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RCOG/BritSPAG statement on BBC report of under 18s seeking labiaplasty

News 3 July 2017

The below statements refer to a report by the BBC's Victoria Derbyshire Show on concerns over young women and girls, under the age of 18, seeking labiaplasty. 

Professor Janice Rymer, a consultant gynaecologist and vice president for Education at the Royal College of Obstetricians and Gynaecologists (RCOG), said:

"We are alarmed by anecdotal reports of adolescent girls requesting labial reduction surgery for cosmetic or other reasons. These decisions are not always based on informed understanding of the normal variations that exist, but are influenced by images in popular culture, such as the mass media, adverts for cosmetic surgery and pornography.

“This is of particular concern in adolescence when changes in the labia minora are part of normal development during puberty. Performing irreversible cosmetic surgery while physical and psychological development are still evolving will risk harm and lead to further dissatisfaction. Due to the lack of evidence concerning the effects of labiaplasty, if this procedure is to be undertaken, it is strongly desirable that the procedure is performed only once development has been complete, usually after the age of 18 years. 

“It is important that clinicians inform and reassure girls and, where appropriate their guardians, about labial anatomy, development and variation, and ways to manage labial discomfort. Education, support and advice should be at the heart of clinical practice in this area. For significant distress, these girls should receive psychological assessment and counselling.”
  
Dr Naomi Crouch, consultant obstetrician and gynaecologist and chair of The British Society for Paediatric and Adolescent Gynaecology (BritSPAG), said: 

“It is highly concerning that girls and young women under the age of 18 years are seeking labiaplasty. There is no scientific evidence to support the practice of labiaplasty and the risk of harm is significant, particularly for adolescents who are still in stages of development both physically and psychologically. There is no medical requirement for labiaplasty, either for discomfort or for appearance. The distress experienced by some of these girls should not be underestimated. It is important for clinicians to provide accurate and sensitive advice and guidance rather than unnecessary and irreversible surgery. Clinicians should improve their skills and confidence in educating and supporting the girls and, where appropriate, their parents. Further development of age-appropriate resources for girls and their parents should be a priority for clinicians.”
 
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Notes

For media enquiries, please contact the RCOG press office on 020 7772 6357 or email pressoffice@rcog.org.uk.

Clear guidance on the role of gynaecologists when seeing adolescents with labial symptoms was published in 2013 by the RCOG (Ethical considerations in relation to female genital cosmetic surgery) and BritSPAG (Labial reduction surgery in adolescents).  

BritSPAG has awarded an educational grant for developing a tool for individuals and clinicians regarding normal anatomy. This will be launched at the BritSPAG Annual Meeting next 12-13 March at the RCOG. 

About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. 

About BritSPAG
The British Society for Paediatric and Adolescent Gynaecology (BritSPAG) was established in 2000 to promote the profile and study of, and clinical approaches to, paediatric and adolescent gynaecology and provide a multidisciplinary forum for discussion, education and training. BritSPAG is a specialist society of RCOG.