Background

In a world with an increasing market for genital plastic surgery in forms such as labiaplasty and vaginoplasty, I was interested in researching the history of such procedures as the subject of this article. Although decorated vulvas for the sake of creative expression are almost always fascinating in their many forms, from tattoos to public hair topiary, I was more interested in the surgically enhanced forms of genital presentation. The readers of this Journal will appreciate how rapidly I came up against the vast wall that separates purely cosmetic surgical procedures on adults and those carried out, often on small children, rooted in ethnic traditions and gender control, which are at the very centre of white hot social and political debate today.

On 21 December 2012, the United Nations General Assembly made a statement that the day before it had passed unanimously a resolution urging countries to ban the practice of female genital mutilation (FGM), calling it an “irreparable and irreversible abuse”. Such mutilation has its origins in many …