How ‘Barbie vagina’ became another unhealthy obsession

“My yoni is like a 16-year-old — I’m not kidding. It looks like a little beautiful peach,” said Jada Pinkett Smith on her online show, Red Table Talk, where the actress proudly discussed the results of her laser vaginal rejuvenation. This statement may seem innocent, but it is full of problematic premises that assume that it is logical for a 52-year-old woman to want to have the genitals of a teenager.

But you don’t have to go to Hollywood, where the Kardashians frequently talk about vaginal operations, to notice the growing interest in aesthetic gynecology. In Spain, it is also on the rise. “The best proof that more and more women are doing it is the large number of gynecologists who are specializing in this discipline. It is important to remember that these treatments always have to be applied by a specialist in gynecology, since they require a multidisciplinary approach that understands the pathophysiology and anatomy of women,” Dr Luis Soto Rabadán, a specialist in aesthetic gynecology at Kiharu clinics, tells EL PAÍS.

Easy access to porn and the growing number of nude photos online are some of the reasons behind why the women are heading into the operating room to get the so-called “perfect vagina.” “As a sexologist and sex educator, I am surprised by the number of patients who have a kind of phobia towards vaginas. Women with insecurities because they think their vulvae are weird because they don’t follow the canon of pornography, women with complexes who are, consequently, sexually dissatisfied,” says sexologist Mariona Gabarra.

But what is the supposedly “perfect vagina”? And why do so many women think their vagina is “not normal”? In the study Labiaplasty, The Representation of a Booming Cosmetic Surgery, Magdala García Ruiz de Alarcón points out that based on her research with women who had undergone labiaplasty, many complexes are due to unfortunate comments from sexual partners. “There are cases where they have been rejected for sex. On other occasions, even if it is a person who has never thought they had a problem with their genitals, the messages conveyed by advertising, magazines, movies, pornography are enough for her to start feeling insecure,” says Ruiz de Alarcón.

“The genitals of women in porn videos are almost all the same, they mark a canon of beauty,” writes Júlia Salander in Your feminist Argument in Data, where she argues there is a beauty canon for each part of the body, which is impossible to achieve naturally. “All these mandates are built based on the world of fashion or cinema [...], although in the case of vaginas, who do you think is setting these trends? Well, as expected, the porn industry,” she explains.

Barbie vagina

While some women are rebelling against these beauty stereotypes, others have become obsessed with achieving the so-called “Barbie vagina.” Although paradoxically, Barbie does not have a vulva, the Barbie vagina has become the beauty ideal. This involves a completely shaved vagina with hidden inner lips.

Aesthetic gynecologist Dr. Junco explains on his website: “The main patient profile is a woman who wants to increase her self-confidence or who feels insecure because of discomfort during sexual intercourse or sports. Thus, getting a Barbie vagina has become a boom, as well as an opportunity for those women who do not feel comfortable with this part of their body.”

Labiaplasty varies depending on whether the goal is to reduce the size of the labia minora (the flaps of skin either side of the vaginal opening) or the size of the labia majora (cutaneous skin folds that form the lateral longitudinal borders of the vulval clefts). In the latter case, as Dr. María Jesús García-Dihinx, specialist in plastic, reconstructive and aesthetic surgery at the Quirónsalud Zaragoza Day Hospital, explains, “the level of excessive adipose tissue found in them is reduced.” And in the case of the labia minora, the excess skin is removed until it can be protected by the labia majora.

Sigrid Cervera, member of the Spanish Association of Sexology Professionals (AEPS) (AEPS) and sexologist at the Barcelona Erotic Museum (MEB), points out that no vagina shape is better than another, and warns against being guided by these beauty standards. “This can result in people coming to sexology consultations asking about sizes, shapes or aspects of the genitals (or any other part of the body), seeing what is different as a negative deviation from what is supposed to be normal,” she explains.

“These fashions or normalities often divert us from our recognition and our acceptance, as if our worth depended on references external to us. Sexological counseling is responsible for providing a new framework of understanding, so that we can understand ourselves in our own peculiar way, from our particular and unique way of being,” says the sexologist.

For years, the American College of Obstetricians and Gynecologists (ACOG) has been warning about the number of children under 18 years of age undergoing vaginoplasty, i.e. vaginal reconstruction. The organization warns that the lack of studies and standardized nomenclature related to female genital aesthetic surgical procedures means there is limited data on its risks and benefits. According to ACOG, it is essential for women to be informed about the lack of high-quality data supporting the effectiveness of genital cosmetic surgical procedures and advised about its possible complications, including pain, bleeding, infection, scarring, dyspareunia (pain during intercourse) and the need for a new operation.

“Obstetrician–gynecologists should have sufficient training to recognize women with sexual function disorders as well as those with depression, anxiety, and other psychiatric conditions. Individuals should be assessed, if indicated, for body dysmorphic disorder. In women who have suspected psychological concerns, a referral for evaluation should occur before considering surgery. As for all procedures, obstetrician–gynecologists who perform genital cosmetic surgical procedures should inform prospective patients about their experience and surgical outcomes,” says ACOG in a paper.

It continues: “Patients should be made aware that surgery or procedures to alter sexual appearance or function (excluding procedures performed for clinical indications, such as clinically diagnosed female sexual dysfunction, pain with intercourse, interference in athletic activities, previous obstetric or straddle injury, reversing female genital cutting, vaginal prolapse, incontinence, or gender affirmation surgery) are not medically indicated, pose substantial risk, and their safety and effectiveness have not been established.”

Dr Luis Soto Rabadán points out that aesthetic gynecology addresses more than the physical appearance of a woman’s external genitalia, such as the effects of menopause. “Due to a sudden decrease in estrogen, a series of consequences occur such as vaginal atrophy and dryness, discomfort during sexual relations, difficulty and pain when urinating etc… That is to say: what is known today as Genitourinary Syndrome of Menopause. To alleviate the consequences of estrogen deficiency, certain local and systemic drugs can be prescribed with estrogens and other molecules, such as prasterone or ospemifene,” he explains. “The role of gynecological aesthetics is present as an adjuvant to these treatments, or as a unique and powerful treatment in women in whom the use of hormones is contraindicated. Gynaecoaesthetics also encompasses surgical treatments such as hymen reconstruction and correction of genital mutilations.”

However, it is vital to remember that presentations on genital aesthetics are already common at congresses — genitals are just another consumer product. What’s more, as Magdala García Ruiz de Alarcón points out, part of the commercial medical discourse encourages a representation of the vulva based on the standardization of a prototype that reduces morphological diversity and is based on an ideal of youth.

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