I was in a discussion recently on the effects of “porn culture” on young boys and girls. I went back and forth a bit with a debater, until she mentioned the rising rates of labiaplasty, prima facie caused by women’s lack of confidence in their own external genitals after watching pornography (which, according to everyone, is a massive, growing, all-pervasive industry).

Labiaplasty, surgery on the vulva to trim or cut away the labia minora (such that they protrude less than the labia majora) or the clitoral hood, is, indeed, on the rise in the West; it can also lead to complications including pain and infection. The number of girls under eighteen that paid for labiaplasty almost doubled between 2014 and 2015, and the number continues to grow.

Insecurity is a leading factor in many women’s decision to pursue the surgery. Patient satisfaction post-op is about 95%. Labiaplasty improves confidence and happiness and can lead to a healthier sex life. Costs are about $4000 – 5000, which is not terribly expensive for a life-altering operation.

However, the logistics alone are deceiving. Plastic surgery is a relatively young field with ever-improving techniques. To attribute the rise in labiaplasty immediately to the effects of an increasingly pornographic culture is disingenuous. There are other factors, and an analysis of labiaplasty patients shows that 32% of women undergoing the surgery did so for functional impairment, 31% for combined functional impairment and aesthetic improvement, and 37% for aesthetic improvement alone. That is a majority of surgeries for achieving or improving upon physical function. Of course, if you’re thinking of getting a surgery to improve a malfunctioning organ and it comes with visually pleasing benefit as well, you might incorporate this a little into your selection process – thus, it is reasonable to assume that many of the patients in the dual percentage were focused primarily on physical function, with visuals as an afterthought. The authors of the study found that “the majority of patients undergoing reduction of the labia minora do so for functional reasons with minimal outside influences affecting their decision for treatment.” This is an inconvenient conclusion if you want to argue that porn culture is causing these surgeries.

There’s also, as always, much more to the story. Female porn stars have what might be called “tidy” mons pubes, in terms of pubic hair and the conspicuousness of labia. These “designer vaginas” don’t accurately represent the general, mammalian populace of people with vaginas. Yet, as noted by Lisa Wade, a sociology professor at Occidental College, the reason porn actresses in Australia maintain such kept labia is not male, female or porn-producer preference, but rating boards (which are government bodies). Soft-core porn, in Australia, can only show “discreet genital detail,” which rules out fleshy, extrusive labia. The labia minora is considered “too offensive” for soft-core. Similar distinctions apply elsewhere. In Germany, for instance, one must be at least 16 years old to purchase soft-core material and 18 to buy hardcore; the distinction falls along multiple lines some of which dictate how extrusive the labia are. In Australia, often airbrushers at porn mags apply digital labiaplasty to “heal” vulvas to an acceptable “single crease.”

One of the feminist authors I’ve linked makes the point clear by comparison: what if porn classificatory boards determined the testicles were too explicit? What if the scrotum had to be airbrushed out in order for men’s genitals to appear in soft-core?

Daisy Buchanan at the Guardian observes another reason women are seeking aesthetic “improvement” to their natural organs: the seductive exhibitionism of pornography is not confined to hardcore adult films anymore, it’s everywhere – at music awards, during celebrity photoshoots, in casual advertisements, whatever.

This point could be worded in one of two ways: society is hyper-sexualized, or, our culture is sexually liberated. The second, more optimistic one, symbolizes a social maturity into sexual autonomy. Buchanan exaggerates by claiming we’re “as likely” to see a vulva on a music channel as on a pornographic website, but nonetheless, sex has become a more tolerable phenomenon for more and more people. The labiaplasty rate can be disparaged as a coercive instrument for young women to meet societal standards, or, it can be lauded as the growth of opportunity for women with functional problems and their willingness (and increased ability to afford) to shape their body how they want it.

As detailed previously on Notes on Liberty (here and here), the stifling force of 20th and 21st century censorship has been obsessed with pornography and female pleasure. For those who view labiaplasty as a disturbing, sexist phenomenon, one place to start would be rating boards, often managed by the government.