Brook has been supporting BritsPAG to develop 'So what is a vulva anyway?' in response to an increasing number of girls and women with cosmetic genital concerns requesting surgery despite having normal anatomy.
According to NHS figures, in 2015-16 more than 200 girls under 18 had labiaplasty and more than 150 of the girls were under 15. These numbers do not include girls and young women having the procedure privately. Experts say these operations do not have a medical justification.
Female genital cosmetic surgery refers to cosmetic surgical procedures which change the structure and appearance of the healthy external genitalia of women. It includes the most common procedure, labiaplasty which involves the lips of the vagina being shortened or reshaped.
The booklet uses illustrations to describe variation in appearance in order to normalise vulva appearance and details the changes which happen at puberty and beyond. It is based on recommendations made by BritsPAG and the RCOG on ethical concerns for women requesting cosmetic genital surgery.
The team who developed the booklet conducted discussion groups with young women in order to gauge their current level of understanding and whether they feel as though this resource would be useful. The consensus is that these young women felt there is a lack of understanding about the vulva and that they are not taught enough in school and are likely to conduct their own research online.
The resource also aims to convey the message that if a young person does have concerns about their body that it is a positive thing to do to reach out and speak to a healthcare professional, such as a GP.
The booklet will also be available to clinicians, including GPs, practice nurses and sexual health staff to be able to give out when meeting young people with genital cosmetic concerns and signpost them to further resources which promote healthy body image.
Ms Louise Williams, clinical nurse specialist at University College London Hospital and co-lead of the project, said:
“We see many patients in our paediatric and adolescent gynaecology clinic who have a poor understanding of the function of parts of the anatomy and also of normal genital variation. This educational resource will help young people to understand their vulva and how it develops during puberty, particularly if they are worried about how they look or feel. We hope it will reassure young people that vulvas come in a variety of shapes and sizes, and if they need advice and support, they can know where to go"
Dr Naomi Crouch, consultant gynaecologist and spokesperson for the RCOG and chair of BritSpag, said:
“There is absolutely no scientific evidence to support the practice of labiaplasty and the risk of harm is significant, particularly for teenagers who are still in stages of development both physically and psychologically. We hope this resource will provide information for girls and young women that their vulva is unique and will change throughout their life, and that this is entirely normal and healthy.”
Ms Laura West, participation and volunteering manager at Brook, said:
“All young people deserve education, support and advice about anatomy, but unfortunately there is a lack of accurate and sensitive information available as part of the school curriculum and on the internet. This new booklet will help to address this need and will inform doctors, girls, young women and their families, as to what is normal and where to seek further help and support if required."
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