The Malleable Vulva?

The demand for female genital cosmetic surgery is on the rise in Belgium and the Netherlands. What is driving this trend? Postdoctoral researcher Dr Hannelore Van Bavel from the interdisciplinary research centre RHEA (Research Centre on Gender, Diversity and Intersectionality) seeks answers. She focuses on the motivations of people with vulvas who choose to undergo surgery. What compels them? What social and medical factors come into play? With her background in feminist anthropology, Hannelore examines not just the surgical procedures themselves but also how people perceive their vulvas—and the ways in which this self-image can be navigated.

Insecurities about the vulva are widespread and affect people of all ages. "Almost everyone with a vulva experiences certain insecurities," says Hannelore. Common concerns revolve around odour, hygiene, and the shape of the labia. However, the ways in which people deal with these insecurities vary greatly. Some opt for surgery, while others find alternative ways to accept and embrace their genital self-image.

"Almost everyone with a vulva experiences certain insecurities"

Alongside the growing popularity of cosmetic procedures, there is also a movement celebrating vulva diversity. Initiatives such as The Vulva Gallery and The Great Wall of Vulva help people develop a more positive genital self-image. "One of my interview participants told me she might not have undergone surgery had she been aware of such initiatives earlier," Hannelore shares.

Sharing experiences with a paintbrush in hand

To gain deeper insight into how people experience their vulvas, Hannelore employed various research methods, including focus groups and interviews. One particularly striking method she used was painting. During the focus groups, participants were invited to paint while discussing their genital self-image.

"Painting made the conversations less confronting and helped people talk about sensitive topics more naturally," Hannelore explains. "When you're using your hands, it often feels easier to put your thoughts into words. You don’t have to maintain constant eye contact, and if you don’t want to answer a particular question, you can lose yourself in the painting process."

In addition to the focus groups, Hannelore interviewed women who had undergone labiaplasty. "Some women reported experiencing functional discomfort but later wondered whether it was actually more about insecurity over their appearance," she says. To build a comprehensive picture, she also spoke with plastic surgeons and gynaecologists, uncovering that the line between ‘functional’ and ‘aesthetic’ motivations for these procedures is not always clear-cut.

What stood out most to Hannelore was the profound impact that insecurities can have on sexual experiences from a young age. "It struck me how 18- and 19-year-old girls are more preoccupied with how their vulvas look and what men think of them than with their own pleasure and experience," she says. "Some even worry about vaginal tightness, despite being at an age where, without pregnancies, that should not be a concern at all. This highlights just how problematic genital self-image can be for young people."

Are policy measures needed?

Hannelore emphasises that there is no single way to approach female genital cosmetic surgery. "The way you look at it determines what you see. My goal is to highlight this complexity."

To further explore this complexity, she plans to collaborate with an interdisciplinary team of plastic surgeons, gynaecologists, bioethicists, sexologists, and fellow anthropologists. Together, they aim to analyse the policy implications of her findings.

Currently, Belgium has no specific guidelines on genital cosmetic surgery, whereas countries like the Netherlands, the United Kingdom, and Canada have already introduced recommendations. "We need to consider whether Belgium should implement guidelines as well, and what these should look like," Hannelore suggests. Key aspects under review include whether regulations should define who is allowed to perform these surgeries and whether vulva diversity should be integrated into medical and sexual education.

Hannelore is still looking for participants for her research. Have you undergone a genital cosmetic procedure and would like to take part? Get in touch at hannelore.van.bavel@vub.be. More information can be found on the website and Instagram of Genitalks.*

*This is a machine translation. We apologise for any inaccuracies.