Kinsey Confidential

Question: \nI've been aware since my pre-teen years that I have rather large labia minora and have often felt very self-conscious to the point that I'd want to cut the "excess" off when I was young. Hearing from health care providers that this is normal has not helped me to feel more secure. Even with my legs together they protrude out. They get in the way of intercourse and while sitting or moving in certain ways while wearing jeans, they may be pinched. I feel labiaplasty could help me. I'd like to speak with someone about this issue and find a doctor who can perform this procedure. Do you have any information for me? \n \nAnswer: \nWhile it's absolutely the case that women's vulvas vary in skin color as well as the shape and size of the labia minora (inner vaginal "lips") and clitoris, most women do not regularly experience vulvar pain or labia pinching from daily activities like walking, sitting or wearing certain kinds of clothing. \nMany artists, including Judy Chicago and Betty Dodson (see bettydodson.com), have glorified the vulva as a graceful, flower-like, and awe-inspiring part of the body. This positive view of the vulva has been important to many women's appreciation of a body part that, at least in the United States, is often otherwise portrayed as dirty, smelly or ugly -- which is why some health care providers try so hard to help women accept their genitals in their natural state. \nAnd yet women's relationship with their genitals is enormously complex, as Eve Ensler showed in her play and book "The Vagina Monologues." Like you, some women feel physically uncomfortable due to the length of their labia. Their labia may get pinched when they wear certain kinds of clothing, engage in various forms of exercise or try different sexual acts. Labiaplasty (surgical cutting and reshaping of the labia) is sometimes used to help women in these situations. \nA difficulty with labiaplasty is that while some popular magazines and Web sites write about (or even promote) what's been dubbed a "designer vagina" type of surgery, the scientific literature tells a story of ever-evolving surgical techniques -- but only a little research about the ways in which surgery might affect women's experiences, sexual or otherwise. \nThe vulva is rich with nerve endings and (as with other body parts) any time cutting occurs, there is the risk of damage to the ways in which you experience sensation, making the surgical choice an important one. If you are interested in consulting with a health care provider with expertise in vulvovaginal health (who could either perform the surgery themselves or perhaps refer you to someone), you might ask for suggestions from the National Vulvodynia Association (www.nva.org) or the American Society of Plastic Surgeons (www.plasticsurgeon.com). \nFurther, you may find that reading "The V Book: A Doctor's Guide to Complete Vulvovaginal Health" by Dr. Elizabeth Stewart (a leading expert on vulvovaginal health) will provide you with a fair amount of information about vulvar health and anatomy. Then, should you consult with a health care provider about labiaplasty, you'll be well-informed and able to ask useful questions about how the surgery might change not only your vulva's appearance (or sensation). \nIf you would like the support of a counselor as you consider these issues about your body, consider making an appointment with a counselor at the IU Health Center's Counseling and Psychological Services atwww.indiana.edu/~caps, or in the community. This can be helpful regardless of whether or not you choose surgery. Good luck! \n \nKinsey Confidential is a service of The Kinsey Institute Sexuality Information Service for Students (KISISS) at Indiana University. Visit the Web site at www.indiana.edu/~kisiss or write to us at kisiss@indiana.edu.