“Ladies, love your vagina,” wrote Germaine Greer in a famous essay - or words to that effect; Greer's original 1971 language was a little fruitier. In her usual provocative style, she then went on to explore the complex relationship women have with their anatomies and the causes of female dissatisfaction with their genitalia. Greer was always ahead of her time, but even she could not have predicted the 21st century rise of the “designer vagina” as increasing numbers of women seek to trim, tighten and transform this most delicate of areas in their search for the perfect pussy. As the campaign grows to clamp down on the barbaric practice of female genital mutilation (FGM), we see increasing acceptance of female genital cosmetic surgery (FGCS) in the Western world, which seems to suggest a kind of cultural relativism at work. We look on in shock and disapproval at FGM, but say nothing as female genital surgery continues to grow in popularity – the most common of which is the labioplasty (trimming and reshaping of the labia, mainly for aesthetic reasons).

Clearly, there are major differences between the two procedures, the most obvious of which is consent. FGM is forced upon babies and children, usually without anaesthetic in unsanitary conditions, and is not generally carried out by a medical professional. Horrific complications can result, including death. In contrast, a “designer” procedure is elective, performed by a surgeon in a theatre, most usually on grown women – although growing numbers of young girls are seeking this kind of surgery, with figures from 2012 revealing that the NHS performed 343 genital surgical procedures on girls under fourteen in the previous six years. FGM is regarded as a violation of human rights by the UN, whereas FGCS is something you can buy off the menu, along with bigger boobs or a nicer nose. Autonomy over our own bodies is one of the key demands of feminism. As Cher once said: “If I want to put my tits on my back, that’s nobody’s business but my own. They’re mine.” Fair enough, but some feminist academics, including Greer, have suggested that FGM and FGCS are two sides of the same coin, and that both are indicative of the subjugation of women in a patriarchal society.

The pressure to conform

Whilst I think forced mutilation is infinitely worse, what connects both procedures is the fact that women’s bodies are being made to conform to some kind of cultural norm. With FGM, the norm is to repress sexuality to ensure that a girl remains a virgin until she marries, and is imposed on its victims by the expectations of the church and the family. With FGCS, the aim is not to repress sexuality, but to enhance it, as its willing victims believe they would look more attractive or would have better sex if they are somehow altered “downstairs”. Instead of the church and family, we have marketing and the media to tell us how we ought to look. In cultures where FGM is practiced, enjoyment of sex by a woman is seen as sinful, whereas in western societies, we are persuaded that it is both our duty and our right to be having great sex and that this can be achieved through acquiring the “perfect” body.

Some gynaecologists, including Linda Cardozo of King’s College Hospital, have warned that British women are placing themselves at risk by undergoing FGCS in private clinics where levels of expertise and experience amongst doctors vary widely. On the NHS, patients seeking cosmetic surgery are required to undergo adequate psychological counselling before surgery is agreed to, whereas private clinics often offer little in the way of a psychological assessment of patients. According to a 2008 survey for the Journal of Sexual Medicine, only 32 per cent of women who underwent FGCS did so to correct a physical problem whilst the rest did so partly or wholly for aesthetic reasons.

A risky business

Risks of FGCS include permanent scarring, infection, bleeding, irritation and nerve damage, which can lead to decreased sensitivity – complications not dissimilar to some of those experienced by girls who have undergone FGM. So a woman might lose sexual pleasure, but never mind, at least she’ll be nice and tight and tucked in, the perfect receptacle for her partner. Whilst FGM is done because men in the cultures which practice it require their wife to be a virgin, FGCS is performed in the western world to conform to the sexual expectations and preferences of men, as viewed through the skewed prism of pornography and the media.

With the explosion of internet pornography, boys and girls are often exposed to pornography at a young age alongside hypersexualised imagery in advertising, so their expectations of what a woman should look like can be very unrealistic. In most pornography, the pussy on parade resembles that of a little girl – neat, clean and hairless. Simone Weil Davis, an academic and author of the fabulously titled “Loose Lips Sink Ships” believes that because most women only see their own vaginas or pornographic images, it is easy to make them doubt that they are “normal”. We don’t generally go around taking a long, hard look at the vaginas of other women, so we may be unaware of the natural variation in size and shape, and the clever marketing executive can easily exploit this by means of strategically placed articles and advertising in magazines.

In search of perfection

Cosmetic surgery in all its forms is the perfect manifestation of free market capitalism. Take something which costs nothing – human insecurity – and market it to offer a solution created by science in order to make a healthy profit. Even in the recession, the cosmetic surgery industry has boomed. At the moment, the designer vagina might seem like a minority procedure for a few silly, vain women, but that’s exactly how it started with the now ubiquitous boob job. Back in the seventies, only Playgirl bunnies and actresses had them. Now, they are so commonplace, it is sometimes harder to spot a real pair. Vaginal surgery is performed on an area not generally on display to the public, so it doesn’t have the obvious benefits of, say, a nose job. But some women are so insecure about their perceived abnormalities that it prevents them from having sex, so little wonder they seek a solution. Once the technology is available, the genie is out of the bottle – if it ain’t perfect, you can fix it. Indeed, you should, or so the subliminal message goes.

It seems odd that at a time when western women are at their most free in terms of career and lifestyle choices, suddenly we are told our vaginas are not okay any more. An animated short film, Centrefold, features three women discussing their own experience of genital surgery and revealing mixed levels of satisfaction with the procedures they underwent. In a short documentary which accompanies the film, gynaecologist Sarah Creighton says she has seen girls as young as eleven who believe their labia are not normal and want corrective surgery.

In 2009, feminist magazine the F Word accused Channel 4’s Embarrassing Teenage Bodies of promoting the designer vagina phenomenon by showing a fourteen-year-old girl undergo the procedure, apparently with good results and no side effects. Many would argue that performing unnecessary surgery on the genitals of such a young girl amounts to mutilation – although it was very much her choice.

The trend for extreme pubic grooming seems here to stay, and amongst young women, it is a rare creature who proudly sports a full bush these days. Waxing and shaving leave the genitals more exposed, perhaps increasing women’s awareness of any perceived difference from a very narrowly prescribed norm. So women are choosing to undergo vaginal surgery to fit in – which is similar to the justifications given for FGM. The message behind both kinds of procedure is that if you don’t have it done, you won’t be wanted or desired by a man. In reality, most men are happy to get anywhere near a vagina, and in the western world, men have their own body hang-ups, with penis enhancement on the increase. As the campaign grows to stamp out FGM, rather than putting themselves through a painful and often totally unnecessary procedure, western women should try to resist conforming to an image created by a porn industry which is made by men, for men. We rightly feel revulsion towards FGM, but no woman requires a man-made vagina.

Read more on the Independent Voices / Evening Standard campaign to end female genital mutilation:

London's challenge to stop girls' mutilation

Please help...I don't want to be cut like my sister when we go back to Africa

Sarah Sands: Judge regimes by how they treat women