Text: Carole Extermann
Photo: Jeanne Martel

“No one would have interviewed me about this topic ten years ago”

DINA BADER Legally, nothing distinguishes excision from cosmetic operations on the genitalia. The researcher shows how ethnocentrism influences perception of these practices.

Dina Bader studied the difference between excision and cosmetic operations on female genitalia (labiaplasty or nymphoplasty). In Vivo dedicated an extensive interview to her. This brought the opportunity to better understand the politics at stake in regulating female genital mutilation and genital cosmetic surgery. The two practices must be compared so that prevention work against excision practices can be carried out properly in the field.

in vivo Your research focused on the concept of female genital mutilation by comparing genital cosmetic surgery and excision.

How did this project come about?

DINA BADER I was interested in excision from a sociological perspective and how it relates to migration and gender. However, over the course of my work, it was not unusual for my online research on genital modification procedures to bring up information about cosmetic surgery. I then realised there was a striking paradox. While excision is firmly banned in Switzerland, genital cosmetic surgery is booming. Exploring the two practices in parallel allowed me to gain a better understanding of the concept of female genital mutilation (FGM). And what differentiates FGM from genital cosmetic surgery such as labiaplasty.

iv How easy was it to obtain information on this subject?

db The idea of comparing FGM and intimate cosmetic surgery is extremely taboo. No one would have interviewed me about this topic ten years ago. Its complexity also comes from the stereotypes associated with these practices. In public discourse, excision is widely portrayed as a barbaric act performed with a rusty razor on a dirt floor, while genital cosmetic procedures are controlled operations that take place in a medical environment. These practices are also commonly distinguished by the category of people they concern: adult women are more likely to have labiaplasty, while FGM allegedly only involves minors. That said, more and more teenage and pre-adolescent girls are undergoing labiaplasty, but excision is also forbidden for consenting adult women. Contrary to popular belief, many excisions are performed in a medical setting. For example in Egypt, 84% of these procedures are done in hospital.

iv Why should cosmetic surgery encompass a discussion of genital mutilation?

db Female genital mutilation became punishable by law in 2012. But legally, nothing distinguishes the two practices. The law makes no mention of consent or age, or even the conditions in which the procedure is carried out. It condemns any damage to the female genitalia, and in this respect, concerns cosmetic surgery. In online discussion forums, women who have undergone genital operations speak of a feeling of mutilation when the operation has gone terribly wrong, or when the result is not what they’d hoped for. In fact, some women go to doctors specialising in vulvar reconstruction, whereas this service was initially designed for victims of excision. The boundary between FGM and genital cosmetic surgery is blurred. The distinction is based on interpretation and conveys a form of ethnocentrism. Some surgeons are reluctant to perform labiaplasty on a young black girl for fear of being prosecuted for FGM. In fact, the consumption of Western pornography by men of African origin is leading to renewed interest in excision. Under Swiss law, genital cutting involving the removal of the labia minora is banned, but labiaplasty, in which the labia minora are partially or completely reduced, is legal. A procedure should not be considered legal or not depending only on the name we give it.

“The legality of cosmetic genital surgery mostly has to do with economic arguments.”

iv How do you think these stereotypes about excision are formed?

db In researching the topic, I analysed media discourse and parliamentary debates. I found that reinforcing these stereotypes and defining the practice of excision as barbaric contribute to stigmatising migrant women, the majority of whom are black and asylum seekers. This gives conservative political parties the opportunity to push an anti-immigration agenda, without taking an openly xenophobic stance. Stereotypes are amplified by social representations that imagine a less developed social morality and medical ethics in non-Western countries.

iv Should the law prohibiting female genital mutilation be relaxed?

db No. The purpose of my work is not at all to question the illegality of excision, but to look into the differences in position. Is it possible to support genital surgery on women, sometimes very young women, while at the same time condemning FGM? In Switzerland, excision is punishable even when performed abroad while the family was still living in their country of origin. However, genital operations are not covered by any explicit regulations. It would therefore be worth questioning the consistency of this double standard and the contradictory messages that come from it.

iv In 2022, the Swiss Society for Plastic, Reconstructive and Aesthetic Surgery estimated that this type of operation has increased 50% over the last five years. Why do you think it’s become so popular?

db The desire to correct one’s sex organs is mostly born out of ignorance. A significant proportion of women don’t know what the vulva in all its diversity really looks like in a natural state. Many are thus guided by pornographic images of smooth, operated or retouched organs, but which are not in line with reality. Then, there are people who start capitalising on this potential complex. Cosmetic products designed to care for and enhance the female genitals are now coming out, contributing to the idea that there is a specific standard of beauty that should be met. Sometimes, claims are also made about improving the patient’s sex life. The scientific studies that prove any improvement often contain significant biases, and the improvement often only comes from getting rid of a complex. However, with labiaplasty, the patient also risks experiencing pain, complications during childbirth and a loss of sensitivity. My analysis of parliamentary debates shows that Swiss lawmakers wanted to make an exception for aesthetic female genital surgery because it’s a lucrative market. It’s tolerated for economic reasons.

iv The reason for this increase is also sometimes linked to the fact people talk more freely about the subject. What do you think?

db During the interviews I conducted in my research, I noted, on the contrary, the taboos that can surround the issue, especially when the operation fails. This can mainly be measured by looking at the difference between stories of failed operations on online forums or during consultations and the number of complaints filed. One expert that I interviewed explained that doctors who perform genital cosmetic surgeries don’t take a lot of risks. Because filing a complaint for a failed vulvar operation would still be considered embarrassing, and that is likely to be dissuasive.

iv Could consent be a criterion to distinguish between labiaplasty and excision?

db That argument is often used. Having an operation for aesthetic reasons would be a choice, while excision would supposedly be practised on women against their will. Unfortunately, it seems difficult to accept that labiaplasty would be a choice outside a specific sociocultural context. Beauty norms, particularly in this field, put strong pressure on women whose social acceptance depends on specific standards. Consent is therefore extremely biased in this context. In addition, excision practices requested by adult women are not deemed acceptable. That clearly shows that consent does not define what FGM is.

iv What solutions can be implemented to raise public awareness about these issues?

db It’s important to reconsider how children are socialised and how they are taught about gender norms. More specifically in the context of sex education, it is vital to explain the diversity and function of the female genitalia. It’s also important to give young people the tools they need to understand issues relating to the appearance of genitalia. I think it’s also crucial to help them to develop a sense of discernment when it comes to often arbitrary beauty standards that tend to change over time and in different cultures. /




As a sociologist, Dina Bader specialises in migration and gender issues. Her doctoral dissertation on the issue of genital mutilation and aesthetic operations was awarded the Gender Equality Award in 2019 from the University of Lausanne. She is currently project manager and lecturer at the University of Neuchâtel.