Female genital cosmetic surgery

I read with great interest the January editorial on female genital cosmetic surgery.1

The Royal College of Obstetricians and Gynaecologists defines female genital mutilation as all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs, whether for cultural or other non-therapeutic reasons.2

The practice of female genital mutilation is generally condemned, and under the Female Genital Mutilation Act 2003 it is illegal in the UK. However, the distinction between female genital mutilation and female genital cosmetic surgery is not clear and it could be argued that many aspects of female genital cosmetic surgery fall within the definition of female genital mutilation. After all, much of female genital cosmetic surgery is purely cosmetic with no medical benefits attached, and as Liao and Creighton point out, much of the drive behind women requesting female genital cosmetic surgery arises because there is a Western societal preference for small labia.1

The World Health Organization further classifies female genital mutilation into four major types. Type 2 excision includes ‘partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora’3 – does this not accurately describe labial reduction?

At a time when there is such a big international drive to stamp out female genital mutilation because it is viewed as a violation of human rights, is it right that in western countries female genital cosmetic surgery is actually on the increase? May we be seen as hypocritical in condemning countries that practice female genital mutilation if we willingly refer girls for female genital cosmetic surgery?

• © British Journal of General Practice, April 2011