Limiting the Medicare rebate for genital surgery is a good move

In parts of Africa, women are tied down and mutilated while in Australia women receive the Medicare rebate for genital surgery

Last week The Age reported that the federal government is expected to target cosmetic genital surgery as it seeks to reduce the cost of Medicare. In Australia, genital surgery is increasing as women seek to improve the shape and size of the vagina and to treat painful or embarrassing conditions. If the surgery, costing about $4500 is considered to be clinically necessary then the patient may be eligible for Medicare payments. But as the Federal Government seeks to reduce its health costs it is expected that qualification for the rebate will soon prove to be more difficult.

The number of Australian women having vaginal ”rejuvenation” surgery has tripled in the past decade. An analysis of Medicare figures reveals almost 1400 women made claims for labiaplasty operations in 2009, a jump from 454 in 2000-01. According to labiaplasty surgeon Dr Stern, many women dislike the large protuberant appearance of their labia minora.  He says that these overly large labia can cause severe embarrassment with a sexual partner.

While western women are increasingly turning to the knife and having the size, shape and appearance of their labia enhanced, feminists and activists continue the campaign to end the practice of female genital mutilation affecting millions of women living in parts of Africa, Asia, and the Middle East. Female genital mutilation is a procedure that intentionally excises genital tissue leading to problems such as frequent bladder infections, childbirth complications and the risk of later surgery. The World Health Organization estimates that there are 100 to 140 million women who have had their lives damaged by FGM.

With the increasing number of Australian women having genital surgery, doctors are suggesting that pornography may be driving women to have unnecessary genital makeovers in a bid to look more desirable. According to Chief Executive of the Australian Society of Plastic Surgeons Gaye Phillips, the women are being influenced by pornography which is much more available with the internet.

Phillips is not alone in connecting the way women feel about their bodies, and in this case their genitals to pornography. Gail Dines, author of PornlandHow Porn has Hijacked ourSexuality, claims the mainstreaming of porn has caused women to believe they are sexually empowered by looking and acting like a porn star. Although women know the images they are seeing are not the ‘real thing but are technologically enhanced’, they are still influenced and feel inadequate in comparison. As well as the tripling of genital surgery, Dines reports that over the last decade there has been a 465 percent increase in overall cosmetic procedures with 12 million operations taking place annually in the U.S. for makeovers such as liposuction, face-lifts and breast jobs.

Dines claims that the multibillion-dollar pornography industry must be considered a major public health and social concern. Her assertion is supported by reports that young women are requiring psychiatric treatment after the genital surgery because they still do not like their bodies.

Also raising concerns is the head of psychiatry at St Vincent’s Hospital, Dr Castle who has previously called for legislation requiring pornography producers to declare all airbrushed images, so that women would have a clearer and more realistic idea of normal female genitalia.

But for the countless numbers of young girls and women who are forced to undergo female genital mutilation it is not about choice or dislike of their bodies. The partial or total removal of the external female genitalia is neither chosen nor performed for medical purposes, but for socio-cultural reasons such as the desire to preserve cultural identity, wanting to control a girl’s sexual desire, and a belief that FGM makes a girl more sexually attractive to men.

In an interview with Nadya Khalife, 18 year old student Dalya told the women’s rights researcher that she remembers a lot of blood and was very afraid. ‘This has consequences now for my period. I have emotional and physical pain from the time when I saw the blood,’ she said.

The clitoridectomy performed on Dalya is the total or partial removal of the clitoris and is considered the least severe form of FGM. But all forms have acute and chronic health complications such as risk of death, heavy bleeding, sepsis and acute urinary retention. Infibulation – the cutting and stitching of the labia minora and majora can cause scarring, urinary retention, menstrual disorders and infertility and prolonged labour.

It is distressing that Australian women choose to have unwanted pieces of labia cut away, while the struggle to stop the mutilation of their sisters continues.

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