such drastic, painful measures to "fix" ourselves?
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Lisa Shields
Poet & Advocate For Special Needs Children
03:56 PM on 08/27/2011
Thank you.

The idea that our most unique sexual feature needs to be "a certain look" is absurd.
If women buy this nonsense, I foresee a future when our labia length becomes a matter of fashion, like hemlines. Next there will be stretching, to achieve a "maxi look"!

Just say no...please?
Women need to stop treating their bodies like play dough, and value what they are intrinsically.
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Yam716
For Natural Hair CurlTalk, Visit: lillian-mae
11:46 AM on 08/30/2011
Amen Sister! We should love and accept ourselves as we are.

F&F!