Name: Nicole Russell
Student Number: 7532784
Topic: Labiaplasty- Structure or Agency?
Tutor: Steve Badman

The Artefact


The Great Wall of Vagina was unveiled in mid-2011 by artist Jamie McCartney. This artwork is comprised of 400 plaster cast vaginas, broken into ten panels of 40; this artefact is just one of these panels. Women from all aspects of life volunteered to be a part of this project, with mothers, daughters, twins and transsexuals just some of the women involved. Despite his efforts, McCartney was not able to find a participant who had experienced female genital mutilation to participate however. Constructed over a five year period, participants were aged between eighteen and seventy-six. (McCartney, 2011).

The Public Health Issue

When the topic of labiaplasty is first discussed, the public health issue is not always apparent. This is due to the overwhelming sense of agency present, as this is considered to be a cosmetic procedure that a woman chooses to have (Davis, 2002). However, when more in depth research is undertaken, it becomes evident that women from all aspects of the world are feeling the social pressure to have the perfect vagina, what has become known as the ‘designer vagina’- thus indicating that the need to conform to a social structure is creating a public health problem for women, both emotionally and physically.

Literature Review

Literature suggests that the reasons in which labiaplasty surgery is undergone can be broken into three different groups. The first, and most common, includes patients who elect the surgery purely for aesthetic reasons. The second category includes patients who elected the surgery to correct a functional issue- such as irritation when wearing tight clothes and the third category includes patients who elected this surgery based on a combination of the previous two options. In a 2008 study conducted by Miklos and Moore, results showed that almost 40% of patients who were about to undergo labiaplasty within their surgery fell into category one. They also noted that just short of 8% of total participants admitted that they had been influenced in their decision to have the surgery by either a male or female partner. Data was gained through the use of surveys prior to and after the operation taking place. A limitation to this research however, is that as this is a very sensitive issue and these women who already have issues in the way they feel about their bodies, may not give truthful answers to all questions, for example, questions regarding their decision being influenced by other parties or the media (Miklos & Moore, 2008). Continuing on from this study, Goodman (2011) reinforces that the main driving reason that women undergo labiaplasty surgery is for aesthetic reasons, with 93% of patients surveyed in his study conveying the same message.

A common issue raised in the reviewed literature was how the media, in particular the pornography industry, have created the ‘designer vagina’. Through glorification of surgically modified vaginas in the media, women now feel pressured to achieve this unspoken standard through surgery (Braun, 2009). Davis quotes an article written in 1958 by plastic surgeon Milton Edgerton, with regards to breast augmentation. “Literally thousands of women… are seriously disturbed by feelings of inadequacy in regard to concepts of body image. Partly as a result of exposure to advertising propaganda and questionable publicity, many women develop an almost paralysing self-consciousness...” (Davis, 2002). Although this is an aged article, the principle of the matter is still relevant. Davis discussed how the essence of this statement can be applied to all aspects of cosmetic surgery, including labiaplasty. Davis (2002) also discusses how plastic surgeons are more and more frequently presented with the latest edition of Playboy magazine and women stating ‘this is what I want’. These images have been airbrushed and digitally altered, giving women a false sense of ‘normality’. Reality television shows that depict bodies that are considered to be abnormal by society have also challenged the way women perceive themselves and what they consider to be normal. Small changes, such as removing their public hair, through to large changes, like altering the appearance of their vagina, are all carried out to allow women to have a sense of social conformity (Levine, 2011)). Women interviewed indicated how strongly they felt this social pressure, therefore having a free choice and agency in the matter almost impossible. Similarly, Braun (2009) discusses how easily women can be swayed in their decision to have labiaplasty based on the cultural standards set out by society on what is considered to be attractive. Labiaplasty surgery, like all cosmetic surgeries, is removing diversity and difference from society, with women all trying to achieve the one desired look (Braun, 2009).

Not only does the literature discuss how the media has a role in altering the way women perceive their bodies, but how the plastic surgery industry also plays a part. Advertising campaigns to attract new clientele have been showed to provoke anxiety amongst women and increase body-esteem issues. One particular advertising campaign that is discussed in Braun’s (2009) article involved sending women the message that in order to be a powerful member of society, you needed to have the perfect vagina- with the slogan ‘empowered women have female genital cosmetic surgery’. Levine (2011) discusses in his article a survey undertaken by physicians in America. Results indicated that more male plastic surgeons were likely to encourage patient to opt for labiaplasty to reduce the size of their labia minora, as opposed to their female counterparts and general practitioners. Many stated that this was because they believed this type of look was more aesthetically pleasing (Levine, 2011). This indicates that not only can women feel pressure to conform from their intimate partners, but also their surgeons- the people they turn to for guidance.

Another interesting point raised within the literature was whether patients undergoing labiaplasty were in fact making an informed choice. With male entertainment magazines exposing women to a skewed sense of what is considered to be normal, as opposed to women being exposed to multiple real vulvas (aside from homosexual women), it is has been suggested a woman’s choice based on aesthetic reasons cannot be seen as real, and are invalid (Braun, 2009). All most all of the articles examined on the topic of labiaplasty indicate that there is no ‘normal’ when it comes to the shape and size of the labia.

Cultural and Social Analysis

Women of all ages are affected by this public health issue. Research indicates that the average age in which women underwent labiaplasty was 35 years old, however, girls as young as 15 were identified to have undergone this procedure (Miklos & Moore, 2008).

The discussion of labiaplasty in terms of structure and agency is one that is highly dominated by feminist theorists. Arguments are strong on both sides of the issue, but all acknowledge that the social pressure to conform that women feel is growing at a rapid rate.

Camille Nurka identifies that female genital cosmetic surgery is another form of body modification; an umbrella term used to cover a range of things such as body piercing and tattoos. Whilst many people believe that they are modifying their bodies to display their individualism, majority of partakers are subconsciously adhering to a social standard, indicating that these practices no longer promote agency, but rather the opposite; an individual conforming to social structure. Nurka also identifies that society has a difficult time identifying this as a cultural issue, rather than a medical issue. (Nurka, 2012).

It is important to realise that not all women are affected by this trend; this public health issue will only effect those whose ideologies possess similar concepts. Women who have a strong sense of agency will not feel the need to adhere to these social standards; however, public health experts still need to address this issue, to prevent those women who do crumble under the pressure of adhering to social structure from suffering adverse effects. As frequently suggested in the literature reviewed for this analysis, public health experts need to address the lack of standards surrounding labiaplasty. Currently, no standards offer medical practitioners any guidance on when they should and should not perform this surgery, leaving it up to their own judgement. This also means that there currently are no uniform assessments of the driving factors behind a woman’s desire to have the surgery; there is no way for the health industry to stop this becoming the next trend within society, no way to stop social oppression from taking over. (Health Reference Centre, 2010). As previously discussed, plastic surgeons can also provide a biased opinion when examining their patients and deeming if surgery is necessary for this same reason. Enacting a uniform standard would ensure that this practice can no longer be performed on women unnecessarily (Levine, 2011).

Another strategy that public health experts could adopt would be to educate women in the wide variety in what is considered to be normal, the same concept that Jamie McCartney presented in his artwork. By providing women with this information, the idea of the ‘designer vagina’ would become irrelevant; eliminating just one of the many trends of society that women feel the need to conform to.


This artefact aims to identify how easily a woman’s ideologies can be swayed by cultural standards set out by society and the media. It represents the diversity among women’s vaginas; it aims to educate women that vaginas are like faces- everybody is different and there is no ‘normal’. McCartney used his position within society to try and ease the pressure women feel to have the perfect vagina. McCartney stated his goal was ‘changing female body image through art’. (McCartney, 2011).

From this assessment piece, I have learnt just how much of an impact society and the media can have on one’s ideologies, even without them knowing. I found it really interesting to read about the differences between cultures, which highlighted to me that what is considered to be normal to me, may be seen as strange to a person from another culture and vice versa. I believe that this will benefit me in the future, especially as a paramedic, to be mindful of others and to view all situations from a range of aspects to ensure I obtain a full understanding.
|| ||

Braun, V. (2009). The Women are Doing it for Themselves. Australian Feminist Studies, 24(60), 233-249. doi:10.1080/08164640902852449.
Davis, S. (2002). Loose Lips Sink Ships. Feminist Studies, 28(1), 7-35. Retrieved from
Goodman, M. (2011). Female Genital Cosmetic and Plastic Surgery: A Review.
The Journal of Sexual Medicine, 8(6), 1813-1825. Retrieved from DOI: 10.1111/j.1743-6109.2011.02254.x.
Health Reference Centre (2010). Labiaplasty for well women, UK.
Reproductive Health Matters. Retrieved October 27, 2012, from|A236247717&v=2.1&u=qut&it=r&p=HRCA&sw=w&authCount=1
Levine, S. (2011). Fashions in Genital Fashion: Where is the line for Physicians?
Archives of sexual behavior, 41(3), 735-736. doi: 10.1007/s10508-011-9849-7.
McCartney, J. (2011). About The Great Wall of Vagina | The Great Wall of Vagina.
The Great Wall of Vagina. Retrieved October 15, 2012, from
Miklos, J., & Moore, R. (2008). Labiaplasty of the Labia Minora: Patients? Indications for Pursuing Surgery.
The Journal of Sexual Medicine, 5(6), 1492-1495. Retrieved from DOI: 10.1111/j.1743-6109.2008.00813.x.
Nurka, C. (2012, August). Female genital cosmetic surgery: a labial obsession.
The Conversation: In-depth analysis, research, news and ideas from leading academics and researchers//. Retrieved November 1, 2012, from