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Labiaplasty in Minors: Medicalizing Mutilation?

Rachel L Walden1, Jasmine Abdulcadir2, Brian D Earp3,4

  • 1Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA. rachelwalden@jhu.edu.

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Summary

Labiaplasty is increasingly common, especially in minors. This study examines "medically necessary" indications to prevent it from being classified as medicalized female genital mutilation (FGM) and highlights research shortcomings.

Keywords:
AdolescentsAestheticsEthicsFemale genital mutilationLabial hypertrophyLabiaplasty

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Area of Science:

  • Gynecology
  • Medical Ethics
  • Public Health

Background:

  • Labial hypertrophy lacks a clear definition, often based on subjective aesthetic norms.
  • Labiaplasty procedures have surged, with nearly 20% performed on minors.
  • Concerns exist regarding the medical necessity and ethical implications of pediatric labiaplasty.

Purpose of the Study:

  • To analyze indications for deeming labiaplasty medically necessary in minors.
  • To assess if these indications prevent the procedure from being categorized as medicalized female genital mutilation (FGM).
  • To identify and address methodological issues in labiaplasty research.

Main Methods:

  • Review of current medical literature and ethical guidelines.
  • Analysis of criteria used to define "medically necessary" labiaplasty in minors.
  • Examination of outcome measurement in pediatric labiaplasty studies.

Main Results:

  • The definition of "medically necessary" is crucial for distinguishing ethical procedures from medicalized FGM.
  • Significant methodological limitations persist in current labiaplasty research.
  • Ethical and legal considerations surrounding pediatric labiaplasty require careful attention.

Conclusions:

  • Clearer, objective criteria are needed for "medically necessary" labiaplasty in minors.
  • Future research must improve relevance, reliability, and generalizability.
  • Addressing ethical and legal concerns is paramount for this controversial procedure.