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WHO classification of FGM omission and failure to recognise some women's vulnerability to cosmetic vaginal surgery
  1. Hermione Lovel, PhD, FFPH
  1. Retired Consultant in Public Health, London, UK; hermione.lovel{at}

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There is a globally recognised and widely used World Health Organization (WHO) classification of types of female genital mutilation (FGM)1 which was omitted from Lucy Cox's personal view article about the vulva2 in the July 2016 issue of this journal. It is usually helpful to use the international terminology.

Myself, and other colleagues with whom I've spoken, have expressed concern that Cox's article2 juxtaposes child abuse FGM with supposedly adult consenting cosmetic vaginal surgery, and that there was insufficient emphasis on FGM as child abuse.3 ,4

Clinical colleagues with extensive experience emphasise another concern, the article made no mention of the fact that women who have cosmetic vaginal surgery are very often highly vulnerable individuals.

It is worrying that recently we have seen an increasing popularisation of cosmetic vaginoplasty and labiaplasty; for example, the celebrity Sinitta is aiming to screen a vaginoplasty operation on her new online TV channel.5

Cox's article2 is to be commended in its delivery of ‘a good read’, but was disappointing in its omission of the global recognition that FGM and cosmetic vulval intervention are so often abuse of the vulnerable.


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  • Competing interests None declared.