Confronting Co-Optation: Thoughts from a Feminist Activist Campaign to Challenge Female Genital Cosmetic Surgery

Rachel Liebert spoke at an event hosted by the Campus Coalition for Sexual Literacy on Tuesday 13th October at the GC, called “Vulvas for Sale? A Discussion on Female Genital Cosmetic Surgery” Increasingly, the aesthetic and sexual medicine industries are adopting and co-opting core feminist concepts such as “empowerment,” “sexual liberation” and “choice” for their own profit motives. For feminist activists, this co-optation presents new ways in which women’s sexuality is repackaged and regulated in “Western” consumer culture. It thus necessitates new approaches and a reconfiguration of discourses in order for us to effectively challenge subjugating practices. In my presentation, I shared our experiences organizing a feminist action campaign to bring attention to an emerging industry of female genital cosmetic surgeries (FGCS) within a framework that attempts to confront, rather than be immobilized by, this persuasive co-optation.

FGCS refers to procedures undertaken on female genitalia for (supposedly) improving aesthetics or sexual functioning, aka the “designer vagina.” The procedures are performed on anatomically normal genitalia, and include cutting the muscles in and around the vagina, partial or full removal of the labia minora, injecting fat into or removing skin of the labia majora, suctioning tissue from the pubic mound, partial or full removal of clitoral hood, stitching across the vaginal canal to create bleeding during intercourse, and injecting artificial collagen into the vaginal wall. Available figures suggest that the numbers of these procedures have been increasing steadily over past decade, with warnings issued by the American College of Obstetricians and Gynecologists and the Royal Australian and New Zealand College of Obstetricians and Gynecologists.

The New View campaign is a grassroots collective of feminist activists, scholars, and practitioners working to challenge the medicalization of sexuality. It started in 2000 in response to the actions of pharmaceutical industry in producing “female sexual dysfunction,” but has now broadened to campaign against industries and practices generally that medicalize and commodify sexuality. In 2008 our attention turned to FGCS with concerns about how these procedures may cause various kinds of personal and social harm. First, they are medically unnecessary, have no independent evidence of their safety and efficacy, are unregulated and unmonitored, and run the risks of scarring, altered sensitivity, painful sexual intercourse, infection and adhesions. Second, FGCS commodifies our sexualities and bodies such that profits are prioritized over women’s wellbeing, conventions such as peerreview and monitoring by professional bodies are circumvented, and marketing that conceals the reality of the procedures is deployed. Third, FGCS potentially creates psychological, sexual, and cultural harm by (re)producing women’s anxiety and distress about their genitals through “disease mongering” (creating a market by pathologizing normal diversity) and narrowing the aesthetic and sexual “ideal” by promoting a prepubescent and age-ist look. FGCS supports heterosexism by enforcing the coital imperative, dismissing the clitoris, and implying that mature women’s vaginas are sexually inadequate. In this way FGCS is different from other cosmetic surgeries as it is embedded within thousands of years of shame, fear and silence about women’s genitalia and the regulation of women’s sexuality. Thus, to raise questions around FGCS, we developed website resources, engaged with popular and academic media, and wrote letters calling for action from professional and government bodies. We also held a street rally outside an FGCS clinic on the Upper East Side that included approximately 40 people marching with placards, chants, flyers, and buttons—“Real choice not consumer choice,” “Mass production is for volvos not vulvas,” “Long live long labia,” “Our vulvas deserve research,” “No two alike,” “Stop marketing discontent,” “Keep diverse normal,” “Love your vulva,” and “End misinformed consent” —and performed a short political street theatre piece called Dr. IFFA (Interest Free Finance Available) and the Two Vulvas.

In everyday personal, professional, academic, and public conversations about our campaign, we encountered a number of recurring arguments that drew upon (very much overlapping) neoliberal and post-feminist discourses. In order for these rhetorical strategies to not immobilize our campaign efforts, we found it necessary to organize our efforts around some specific counterrhetoric. In response to the neoliberal arguments—framed primarily in terms of choice and personal responsibility— we argued that choices do not occur in a vacuum, but are constrained by the information available for women and a context which affects the availability of alternative options, and that they have collective consequences. We therefore emphasized informed choice and challenged FGCS marketing, targeted surgeons’ responsibility for providing information, demanded more research in terms of the safety and effectiveness of procedures, and promoted female genital diversity. We also drew parallels between FGCS and female genital mutilation (FGM) thereby illuminating the hypocrisy in seeing ‘Other’ women as influenced by culture, but we ‘Westerners’ as miraculously immune free-choosing agents.

The post-feminist rhetoric was framed primarily in terms of the procedures being both a consequence of, and aid to, our sexual liberation. In response to this, we argued that FGCS defines and constructs bodies, sex, and desire through a very limited (patriarchal and heterosexist) lens, damages or removes sexually sensitive tissue and desensitizes the clitoris, and that there is no rigorous evidence that FGCS improves sexual satisfaction for women or their male partners. Moreover we drew attention to the dubious nature of placing women’s empowerment in the hands of a profitdriven industry, and argued that the procedures are collectively disempowering by both narrowing aesthetic and sexual “ideals,” and blaming women’s bodies for sexual dissatisfaction rather than cultural restrictions on our pleasures and practices.

Overall we believe FGCS discourses and assemblages are simply another technology in the (albeit now sassy) policing of women’s sexuality, and, in contrast, that we are fighting for women’s choice and sexual liberation through honoring diversity and desire. In line with this we recently hosted the second phase of our activism around FGCS, Vulvagraphics, which was an event to celebrate female genital diversity. We solicited a number of grass-roots artists whose work with the vulva challenges the medical and corporate co-optation and homogenization of sexualities, and provided opportunities for people join us in advocating for more comprehensive sex education. In addition, I have also founded The International Vulva Knitting Circle as a somewhat tongue-n-cheek grass-roots activist collective to provide a space for (young) women to craft resistance to the chain-store production of their bodies and sexualities, while also weaving together what feminism and activism mean for us given current-day sociopolitics.