The Secret Lives of Mormon Wives — Labiaplasty?

Hi, Bestie! Have you also been binge-watching The Secret Lives of Mormon Wives or is that just me? What a fascinating reality show with enough material to keep us talking for a century. While we can’t cover every topic today (and boy are there pelvic health references upon pelvic health references in there), something I thought we could touch on is labiaplasty. 

What are the labia minora?

The labia minora are the two flaps of skin on either side of the introitus (vaginal opening) (1). They are the “inner flaps” that sit within the labia majora, or the “outer flaps.” The labia minora are important in the protection of the vaginal opening, urethral opening, and clitoris (2). They also come in a variety of different shapes, sizes, and colors. All vulva owners have unique labia minora and appearance of the vulva. Some labia minora are longer than others and protrude beyond the labia majora, while others are shorter and do not extend beyond the labia majora’s margins. 

What is a labiaplasty?

A labiaplasty is a surgical procedure used to reduce the size of the labia minora (1). It may be performed for functional or cosmetic reasons. Most of the labia majora is made up of skin that is just like the skin around the rest of the body (3). It can grow hair and stays dry. However, the labia minora is lined in a modified mucous membrane and remains moist due to secretions from nearby glands (3, 4). 

When the labia is larger than expected, it is called labial hypertrophy (2). Hypertrophy can affect both the labia majora and labia minora, but more often affects the labia minora (2). In cases of labial hypertrophy of the labia minora, labiaplasty may be indicated for functional reasons (5). This is because extension of the delicate labia minora tissue past the labia majora can be uncomfortable and irritating for some. Since the tissue is made of a modified mucous membrane, it is more susceptible to irritation which could be caused by a number of factors such as constant rubbing against fabric, sexual intercourse, horseback riding, or others. 

The labia minora may change throughout life. Some experience labial hypertrophy of the labia minora after pregnancy, while others experience a shrinking of the labia minora tissue (2). For those with labia minora irritation or discomfort, labiaplasty is not the only treatment. Wearing cotton undergarments, opting for loose-fitting pants, and switching to scent-free soaps can make a big difference (2). If these noninvasive treatments don’t do the trick, labiaplasty can be beneficial in improving quality of life. 

Cosmetic Labiaplasty

Labiaplasty may also be performed for cosmetic reasons. For example, if a vulva-owner is not happy with the look of their labia minora, they might opt for a labiaplasty to improve the appearance of the vulva. Please note that, in the absence of pain, discomfort, or disease, all vulvas are as they should be. They all look different from one another and no one appearance is better or worse than another. Society has impressed upon young vulva-owners that there is a certain way their vulva should look and it is driving more and more of them to seek out labiaplasty surgery.  

In the United States, labiaplasties experienced a 36% increase in 2021 compared with 2020 (6). Globally, there was a 73% increase in labiaplasties between 2015 and 2020 (6). Granted, some of these labiaplasties were likely done for reasons of pain or discomfort in the labia minora. However, research looking at patients’ motivations to pursue labiaplasty has suggested that appearance is the top motivating factor (6). It is clear that labiaplasties are growing in popularity due to societal pressures and standards. While there is absolutely nothing wrong with getting a cosmetic labiaplasty to “beautify the vulva,” (your body, your choice!) I am concerned about the societal “norms” that have driven more and more young females toward surgical alteration in order to fit a specific mold. One study found that 71% of those that decided to undergo labiaplasty had received at least one critical comment from a sexual partner (7). To say that I find this absolutely infuriating is the understatement of the year. 

A few years ago, I was taking a continuing education course on pelvic health. During the course, the instructors showed the class a bunch of images of different vulvas and talked about how each vulva is unique, just like a flower. One young woman who was in the audience stood up, crying, and shared her experience with her own labia. She talked about her lack of confidence in her anatomy and her feeling like she did not look “normal.” She said she had considered undergoing labiaplasty to improve the aesthetics of her labia minora. However, after seeing the wide range of normal vulvas , she realized her anatomy was perfectly normal. It brought her a great deal of peace and self-acceptance. 

That was one of the most beautiful moments I’ve ever witnessed. It was a woman developing a deeper love for her own body. All it took was a little bit of education and a room full of others who could completely understand and relate to her. I replay that moment in my mind often.

As a pelvic health practitioner, you see vulvas all day long. It becomes apparent very quickly that everyone looks a little different. For most people, the only vulva they see is their own. This can make it difficult to know what is normal. My recommendation is to build a love and appreciation for your own anatomy. It is unique and beautiful the way it is. You deserve to make choices about your body and may even choose to pursue a cosmetic labiaplasty, but my hope for you is that you don’t let that choice be driven by your desire to fit into some “norm” that is completely fabricated by the world around us. If you experience vulvar discomfort, talk to your medical about what treatment options are available. 

Thanks for being here, you’re beautiful inside and out.

XOXO,

Your Pelvic Bestie  

References:

1. https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery/labiaplasty/

2. https://www.medicinenet.com/what_is_the_purpose_of_the_labia/article.htm

3. https://www.twolips.vip/blogs/experts-say/is-the-skin-of-the-vulva-the-same-as-the-skin-of-the-rest-of-the-body-or-is-it-more-sensitive-in-comparison#:~:text=The%20skin%20of%20the%20labia,fluid%20secreted%20by%20specialised%20cells.

4. Nguyen JD, Duong H. Anatomy, Abdomen and Pelvis: Female External Genitalia. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547703/

5. https://www.medicinenet.com/what_is_the_purpose_of_the_labia/article.htm

6. Sharp G, Draganidis A, Hamori C, Oates J, Fernando AN. Beyond Motivations: A Qualitative Pilot Exploration of Women's Experiences Prior to Labiaplasty. Aesthet Surg J. 2023 Aug 17;43(9):994-1001. doi: 10.1093/asj/sjad105. PMID: 37066825; PMCID: PMC10434981.

7. Sharp G, Mattiske J, Vale KI. Motivations, expectations, and experiences of labiaplasty: a qualitative study. Aesthet Surg J. 2016;36(8):920–928. doi: 10.1093/asj/sjw014

*The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a qualified health provider regarding any questions you may have about a medical condition or health objectives