One of the key ways in which these “regulatory norms” operate is by using institutions and discourses of power to produce messages about how gender is properly expressed through the body. Perhaps most obviously, the institution of Western medicine uses a discourse of disease to pathologize the female body and encourage adherence to gendered notions of normalcy.
The plastic surgery industry in particular has developed a new lexicon to classify even healthy bodies as abnormal. For example, in the early 1980s, the American Society of Plastic and Reconstructive Surgeons launched a media and educational campaign claiming that women with very small breasts were suffering from the disease “micromastia.”
The society submitted petitions to the Food and Drug Administration (FDA) in which they asserted that breast implants were essential to “correct physical deformities.” The physicians also targeted female consumers directly, promoting implants as a solution for flat-chested women to look “more normal.” The literature touted the implants as feeling both “real” and “natural,” underscoring the possibility for “realness” and “naturalness” to be qualities that one can achieve or even purchase (Bloom 95).
Doctors have used similar strategies in advertising genital plastic surgery procedures. Dr. David Matlock, a Beverly Hills-based plastic surgeon, is one of the most outspoken proponents of vaginoplasty, a surgical technique in which incisions are made in the vaginal muscles before resuturing them to achieve a tighter opening.
Generally, the procedure is marketed to women who have experienced a relaxation of the vaginal muscles after childbirth. His office’s publicity materials claim that his “laser vaginal rejuvenation surgery” (an $8,000 procedure which he has trademarked) is an “essential service for women with a certain physical dysfunction” (Gorov C1, Healy F1). Here, the typical and nonpathological condition of a woman’s genitals after childbirth has been elevated to the status “dysfunctional” and requiring surgical intervention.
Rhetoric of “the normal” figures prominently in the power of medical discourse. In interviews with women who have sought out these surgeries, the women emphasize that they are not pursuing some idealized version of bodily perfection. Rather, they simply want to look and feel “normal.” In a New York Times article, journalist Mireya Navarro interviews a 39-year-old woman from Boston who underwent labiaplasty, cosmetic surgery to reduce or reshape the labia. She says, “Now I feel free. I just feel normal.” Similarly, a 34-year-old woman from Long Island, who underwent the procedure to reduce her inner labia, says, “I look down and I say, that’s the way it should be” (9.1). Julia Scheeres’s research on the marketing strategies used by this niche of the plastic surgery industry reveals the prevalence of this discourse of normalcy as well. She cites an advertisement from a Los Angeles newspaper that addresses itself to women who “suffer from low self-esteem due to abnormal vaginal appearance.”
Appropriating second-wave feminists’ messaging about empowerment through bodily self-discovery, a press release urges women to “take out [their] hand mirrors” and inspect themselves for defects (71). The message is clear: Simply having female primary sex characteristics in no way ensures that one is a normal woman. Yet, when surgery is promoted as the path to achieve normalcy, the constructedness of the very idea of “normal” is revealed. Although many women may understand “normal” to mean the way their bodies should have been, the notion might more accurately be understood as the way in which culture dictates their bodies must conform.
Alongside the rhetoric of “the normal” is that of “the natural.” The aptly named Dr. Gary Alter is a pioneer in labiaplasty, a procedure sought by many women whose labia minora hang below their labia majora or are asymmetrical in size or shape. He has developed his surgical technique around this very notion of naturalness. In his interview with Fabula, a feminist magazine, he says that in the past doctors would simply “cut off” the offending tissue. However, Dr. Alter found the resulting suture line to be “very unnatural.”
Thus, in an attempt to achieve the all-important quality of “naturalness,” Alter developed a new procedure by which the labia are reduced, but their original edges are left intact (Loy 26). Likewise, some women claim to have sought surgery in the first place because they found their large or asymmetrical labia to be “unnatural.”
Again, this example effectively highlights how this idea of naturalness, although conventionally thought to be a pure condition that exists before any type of cultural intervention, in fact denotes the mark of culture itself. In practice, a body regarded as “natural” is a body that has successfully modified itself to earn such a classification.
Similarly, rhetoric of “hygiene” is often called upon as justification for labiaplasty, as well. Nearly every report of this trend that has appeared in mainstream media publications has quoted doctors and patients alike describing the new beauty standard for the vulva as one of looking “neat” and “clean.” For example, in a Boston Globe article, a 25-year-old student from California, a patient of Dr. Matlock’s, describes her post-surgery genitalia as “cleaner” and “more hygienic” (Gorov C1). Women’s eNews quotes Crystal, who says, “I had labiaplasty and now I love the way I look; nice and neat and new” (Kobrin).
Dr. Matlock offers a similar vision for what he considers the definition of vulvar beauty—specifically, a “nice, clean look” (Healy F1). These descriptions of the ideal of feminine cleanliness recall the shame with which the female “dark continent,” the site of Freud’s castration horror, has long been associated. As Davis writes,
The same social world that generated the mythos of the delicate, proper lady has also continually spawned and recycled dirty jokes about ‘vaginal dentata,’ fatal odors, and other horror-story imagery about female genitalia. The off-color disgust has always been tied in a complex way to a vast, off-color desire, and these both have been concomitant with the prescription to stay dainty (8).
The ideal of the clean, delicate, discreet vaginal slit so widely used in industry discourse functions to cast those bodies that have not undergone these procedures as necessarily dirty and unsightly. Thus, plastic surgery of the vagina becomes a kind of ritual of purification by which the dark, dirty, shameful female body can finally achieve a sense of decorum.
Other discourses are also hard at work to encourage women to bring their bodies in line with gender norms. In the case of genital plastic surgery, the media/entertainment industry factors heavily into how gender norms are perpetuated. Media representations of women with extremely thin bodies and large breasts promote ideals that women want to emulate. However, these images often cannot be achieved without plastic surgery.
A similar phenomenon operates with representations of the female genitals as well. Scholars have noted that in years past, women rarely had the opportunity to see other women’s vaginas and thus had no sense of how a typical vagina might look. However, with the mainstreaming of the adult entertainment industry, that situation has changed. Now, a beauty standard has emerged, one established primarily through porn actresses, nude models, and strippers. According to surgeons, women are bringing in pictures from magazines and adult Web sites, pointing out whose vaginas they want to recreate.
However, the irony of this situation is that in pornographic films and photographs, everything from eye color, to stretch marks, to genitalia can be digitally modified. Gary Rohr, who does image retouching for Flynt Publications says, “The easiest thing to do is to replace genital shots. You take one you prefer and paste it over the one you don’t” (as quoted in Scheeres 73). Similarly, Sharon Mitchell, of the Adult Industry Medical Healthcare Foundation, claims that asymmetrical or wrinkled labia are routinely airbrushed (Healy F1). Thus, the pictures that women bring in to their doctors’ offices and point to as the “ideal” female genitals often depict bodies that never actually existed. In a process that suggests Baudrillard’s simulacra, women are remaking their bodies to become copies of copies that in fact reference no original.
