Type IV & FGM

Aesthetical genital surgeries and procedures


Aesthetic or cosmetic genital surgeries and procedures include a wide variety of practices performed for aesthetic or sexual reasons, including labioplasty (inner labia surgery), labia majora enlargement or reduction, genital whitening, G spot injections, hymenoplasty (hymen reconstruction), laser vaginal rejuvenation, clitoral hood reduction, etc. In contrast to the lip enhancement communities, the social norm in Europe and other Western societies is that of smaller vulvae with less protruding lips. As a result, some European and American women choose to undergo cosmetic genital surgery to reduce the size of their lips, sometimes even bringing them closer to pre-pubescent lips. These types of cosmetic genital surgeries are sometimes called “designer vaginas” (Mandal, 2018, Thomas, 2018).

Cosmetic genital surgery is legally accepted in many countries. However, some experts have argued that these forms of plastic surgery can be compared to genital mutilation in different ways. They are usually performed for non-medical reasons, can have negative health consequences and women tend to perform them under social pressure to approach an “ideal vulva” model, or to remain a virgin before marriage (in the case of hymen repairs).

FGM, consent, aesthetical genital surgeries (members’ contributions)

During the discussion, it was noted that there is an increase in the number of adult women resorting to genital cosmetic surgery, which can be compared to type IV and sometimes type I FGM. 

Anne-Marie Middelburg reported that she had been invited to speak at a conference organised by plastic surgeons and gynaecologists in Germany. The programme included live viewing of six plastic surgery sessions. The audience witnessed a reduction of the foreskin of the clitoris, a tightening of the vagina and some reduction of the labia. While the surgeon was operating on these women, the audience could follow the operation live on large screens and could even ask questions. 

“FGM of any kind, including type IV, is considered a human rights violation and is criminalized. Even ‘pricking’ is considered to be a form of FGM. But these types of genital operations (some of which were quite serious) are not considered a human rights violation, are not criminalized and occur on a large scale.”

Indeed, some women in Liberia, Sierra Leone, the Gambia and Kenya are campaigning for adult FGM. In their view, once a girl is over 18, she should have the right to undergo (a “light” form) of FGM.

On the same topic

Labia elongation (not included in WHO’s classification)

Type IV & FGM Labia elongation (not included in WHO's classification)   What, Where, Why? The “labia minora” (inner lips) are the folds of skin on either side of the vulva. Their size varies greatly from woman to woman, so there is no “normal” labial length....

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Other forms of Type IV FGM

Type IV & FGM Other forms of Type IV FGM   The definition of type IV has been modified in the new typology, published in 2007. Some forms are no longer found in the WHO definition of FGM type 4. It was decided to focus on “cuts” because of their obvious...

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Genital Piercing

Type IV & FGM Genital Piercing   What, Where, Why ? Piercing can be defined as “an opening in any part of the body through which jewellery can be worn”. Among the most common forms of female genital piercing is the clitoral cap, of which there are different...

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Type IV & FGM Pricking   What, Where, Why? The piercing the clitoris or surrounding tissue, pricking, is a procedure in which the skin is pricked with a sharp object. Blood may flow but no tissue is removed and no stitching is done. Pricking is practiced in...

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