Title: Genital Aesthetics
Abstract
Why are so many people uncomfortable with their own genitals? Where have all the foreskins gone? Why is labiaplasty one of the fastest growing plastic surgery procedures in the US? Ultimately, American culture is largely based around images of sexual normalcy. Aesthetically-based genital modification, especially circumcision and labiaplasty, represent the extremes of this normative imperative, and highlight the ways in which encompassing sexual standards manifest themselves in the personal. Our podcast aims to highlight the similarities and differences in societal perceptions of genital aesthetics and get one step closer to answering the question “what are normal genitals?”
Bios
Kathryn Yetter
Kathryn Yetter is a fourth year computer science major. When she is not learning about sex in American history, she works to expand her cooking repertoire, plays with the ultimate frisbee team and works as a mentor in the computer science department. Upon graduation she will spend the summer as a camp counselor before beginning her work at an open source software development company.
Christopher Brunet
Christopher Brunet is a third year chemistry major and environmental studies concentrator plans on attending graduate school in biogeochemistry with a focus on nutrient pollution. An employee at Grinnell’s Sexual Health Information Center, he was drawn to this podcast by an interest in people’s perceptions and treatment of their own bodies and sexual health. In his free time he enjoys cooking, running, and throwing javelin.
Sarah McCarthy
Sarah McCarthy is a third year at Grinnell College majoring in Physics and Gender, Women’s, and Sexuality Studies. In her free time, she likes to run, read, or shatter glass ceilings. She loves learning history to see how little the human experience has changed over time and to hear voices that have been systematically silenced.
Jillian Rix (sound editor)
Jillian Rix is a third year physicist, mental health podcaster, and “liberal…threatening to capital and capitalism” (according to a male American Physical Society representative). She plans to graduate from Grinnell in December 2018 and sell her soul to the tech industry for a few years before pursuing a masters degree in mechanical engineering or education. Jill is interested in studying intersections between culture, race, gender and technology. In her free time she enjoys drinking milk stout and backpacking near her hometown in the pacific northwest.
Credits
Joseph Knopke (Voice Actor)
Carolyn Herbst Lewis (Life Icon and Role Model/Advisor)
Gina Donovan (Technology Consultant)
Thanks to our anonymous interviewees and contributors.
Music by Bensound.
Bibliography
Primary Sources
Anonymous. Interview by the author. Grinnell, IA. April 25, 2018.
Harper, Jorjet. “Lesbomania.” Outlines: The Voice of the Gay and Lesbian Community 12, no. 11 (1998): 24. Archives of Sexuality & Gender (accessed March 14, 2018). http://tinyurl.galegroup.com/tinyurl/66wPj5.
Anonymous. Interview by the author. IA. April 6, 2018.
Anonymous. Interview by the author. Grinnell, IA. April 25, 2018.
Secondary Sources
Berer, Marge. “Labia Reduction for Non-therapeutic Reasons vs. Female Genital Mutilation: Contradictions in Law and Practice in Britain.” Reproductive Health Matters 18, no. 35 (2010): 106-10. http://www.jstor.org/stable/25767335.
Davis, Simone Weil. “Loose Lips Sink Ships.” Feminist Studies 28, no. 1 (2002): 7-35. doi:10.2307/3178492.
Douglas, Carol Anne, Priya Verma, Katherine Goktepe, Laura Nixon, and Chapin Harris Jen. “United States: Men Coerce Women into Vaginal Cosmetic Surgery.” Off our Backs 35, no. 1 (Jan, 2005): 9. https://search.proquest.com/docview/197135192?accountid=7379.
Ehrenreich, Nancy, and Mark Barr. “Intersex Surgery, Female Genital Cutting, and the Selective Condemnation of “Cultural Practices”.” Harvard Civil Rights-Civil Liberties Law Review 40:71-140. Accessed March 14, 2018. http://www.law.harvard.edu/students/orgs/crcl/vol40_1/ehrenreich.pdf.
Fletcher, C.G. Circumcision in America in 1998. Edited by George C. Denniston, Frederick Mansfield Hodges, and Marilyn Fayre Milos. Boston, MA: Springer, 1999. doi:10.1007/978-0-585-39937-9_19.
Frueh, Joanna. “Vaginal Aesthetics.” Hypatia 18, no. 4 (2003): 137-58. http://www.jstor.org/stable/3810978.
Intact America. “Intact America.” Intact America. Last modified 2018. Accessed March 14, 2018. http://www.intactamerica.org.
Johnston, Josephine. “Normalizing Atypical Genitalia: How a Heated Debate Went Astray.” The Hastings Center Report 42, no. 6 (2012): 32-44. http://www.jstor.org/stable/23883440.
Kessler, Suzanne J. “The Medical Construction of Gender: Case Management of Intersexed Infants.” Signs 16, no. 1 (1990): 3-26. http://www.jstor.org/stable/3174605.
Kilmer, Martin. “Genital Phobia and Depilation.” The Journal of Hellenic Studies 102 (1982): 104-12. doi:10.2307/631129.
Labuski, Christine. “Vulnerable Vulvas: Female Genital Integrity in Health and Dis-ease.” Feminist Studies 39, no. 1 (2013): 248-76. http://www.jstor.org/stable/23719315.
Liao, Lih Mei, and Sarah M. Creighton. “Requests for Cosmetic Genitoplasty: How Should Healthcare Providers Respond?” BMJ: British Medical Journal 334, no. 7603 (2007): 1090-092. http://www.jstor.org/stable/20507239.
Mor Z, Kent CK, Kohn RP, Klausner JD (2007). “Declining Rates in Male Circumcision amidst Increasing Evidence of its Public Health Benefit.” PLoS ONE 2(9): e861. https://doi.org/10.1371/journal.pone.0000861
Morris, Brian J et al. “Estimation of Country-Specific and Global Prevalence of Male Circumcision.” Population Health Metrics 14 (2016): 4. PMC. Web. 30 Apr. 2018.
Patel , Flaherty EG, Dunn J. “Factors Affecting the Practice of Circumcision.” Am J Dis Child. 136, no. 7 (1982): 634–636. doi:10.1001/archpedi.1982.03970430066019
Robbins, David, Dr. Interview by the author. West Des Moines, IA. April 6, 2018.
Tiefer, Leonore. “Activism on the Medicalization of Sex and Female Genital Cosmetic Surgery by the New View Campaign in the United States.” Reproductive Health Matters 18, no. 35 (2010): 56-63. http://www.jstor.org/stable/25767329.
The Circumcision Reference Library. “United States Circumcision Incidence.” Last modified January 14, 2012. Accessed April 25, 2018. http://www.cirp.org/library/statistics/USA//.
Wohl, Hannah. “Community Sense: The Cohesive Power of Aesthetic Judgment.” Sociological Theory 33, no. 4 (2015): 299-326. http://www.jstor.org/stable/44114449.
Transcript
Chris: Its April 27th, 2018 and were here in Grinnell, Iowa
Kathryn: I’m Kathryn Yetter,
Sarah: I’m Sarah McCarthy,
Jill: And I’m Jill Rix
Chris: And I’m Chris Brunet
Chris: We’re talking today about genital surgery and aesthetics. We started by just talking to some people about what they thought about their own and other people’s perceptions of genitals.
Sarah: What do you see in these two pictures?
The following is a cut of many different voices who will be separated by quotation marks.
I mean they’re pretty much just dicks
“One is circumcised and one is uncircumcised”
“Maybe the circumcised penis looks better”
“I think more people probably think circumcised looks more normal”
“It’s probably like more present in porn”
“I think because people are generally they’re probably more concerned about… like health concerns with circumcised vs uncircumcised but there’s also like religious reasons for why people are circumcised’
“These are drawings of a woman’s pelvic area’
Sarah: And do you notice a difference between the two photos at all
“Ahhh interesting I see I think the other one is either a circumcised or surgically constructed vagina”
“Ok so it’s like what the Labia minora lips are a little bit bigger in this one?”
“Um I think that the labias are a bit different like on the left the lips are larger but I mean they just come in different shapes”
“No I feel like Iven heard somewhere that most people have really protruding labia”
“I think it’s just more normal to have big labia
“I think typically people to tend to like like a smaller labia it seems like an odd preference to have although it seems less odd for me to have a preference for a circumcised or uncircumcised but they really are pretty similar.”
Chris: I think we did see a lot of this confusion when we were talking to people in our initial interviews about what is the proper name? I think we heard everything from anatomical naming to I think someonse said “pelvic area” for their decription. And also kind of comparing people’s reactions to the circumcised penis and the labiaplasty that people immediately recognized a circumcised vs uncircumcised penis where as people tended to be more confused about what the differences between the pre and post labiaplasty were.
Sarah: I think part of that comes from the fact that we intentionally didn’t tell them this is a pre and post diagram of what happens to your body and instead people were really quick to think oh well this other picture just looks like someone just naturally has really small labia. No they’re absent from the photo!
Kathryn: I felt that was really true like it’s cool that there’s some idea that maybe they’re just smaller set. But if we showed them if we showed them a picture of somebody that was missing like a different appendage they’d be like “oh its a person without an arm.” It wasn’t ooking at the picture and saying this is a part of my body that’s missing and completely abset from the photo It was just a I’m not familiar enough to say that it couldn’t be there or I want to acknowledge that it could be there and I just don’t see it. I don’t think we would have gotten the same reaction for a different body part.
Sarah: But also there’s this assumption that well maybe someone out there has that perfect pelvic area and maybe that’s the norm. You don’t look at a photo of a circumcised penis and say maybe that person just has really really small foreskin.
Chris: We’ll start today by talking today about circumcision if you’re not previously familiar circumcision in males is the medical removal of the foreskin police cussing some theory facts and also talking to someone who had a medical circumcision later in life and their perceptions of it.
Kathryn: One thing I thought was really interesting was that people especially in the beginning of our podcast talked about circumcision as the norm and it’s true that most true that most people in the US are circumcised the CDC reports that the rate of circumcision has dropped precipitously from 56% in 2006 to 32.5% in 2009.
Sarah: What’s also really interesting as this is not a global phenomenon the NIH how to study where they found out globally only 38.7% of males are circumcised. In the US however that number is well above 70 So there’s kind of this assumption that in the US to be normal quote normal you know you have to be circumcised but then you look at the data and that’s not true all over all you know in the rest of the world.
Kathryn: In a study done by More and Kent they looked at between the years of 1996 and 2005 in San Francisco the rates of circumcision at an STD clinic they found that male circumcision may have been modestly protective against zipless in HIV-infected heterosexual men so there is some evidence that cutting off the foreskin helps protect the penis and like keep it clean and like the idea the helping to prevent disease.
Chris: There’s a number of other reasons that people site for the medical necessity of circumcision some people feel with their foreskin is too tight we talked to one person who had a emergency medical circumcision at age 10 due to infection. This interview was originally conducted between myself and someone who wishes to remain anonymous so it’s been generously recorded by Kathryn and a voice actor Joseph Knopke.
P1 indicates the interviewer. P2 our anonymous interviewee. The full audio of this interview has been edited slightly.
Original Interview Transcript:
P1: To start, can you just explain why you had a circumcision or the reasoning medical staff gave for it?
P2: Yeah I can’t remember exactly but there was an infection and I just remember being told at the time that circumcision was the solution to it.
P1: Ok. Do you remember anything about going into the procedure?
P2: Yeah I remember going to the hospital and being put under anesthesia
P1: Did they knock you out completely?
P2: Yeah and then after it was a quick recovery. I think I was out of the hospital the same day
P1: Do you remember if it was planned somewhat ahead of time or was in an emergency procedure?
P2: Yeah it was. I was at my grandpas house in Oregon in the summer. And it was bad, like I couldn’t pee without being in excruciating pain and it was funny colors. I think they put me on antibiotics for a little bit and then when I got back, I don’t remember the exact time frame but it wasn’t an overnight thing
P1: And it cleared up right away? Like it was a sound medical fix?
P2: Yeah
P1: Do you think your life or even your sex life would be different had that not happened or if you were uncircumcised?
P2: Hard to say right. Probably not in any major way.
P1: Ok. Do you, with your experience, have any opinions about circumcision in general or on whether people should circumcise their children?
P2: I don’t feel very strongly either way. Its up to them. Up to every family. You know if you’re religious and you’re doing it. That makes sense. If you’re not and you don’t want to do it… I don’t I would want to look more into health benefits of doing it or not doing it. And that what I think it would come down to.
P1: Do you think you if you hadn’t had a procedure or other people who were uncircumcised would consider voluntarily having a circumcision later in life if they thought it had medical benefit or was “cleaner”
P2: Uhh. Not me but probably some people. I don’t think unless I was told that I was like missing out on something really great I wouldn’t but I’m sure that some people would or have
P1: Do you have anything else to add about your own experience?
P2: Yeah, it was really embarrassing actually. I told my mom to tell everyone that I was like really sick. I’m sure she like told my friend’s parents what happened for real but I was like “no tell them I had a really bad cold.” And yeah that’s it.
Sarah: There’s now currently increase in literature among academics where they’re starting to be a prevailing norm acknowledging that there is no medical necessity for circumcision and a lot of times it can be difficult to equate this to the unnecessary removal of other body parts like at the doctor were to say like pinky on your hand you don’t really need it we can just cut it off because you’ll look nicer. You know that would be malpractice you’re not allowed to remove other body parts on unnecessarily as a medical professional but then why is there this normal okay when it’s done for a moral reason
Chris: yeah I think that’s one of the interesting things that makes us a complicated topic is that it’s so culturally tied but it’s also become so heavily medicalized that the two or strangely hard to separate and it’s hard to make an argument about one without dealing with the other.
Were now going to move from talking another practice circumcision into talking about labiaplasty and comparing the differences and similarities between the surgiers In general labiaplasty refers to a cosmetic procedure which is a surgical cutting away of the labia minora.
Kathryn: When we initially started researching this we kind of wondered when this kind of started and there are reports of cutting off parts of a woman’s genitals stemming way back as a treatment for kleptomania.
Sarah: yeah and there’s so many factors going into why people choose to get the procedure like and there actually are some really interesting interviews with Doctor published in places like Off Our Backs. They really talk about how bored there’s a general Norm of men coercing women into getting all sorts of vaginal cosmetic surgeries weather that the procedure like vaginal rejuvenation or a labiaplasty and actually Dr. young doctor from Florida said that the most common reason why women said that they’re were getting a labiaplasty was a negative comment made by a male sexual partner.
Kathryn:
we’re reading on activism on the medicalization of sex points to the release of Viagra as really kind of the beginning of medicalization of Sex and the author talks about how she thinks the sex has now moved from this realm of like your personal experience with sex to the realm of medicalization big point is that medicalization of sex compounds on women’s opression and so it’s actually then they have to ask themselves “what did I do wrong” and the medical profession is here to stay like we have a cure for you you know whatever the cost is
Chris: Our sound editor Jill Rix went to a cosmetic surgeon to have a consultation about a labiaplasty so we can hear some thoughts from someone who performs the procedure about what they thought is purpose was.
Unnamed Doctor: so I have you hold this mirror because I just want to make sure that we’re understanding anatomy. So labia minora and then so that’s what bothers you? So its a little bit, there’s some pretty good symmetry, so I’d just make an incision here.
Jill: show up at the store plastic surgery place and it was really surreal my body was very much quickly reduced to like something that needed to be fixed and having this nurse but kind of validate all my concerns about myself and be like yeah this is like a really common thing that happens to people and like it was an entirely different atmosphere around the Doctor Who who in the recording said that he’s not like vagina expert but he was like it’s about like which types of procedures he thought looks best and which types of procedures he didn’t like.
Unnamed Doctor: The labia really serve no purpose serve no purpose other than just appearance so when its enlarged like that it can be trouble for people I was trained by gynecologist in California and out there they removed with some people wanted they’ll remova all the labia. In my opinion when I was out there thats not like the appearance that I prefer that like there’s something missing here.so I don’t do that, people in Iowa don’t want that.
Jill: also talked about how late some women decide to get it because they don’t like the way their labia looks like in tight pants or that like the cameltoe kind of thinking that like women might get it to avoid that happening so they can wear tight or yoga pants or so they can bike. All these other reasons that I might want to get it kind of just came out of the air from the nurse and doctor
Unnamed Doctor: Well there’s two types of patients we do labiaplasty on. That’s the most common one, we do two kinds of vaginal surgery but labiaplasty is the number one. I would say that 50-60% are pre-kid, you would think that they would all be post kid because things get stretched out a little but I would say that the majority at least that I see are born that way.
Jill: and he looked at me for probably 15 seconds and told me that I would be a good candidate for the surgery
Sarah: One thing I think is really tricky to consider with this procedure specially since it’s not covered by procedure especially since it’s not covered by insurance is consent and can you trust the advice of a doctor who is going to make an awful lot of money off of this procedure. When there is a power structure that makes consent very very difficult because you can also be coerced into things. We talked about two procedures where what would be considered excess skin is removed from genitals. But, the perceptions of male circumcision and labiaplasty are so different.
Kathryn: Well I think part of it from my perspective is that labiaplasty as known as labiaplasty instead of genital cutting is a newer phenomenon in a lot of ways. I think circumcision has these like historic religious roots and that the majority people in the United States who have penises are circumcised and I think that really adds to them being treated as differently it’s normal to talk about like a circumcised or uncircumcised penis. But because fewer people had labiaplastys we don’t talk about it it’s like “oh do you still have your labia minor or do you not have your labia minora?”
I guess we’ve been talking a lot about these two procedures and issues of these procedures but I think we all feel like we would be amiss if we didn’t also talked about intersex procedures that happen at Birth or you know within the first 5 years off and on to a child’s life where a child is born with genitalia that is seemingly ambigious, the doctors at the time decide to undergo some sort of medical procedure with this child to make the genitalia look more like a vagina or more like a penis and so how the medicalization of gender and of sex goes into what genitalia are constructed for this child. Medical construction of gender article by Kessler she talks about to how lot of Surgeons talk about this need for their parents to be sent home with a boy or a girl.
Sarah: The way that Doctors often times handle the cases of these intersex infants also relies on them differently valuing the sexual pleasure that a penis or clitoris would have and in that it’s more acceptable for there to be female genitalia that would not be able to orgasm than that there would be male genitalia that would not be able to orgasm.
Chris: I think that these are all about but that we really should have come far in the theory and in the details of talking about the cultural meaning and necessity of some of these procedures and their similarities in their differences I think that looking at all of these things helps us come to some conclusions about why people have these procedures who has power in these procedures the cultural meaning behind these procedures and how we build identity or communities around these procedures. I think we’ve seen that across-the-board people feel that even though our constructions of what normal is particularly in terms of General Aesthetics that people feel strong cultural ties or cultural pressures to fit into that Norm despite what alteration or surgery it might take.
Transcript
