While the discourses of medicine and the media function to disseminate and reinforce “regulatory norms of sex,” plastic surgery procedures give those norms a material reality by reshaping the flesh of the body. Most labiaplasty procedures eliminate the “excess” tissue that hangs below the labia majora in many women. The removal of this dangling flesh, which hangs between a woman’s legs like a phallus, serves to further distinguish the female genitalia from the male. The female body must be distinguished from the male body because it is in contrast to the female that the male has meaning. The system of gender is relational, operating through binaries: a “man” is “not woman,” just as “masculine” is “not feminine.” The two concepts are locked in an interdependent relationship. If the binary begins to break down, the salience of each of these categories breaks down as well. Therefore, to prevent such a degradation, the rigidity of the categories “man” and “woman” and the strict boundary that exists between them is fiercely protected. Because of this, in contemporary Western culture, ambiguity of the genitalia is culturally unacceptable. If a baby emerges from the womb with anything less than a body clearly marked as either male or female, medical technology and expertise rush in to give precision to the anatomy. Suzanne Kessler, who has done extensive research on gender reinforcement surgery on intersexed individuals, says, “Genital ambiguity is corrected not because it is threatening to the infant’s life, but because it is threatening to the infant’s culture” (25). The “in-between-ness” demonstrated by fleshy or hanging labia is threatening because it complicates the strict gender binary that underpins the Western social fabric. Consequently, society marshals its forces—economic, cultural, and political—to bring those aberrant bodies in line. In this case, the female body must be appropriately feminized. Thus, the female genitals, generally thought to be the marker of womanhood, are in many cases “not female enough.”
This removal of labial tissue does more than simply sharpen the distinction between the female body and the male body, however. The excision of tissue deemed “excessive” functions on a symbolic level as well, for it reflects broader societal norms that forbid a variety of excesses among women, particularly inordinate sexual appetites. Simone Weil Davis historicizes the association between large labia and heightened sexuality, noting, “at least since the sixteenth century they have indicated to doctors the alleged presence of hypersexuality, onanism, and possible ‘tribandism’ or lesbian tendencies” (37). Through labiaplasty, both her body and behavior are “civilized,” metaphorically reigned in to meet society’s insistence on female restraint and discretion. Saartjie Baartman, or the “Hottentot Venus,” perhaps best illustrates this type of phrenology by illustrating society’s attempt to draw a link between the physical appearance of the woman’s genitals and her character. Baartman was an African woman whose body was put on display through a touring exhibition across Europe for five years in the early part of the nineteenth century (Gilman 232). Her labia were of particular interest to the Europeans, who were eager to seize upon physical characteristics that could be used to make classificatory distinctions between the races. European travelers of the eighteenth century had returned from Africa with reports of the “Hottentot Apron,” a “hypertrophy” of the labia found among some tribes (232). Western colonialists used the “primitive” nature of the black woman’s sexual organs as evidence of a corresponding “primitive” sexuality, generally defined by “excesses,” including lesbianism (237). The Hottentot Venus provided a contrasting image for bourgeois European women’s genitals and sexuality. Unlike the untamed excess of the Hottentot, white women demonstrated a properly modest, civilized sex. Those highly gendered notions of the proper female body can still be detected in the modern practice of genital plastic surgery, which aims to reduce women’s sex—and sexuality—to more acceptable proportions.
Other surgical procedures besides labiaplasty are also tasked with sexing female bodies. For example, physicians’ promotional materials hail vaginal rejuvenation surgery (or vaginoplasty) as an “essential service” for women to enhance their physical sensation during sex, with advertisements touting “You won’t believe how good sex can be!” (Gorov C1). However, many doctors have voiced skepticism about such claims. A New York Times piece from 2004 quotes Dr. Thomas G. Stovall, president of the Society of Gynecologic Surgeons, as saying that no scientific evidence exists to support the claim that women experience enhanced sensation during intercourse after the procedure (Navarro 9.1). In fact, he claims the opposite, as some women actually experience pain after the surgery as a result of the muscles being too tight. Other risks include nerve damage leading to loss of sensation, a buildup of scar tissue, or infection. Despite some plastic surgeons’ repeated insistence that the women they treat seek the procedure to enhance their own sexual satisfaction, others concede that many women have a consultation at the urging of their husbands, boyfriends, or partners who want increased sensation for themselves. Thus, by surgically altering the vagina toward the goal of enhancing male sexual pleasure, vaginoplasty reinforces the instrumental function of the vagina in normative heterosexuality. Being a site of pleasure for the male sexual organ is a primary function of the vagina under the heterosexual matrix of gender. If the vagina fails in this capacity and is no longer able to deliver adequate stimulation to the phallus, a cultural intervention is required. Underscoring Butler’s theory, the vagina itself does not qualify one as a woman. Being a woman, a condition that under the normative heterosexual culture of contemporary society includes accommodating the phallus, requires medical assistance. As Simone de Beauvoir famously said, “One is not born a woman, but becomes one.” In this case, one is not born a woman, but is made one: Her sex is brought in line with her gender.
In addition to the function of the vagina being important under the heterosexual imperative, the appearance of the vagina is important as well. A desire for youthfulness stands as a key motivation for genital surgeries, as it does for plastic surgery in general. In her article “Vulva Goldmine: How Plastic Surgeons Snatch Your Money,” Julia Scheeres quotes UCLA psychology professor Paul Okami, who says, “These procedures are designed to approximate that of a pubertal vulva or vagina.” And, as other feminist critics have done, Scheeres points to the infinite number of Web sites promoting images of “teenage sluts” or “barely legal babes” as additional evidence of patriarchy’s sexual obsession with young, barely pubescent girls (75). Aside from having vaginoplasty to “rejuvenate” the genitals, some women have fat injected into their labia to give them a plumper shape. Feminist health expert Judy Norsigian, as quoted in the Los Angeles Times, situates this trend in the context of men’s obsession with barely pubescent young girls. She attributes the popularity of Brazilian waxing—in which nearly all of the pubic hair is removed—as further evidence of this. In the context of the heterosexual imperative, the female must be ever vigilant to keep herself alluring and hold the male’s sexual interest. Physicians point out that older women may be in a losing battle against gravity as they begin to notice their nether regions increasingly “on the move.” As Davis says, “It is woman’s work to make sure her genitalia are snug, not wayward” (15). Sustaining a youthful, feminine body, as necessitated under the heterosexual matrix of gender, requires constant attention and maintenance.
Hymenoplasty, in which the hymen is surgically reconstructed to mimic the virginal state, is yet another example of how the female genitals are produced to support heterosexual normativity. The procedure is not new. However, it has historically been performed on women from Middle Eastern or Latin American cultures that would themselves or their families suffer physical harm or shame if they were discovered not to be virgins upon marriage (Masterson 7). The small operation would erase physical evidence of prior sexual activity or rape. Although the number of women seeking these procedures is considerably less than those pursuing labiaplasty or vaginoplasty, its popularity has begun to take hold in the U.S., primarily among white, affluent, urban women. To distinguish it from the aforementioned cultural context, those in the industry have dubbed the procedure “recreational” hymenoplasty. A Philadelphia Daily News article quotes one woman who is having the $5,000 surgery as a “gift” for her husband who, she says, “deserves everything” (Armstrong 1). Other women undergo the procedure to mark anniversaries or other special occasions. Unlike vaginoplasty, though, in which some doctors still make the case for enhanced female pleasure (despite evidence to the contrary), hymenoplasty guarantees women’s discomfort. Again, if the vagina no longer meets a key requirement of womanhood under heterosexual society—keeping the phallus endlessly stimulated and entertained—then action must be taken to create proper bodies.
These various practices—vaginoplasty, labiaplasty, hymenoplasty—and a range of others, highlight the constructedness of the sexed female subject because her body requires constant maintenance to adhere to gender requirements. Dominant gender ideology enlists her to become a sentinel, watchful for aberrations or abnormalities that cause her body to slip beyond the boundaries of acceptable womanhood. Thus, responsibility for the enforcement of norms rests within the individual subject herself. Just like the docile bodies of Foucault’s Panopticon, bodily surveillance has been internalized: “We are neither in the amphitheatre, nor on the stage, but in the panoptic machine, invested by its effects of power, which we bring to ourselves since we are part of its mechanism” (217). With gender, there is no center of power that enacts rules and then punishes transgressors. Rather, the gender binary is so strong and so pervasive that no external policing is necessary. On our own, as sexed subjects, we accomplish the disciplining of our bodies to fulfill the requirements of gender categories.
However, because the very definitions of these categories are cultural creations, they are subject to change over time and space. As the gender norms shift, so must our disciplining practices. The variance that exists among norms becomes apparent when examining the practice of labiaplasty in the West alongside the practice of female genital operations (or FGO) in Africa. According to Davis, both cultural practices are underpinned by the idea that “the genitalia are cultural terrain that must conform to identificatory norms” (17). Nonetheless, most American women who seek labiaplasty would no doubt be horrified at the comparison between their own procedure and the practice of FGO in Africa. However, Davis asserts that the distinction between the two is not so great. Since the mid-1990s, ten U.S. states have passed anti-FGO laws. Although the nature of the operations criminalized in these laws would easily apply to the kinds of procedures being performed in the offices of Beverly Hills plastic surgeons, the laws include language to address specifically “the custom and belief-based cutting of African immigrants” (21). Consequently, the parents of intersexed American infants are free to have the genitals of their children cut or excised, as are women who have made the determination that their labia stand in need of some corrective measures, without concern for legal ramifications. Yet, the distinction between Western practices of plastic surgery and African practices of FGO is one figured along cultural, racial, and national lines. In practice, the difference is not so pronounced: “Among the key motivating factors raised by African women who favor female genital surgeries are beautification, transcendence of shame, and the desire to conform; these clearly matter to American women seeking cosmetic surgery on their labia, as well” (Davis 23). Davis goes on to quote Soraya Mire, a Somali filmmaker, who says “In America, women pay money that is theirs and no one else’s to go to a doctor who cuts them up...Western women cut themselves up voluntarily” (21). In this way, one could see Western female consumers who consent to the procedures (and even finance them) to be even more oppressed and bound by normative gender than their African counterparts.
The comparison between practices in the U.S. and Africa shows that although the specific methods may vary across space and time, normative gender imprints itself upon the body. In the U.S. context, the discourses of Western medicine and the media work together to reinforce messages about normative gender and the female body. Plastic surgery then functions as the means by which those gender norms are translated into flesh, transforming women’s bodies into “properly sexed” female subjects that are better able to fulfill their duties in the service of imperative heterosexuality. The process of “sexing” the female body, however, does not end when the anesthesia wears off. Rather, under the matrix of gender relations, women exist in a constant state of monitoring and correcting, forever striving to hit the moving target that is “woman.”
This removal of labial tissue does more than simply sharpen the distinction between the female body and the male body, however. The excision of tissue deemed “excessive” functions on a symbolic level as well, for it reflects broader societal norms that forbid a variety of excesses among women, particularly inordinate sexual appetites. Simone Weil Davis historicizes the association between large labia and heightened sexuality, noting, “at least since the sixteenth century they have indicated to doctors the alleged presence of hypersexuality, onanism, and possible ‘tribandism’ or lesbian tendencies” (37). Through labiaplasty, both her body and behavior are “civilized,” metaphorically reigned in to meet society’s insistence on female restraint and discretion. Saartjie Baartman, or the “Hottentot Venus,” perhaps best illustrates this type of phrenology by illustrating society’s attempt to draw a link between the physical appearance of the woman’s genitals and her character. Baartman was an African woman whose body was put on display through a touring exhibition across Europe for five years in the early part of the nineteenth century (Gilman 232). Her labia were of particular interest to the Europeans, who were eager to seize upon physical characteristics that could be used to make classificatory distinctions between the races. European travelers of the eighteenth century had returned from Africa with reports of the “Hottentot Apron,” a “hypertrophy” of the labia found among some tribes (232). Western colonialists used the “primitive” nature of the black woman’s sexual organs as evidence of a corresponding “primitive” sexuality, generally defined by “excesses,” including lesbianism (237). The Hottentot Venus provided a contrasting image for bourgeois European women’s genitals and sexuality. Unlike the untamed excess of the Hottentot, white women demonstrated a properly modest, civilized sex. Those highly gendered notions of the proper female body can still be detected in the modern practice of genital plastic surgery, which aims to reduce women’s sex—and sexuality—to more acceptable proportions.
Other surgical procedures besides labiaplasty are also tasked with sexing female bodies. For example, physicians’ promotional materials hail vaginal rejuvenation surgery (or vaginoplasty) as an “essential service” for women to enhance their physical sensation during sex, with advertisements touting “You won’t believe how good sex can be!” (Gorov C1). However, many doctors have voiced skepticism about such claims. A New York Times piece from 2004 quotes Dr. Thomas G. Stovall, president of the Society of Gynecologic Surgeons, as saying that no scientific evidence exists to support the claim that women experience enhanced sensation during intercourse after the procedure (Navarro 9.1). In fact, he claims the opposite, as some women actually experience pain after the surgery as a result of the muscles being too tight. Other risks include nerve damage leading to loss of sensation, a buildup of scar tissue, or infection. Despite some plastic surgeons’ repeated insistence that the women they treat seek the procedure to enhance their own sexual satisfaction, others concede that many women have a consultation at the urging of their husbands, boyfriends, or partners who want increased sensation for themselves. Thus, by surgically altering the vagina toward the goal of enhancing male sexual pleasure, vaginoplasty reinforces the instrumental function of the vagina in normative heterosexuality. Being a site of pleasure for the male sexual organ is a primary function of the vagina under the heterosexual matrix of gender. If the vagina fails in this capacity and is no longer able to deliver adequate stimulation to the phallus, a cultural intervention is required. Underscoring Butler’s theory, the vagina itself does not qualify one as a woman. Being a woman, a condition that under the normative heterosexual culture of contemporary society includes accommodating the phallus, requires medical assistance. As Simone de Beauvoir famously said, “One is not born a woman, but becomes one.” In this case, one is not born a woman, but is made one: Her sex is brought in line with her gender.
In addition to the function of the vagina being important under the heterosexual imperative, the appearance of the vagina is important as well. A desire for youthfulness stands as a key motivation for genital surgeries, as it does for plastic surgery in general. In her article “Vulva Goldmine: How Plastic Surgeons Snatch Your Money,” Julia Scheeres quotes UCLA psychology professor Paul Okami, who says, “These procedures are designed to approximate that of a pubertal vulva or vagina.” And, as other feminist critics have done, Scheeres points to the infinite number of Web sites promoting images of “teenage sluts” or “barely legal babes” as additional evidence of patriarchy’s sexual obsession with young, barely pubescent girls (75). Aside from having vaginoplasty to “rejuvenate” the genitals, some women have fat injected into their labia to give them a plumper shape. Feminist health expert Judy Norsigian, as quoted in the Los Angeles Times, situates this trend in the context of men’s obsession with barely pubescent young girls. She attributes the popularity of Brazilian waxing—in which nearly all of the pubic hair is removed—as further evidence of this. In the context of the heterosexual imperative, the female must be ever vigilant to keep herself alluring and hold the male’s sexual interest. Physicians point out that older women may be in a losing battle against gravity as they begin to notice their nether regions increasingly “on the move.” As Davis says, “It is woman’s work to make sure her genitalia are snug, not wayward” (15). Sustaining a youthful, feminine body, as necessitated under the heterosexual matrix of gender, requires constant attention and maintenance.
Hymenoplasty, in which the hymen is surgically reconstructed to mimic the virginal state, is yet another example of how the female genitals are produced to support heterosexual normativity. The procedure is not new. However, it has historically been performed on women from Middle Eastern or Latin American cultures that would themselves or their families suffer physical harm or shame if they were discovered not to be virgins upon marriage (Masterson 7). The small operation would erase physical evidence of prior sexual activity or rape. Although the number of women seeking these procedures is considerably less than those pursuing labiaplasty or vaginoplasty, its popularity has begun to take hold in the U.S., primarily among white, affluent, urban women. To distinguish it from the aforementioned cultural context, those in the industry have dubbed the procedure “recreational” hymenoplasty. A Philadelphia Daily News article quotes one woman who is having the $5,000 surgery as a “gift” for her husband who, she says, “deserves everything” (Armstrong 1). Other women undergo the procedure to mark anniversaries or other special occasions. Unlike vaginoplasty, though, in which some doctors still make the case for enhanced female pleasure (despite evidence to the contrary), hymenoplasty guarantees women’s discomfort. Again, if the vagina no longer meets a key requirement of womanhood under heterosexual society—keeping the phallus endlessly stimulated and entertained—then action must be taken to create proper bodies.
These various practices—vaginoplasty, labiaplasty, hymenoplasty—and a range of others, highlight the constructedness of the sexed female subject because her body requires constant maintenance to adhere to gender requirements. Dominant gender ideology enlists her to become a sentinel, watchful for aberrations or abnormalities that cause her body to slip beyond the boundaries of acceptable womanhood. Thus, responsibility for the enforcement of norms rests within the individual subject herself. Just like the docile bodies of Foucault’s Panopticon, bodily surveillance has been internalized: “We are neither in the amphitheatre, nor on the stage, but in the panoptic machine, invested by its effects of power, which we bring to ourselves since we are part of its mechanism” (217). With gender, there is no center of power that enacts rules and then punishes transgressors. Rather, the gender binary is so strong and so pervasive that no external policing is necessary. On our own, as sexed subjects, we accomplish the disciplining of our bodies to fulfill the requirements of gender categories.
However, because the very definitions of these categories are cultural creations, they are subject to change over time and space. As the gender norms shift, so must our disciplining practices. The variance that exists among norms becomes apparent when examining the practice of labiaplasty in the West alongside the practice of female genital operations (or FGO) in Africa. According to Davis, both cultural practices are underpinned by the idea that “the genitalia are cultural terrain that must conform to identificatory norms” (17). Nonetheless, most American women who seek labiaplasty would no doubt be horrified at the comparison between their own procedure and the practice of FGO in Africa. However, Davis asserts that the distinction between the two is not so great. Since the mid-1990s, ten U.S. states have passed anti-FGO laws. Although the nature of the operations criminalized in these laws would easily apply to the kinds of procedures being performed in the offices of Beverly Hills plastic surgeons, the laws include language to address specifically “the custom and belief-based cutting of African immigrants” (21). Consequently, the parents of intersexed American infants are free to have the genitals of their children cut or excised, as are women who have made the determination that their labia stand in need of some corrective measures, without concern for legal ramifications. Yet, the distinction between Western practices of plastic surgery and African practices of FGO is one figured along cultural, racial, and national lines. In practice, the difference is not so pronounced: “Among the key motivating factors raised by African women who favor female genital surgeries are beautification, transcendence of shame, and the desire to conform; these clearly matter to American women seeking cosmetic surgery on their labia, as well” (Davis 23). Davis goes on to quote Soraya Mire, a Somali filmmaker, who says “In America, women pay money that is theirs and no one else’s to go to a doctor who cuts them up...Western women cut themselves up voluntarily” (21). In this way, one could see Western female consumers who consent to the procedures (and even finance them) to be even more oppressed and bound by normative gender than their African counterparts.
The comparison between practices in the U.S. and Africa shows that although the specific methods may vary across space and time, normative gender imprints itself upon the body. In the U.S. context, the discourses of Western medicine and the media work together to reinforce messages about normative gender and the female body. Plastic surgery then functions as the means by which those gender norms are translated into flesh, transforming women’s bodies into “properly sexed” female subjects that are better able to fulfill their duties in the service of imperative heterosexuality. The process of “sexing” the female body, however, does not end when the anesthesia wears off. Rather, under the matrix of gender relations, women exist in a constant state of monitoring and correcting, forever striving to hit the moving target that is “woman.”
