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DESIGNER VAGINAS

The goal of creating the idealized female form is neither new nor novel.  
Women have been altering their bodies for centuries. However, the focus re-
cently has come onto the vagina - the most culturally value-laden of anatomical 
parts.  This paper seeks to explore how historical representations and contem-
porary perceptions of the vagina have shaped attitudes towards female geni-
talia, and why society has perpetuated the objectified, idealized female image 
and imposed that falsification on the vagina.  Additionally the author explores 
the practice of female genital cosmetic surgery (FGCS), potential impetus be-
hind the increase in elective vagina surgeries, and the implications of FGCS for 
both the individual and broader society. Further the author hopes to examine 
implications for social work practice working in a society blanketed with the 
pernicious cultural message that in order for a woman to be accepted and feel 
adequate, she must attain the “perfect” physical form.

    or centuries, women have altered their bodies to achieve a perceived 
physical ideal. In the developed Western world, pervasive cultural constructions 
of “perfection” have motivated women to dye their hair, adorn themselves with 
permanent makeup, adopt emotionally and physically destructive diets, and at 
the most extreme, undergo cosmetic surgery (Davis, 1995). Popular culture and 
the media perpetuate this belief that women can and should literally construct 
themselves into the enigmatic, heterosexual female ideal (Braun & Kitzinger, 
2001). Thus, it was only a matter of time before women’s focus shifted to the 
vagina, and thus birthed an additional form of modification: female genital 
cosmetic surgery (FGCS). Throughout this paper, the author will examine the 
history and current status of the vagina in public discourse. Additionally, this 
author endeavors to explore the current phenomenon of elective FGCS and the 
role that the media and societal attitudes play in the practice of FGCS. While 
important, female genital cutting or surgery for transsexual and intersexed peo-
ple will not be discussed within this paper as such topics are beyond the scope 
of this paper.

The vagina has become increasingly prolific in contemporary art, which 

Katherine (Katie) Querna

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is represented through popular culture. From Judy Chicago’s ‘The Dinner Party’ 
to Annie Sprinkle’s ‘Speculum Parties of in the 1980s, artists’ representations of 
the vagina have become increasingly more mainstream. These feminist artists 
paved the way for the most well-known representations of vagina in art such as 
Eve Ensler’s The Vagina Monologues (Braun & Wilkinson, 2001). Additionally, 
the proliferation of pornography has furthered the dialogue around female geni-
talia (Braun, 2005; 2001; Davis, 2002; Nagel, 1996; Scheeres, 2006). This larger, 
vagina awareness in the media helps normalize anatomy and is a positive shift 
towards bringing the vagina into public discourse. These contemporary represen-
tations have developed after the years of derogatory discourse regarding female 
anatomy. The vagina has traditionally been thought of as gross and shameful, 
often as something to be hidden (Braun, 2005; Braun & Wilkinson, 2001; Davis, 
2002).  These attitudes manifested in secrecy around female genitalia, as some-
thing not to be discussed. When the vagina was made public, it was ridiculed or 
presented as disgusting (Braun & Wilkinson, 2001; Braun, 2005; Davis, 2002).

Historically, women’s bodies have been a site of struggle for power and 
control (Brownmiller, 1994). As Brownmiller (1994) commented “the female 
body often reduced to isolated parts, has been mankind’s most popular subject 
for adoration and myth, and also for judgment, ridicule, esthetic alteration, and 
violent abuse” (p. 58).  While research about female bodies and the media’s rep-
resentation of women is widespread, literature discussing the vagina as a topic 
is scant. Despite this lack of attention, there exists a wealth of pejorative and 
paradoxical socio-cultural representations of the vagina.

The Vagina in History

Symbolic constructions of the vagina were originally created by a hetero-
sexist, male-dominant culture which sought to perpetuate the subordinate status 
of women by creating the idea that women’s bodies are dangerous and uncontrol-
lable, and thus, the vagina is something to be feared (Davis, 2002). This con-
struction of female bodies as a source of disgust, fear and danger (Ussher, 1989) 
is manifested in the mythological idea of the dangerous vagina (Beit-Hallahmi, 
1985; Otero, 1996). For example, the vagina dentata –a vagina equipped with 
teeth is a common mythological motif around the world (Beit-Hallamhmi, 1985). 
Lederer (1968) uses this imagery in the fairytale Sleeping Beauty, metaphorically 
comparing the impenetrable wall of deadly thorns to the vagina. In New Zealand, 
Maori legend describes the Goddess of Death, “in the place where men enter her 
she has sharp teeth of obsidian and greenstone” (Alpers, 1964, p. 111). 

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Perhaps the genteel status women aimed to occupy later in Western his-
tory is in response to the early derogatory perceptions of women and their vora-
cious desires as symbolized through their vaginas (Braun and Kitzinger, 2001). 
Notions of female lust were transformed into the myth of feminine modesty. 
During the late eighteenth century, any derivation from that modesty was seen 
as amoral and promiscuous; the antithesis of what a woman was supposed to or 
would want to be. As to not be perceived as threatening, women were obliged to 
emanate demureness and docility, the goal of which was to convey self-control. 
Self-containment was highly valued. This was the antithesis of the “sexually in-
satiable female” dogma of the past.

During the same era, a large labia came to be associated with deviance, 
because they implied, albeit incorrectly, promiscuity (Braun & Wilkinson, 2001; 
Pliskin, 1995). The vagina quickly morphed into a public health concern. A 
woman who was unable to control her sexual desires (just by virtue of feeling 
sexual desires), would pose a threat to the population as though her perceived 
promiscuity were contagious, and a disease in and of itself. Women who lacked 
etiquette were perceived as sexual. Women with “overly” long labia, as deter-
mined by the dominant culture were were dangerous to the public (1995).  

The vagina as dangerous arose symbolically arose as the uncontrollable 
female. In more practical or pseudo scientific terms, the vagina was the melting 
pot for diseases. Such concepts were infused into contemporary periods as well. 
Erik Erikson (1968) suggested: “Dreams, myths, and cults attest to the fact that 
the vagina has and retains (for both sexes) connotations of a devouring mouth” 
(Braun & Wilkinson, 2001, p. 24). American servicemen in Vietnam recount 
hearing stories of sex workers with razors, sharp glass, or even grenades in their 
vaginas (Gulzow & Mitchell, 1980).  Thriller genre films frequently use vagina 
detanta imagery “for the purpose of portraying female sexuality as a monstrous 
threat to the male” (Braun & Wilkinson, 2001, p. 24, Galvin, 1994, p. 9).

The male psyche played a critical role in perpetuating the myth that the va-
gina is dangerous and erratic; a metaphorical part of the woman to be controlled. 
The vagina is seen as a hole of uncertainty –mysterious, fleshy, devouring the 
male penis (Galvin, 1994). Additionally, the vagina physically is not physically 
seen as easily as the penis, nor has it been represented as often in media and so-
cial dialogue around genetalia. Thus the vagina (that we aren’t as familiar with) 
is unpredictable (Braun & Wilkinson, 2001; Braun, 2005). 

The Vagina in Public 
These attitudes subsequently infiltrate popular psyche and seep into media 

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outlets, perpetuating cultural beliefs about the vagina. According to Braun and 
Wilkinson (2001), the vagina’s degraded status plays out in several ways: the va-
gina as (a) inferior to the penis; (b) as absence of a penis; (c) a passive receptacle 
for the penis; (d) sexually inadequate; (e) disgusting; (f) vulnerable and abused, 
and; (g) dangerous. The consistent invalidation of the vagina leads women to 
see their own anatomy as undesirable; as parts that need to be transformed to be 
accepted.

Women are inundated with derogatory cultural attitudes surrounding va-
ginas, which are portrayed as dirty, unhygienic, and even dangerous (Braun & 
Wilkinson, 2001). The media perpetuates this stigmatization of female anatomy 
by asserting that women need to clean and hide their vaginas to maintain some 
level of decorum. Douches, scented panty liners, and a cadre of various “femi-
nine hygiene” products created to sophisticate the vagina are marketed to wom-
en, increasing the stigma that vaginas are shameful things meant to be hidden 
and perfumed (Kane, 1997; Braun & Wilkinson, 2001; Davis, 2002). The vagina 
consistently has been portrayed as problematic. Popular teen and women’s maga-
zines are rampant with questions from readers about how to improve the look, 
smell, tone, even taste of their vaginas (Kane, 1997). “A significant amount of 
women would gladly swap their real vaginas for something less troublesome-an 
unexploded warhead in their back garden, say…” (Ellen, 1999). 

Movies, television, and music, all perpetuate these imbedded attitudes by 
recycling tired jokes about the “foulness” of the vagina. Such carriers of pop 
culture allude to the danger the vagina poses to society if it is not controlled 
(Legman, 1975; Braun & Wilkinson, 2001; Davis, 2002). The message is clear: 
women must conform to what the male authority of popular culture dictates as 
acceptable, so that men can feel some amount of control over women and their 
sexuality (Braun, 2005). Media representations of female sexuality as “insatia-
ble” or “voracious” are arguably born from this fear of the female; that men’s pe-
nises could get devoured by the “uncontrollable beast” that is the vagina (Pliskin, 
1995).

From a feminist perspective, women have internalized society’s misogy-
nistic attitudes about women and their “sub-par” anatomy, and some have con-
sequently elected to undergo female genital cosmetic surgery (FGCS). Further, 
television shows glorify cosmetic surgery, creating the impression that “every-
one is doing it.” The expectation becomes that one must improve their own ap-
pearance in order to fit in. 

FGCS is one of the newest in a lineage of surgical and cultural arsenals 
meant to popularize the idea that female bodies are inherently flawed. The in-

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creasingly normalized status of commercial pornography coupled with vaginally 
focused art and prints material, albeit positive cultural changes, may have led to 
an increase in FGCS (Braun, 2005; Davis, 2002; Nagel, 1996; Scheeres, 2006). 
Women, who often look to magazines for representations of the traditional femi-
nine ideal are increasingly shifting their focus to pornography and consequently 
to their own genitals. Davis (2002) quotes a well-known cosmetic surgeon in 
saying “…they look at Playboy, the ideal woman per se, for the body and the 
shape and so on. You don’t see women in there with excessively long labia mi-
nora” (p.7). Women who internalize this notion of the vagina coupled with their 
attitudes around their own anatomy are susceptible to FGCS. 

Plastic surgeons perpetuate the practice by emphasizing the notion of the 
“perfect, tight” vagina. A purveyor of FGCS, Dr. Gary Alter proclaims “take out 
your hand mirror and check out those labia, after all, you just might not measure 
up” (Braun and Kitzinger, 2001, p.272). Media reports covering the work of 
many modern practitioners state that vaginal tightening (vaginoplasty) increases 
the sexual pleasure for women. This has yet to be explored empirically; how-
ever it is often cited as the impetus for women undergoing surgery. Curiously, 
this procedure seems like it would increase male pleasure more markedly than 
women’s.

History of Vaginal Surgery

FGCS began in the 1840’s with J. Marion Sims, a physician who performed 
a series of experimental surgeries for vesico-vaginal fistula on Southern slaves. 
These fistulas were often a result of childbirth and presented as necrotized vagi-
nal tissue between the bladder and the vagina, which allowed for the involuntary 
discharge of urine into the vaginal vault (Littrell, 1995). Although the procedure 
was intended for white women post-childbirth, a black woman’s subordinate sta-
tus, manifested as an inability to refuse treatment. Coupled with her higher birth 
rate, black women were increasingly vulnerable to this experimental surgery 
(Adams, 1997). Additionally, since enslaved women were often undernourished, 
the incidence of childbirth complications increased, and Sims was endowed with 
a higher patient yield to experiment upon. Although Sims’ work provided a cure 
for visico-vaginal fistulas, it set the tone for further scrutiny of natural female 
anatomy and the creation of procedures for illusory maladies. 

Such was the case for nineteenth century British physician Baker Brown 
who was called into question for performing non-consentual clitorectomies on 
women with reported pronounced sexual desire (1997). Clitorectomies entail 

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surgical removal of all of the clitoris and sometimes the labia as well (Littrell, 
1995). Current vernacular describes the procedure that Brown performed on 
women as female genital mutilation or forced circumcision. Brown’s apparent 
goal was to “cure” women of their want for clitoral stimulation, however, his 
procedure led to further pathologizing of female sexual desire.  

Contemporary FGCS

In this day and age, bodily perfection, a tight, unadulterated vagina-is cul-
tural currency (Davis, 1995; Davis, 2002). Many women who have undergone 
genital cosmetic surgery cite feelings of aesthetic dissatisfaction with the ap-
pearance of their vaginas, consistently noting that their labia are too loose or 
that their labia minora protrude beyond their labia majora (Braun & Kitzinger, 
2001). It seems that women are proceeding under the assumption that there is 
a “normal vagina” that does not look like their own. Society created the image 
of a “normal” vagina and ascribed a pejorative status to a “loose vagina” which 
purportedly signals sexual promiscuity (2001). It behooves the male-dominant, 
Western culture to perpetuate this idea, as a large penis is conversely valued; thus 
if a man feels that the size of his genitalia is inadequate, he can turn his problem 
of a small penis into her problem of a loose vagina (Braun & Wilkinson, 2001; 
Braun, 2005). 

The phenomena of contemporary FGCS began with controversial gyne-
cologist Dr. James Burt, who stated in his 1975 book Surgery of Love that he 
had been performing “love surgery” on women without their consent for years 
(Adams, 1997). This surgery involved realigning the vagina and removing the 
skin covering the clitoris, with the intent, Burt asserted, of enhancing female 
sexual pleasure. Burt was motivated by a self-held idea that women’s vaginas are 
“structurally inadequate for intercourse” (p.61), and thus should be altered. This 
claim was turned on its head when, in 1989, Burt had his license revoked after 
several former patients filed suit for malpractice claiming that they were sexu-
ally crippled and suffered chronic debilitating pain, urinary tract infections, and 
incontinence (Adams, 1997). Both Brown and Burt operated on women under 
the guise of benevolence; however, they were guided by traditional, male-centric, 
heterosexual values and believed that women suffer from an inherent sexual pa-
thology that necessitates intervention (Adams, 1997).  

According to several theorists, medicine created numerous procedures in-
tended to help construct the coveted “ideal” vagina: a youthful, tight, rounded 
vulva, with labia majora enclosing the labia minora and clitoris (Braun, 2005; 

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Braun & Wilkinson, 2001; Braun & Kitzinger, 2001; Davis, 2002). The scope 
of modern FGCS includes vaginoplasty (tightening of the vaginal muscles), la-
biaplasty/labioplasty (labia minora reductions), labia majora “augmentations,” 
(tissue removal, fat injections), liposuction (mons pubis, labia majora), vagi-
nal tightening (fat injections, G-spot “amplification” - collagen injected into the 
“G-spot” which swells it), -and hymen reconstruction (intended to restore the 
appearance of virginity). Given the nature of these specific reconstructive surger-
ies, it would appear that women are after pubertal genitalia.

Although specific quantitative data regarding FGCS currently does not ex-
ist, a collection of qualitative interviews of 24 Western surgeons suggests that 
increasing numbers of women are electing to undergo FGCS for a variety of 
motivations and costs, both emotional and material (Braun, 2005). Many pa-
tients who opt for FGCS previously have undergone cosmetic surgery (Gagne 
& McGaughey, 2002; Braun & Wilkinson, 2001; Haiken, 1997: Davis, 2002; 
Scheeres, 2006). Given the problematic historical representations of the vagina 
by the medical community, the media, and society at large, it seems natural that 
women would feel the need to alter their genitals. 

Implications for Practitioners

Regardless of the plethora of procedures conducted upon the vagina, or 
reasons given for their necessity, only in very rare cases do FGCS procedures 
serve any other purpose than to perpetuate the derogatory ideology that women’s 
vaginas are imperfect; their bodies are not good enough and they are not good 
enough follow (Braun, 2005; Braun & Wilkinson, 2001; Davis, 2002). 

However, there is hope to end this oppressive attitude. Literature on FGCS 
is becoming increasingly prevalent in popular media. Cosmopolitan, Harpers 
Bazaar, and Marie Claire, as well as Salon online ran stories on the subject. 
These pieces all discussed labiaplasty, a relatively recent plastic surgery proce-
dure that involves trimming away labial tissue and sometimes injecting fat from 
another part of the body into labia that have been deemed excessively droopy 
(Davis, 2002). These articles also included remarks from skeptical colleagues 
and from polled readers who feel that their labia are satisfactory; encouraging 
reports that show resilience to the pernicious myth of perfection.

Judy Chicago, Annie Sprinkle, and well-known writer Eve Ensler not only 
included the vagina in their work, but made it the focus. As well, the normaliza-
tion of pornography has furthered modern discourse on human anatomy thus 
serving to de-stigmatize and de-mystify the “gross, dangerous” vagina (Braun, 

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2002; Braun & Wilkinson, 2001; Davis, 2002; Nagel, 1996; Scheeres, 2006).
Because FGCS is manifested on/in the body, it is imperative that practi-

tioners explore the potentially deleterious health consequences resulting from 
any one of the FGCS procedures. Women report loss of sensation (ironically 
“increased pleasure for women” is a common reason cited for the decision to un-
dergo the surgery), chronic pain, and frequent urinary tract infections (Navarro, 
2004; Scheeres, 2006). There also exists evidence of increased incidents of vagi-
nismus, a condition in which the vaginal muscles constrict, restricting access to 
the penis, thus compromising any sexual activity (Scheres, 2006). The irony here 
is that some women who choose FGCS in order to create the “ideal vagina” or 
“increase their sexual pleasure” ended up with an inability to have sex at all (Da-
vis, 1995). Along with a $10,000 price tag, FGCS may be an exorbitantly high 
price to pay for the “perfect” vagina.  

Concurrently, the idea of women’s bodies as shameful, private things could 
affect women’s help-seeking behavior and willingness to discuss certain symp-
toms with practitioners, or even examine their own genitals and recognize causes 
for concern. Normalizing real (as opposed to idealized) vaginas is beneficial to 
women as it may allow them to feel freer to discuss concerns with practitioners 
as well as serve to generally cultivate greater body acceptance.  

Clinicians would be well served to investigate how these cultural attitudes 
manifest for women with whom they practice. Female subordination and the 
drive for bodily perfection can manifest into destructive behaviors such as dis-
ordered eating, overzealous exercising, capriciously use of plastic surgery, and 
other body punishing rituals all in pursuit of a perceived physical ideal (Blessing, 
2005; Delinsky, 2005). Research suggests that women who undergo cosmetic 
surgery have a higher propensity for disordered eating patters, body dissatisfac-
tion, and general attitudes of their bodies as defective (Blessing, 2005; Delinsky, 
2005). 

 Future social work research should examine individual outcomes for those 
who choose to undergo surgery, as well as the impact of increased cosmetic sur-
gery on societal ideals (Delinsky, 2005). This gives rise to the question, is it the 
perceived ideals that are driving the increase in FGCS, or is it, the other way 
around? Could the phenomena of more women opting to construct their perfect 
vagina constructing the perceived ideal? Further, women could be proceeding 
under false assumptions; the reality could be that in our heterosexually driven 
culture, men do not lust after one perfect female form, but are happy with any 
number of differing aesthetics regarding a woman’s anatomy.  

The danger of FGCS is when dysmorphic thinking moves fluidly into ac-

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tion; and the body becomes a site for alteration rather than reflection. Blessing 
(2005) suggests: “… heartbreaking consequences can emerge when thinking is 
supplanted by action and when fantasies are responded to as if they were real” 
(p. )  Future research should explore women’s reported motivations for undergo-
ing FGCS. Findings could inform best practice models targeted at mitigating the 
self-esteem issues that can be the impetus for women compelled to alter their 
appearance. 

Gillespie (1996) discusses the implications for cosmetic surgery on the 
macro societal level. She states that cosmetic surgery “encourages women to 
experience their bodies as pathology and reinforces unrealistic ideals…this may 
lead to disharmony and dissatisfaction, and make body preoccupation normal 
feminine behavior” (p.83). If that cultural truism perpetuates it could exacerbate 
self-destructive behaviors, which are all topical issues for social workers. 

Additionally, it must be said that body dissatisfaction is not limited to 
females. Normalizing the creation of the perfect form could lead to increases 
in erratic and overzealous rituals aimed at body modification in males as well 
(Striegel-Moore, Silberstein, & Rodin, 1986). Issues typically associated with 
males and cosmetic surgery are too broad for the scope of this paper, however, it 
is safe to say that creating a unilateral ideal for any population is harmful to the 
individual and for the broader society. 

The tenacity of negative representations suggests that society has an ob-
ligation to think critically about how the vagina is discussed in schools, media, 
and coming generations. Cultural representations affect women’s health. Sexual 
and psychological well-being can only be improved by a shift in ideology. Break-
ing the taboos of shame and secrecy by talking seriously about the vagina and by 
challenging derogatory representations is imperative in this restorative process 
of healing the female psyche and steering attitudes towards what should be ideal: 
the vagina as a healthy, functional, beautiful part of female anatomy.

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KATHERINE (KATIE) QUERNA is a second year master’s student in the 
Advanced Generalist Practice and Programming method. She holds a BA in El-
ementary Education with a minor in Spanish from Linfield College. She is cur-
rently an intern at the Social Intervention Group working on international, pub-
lic health and trauma studies research.  Her email is kaq2102@columbia.edu.

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