Translator: Alice Chuang Reviewer: Peter van de Ven
I'd like us to try an exercise together.
In psychology, when a person finds an object
or an experience scary or difficult to face,
we gradually expose them to this object
so they get used to it bit by bit and no longer fear it.
And it seems that we as a society
find it very difficult to talk about women's genitals
in an open and honest way.
So I'd like us to try this exercise together now.
Please repeat after me. Say "vagina."
(Audience) Vagina.
Okay.
Now if that was easy, that's great,
but I'm pretty sure that wasn't the case for everyone here.
So I'd like to try it again. Please say "vagina."
(Audience) Vagina.
Okay.
So that time was probably
a little bit easier than the first,
but I'd like to try it again, just twice more.
Please say "vagina, vagina."
(Audience) Vagina, vagina.
Great.
So now you're feeling a bit more comfortable
saying the word "vagina."
But what about an entire conversation on this topic?
And that's where we as a society really struggle.
And researchers think that this lack of open discussion
about a perfectly normal body part,
particularly around how it's supposed to look,
may be fueling
the world's fastest growing cosmetic-surgery trend:
labiaplasty,
also known as designer vagina surgery.
Now, in the United States, in the last five years alone,
there has been a 500% increase
in the number of labiaplasties performed.
And what this procedure does
is reduce the size of the inner lips of the vagina,
known as the labia minora,
so they no longer protrude beyond the outer vaginal lips,
known as the labia majora.
And what this does is create a smooth genital surface,
just like a Barbie doll,
because, as we can see,
Barbie has no genital features whatsoever.
We also talk about this surgery colloquially
as turning an "outtie vagina" into an "innie vagina."
Yes, these aren't just terms
reserved to describe belly buttons anymore.
And while the medical research is gradually accumulating in this field,
because it's still a relatively new procedure,
we still don't know the long-term safety and efficacy.
Like what happens to these women when they go through menopause
and their vaginal tissue naturally thins and dries?
Not to mention that labiaplasty
is associated with some pretty serious side effects,
like infection, scarring, and even loss of sensation.
And so it's pretty concerning that at least some women
think that their perfectly healthy outer labia minora tissue
is so unacceptable
that it needs to be permanently removed through surgery.
In fact, many girls and women
have fundamental misunderstandings about their own genital appearance.
In case you weren't sure,
there are actually two openings
in the female genital region.
There's the urethra, where urine flows out,
and the vagina, where menstrual blood flows out.
They're not the same passage.
But is this fundamental misunderstanding about basic anatomy really so surprising?
We hardly encourage young girls
to explore or ask questions about their own genital anatomy.
Instead, on the rare occasions that we do talk to them about it,
we tend to use cute euphemisms, like "lady garden,"
or "flower," or even just "down there,"
to avoid using the proper terms.
And so young girls are getting the message
that this is a very private part of their body
that they need to keep hidden
and certainly need to avoid touching.
And it's no wonder that girls are growing up
thinking that their genitals are shameful, embarrassing,
and sometimes even ugly.
A young girl may become particularly concerned
about her labia minora appearance when she goes through puberty
because her labia will start to grow,
just like the rest of her body is growing.
At this stage, her labia may appear more prominent,
and one side may grow faster than the other.
This may prompt her to look on the internet
for an explanation for this change in her genital appearance,
rather than having a potentially embarrassing conversation
with a family member, friend, or health professional.
And rather than finding reassurance about her genital appearance
on the Internet,
she's likely to come across labiaplasty,
as a relatively simple and easy solution
to her perceived problems with her genital appearance.
And sadly, this has meant
that girls as young as nine are requesting labiaplasty.
The message these young girls are not receiving
is that their prominent and asymmetrical labia at puberty
may just balance out.
Their genital appearance
is meant to shift away from that pre-pubertal Barbie-doll look.
In fact, there's a huge variety in labial size, shape and color.
They're just like snowflakes:
no two are alike.
And there's certainly no one normal way for them to look.
Labia also served really important functions,
like protecting the entrance of the vagina and the urethra from infection,
and they also enhance sexual pleasure and lubrication during intercourse.
So the surgical removal of this tissue is not to be taken lightly.
We know that girls and women who are seeking labiaplasty,
if they're told about this great diversity in genital appearance,
it doesn't always make them change their minds.
By this stage,
when they're considering surgery,
it's probably too late.
Their concerns about their labia
have probably been present since childhood or adolescence.
And they're now firmly ingrained.
So if we want young girls
to feel positive about their genital appearance,
we need to start having these conversations
from a very young age,
as soon as girls start to become curious about their own bodies,
and certainly well before they're secretly harboring concerns
that their genital appearance may not be quite right.
And let's not forget that young boys can benefit from these conversations too.
Research has shown
that receiving negative comments from male sexual partners
about genital appearance
can and does influence women's consideration of labiaplasty.
So if young boys grow up
with a basic understanding of female genital anatomy,
they may be less critical of any future female sexual partners.
So now I've started you on this open conversation pathway,
encouraging you to feel more comfortable saying the word "vagina."
But now it's time to teach you the more correct term.
We sometimes mistakenly call the entire genital region "the vagina,"
but really this is just the inside part.
The outside part that you can see,
which includes the labia minora and labia majora,
is actually called "the vulva."
So let's start our first exercise again, shall we?
Please repeat after me. Say "vulva."
(Audience) Vulva.
And again. Vulva.
(Audience) Vulva.
And one last time with gusto.
(Audience) Vulva!
Terrific!
So let's start talking about vulvas and not vaginas.
Thank you.
(Applause)