Websites for providers offering female genital cosmetic surgery (FGCS) contain poor quality and limited clinical information regarding procedures and risks, show study results.
The terminology is confusing, and in the absence of robust evidence for clinical effectiveness, websites make scientifically inaccurate claims about procedures' physical, psychological, social, and sexual benefits, say the researchers.
"Impeccable professionalism and ethical integrity is crucial for this controversial practice," recommend Sarah Creighton and colleagues, from University College Hospital in London, UK, whose internet search using the term "designer vagina" identified procedures ranging from "genital reshaping" to "labial hypertrophy."
Creighton and team suggest that healthcare providers "should emphasise that healthy vulvas come in all shapes, sizes, and colours, that all vulval appearances are compatible with psychological and sexual wellness, and that the majority of women do not choose to surgically alter their healthy vulva."
The team analyzed the content of five UK and five US websites offering FGCS using 16 information categories including immediate and long-term potential clinical effectiveness, and adverse events.
A total of 72 procedures were mentioned by the sites with some terms possibly referring to the same procedure (eg, hymenoplasty/hymen reconstruction/revirgination). The greatest proportion of text was devoted to labia minor reduction, report the researchers, with three websites using the term "labial hypertrophy" as a reason to undergo this procedure.
Indeed, "labial hypertrophy" is a rhetorical term since it is "not rooted in science," remark Creighton and co-workers.
Just two websites gave success rates of surgery (95% and 100%, with no definition of what constituted success), yet the "social and psychological" advantages of FGCS were mentioned on all 10 websites. Six websites gave lists of common surgical effects including infection, while four sites did not name any risks at all.
Most disturbing, say the researchers, was that no websites gave a lower age limit for any of the FGCS procedures.
"Given the fact that anatomy continues to change throughout the lifespan, the younger a girl begins her FGCS journey, the higher the number of lifetime operations and the greater and more multiple the risks," they conclude.
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