Tread gently: This article is not for the squeamish. Everything described here is very real.
“What a beautiful vulva you have, Grandma!”
“Oh, the better to keep your Grandpa happy with, my dear!”
It is 2025.
The modern-day fairy tale is still filled with damsels in distress, littered with knights charging into pointless rescue, crowded with dragons who have shifted shape and often show up as regular people in the media, in politics, in police. Sometimes the fairies show up as your neighbour who offers to keep your cat when you travel. Sometimes the wicked stepmothers and stepfathers have merged into blended families. Wicked wolves can come dressed as your family friend or uncle or cousin and put their paws and jaws on Red Riding Hood and not even the woodcutter is always around to intervene.
Beauty often marries what looks like a Prince who then turns into a Beast. Cinderella is sometimes unable to run away from the abusive Prince.
It is 2025.
As humans we have collectively achieved the moon landing, Voyager 1 has left the solar system, and over half the human population is connected to the Internet.
But we also have a trillion-dollar fashion industry, an almost infinite number of reels and posts on social media, over 30 million plastic surgeries done every year (yes, 30,000,000 – with that many zeroes), and a collective normalised gaslighting for women to obey, take up less space, apologise, always sacrifice and know that they are lesser than. To know that they should be grateful to even be allowed to be born into a world that really hates them at a kind of molecular level.
Women should express this gratitude by staying thin but having large breasts, be hairless, except for the scalp where their hair should be luscious, have features that are attractive – to the male gaze of course.
And they should enhance all this by any means possible because they have to always remain in competition for this male approval, gazing into the mirror every day to ask, “Who is the fairest of them all?” After all, any day now, the husband may bring home a fresh and fair 20-year-old and banish you to the forest.
Stay-at-home mothers are in competition with ‘working’ mothers, older women with younger women, fat women with thin women, married women with single women.
It is an endless factory line in which everyone loses.
The only winner is the patriarchy.
Patriarchy, feudalism, religion, capitalism, colonisation, neoliberalism, medical industrialisation and globalisation have all added their own contribution to the collective gaslighting of women, misogyny and oppression.
***
As gynaecologists and obstetricians what we learnt about women’s bodies was mostly about the parts that were needed for reproduction (and the controlling of it) and some fleeting information on cancer prevention and management. None of the other specialities (like surgery, ophthalmology, orthopaedics) ever even spoke of women needing anything different from the default male prototype in terms of diagnosis or management or access to healthcare facilities or systemic oppression.
No understanding of gender issues, social determinants of health, health-seeking behaviour, impact of financial control, lack of travel freedom, women being primary caregivers and putting themselves last (until they came to Tata Memorial Hospital with cervical cancers literally as large as bleeding cauliflowers protruding from their vulvas).
But we are not here to stop that from happening.
No, no!
We are here to make their vulvas more beautiful. Super aesthetic. More pleasing, tighter, whiter – more like a little girl’s, all hairless and smooth, for the man who is using it to insert his magical and powerful wand into it for his own pleasure.
***
When I first read the email on cosmetic gynaecology that found its way to my inbox, I deleted it, thinking that those words made no sense and had no meaning put together. What cosmesis was possibly needed in gynaecology??
We dealt with menstruation, urinary incontinence, uterine prolapse, cancers, infertility. Not pretty little things, I grant you.
But where the hell was anything needing beautification??
How wrong I was!
***
Over the years I have received a deluge of emails on the shiny new super-specialisation branch of Cosmetic Gynaecology, which I can study in NYC or Dubai, if I want. In recent years these are available even in Tier 2 cities in India through pop-up training workshops.
Bangalore, Chennai, Hyderabad, Indore, Varanasi (Varanasi???). So many cities and towns where women may not have access to safe respectful abortions and deliveries, no one to rescue them from marital rape, physical violence, emotional abuse, financial control, and being burnt to death or chopped to pieces for not bringing enough dowry.
But hey, they can get their lady parts, diverse and beautiful as nature made them, ‘cleaned up’ and ‘beautified’.
So, what is on the menu that’s getting hot at this bodyshop?
It is truly unholy.
- Labiaplasty, Vaginoplasty, Clitoroplasty, Clitoral hood reduction, Anal skin tag excision
- Labia Minoraplasty, Labia Majoraplasty
- Unified Approach
- Clitoral Hood Reduction, Clitoral Reduction
- Botched Labiaplasty Revision (that would make some people stop and think, right?)
- Vaginoplasty
- Vampire Wing Lift/Majora Augmentation (VAMPIRE wing?! Vampires have wings?)
- Perineoplasty
- Hymenoplasty
Why is this a problem? Let me count the ways……
‘Cosmetic’ by definition is something that does not resolve a pathology. If it resolved a pathology then it would be called therapeutic.
The wild claim that removing the hood of the clitoris will improve sexual pleasure for women has absolutely no evidence. The clitoris , which was ignored by medicine till the 1900s and whose complete anatomy was unknown till 1998, has suddenly become the holy grail for cosmetic gynaecology.
Seriously? Since when do we as a society or the medical profession care about women’s sexual pleasure? With hymen repair, husband’s stitch, FGM and Viagra around, it’s obvious that women are for virginity and honour while men are all about pleasure and power.
There is no conversation happening in ObGyn circles, or even conferences, around the lack of sexuality education, body shaming, the impossible beauty standards that cater to the male gaze, lack of foreplay and intimacy in most marital relationships, high rates of domestic violence and marital rape, patriarchal demands for women to always take up less space, medical gaslighting, lack of financial control, gender inequality, the staggeringly large pay gap, male entitlement, misogyny, rape culture and such like … which could perhaps also be having an impact on women’s sexual pleasure?
Perhaps? Maybe?
Meanwhile, many many male doctors are becoming experts and inventing fantastically marketed procedures to help women have ‘improved sexual pleasure’, with, of course, absolutely no input for the other (most likely male) partner.
Would you consider a Barbie-plasty?
‘The Barbie’ involves the removal of all, or almost all, of the labia minora so that only the labia majora are visible – so they look like the genitalia of the doll named Barbie.
The American College of Aesthetic Plastic Surgeons recorded 2,140 vaginal rejuvenation surgeries in 2010 in the US. The International Society of Aesthetic Plastic Surgeons report 75,719 surgical vaginal rejuvenation procedures globally in 2024. Do a simple Google search for ‘number of labiaplasties annually’, and you will see how, worldwide, it is rising year by year: 12,666 in 2016 and 189,058 in 2023.
This is despite the fact that the American Congress of Obstetricians and Gynecologists have issued statements advising against vaginal cosmetic procedures, because their safety and effectiveness are questionable.
As early as 2011, The Atlantic reported on the growing trend of labiaplasty, which was a hot topic of discussion at the fifth annual Congress on Aesthetic Vaginal Surgery in the US in 2010. Apparently a highly lucrative business. As reported:
“Although obviously labiaplasty operations are only ever performed with the consent of the patient, the procedure does draw some uncomfortable comparisons with Female Genital Mutilation …”
So there we have it.
As a Gynaecologist myself, I am baffled by the lack of any legal response to what is basically an unverified, unapproved procedure which treats a mythical creature called ‘women’s sexual pleasure’ in a society riddled with patriarchal violence and misogynistic abuse of women at every stage.
How many of us lie down on the floor or bed with a large mirror to look at our vulvas?!
Who the heck is this ‘Barbie look’ for?
Wasn’t shaving and painful waxing to make an adult vulva look like that of a pre-pubertal girl already problematic and with inherently creepy paedophilic vibes?
Now we need to have it look like the genitalia of a Barbie doll? A plastic toy that is so disproportionate that her boobs are way beyond the centre of gravity and hence she cannot stand independently?
How will the appearance of something we can’t even see improve our sexual pleasure?
Oh wait, it’s because the assumed male partner will find it more pleasing since his aesthetic has been warped by watching porn and then he will presumably be more enthusiatic about sex with you?
Which I find difficult to understand in the face of the statistics of marital rape and physical abuse which states that nearly 1 in 3 women have suffered spousal violence. And then, read this:
Seriously?! We want MORE enthusiasm here??
Even for those who are having sex with consent, it is incredible how in this day and age we can actually have women choose hymenoplasty. This 2006 article offers an example:
The same article goes on to say:
We Indians are cutting-edge too (pun intended)
Of course, we in India are not to be left behind. We are right up there, with the best of them. There are many clinics all across the country offering a range of services. The “Bikini-bump fat removal” aka mons liposculpting in which fat above the pubic bone is removed, to reduce the “ugly” bulge when wearing fitting clothes. Fat grafting for the labia majora which are “plump, full and perky” in young women and then become saggy baggy in older women. Labiaplasty for the labia minora – our very own Indian Barbie look.
And, in case you want to offer your husband that very ‘special gift’, there’s also “Re-virgination” (also called hymenoplasty or hymen repair surgery), a cosmetic surgical procedure where the hymen is reconstructed. It costs between Rs. 30,000/- to Rs. 60,000/-
Cannot afford it? Then you can simply buy a kit for less than Rs. 8,000/- with an artificial hymen and some ‘blood capsules’ (capsules with food-colouring liquid) that you can use to bloody effect on your wedding night. After all, it is all about loving your hubby, your in-laws, and keeping the family honour intact.
Ah, it is never-ending There is also the O-Shot. Short for Orgasm Shot, the O-Shot procedure involves injecting platelet-rich-plasma (PRP) derived from a woman’s own blood into specific areas of vaginal tissue. It is supposed to increase blood flow, nerve sensitivity and tissue regeneration in order to enhance arousal, lubrication and the frequency and intensity of orgasms. Scientific evidence for these claims is yet to come in.
Thinking of getting one? The O-Shot procedure cost varies widely by clinic, location, and desired outcomes, but generally ranges from approximately Rs. 80,000/- to Rs. 1,20, 000/- per session in India. (Pro tip – when you inject parts of your own blood back into your own body, guess where they go? They get absorbed/ digested like anything else and do not sit around enhancing arousal and orgasmic intensity eyeroll)
Mum, forever young
The double standard operates not just around our sexual lives but even around bodies after parenthood. Women are bombarded with expectations to ‘bounce back’ the moment they give birth as if their entire physiology has not been completely (and often radically and permanently) transformed by growing an entire human being inside them and then delivering it through pain and peril. Meanwhile, men are celebrated for their so-called ‘dad bods.’
‘Mommy makeovers’ are promoted to erase all evidence of pregnancy as quickly as possible through strict diets, workouts, shape-wear, and even “tummy tucks”. Medical tourism companies offer packages – choose between “Timeless Mom” and “Evergreen Mom” and combine this with wellness treatments, Ayurveda and/or visits to tourist destinations.
Women’s bodies are relentlessly policed at every stage of life: too young, too old, too thin, too curvy, too maternal, too sexual. Thigh gap was a thing for a while, remember? Thigh gap?!!
It is not just absurd. It is cruel and it is abusive. It keeps women locked in cycles of self-surveillance, shame, and endless striving. Shrinking themselves constantly while men are permitted to age, expand, occupy space without losing social capital or desirability.
From the time a girl is old enough to look in the mirror, she is made aware that she is in a lifelong competition with every other girl and woman.
A woman’s worth, she is told, does not rest in her intellect, humour, compassion or caregiving, but in how closely she can approximate an ever-shifting beauty ideal. This phantom competition is insidious because it is unwinnable by design. The rules change constantly: be thin, but not too thin; curvy, but only in the ‘right’ places; natural, but flawlessly so. Even your makeup should have a ‘no makeup’ look.
The machinery is ruthless. Weight loss companies profit from postpartum shame. Cosmetic surgeons profit from insecurities about breasts, noses, labia and anuses. (Anuses?! Need cosmetic surgery now?)
It’s a billion-dollar cycle built on convincing women that they are never enough as they are.
Never.
What makes this particularly abusive is that it is framed as choice.
***
Surgeons and clinics push these procedures as somehow supporting empowerment and exciting desire and fulfilment, but they are cashing in on shame planted by beauty, fashion and even health industries that benefit from women feeling inadequate.
In such a landscape, doctors occupy a uniquely powerful role as moral and ethical agents. Medicine does not exist in a vacuum. Healthcare decisions are deeply entangled with social narratives about gender, sexuality, and worth.
When doctors offer tummy tucks after pregnancy, or labiaplasties to fit pornographic ideals, or endorse fertility pressures without supporting women’s autonomy, without bearing witness to oppression and violence, they become complicit in the oppression and violence. When doctors offer a hymen repair or a labioplasty but don’t have anything to offer the male partner to be a better lover, they are also commodifying the woman and reducing her to a passive being whose main role is to pleasure the male partner.
Women often turn to healthcare professionals at their most vulnerable moments – after childbirth, during illness, in times of self-doubt about their bodies. In those moments, a doctor’s words can reinforce oppressive beauty myths or dismantle them. A doctor’s recommendations can serve corporate interests or human dignity. The responsibility is immense.
As medicine increasingly intersects with cosmetic industries, reproductive technologies, and gender politics, physicians must reclaim their ethical duty not just to treat the body, but to defend the personhood of those who inhabit it. To stand with women not as objects to be fixed or marketed, but as full human beings deserving of respect, autonomy, and truth.
Cover image by Brooke Lark on Unsplash
