Talk:Labiaplasty/Archive 1

Comment
"Labiaplasty is sometimes performed to revise anomalies and congenital conditions such as large inner labia" A large inner labia is not an anomaly or an congential condition.Spuddy 17 03:16, 23 December 2005 (UTC)

Removed external links
I removed several commercial external links. Joie de Vivre 19:00, 15 February 2007 (UTC)
 * Sources being hosted on commercial sites doesn't disqualify them under Wikipedia policy. Sources such as before and after photos of the procedure seem to be very relevant.--Ty580 10:40, 16 February 2007 (UTC)


 * Number 4 in the list of Links normally to be avoided is Links to sites that primarily exist to sell products or services. The sites I deleted exist primarily to advertise a particular surgeon's work. Therefore, they are inappropriate for the external links section.  As far as the necessity of links to such images, why should one surgeon's work be featured over another?  These websites don't provide comprehensive, neutral information on labiaplasty and what the results look like, they exist to sell expensive surgical procedures.  Google image search can be used by anyone who wants to see such photos. Joie de Vivre 17:02, 16 February 2007 (UTC)


 * You're correct, I did not follow the guidelines. I found the videos very informative from the patients point of view, that's why I added them, but, yes, they can be Googled. LoveyK 16:41, 21 February 2007 (UTC)

Toronto Globe link
The The Toronto Globe piece no longer exsists on the Globe’s website. The link posted is a text copy on the www.noharm.org[] (National Organization to Halt the Abuse and Routine Mutilation of Males) website and only has the one page with a text copy of the Globe article refering to labiaplasty. Preceding the text copy of the Globe article is this controversial and somewhat confusing comment: “Looking Like Mommy? Labiaplasty Dilemma”, “... If a woman has her genitals altered in this way, and then becomes pregnant with a daughter and feels that it would be in her child's best interests that the girl's genitals should "look like mommy's", would this be sufficient reason for a physician to carry out the "service" of altering the girl's genitals? ... etc,etc.” I think the link should be removed. Please advise. LoveyK 16:41, 21 February 2007 (UTC)

NPOV
I don't really care about this topic, so I'd like to just note people's edits are very far from complying with WP:NPOV. It's an old POV warrior strategy to attribute the opinions of article authors to the journals themselves in order to artificially bolster one's case.--Ty580 01:55, 27 May 2007 (UTC)

Removed paragraph moved here
I've moved this paragraph from the controversies section to here because it's contracted by both pro and con sources. (The British Medical Journal blasts all labiaplasties, whether for quality of life or cosmetic.)--Ty580 20:13, 29 May 2007 (UTC)
 * Labiaplasty evokes strong emotional responses far more often than more common procedures like rhinoplasty. There is considerable controversy surrounding such surgeries for many patients, notably around women who worry that their labia are abnormal. While plastic surgery websites state this procedure may be appropriate for women experiencing discomfort during physical activities, sexual intimacy, or from irritation caused from close-fitting garments, the controversy surrounds the phenomenon of women undergoing labiaplasty for aesthetic reasons alone.

NPOV continued
I’ve interviewed dozens of labiaplasty patients along with surgeons who provide the procedure. In the U.S., hardly anybody is concerned about a so-called “controversy”. Primarily, patients are having labiaplasty for the three reasons cited by Ty 580, because they want it for themselves and possess the wherewithal to happily pay for it. Moreover, when done correctly, the procedure produces positive changes in women’s lives. The vast majority of labiaplasty patients would have the procedure again and unfailingly recommend it to their interested friends.

Overall, I see an extremely judgmental slant against the procedure and the women who undergo it. Moreover, the trend is not driven by clever marketing (people are not such fools) but by popular culture and the changing lifestyles of women of means. Overall, my impression is I’m reading a lecture by a stern, finger-pointing aunt, saying, “Shame, shame for being so vain.” Additionally, the references are not academic references at all but two pieces of news copy and an opinion piece by, not an expert in plastic surgery, but a seemingly alarmed psychologist and gynecologist. At least, I see nothing of the scientific method in their approach to the topic. And what does genital mutilation have to do with the topic?

Finally, any plastic surgeon in the U.S. or the U.K. worth his or her salt fully informs prospective patients about the possible risks from any surgery.

If a truly neutral entry is the object, I recommend starting from scratch. This is what we Yanks call a “hatchet piece.Charles.Downey 00:42, 1 June 2007 (UTC)


 * sooo - my take from your above comment is; "If you can pay for it, then that's okay", yes? I have to question the whole concept of aesthetic labiaplasty in the first place, given that 1) it's a surgical procedure and 2) it's largely driven by hyped social expectation. As with any procedure, there may be complications, esp. given the location of the surgery and the proliferation of nerve endings in that region. You do acknowledge this, right? If you're concerned, mark the article npov, by all means. If you can provide good primary sources to back up your comments here - then even better - A l is o n  ☺ 00:53, 1 June 2007 (UTC)


 * Actually, a more correct summary would be: “If you are an appropriate candidate, and can pay for it, then it’s okay.” Given that labiaplasty results are not as visible as, say, a rhinoplasty, the procedure is a fully private matter between a patient and her doctor. One thinks labiaplasty is only driven by social expectations if one lives in a nudist colony. Of course, all plastic surgery -- Botox injections included -- is surgical to one degree or another and is subject to possible risks and complications. However, labiaplasty patients suffer no more, or fewer, complications than in other plastic surgery procedures. Primary sources and references? Happy to oblige. Before-and-after pictures, too? —The preceding unsigned comment was added by Charles.Downey (talk • contribs).
 * Sounds good. Make sure the images are compliant with licensing here (GFDL or CC or PD) and that the subjects are aware and are consenting. Stats and primary sources would be cool. If you'd like to paste them here, we can go for it. BTW - labiaplasty can be driven primarily by social expectation; one's labia don't have to be publically visible for one to be aware of the implications of 'incorrect' labia (as defined by ... whom?) and the imagined effect it would have on one's partner. That's the primary motivation for this and thus the comparison to rhinoplasty is just a little off. The comment, "labiaplasty patients suffer no more, or fewer, complications than in other plastic surgery procedures", I really would like to see some good evidence for. Fewer? Really? -  A l is o n  ☺ 03:08, 2 June 2007 (UTC)

Really. I'll take care of it shortly, as soon as time allows. Stay tuned.Charles.Downey 23:26, 6 June 2007 (UTC)
 * Great. One point to note: make sure everything stays WP:NPOV and balanced! - A l is o n  ☺ 23:27, 6 June 2007 (UTC)

British Medical Journal article
Does anyone have access to this? Email me, please. Joie de Vivre T 13:15, 15 June 2007 (UTC)

more NPOV
This looks neutral to me but I supposed we'll have a bit more debate. The surgeon to whom I made the first external link is willing to sign over the rights to that before-and-after Labiaplasty picture if you think it would explain things better. I did have the BMJ article in question but the owner filtched it back. The article does list the reference for that if you want to get a copy.Charles.Downey

Comment 2
I posted the other side of the controversy issue according to a leading expert and it was deleted entirely. I don't think it does anyone any good to have only one side of a controversy. I'll post it again later when I have more time. 6-16-07


 * I posted this to the Talk page of the registered user who added the section. Basically statement contained no sources to establish the verifiability of the statement, nor did it establish Pam Mirabadi's opinion as being important enough for inclusion.  Joie de Vivre T 11:08, 16 June 2007 (UTC)

Downey Version
Congrats Charles.Downey on an improved version. The only think lacking was a 'controversy' section which I have added back in. I think this focusses the debate a bit better. I have edited the controversy section to remove some of the weasel words but it still needs better references. Well done. Gillyweed 23:18, 19 June 2007 (UTC)
 * I think that the Downey version is a major improvement & is well-cited, too. Gillyweed - I think your edits have also rebalanced it well, as it had become a bit too slanted and it is a controversial subject. I've also re-added the transsexual labiaplasty section which got excised (if you'll pardon) as 1) it's significant for 2-stage sex reassignment surgery and 2) it's one of the techniques that Dr. Altar (cited) specialises in. Good job, all :) - A l is o n  ☺ 23:31, 19 June 2007 (UTC)

Edits to Downey version
I did a thorough sweep-through of the article, improving the Wikilinking, as well as grammar and sentence structure in a few places, as well as requesting citations. Joie de Vivre T 19:36, 20 June 2007 (UTC)

Removed paragraphs
I removed three paragraphs that were either poorly sourced, or constituted undue weight. Here they are, for discussion. Joie de Vivre T 19:36, 20 June 2007 (UTC)

Paragraph 1
However, plastic surgeons like Pamila Loftus and David Matlock, who have been performing labiaplasties and other cosmetic surgeries of the vulva for two decades in the U.S., report that they have been bombarded with requests for the procedure in the last four years. Loftus reported performing about six a week in 2004. One author at the University of Auckland in New Zealand thinks the popularity of female genital cosmetic surgery may also be due to heightened orgasms, because elongated clitoral hoods are also often shortened by the same practitioners. The hoodectomy procedure allows the clitoris to receive more direct stimulation.

Paragraph 2
Some surgeons have reported that many of their labiaplasty patients have suffered irritating, chaffing tissues in silence, thinking they were alone with their condition. One physician, Robert Ersek, M.D. a Texas plastic surgeon, reported that one such patient, a successful attorney in middle age, had previously undergone several surgical rejuvenation procedures. When the attorney saw on a website before-and-after pictures of a patient who found relief from grossly enlarged labia minora, she, too, requested the surgery saying, she had no idea until now that anything could be done to improve her condition In the same letter, Dr. Ersek observes: “Reconstructive surgery aims to restore form and function to near normal. ‘Cosmetic’ designation is an attempt to improve appearance beyond, or better than, normal. No one is going to request surgery in this or any other area unless they perceive their anatomy as “unnormal.”…..I write to tell you these patients should not be ignored or trivialized.’”

Paragraph 3
Doctors John Miklos and Robert Moore, board-certified gynecological surgeons in Atlanta, Georgia, reviewed the medical records of 131 patients who underwent labiaplasty over 32 months. They divided the patients into three groups -- those who had the procedure strictly for aesthetic reasons; patients motivated by pain and discomfort and a group who were motivated by both symptoms and aesthetic concerns. They found that 62 percent of the study group had labiaplasty for functional or symptomatic reasons, including discomfort in some clothing and while exercising or during intercourse.

My responses
Paragraph 1: I don't see the rate at which a given surgical practice performs labiaplasty as being particularly important, nor do I see their speculation on the possibility of sexual improvement as well-founded.

Paragraph 2: The phrase "suffering in silence" is rather flowery and, again, I don't see what the purpose is of including one anecdote of one person's reason for having surgery. This part reads like a brochure for labiaplasty.

Paragraph 3: This does not constitute a full report. They only reported the percentage of women who responded as choosing the surgery for a functional reason (62%). This is misleading; because they don't clarify if that refers to women who chose it for functional reasons alone, or if they also included women who chose for both functional and aesthetic reasons. There is no way to tell, because they didn't specify.

My guess is that the 62% refers to those who chose it wholly or in part for a functional reason, which, if true, would mean that any percentage of that 62% cited looks as being at least part of their reason. In other words, if this interpretation of their ambiguously-presented data is correct, at least 38% chose it for an aesthetic reason alone, and the percentage of those who chose labiaplasty at least partially for aesthetic reasons could be 100%.

—Joie de Vivre T 19:48, 20 June 2007 (UTC)

Comments
Please place comments here. Joie de Vivre T 19:37, 20 June 2007 (UTC)

I think the neutrality is still in question. How about a second opinion from another editor? If you find that fair, I'll concentrate in the meanwhile on getting the citations called for.

2. How about a citation notice after the following statement under the Controversy section? "For most women, it (labiaplasty) is cosmetically unwarrented, and constitutes a needless exposure to the risks inherient in any surgery." One thinks that is more personal opinion than fact.

3. The Transsexual section really does not fit. For one, the preferred nomenclature for the procedure is the nonjudgemental and more neutral, "gender reassignment surgery." Additionally, a great deal more than labiaplasty takes place during gender reassignment.Charles.Downey 20:13, 20 June 2007 (UTC)


 * What do you mean by "think the neutrality is still in question"? Joie de Vivre T 13:29, 21 June 2007 (UTC)

NPOV
Why is there such flattery of the doctor and his 'international' recognition or his citation on Dr. 90210? Both feel like marketing and make that section of this article seem like a brochure. There's also the weird weasel language 'was said to be refined' which has no attributable sources. In addition, the tone of the article has some odd points of view and 'some say' attributions. I'm removing the weasel language and advertising. I think the article as a whole could use some clean up. —The preceding unsigned comment was added by 71.130.221.30 (talk • contribs).


 * Agreed. No proof that his was some sort of big leap forward.  Here is the rest of it, can be reinstated if it can be proven by an outside source that it was some sort of breakthrough.


 * The procedure was refined by urologist and plastic surgeon, Gary Alter. Alter created a more aesthetic reduction of the labia minora, known as central wedge nymphectomy.  The doctor’s latest contribution is known as the Alter Labia Contouring Method, which he claims better preserves the normal contour, colour and anatomy of the edge of the labia minora.  Alter also removes skin via a partial hoodectomy on the sides of the clitoral hood, claiming that this part of the procedure is undetectable.


 * —Joie de Vivre T 15:38, 22 June 2007 (UTC)

Inappropriate photo??
Is a photo of such a graphic nature appropriate for publishing? I didn't see any sort of 18+ warning. Wouldn't that potentially violate certain US laws regarding showing photography of genitalia?? —Preceding unsigned comment added by 66.28.35.109 (talk) 20:53, 13 April 2008 (UTC)
 * The image does meet guidelines for content, and although I could not find any specific guidlelines for the use of graphic images (other than seeking consensus before adding/removing images), I found article-specific discussions about the suitability and use of graphic photos, including several at Talk:Penis. Per the discussion below, I moved the photo down to the section relating to patient results and reaction, but the image was already set up as a thumbnail per image style guidelines, so I didn't resize it. Flowanda | Talk 23:44, 13 April 2008 (UTC)
 * If you think it violates certain US laws, why don't you detail what those are? I know of none that would prohibit this picture, and I'm not about to try to disprove its prohibition under the thousands of laws we have if you don't care to provide a citation.  The picture is appropriate to the topic, and is not sexual in nature, i.e. its not pornographic.  I think it should stay.  The human body is not 'dirty' and anyone who thinks it is should not be reading an article on labiaplasty.  How someone could com here and be shocked to see female genitalia is beyond me and such an unreasonable person's concerns surely shouldn't guide this discussion.--24.29.234.88 (talk) 02:08, 7 October 2008 (UTC)

Inappropriate photo - the person is sharing their story - how is that relevant?
The person who published the photo shares how they got a piercing, etc. How is that relevant? This should be a generic article?

Wikipedia: how do you remove photos?? —Preceding unsigned comment added by 66.28.35.109 (talk) 20:54, 13 April 2008 (UTC)
 * You raise some good points, and I had not read the caption on the description page. There are caption style guidelines if you'd like to tackle wikifying the description. Although I think the image seems to convey what the procedure does, it may be disconcerting to some readers. This discussion deals with more sexual than graphic: WikiProject Sexology and sexuality/WIP-image-guidelines, but there are comments about not removing images without consensus. Perhaps for now, moving the image down and resizing it could be a temporary solution while I look for how other graphic images have been handled? Flowanda | Talk 21:59, 13 April 2008 (UTC)


 * Wikipedia is not censored! Wikipedia does not need any moral panic. However, can someone shed some light on what the purpose of removing the clitoral hood and labia minora was? Sounds like nothing but FGM to me. --GSchjetne (talk) 16:12, 30 August 2008 (UTC)
 * FGM is involuntary and involves the clitoris, so the comparison is unfair. But is this image representative for labioplasty? I would call it a labiectomy. -plasty means (re)building, not just cutting something away. Labia majora augmentation should also be mentioned in the article.--87.162.1.203 (talk) 14:25, 23 September 2008 (UTC)

I believe this to be an extreme example of labiaplasty and not the sort of thing that many women looking at labiaplasty would consider, thus it would be more appropriate to put a before and after photo of a common labiaplasty reduction which would be more relevant. Labiadectomy is an extreme and uncommon example which isn't the norm for this sort of surgery. It's the difference between breast augmentation and a mastectomy for example. —Preceding unsigned comment added by Ubervixxen (talk • contribs) 16:47, 28 December 2008 (UTC)

i removed this image, and was reverted by an ip, due to concerns over self-promotion and inaccurate medical representation by the porn photo (complete with piercing). if anyone has justification why it is medically representative or otherwise adds encyclopedic value, please comment. untwirl (talk) 05:26, 23 February 2009 (UTC)

reference to cosmeticsurgery.com
I removed a citation to a promotional article on an MD directory website that doesn't meet WP:RS. Flowanda | Talk 00:16, 8 June 2009 (UTC)

“G-spot amplification”!?
Someone who gives oneself out as performing “G-spot amplification” must be a quack since the very existence of the G-spot is controversial!

2009-08-01 Lena Synnerholm, Märsta, Sweden. —Preceding unsigned comment added by 213.114.155.69 (talk) 10:32, 1 August 2009 (UTC)

risks
the risk section needs to be redone. it doesnt talk about the risk about the surgery but it compares it to other surgeries. im not against that but it is mostly COMPARING. I've couldnt find any story about someone dying form the surgery but the section talk about people dying from liposuction. why? it seems to me that that this article is not neutral. —Preceding unsigned comment added by 134.154.252.97 (talk) 21:05, 16 March 2010 (UTC)

Also know as circumcision?
I know there are multiple kinds of circumcision and I've heard hoodectomies referred to as the like the "proper" form of female circumcision, like the female equivalent of male circumcision. Not sure if I can provide a source but wondering if anybody else has any thoughts or could maybe provide a link on either page as I feel it's kind of relevant. One searching for female circumcision (NOT mutilation) may be interested in this topic. 64.222.103.254 (talk) 08:36, 19 October 2010 (UTC)

No, because that would mean that women whose labia are already small wouldn't be able to get circumsized, whereas all men can get circumsised. They are not equivalent. I really do think that mutilation is the only equivalent. —Preceding unsigned comment added by 75.200.30.65 (talk) 08:28, 4 January 2011 (UTC)

Image
I've removed this image twice, because it appears not to be the same person, as the caption states, and the same concern has been raised on the image page. We would need a high-quality reliable source confirming that it's the same person before it's restored. SlimVirgin TALK |  CONTRIBS 19:58, 16 September 2011 (UTC)

Dear slim virgin:

Good, excellent! However, the burden of proof is upon you! Because the image is already registered and legitimate for Wikipedia use. Please, play by the rules you claim to enforce as an Administratrix; prove your point. Anonymous "somebody says" is dishonest.

99.148.69.27 (talk) 04:21, 17 September 2011 (UTC)


 * The image was been restored with the edit summary "Restored pertinent, licensed medical image." Could we see some evidence of it being a licensed medical image, and what that means exactly?  SlimVirgin  TALK |  CONTRIBS 20:03, 17 September 2011 (UTC)
 * Agree with SV's concerns. -- J N  466  11:45, 18 September 2011 (UTC)


 * I'm going to remove the main image too, because it offers the image on the left as an example of "hypertrophied labia minora," whereas it seems quite normal. I'm concerned that we're offering images of normal women with the implication that they need surgery. Per WP:MEDRS, the article should stick to the definitions and descriptions of cases in peer-reviewed secondary sources (i.e. review articles) and medical textbooks, and high-quality media articles that explain the issues from a social perspective. SlimVirgin  TALK |  CONTRIBS 17:08, 18 September 2011 (UTC)


 * I've tried to tidy a little, added some headers, removed some repetition, and added some citation requests. I've removed the measurements, because they relied entirely on a suggestion in this paper—Davison SP, West JE, Caputy G, Talavera F, Stadelmann WK, Slenkovich NG. "Labiaplasty and Labia Minora Reduction", eMedicine.com, 23 June 2008. The article relies on this a lot, sometimes word for word. It would make sense to find other sources, and to rely on secondary sources for any definitions or measurements—using in-text attribution as appropriate—so that we don't present one idea from a primary source as the norm in Wikipedia's voice. SlimVirgin  TALK |  CONTRIBS 19:09, 18 September 2011 (UTC)

Hi, SlimVirgin:

I do not wish to edit war with you and your friends, but, it is normal and usual for the accuser to present evidence of the wrong-doing of the accused, User: OttoPlacik. The Labiaplasty article is substantiated with proper citations, from the pro and the con sides of Labiaplasty; they are at the bottom of the page. Tell me your specific concerns, because your addition to the Critism section contradicts you: it says that Female Genital Mutilation does not include Labiaplasty. This article is about a plastic surgery procedure, not its sociology, that is why the Criticism section exists.

Otto Placik (talk) 19:17, 18 September 2011 (UTC)
 * Agree with Slim's changes. It's also my impression that the lead presently overemphasises aesthetic considerations as opposed to physical discomfort . I've wondered if it would be useful to add an EL to this collection of drawings, illustrating the anatomical range of variation. It's not an academic site, but quite notable, popular and generally well regarded (see e.g. ). Of course, perhaps we can find a better alternative. For risks (and comparisons to FGM), see . -- J  N  466  19:54, 18 September 2011 (UTC)


 * Good idea about Betty Dodson's images; I've added them as an external link inside the anatomy section.  SlimVirgin  TALK |  CONTRIBS 20:13, 18 September 2011 (UTC)
 * Thanks. Must remember that external media template. -- J N  466  20:16, 18 September 2011 (UTC)
 * Hi, there are several problems with the article, as explained above. It seems to rely heavily on an article published only on eMedicine, one that wasn't peer-reviewed and doesn't go into much detail. It uses images of unclear provenance, or where the woman presented as needing surgery looks quite normal. It offers a definition of labial hypertrophy where no agreed definition exists. And the version you restored includes no criticism in the lead, per WP:LEAD, which makes it appear to violate WP:NPOV.


 * What is needed is a reliance on peer-reviewed secondary sources for an overview, i.e. review articles, which we can use to frame the issue. We can then add primary sources as needed, but currently it relies too much on primary sources, making parts of it look like what we call original research. There is a page at WP:MEDRS, which describes how medical sources are best used on Wikipedia. SlimVirgin  TALK |  CONTRIBS 19:50, 18 September 2011 (UTC)

COI ?
I was struck by the changes in the article between 2 October and the current version 26 October, which seem to have made it rather more technocratic and less questioning of the procedure, so I have posted at WT:MED to ask for some uninvolved review, and also perhaps whether there might have been the inadvertent possibility of some WP:COI. Jheald (talk) 01:38, 6 November 2011 (UTC)

Dear JHeald:

How is an alarmist newspaper article more medically accurate than a medical source, such as the one deleted from the introduction? The sociologic aspect already is addressed in its proper place, in the Criticism section. Would you be specific about the conflict of interest? I ask because your alarmist tone is misleading about the content of a medical article, and I have read no such conflict of interest in the text. . . Where is the sales pitch? Mhazard9 (talk) 15:54, 17 November 2011 (UTC)

Splitting and other issues
There is some content that imho should live in own articles or get merged into existing ones.
 * Surgical anatomy of the vulva -- should it get an own article or be merged into vulva?
 * Labial hypertrophy -- own article or ->vulva?

The article should follow the manual of style - it looks terribly obfuscated in places ("The patient"). File:Variation of female genitalia.jpg would be a nice addition to the article, also see Elongated labia.

Richiez (talk) 22:12, 15 November 2011 (UTC)


 * On the first, I'm inclined to merge it into Vulva. We'll need a summary here, especially of the more immediately relevant bits.
 * On the second point, I don't much care either way, but I'm slightly leaning towards a separate article at Labial hypertrophy, with Main summaries in both this article and Vulva. WhatamIdoing (talk) 17:50, 16 November 2011 (UTC)

Follow-up queries to the worries

Dear Richiez:

I think that the labia image recommended would be a good addition, much better than a hypertextlink. But, a surgical anatomy description is not the same as a morphological description, because VULVA is about morphology and function, while LABIAPLASTY is about surgery. . . your claim is an illogical non sequitur, not objective. Perhaps you are too close to the subject? Still, deleting medical citations reveals (anti-intellectual?) PARTIALITY, not objectivity. Terribly obfuscated, as in HIDING FACTS? Where?

Please, explain yourself more, because your first-person plural tone bespeaks that you represent others, which is never a good sign, because the speaker is hiding a POLITICAL agenda; y'know, feelings, rather than thought, emotions, rather than reason, opinions, rather than facts, as in Appeal to emotion, rather than critical thinking? I find that most worrying, almost terrifying in its book-burning, clock-stopping obviousness. A ruse, perhaps, for dumbing down a "faux controversial" article, in the name of. . . the children and their endangered innocence? Really? Are the Harley Street physicians at it again?

Do I understand you well, are WE (Wikipedia editors) to destroy the Labiaplasty article because the subject offends your sensibilities? The article is about a surgical procedure that has SECONDARY applications as cosmetic surgery, not the inverse. Does such politically correct illogic really not elicit derision among self-respecting editors? I ask because the editorial comments in the edit summaries betray partiality, i.e. I just don't like it!

As you might recall, Wikipedia is not censored, simply because your sensibilities might be bruised. Still, following your illogic, my dislike of Nazism would not justify a disingenuous demand that the article be chopped up an redistributed to other fascism articles, simply because I lost family in the Holocaust? Would it?

Please remember to remember: The Self is not the world, and the world is not the Self. The canard is too obvious.

Mhazard9 (talk) 16:43, 17 November 2011 (UTC)


 * Um, wow. With all that vinegar, it's obvious that you don't want to win friends and influence people here.
 * Second person is when the writer uses the word "you", which does not appear in Richiez's comments, but does appear in yours.
 * Nobody has proposed entirely removing information about the anatomy; the proposal is to add that information to Vulva and to focus what's here on the specifics that are relevant to this surgery.
 * Wikipedia's guidelines demand that articles be written in plain, direct English. This is not the place to show off how much medical jargon we know.  Writing in plain English means that more people will understand the article, not fewer.  Writing something like "Methodological observation of the sociometrical behavior tendencies of prematurated isolates indicates that a casual relationship exists between groundward tropism and lachrimatory, or 'crying,' behavior forms" is not an improvement over "Children cry when they fall down". While nothing in this article is nearly that extreme, there is a lot that could be improved to comply with WP:MEDMOS and WP:MTAA.
 * I do not understand how the article can be primarily about a surgery and secondarily about a surgery. Perhaps you mean that it is primarily about how-to perform the surgery and secondarily about why people want this done?  That's an opinion, to be sure, but not one that everyone shares.
 * Putting more information in other articles, and thus increasing the number of people who learn about vulvar anatomy, cannot possibly be construed as censorship. Spreading information is the opposite of censorship.  WhatamIdoing (talk) 17:17, 17 November 2011 (UTC)

Dear WhatamIdoing:

The vinegar equals the hysteria; the argumentum ad hominem confirms the political nature of the imprecise complaints. The Labiaplasty article does not tell the reader how to perform a labiaplasty. It does not communicate how to hold the scalpel, how to do things in the OR, but does communicate WHAT is done. Please, stick to the subject; thus "the vinegar" to cut the misrepresentations. I agree with you that the distribution of information is necessary, but not by arguing that NEWSPAPERS trump MEDICAL sources, as did you. The groupthink comment betrays you; Wikipedia does not demand, it recommends. The article is about a surgical procedure, not how to do it. Your politics betray you; and I wrote explicitly. Quote the faults of the article, not some off-side nonsense, as you just did. If the faults exist, then you can quote them. Complaining without examples is a canard, worsened with off-subject examples that AVOID the Labiaplasty subject; be specific, give examples.

You have not addressed the subject, just my replies to PC whingeing meant to appeal to emotion, not reason. Because the dumbing down of the introduction, which reverted the surgery's purpose from correction to cosmetics, and deleted a medical citation, does not communicate impartiality or objectivity. Your opposition is noted. Include it to the criticism section, but, please, do not lie, and write that labiaplasty is mainly for cosmetics and SOMETIMES for medical reasons. If what you claim is true, why go ask others to do your work for you?

The sociologic criticism is present, ALL OF IT, not just the selective, anti-surgery alarmism from the 2 October 2011 version. What is the problem? Where is the advertising? Where is the advocacy? This article does not misrepresent any of the FACTS, as does the Labiaplasty text in VULVA ("Some say Labiaplasty is FGM"), which is based on the SAME SOURCES as the criticism section of Labiaplasty, so. . . Which is it? The sources are explicitly quoted herein (Labiaplasty) and obscured elsewhere (Vulva). Gosh, what intellectual minimalism am I missing?

Mhazard9 (talk) 17:58, 17 November 2011 (UTC)


 * (ec) The article is about a surgical procedure that has SECONDARY applications as cosmetic surgery, not the inverse.
 * Really?
 * Consider this recent Guardian report from a medical conference devoted to labiaplasty, "one of the fastest growing cosmetic procedures in the US", which is an interesting read in itself, but note the attitude to what actually would be required for purely medical reasons:
 * "It should be noted that labiaplasties done for purely functional reasons, such as dyspareunia (pain during sex), may be categorised as medically necessary and therefore eligible to be covered by insurance. However, when I spoke to practitioners at the conference, they waved away the idea that either they or the client would want to take that route. 'It'll take me 10 minutes, but I'll get only $300,' one explained. 'And it'll look like I spent 10 minutes on it.' Another agreed, explaining that much of the elective fee he charged had to do with the two hours he'd spend 'making it look pretty'."
 * In contrast, consider this study (summary) in BJOG this year of 33 women referred by their GPs to a Central London teaching hospital as potential candidates for labiaplasty. On examination none of the 33 were considered to have labia outside the range of size considered normal.  As noted in an editorial for the journal Reproductive Health Matters (May 2010), despite the procedure being carried out in rapidly growing numbers "In almost all cases, labiaplasty is a response to the physical appearance of completely normal labia and a desire for more "attractive" genitalia." (emphasis original).
 * In view of this, current policy practice documents from many NHS areas, eg NHS Suffolk, for labiaplasty on medical grounds limit approval to some very specific scenarios only, identifying an "absence of robust evidence from high quality research" to justify anything beyond this. The private medical hospital operator/insurer BUPA views the procedure as "purely cosmetic"..
 * This is something which is squarely part of what the article should reflect -- and, per WP:LEAD, reflect in the lead. Jheald (talk) 18:44, 17 November 2011 (UTC)
 * I agree with pretty much all of the concerns outlined here. Redundant information should be merged/split, WP:NOTHOWTO should be removed, and language should be more accessible.--Taylornate (talk) 18:44, 20 November 2011 (UTC)


 * Taylornate and Jheald, perhaps you would look over the article and see whether that needs to be clarified, or if it already is sufficient. Are any of you willing to start moving relevant information over to Vulva?


 * Mhazard9, I invite you to show me which words in my comment suggest that I think newspapers trump medical sources for biomedical information. Please do your best; if nothing else, the effort will amuse the folks who know how much of WP:MEDRS's anti-newspaper sections I've helped write.
 * As for your assertions about my "political" views on labiaplasty, I have none. I was barely aware that this procedure even existed before responding to a request for help, and I don't much care what other people choose to do to their bodies or what their reasons are for doing it.  As far as I'm concerned, labiaplasty is no different in kind from a boob job:  there may be a medical reason for it (e.g., prophylactic bilateral mastectomy for women with BRCA mutations), but as far as I'm concerned, women without a medical reason are welcome to get the same procedure done, if that's what they want to do.  WhatamIdoing (talk) 01:16, 23 November 2011 (UTC)
 * I will work on it when I find the time—unless someone beats me to it or I forget.--Taylornate (talk) 15:07, 28 November 2011 (UTC)

Images
I somehow don't see the purpose of many images in the article (Tanner stages, Boticelli, Courbert), as they don't illustrate anything related to labiaplasty.--Bus Bax (talk) 19:57, 30 July 2012 (UTC)
 * I agree completely and will go on to say that we have similar problems with prose in this article and several others related to plastic surgery. As I alluded in another section, this is the work of one particular editor who has been quite persistent.  More recently he has not been active, so maybe we can start to reel things in.--Taylornate (talk) 21:53, 31 July 2012 (UTC)

Termini
Why is this article talking of "pudendum femininum", while everywere else the more common term "vulva" is used?--Bus Bax (talk) 19:58, 30 July 2012 (UTC)
 * This is the work of one particular editor who likes wordiness. Obviously, it should be changed.--Taylornate (talk) 01:54, 31 July 2012 (UTC)
 * That's what I was thinking. Do you also have an opinion about my comment from above?--Bus Bax (talk) 21:42, 31 July 2012 (UTC)

Dear Editors Bax and Taylornate:

The Labiaplasty article is about surgery of the pudendum femininum, of which the vulva is a part; they ain't equivalent; the part is not the whole. The "medical student" Taylornate is in error, the word pudendum femininum identifies the area of the subject matter, which is labiaplasty, so, it is not a personal matter of wordiness; yours are understandable mistakes common to laymen. The artistic images in the criticism section are relevant to that section, and are necessary, because of the layperson hysteria usually provoked by this subject; read before you delete an illustration that SUPPORTS the text; otherwise, you are dumbing down the article, which is disrespectful of other readers. This is not a pop culture article, like most of the articles in your work histories, so, please, do not remove text and images, simply because you dislike them, abide the wiki-rules.

Say “Hello!” to the Dutch Doctor, from Dr. P.

Regards, 24.1.181.44 (talk) 17:40, 9 August 2012 (UTC)
 * I'm not sure which rules you are thinking of, but please see WP:Jargon.--Taylornate (talk) 23:56, 9 August 2012 (UTC)


 * Well, maybe you could be so kind to explain, what exactly the term "pudendum femininum" describes. And for sure this article is NOT about "surgery of the pudendum femininum" but about surgery of the labia, which certainly is a part of the vulva. And the images are "necessary, because of the layperson hysteria usually provoked by this subject"!?! First: which hysteria? Second: how does it make the images necessary? --Bus Bax (talk) 18:52, 22 August 2012 (UTC)

Against censoring a medical article, because you just don't like the subject.
To the Editors who have censored this article:

I have reverted the censorship you four editors have forced on this Labiaplasty article, because your action contradicts the very point of Wikipedia -- uncensored factual information! I do not see any conflict of interest, other than your opinion, because the images are real, and not sensational, and are not advertizing. So please show where and how, in the article, there exists a conflict of interest?

Please explain, how making the article a sensationalistic newspaper report, complete with boosterism of you favorite opponents, makes this an objective presentation of a plastic surgery subject?

I have done this reversion anonymously, as an IP address, because the editors being addressed tend to revenge edits elsewhere in the work of anybody who opposes them. Please practice what you preach, and give your reasons for censoring an article that only you four individual editors oppose in the name of everybody else in Wikipedia. You know, the give-and-take of collegial, intellectual debate about a subject, rather than authoritarian censorship.

And, asking the medical editor, User:Otto Placik, who created the article, to request your permission is discourteous, to say the least, and quite contrary to the collaborative spirit of Wikipedia.

64.107.183.115 (talk) 21:07, 8 August 2013 (UTC)
 * I addressed the matter here at the talk page of WP:MED. See Wikipedia talk:WikiProject Medicine. Flyer22 (talk) 00:07, 9 August 2013 (UTC)

Updating the Labiaplasty article: Placik's comment
To Flyer22:

It is unnecessary to conduct a sock puppet investigation, because I edit only under my name: User:Otto Placik. Yet I do have friends among the Wikipedia Medical Community, despite the spurious accusations of "excessiveness" leveled in the Wiki Med discussion page. Sharing an IP address range is not evidence, neither are hunches and opinions, so sharing an IP address range is just that.

I have reviewed the complaints of the lay editors, and shall provide the medical references they require to believe an anatomic description. So, please, be patient while I do the work. I will follow up with factual corrections to the text, in order to dispel doubts about conflict of interest, self-promotion, and original research. Silence is not acknowledgement of wrong-doing or bad faith, it means just being busy outside Wikipedia.

Thanks

Otto Placik (talk) 17:29, 9 August 2013 (UTC)
 * I've very recently replied at WP:MED. Make sure that you use sources that comply with Identifying reliable sources (medicine) when using sources for medical material. Flyer22 (talk) 17:56, 9 August 2013 (UTC)

A request
Hi Otto, would you mind discussing your proposed edits here on talk first? There seems to be a significant COI, and people have expressed concern about it a few times on WikiProject Medicine; for example, see 18 June 2009, 6 November 2011, 27 January 2013, and 8 August 2013. Also see this section of the COI guideline, which says that anyone with a financial connection to a topic should use the talk page to suggest edits, or the request edit template.

That apart, your edits seem to violate some of our polices. Removal of the risks and the comment from Linda Cardozo is arguably a violation of Neutral point of view and WP:LEAD. Rewriting the criticism section to add your own opinions violates No original research. Some of the material you're adding is unsourced, violating Verifiability. Other sections are sourced to primary sources, in violation of WP:MEDRS, which is our sourcing guideline for medical articles; it says we should mostly rely on secondary sources such as review articles. You're also adding distinctive formatting.

For all these reasons, I'd appreciate it if you would post your proposals here on talk, together with the sources, so that they can be discussed before adding them to the article. SlimVirgin (talk) 22:33, 23 August 2013 (UTC)

Otto, one more revert and you may shortly find yourself the subject of a discussion at AN/I. Editing Wikipedia is a collaborative effort, and it should be clear to you by now that your unilateral changes do not have consensus. Regards, Andreas JN 466 04:33, 24 August 2013 (UTC)


 * Have full-portected - although indef, am happy for any other admin to unprotect if discussion productive. Cas Liber (talk · contribs) 04:52, 24 August 2013 (UTC)

Reply to Slimvirgin and cohort:

Your POV-pushing version, and your censorship of the legitimate medical photographs, already were factually countered by the Adminstrator Flyer22. So, you, Slimvirgin, a Wikipedia Administrator, and your cohort, are obliged to follow the rules that you ask me to follow, that is, you must prove your accusations, because the word "seems" indicates your doubts about what you claim is wrong with the article.

For two years, you have deliberately vandalized the article, and used the sources to push a pov that does not match the reality, either medical, clinical, or sociological, about this subject. In fact, your censorship and page-owner behavior were the subject of the January 2013 discussion that Flyer22 had with you and your fellow editors, in which she informed you that you are in the wrong in CENSORING the article, because you just don't like it. That is why we are quarreling. Everything I have contributed is true to the sources, after all, this is an article about an elective medical procedure, not about the sociology of Labiaplasty, which is the pov-pushing you have been doing for two years.

So, let us meet half-way, and you begin the dialogue, by showing the specific sections, subsections, and sentences that are factually untrue. Playing games is conduct unbecoming a Wikipedia Administrator, the ethical onus is upon you, because it is you, Slimvirgin and cohort, who disagree with the medical facts of a medical article. The sources are listed, please explain where the article does not correspond to the facts cited.

Come, let us begin.

Otto Placik (talk) 04:54, 24 August 2013 (UTC)


 * Thanks for the protection, Cas, and Otto, thank you for the response. It's hard to know where to begin, because there is so much to go through. One of the main issues is whether the medical sources are compliant with MEDRS, which is our sourcing guideline for medical articles. That is an issue for the current version too, by the way, particularly the surgery section which I've considered simply removing. Your version seems to rely extensively (even more than the current version does) on primary sources.


 * The question is how we go about writing an article about this that relies mostly on secondary sources (review articles). SlimVirgin (talk) 05:13, 24 August 2013 (UTC)
 * Placik, you may have already seen what I stated in this edit summary, but I am not an administrator. And though I have disagreed with SlimVirgin with regard to removing images of labiaplasty, considering that this is an article about a medical procedure, she has made solid points with regard to your editing. Flyer22 (talk) 07:42, 24 August 2013 (UTC)

AN/I discussion
Please note Administrators%27_noticeboard/Incidents. Regards, Andreas JN 466 05:55, 24 August 2013 (UTC)

Standard deviation
I think we ought to explain the term "standard deviation". Readers should understand that in a normal distribution (the type of statistical distribution most anatomical measures follow approximately), a little over two-thirds of the population are within the range of mean ± 1 standard deviation, a little over 95 percent lie within mean ± 2 standard deviations, and 99.7 percent lie within mean ± 3 standard deviations. This would enable readers who lack statistics knowledge to gain a realistic idea of the size of their own labia relative to the general population. (The graphic is primarily intended to help editors here on this talk page understand the issue, though we could think about adding it to the article too if editors think it would help readers understand the normal human range of variation.)

It also seems to me there is some confusion over the definitions of "width" and "length". Otto Placik sought to introduce a definition that termed anything in the range from 3.0 to 5.0 cm as "excessive" (while adding that a length in excess of 5.0 cm would "present functional and aesthetic problems for the woman who seeks a labioplastic correction").

In the table, the mean for "length" of the labio minora is 60.6 mm (standard deviation 17.2 mm), while "width" has a mean of 21.8 mm (standard deviation 9.4 mm). If Placik's "length" is the same "length" as in the table, that would mean that well over 90% of women have "excessive labia", according to his definition. If Placik's "length" corresponds to "width" in the table, this would still mean that about one in five women have "excessive" labia according to Otto Placik's version, making them candidates for plastic surgery.

Note also that there is no universally agreed method of measurement for all of this, e.g. whether the labia should be stretched to their maximum extent for measurement, or measured in their natural state. Andreas JN 466 18:27, 24 August 2013 (UTC)


 * Thank you, that's very helpful. I found this comment today on Scarleteen, in response to mail from young girls who think they're abnormal because their labia stick out or are wrinkled:


 * "Whether more people are just asking about it than before, or concerns are growing, we've been seeing more and more – often unfounded – worries about labia as the years have gone by. ... We've done a couple blog-a-thons on it in years past. We've answered questions like this tirelessly for years. We've talked about it in other pieces, we've suggested visiting gynecologists to have an expert assure someone they're normal. We've directed people to some links or books with labial imagery. We've worn t-shirts which proclaim 'I Love Labia!' while shaking peach, violet, brown and pink pom-poms on the White House lawn (okay, so we haven't but if someone sent me the supplies, I would in a heartbeat), but for the love of Pete, the labia-freakouts keep sticking around. Whatever it is that keeps churning labia worries out these days is doing it like bunnies."


 * It would be good to make sure Wikipedia doesn't add to this. SlimVirgin (talk) 19:36, 24 August 2013 (UTC)
 * Indeed. Disease mongering is a terrible thing. Adrian J. Hunter(talk•contribs) 01:32, 25 August 2013 (UTC)
 * These are difficult issues. Normal is not defined by two standard deviations. If one applies the DSM 4 criteria to a random population in the US nearly 50% of people have at least one major psychiatric condition. Some people take this to mean that the criteria are overly broad and other take it to mean that we are not treating enough people. Supposedly DSM5 will diagnose an even higher percentage. THis of course is important to plastic surgery as it is done for psychological rather than functional reasons. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:51, 24 August 2013 (UTC)

Semiprotection
Right, I've shifted from full to semi-protection - let's keep this to named accounts rather than IPs. Any IP is welcome to make an account to discuss the article. Cas Liber (talk · contribs) 03:40, 3 September 2013 (UTC)

Before after image
One before after image IMO would be useful for this procedure. This one is not to bad  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:02, 24 August 2013 (UTC)
 * Per the "A request" section above, I obviously agree that one image would be useful. I also don't see the problem with the one you propose; it has been in this article before. Flyer22 (talk) 10:21, 24 August 2013 (UTC)
 * The problem with it is that the "before" shot is of a perfectly ordinary woman; when it was in the article before, the caption was "the pre-operative aspect of hypertrophied labia ..." The article should avoid giving the impression that ordinary labia require surgery.


 * If there's consensus that we need an image, I'd prefer to contact some of the gynaecologists who have concerns about this procedure to find an image that doesn't give the wrong impression. SlimVirgin (talk) 19:05, 24 August 2013 (UTC)
 * I echo these concerns. I would rather use an educational image that is untainted by a commercial conflict of interest. Andreas JN 466 19:25, 24 August 2013 (UTC)
 * Yes agree that the before image looks perfectly normal. I question the operating on a normal variant but than am not a plastic surgeon. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:52, 24 August 2013 (UTC)
 * My view on not using an image of normal female genitalia that has undergone labiaplasty has already been expressed (as noted by Placik above). I still find it silly (extremely silly, in fact) that this article should be held to a double standard. It is a double standard because, in Wikipedia medical procedure articles, the existence of images of perfectly normal body parts before surgery is common practice and is considered needed; for example, the Breast implant or Rhinoplasty articles. Just like some women choose to have breast implant surgery or rhinoplasty because they do not like the appearance of their breasts or the appearance of their nose, there are women who get labiaplasty because they do not like the appearance of their labia. It's not about sending a message. Wikipedia is not supposed to take a stance on what is right or wrong in this case, much like we are not supposed to take a stance in the case of "giving equal validity." It's about showing what the results of the medical procedure are. And we don't need a picture of abnormal labia as the before picture, as though that is the only time labiaplasty is performed. But pictures of normal and abnormal labia before surgery would help balance things out. I've stated enough about this, and speaking of it any further only makes me frustrated. So consider me mostly done with this image topic. Flyer22 (talk) 23:24, 24 August 2013 (UTC)
 * Yes my primary concern is that the before and after pictures are presented in the same light. The previous caption seemed to be an issue though. What should we have for a caption? Maybe simply labia before and after labiaplasty. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:38, 24 August 2013 (UTC)


 * We used to have an image in the article (added here) that didn't even seem to be of the same woman (see deletion discussion), yet it was offered as a before-and-after shot. I would really prefer to avoid the current images and look for something we can all agree on. SlimVirgin (talk) 23:45, 24 August 2013 (UTC)
 * Yes no hurry. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:52, 24 August 2013 (UTC)


 * I think for a general encyclopedia there are two "use cases" for images demonstrating a procedure, really any procedure. First is to show the before and after effect of the procedure clearly, with a very obvious difference between the before and after, ideally with the same subject.  In this first case, a more extreme "before" example may be selected if in the more usual case the effects are more subtle.  This might not be how a medical textbook would do it, but Wikipedia isn't a medical textbook and our typical reader isn't trained in medicine.  The second use case is to show a more typical example, even if it's more subtle.  Ideally images depicting both cases should be included and described.  I understand SV's point, and my first use case argument would actually recommend finding a more extreme "before" example as she'd prefer, but not necessarily for the same reason, as my thinking is more in line with Flyer's -- it's not our primary responsibility to be concerned about whether the "before" image is sending any kind of message, but rather to choose informative and educational images that support the article content.  For this reason I would actually prefer images like File:Dr. Placik Labiaplasty.JPG or File:Labiaplasty-Before and after, anterior hypertrophy.jpg instead of File:Vaginoplasty.JPG for the "defining" image if the article is to have one.  An image like File:Vaginoplasty.JPG should also be included if indeed it is highly (numerically) representative of the before/after as actually performed, but I haven't dug into the sourcing yet to see if that is the case.   00:47, 25 August 2013 (UTC)


 * Zad, I think we do have to take into account what messages we're sending, when physicians are saying they're worried about the number of young girls who ask for this procedure. Labia aren't like noses, where we can all easily see whether our nose fits into a normal range. Girls will usually only see their own labia, then when they look online will tend to find pornographic, air-brushed, labia-plastied versions. So they all come away thinking there's something wrong with them. In that situation Wikipedia surely does have a responsibility not to make things worse. SlimVirgin (talk) 00:56, 25 August 2013 (UTC)


 * Well, as far as the image goes, like I mentioned above I do support choosing a more, let's say, uncommon "before" image (avoiding the emotive although probably technically correct "abnormal"). If we're going to include a second image that has a perfectly normal "before", that should be explained clearly in the caption and the article content ("For aesthetic reasons, some women with normal labia choose... etc.") assuming that authoritative, good-quality sourcing is available to support it.  Would that address your concerns?   01:06, 25 August 2013 (UTC)


 * It's difficult because calling it an aesthetic reason implies that there was an aesthetic issue, when the caption "this very young woman was brainwashed into thinking she was ugly," might be more accurate. :) But yes, I take your point. Rather than having two images, though (one extreme, one normal), we could try to find one image that's somewhere in between. I've already started sending out emails. SlimVirgin (talk) 01:25, 25 August 2013 (UTC)


 * The only recent review article I've found is, found here, by Goodman. (As a side note, it's sorely underused, only to support one statistic and only in the lead... that needs to be fixed.)  Goodman mentions that there is a wide range of "normal" and these types of procedures (Goodman covers several related ones) are often chosen for aesthetic reasons.  Labiaplasty is also chosen because the individuals involved find that the labia interfere with sex in an unacceptable way (Goodman). Women choose these aesthetic procedures because they're dissatisfied with their bodies (it isn't up to us to tell them they shouldn't be) or want to "feel more normal" (that's in Goodman), and are generally happy with the results (Goodman). This is a tough one, I'm having a difficult time coming up with an approach to the content that covers what the sources say without judgment, and somehow mentions that the women choosing these procedures are normal before, without editorializing, unless we can find a source to say so. We should be looking at more sourcing to find authoritative commentary on this...   01:45, 25 August 2013 (UTC)
 * Yes I also consider a single before an after image to be important. I consider this one okay or this one  but happy to consider other suggestions aswell.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 14:50, 11 September 2013 (UTC)
 * The examples shown in Dr Goodman's review article have larger labia than those shown in, in both the before and after images. I'm against using that advertorial image. Andreas JN 466 16:21, 11 September 2013 (UTC)
 * For a source saying that women with normal anatomies are having surgery, Medscape has the following:
 * "We need to educate women that vulvas are unique and that not everybody has to look like a Barbie doll. Women's health specialists should create campaigns aimed particularly at teens, so that these young women can understand what's normal down there. Displaying contrasting images of normal vulvar anatomy would be useful.
 * The marketing for these procedures has much power over people's perceptions. That women are willing to alter normal anatomy or have these procedures for sexual enhancement is very disturbing. Even worse, what sells right now in such publications as Playboy and Penthouse and in Internet pornography are prepubescent images. I hope that larger labia and pubic hair return as fads.
 * It's our ethical obligation to listen to our patients and to educate them. Many women are really bothered because they think that they are supposed to look a certain way. And they may have partners who are also telling them that they need to look a certain way. So it's not just about educating women; it's also about educating both men and women."
 * This is from an interview with Dr. Iglesia, who is Section Director of Female Pelvic Medicine and Reconstructive Surgery at MedStar Washington Hospital Center and is an Associate Professor of Obstetrics, Gynecology, and Urology at Georgetown University in Washington, DC. As far as I understand from the article, she performs such surgery, but only when medically indicated, as bona fide interventions covered by insurance. (She also says, "Complication rates range anywhere from 4% to 18%. People need to understand that these rates are not small. Complications include pain with sex, bleeding, scarring, and improper healing.) The author of the above review article, Dr Goodman, indicates "Conflict of Interest: None" at the bottom of his article, but offers labiaplasty to paying customers on his website, on a page named "Safe labiaplasty", which says he specialises in the procedure. I find that disappointing.
 * I just came across a very recent (August 23 2013) article in the same journal, which might be useful: "Physicians' Attitude toward Female Genital Plastic Surgery: A Multinational Survey". The summary of the conclusions reads, Self-image was regarded as the main factor in the demand for FGPS. Many practitioners in the field of sexual medicine recommend that women be referred for consultation with a psychiatrist or psychologist before undergoing FGPS.
 * At any rate, I think it is important for Wikipedia to reflect the views of mainstream medicine in this article, rather than those of commercial plastic surgeons whose income depends on people electing to have the surgery. Given the outcome of the recent sockpuppeting case, it seems clear that Wikipedia has failed to do that for much of the past five years. Andreas JN 466 16:21, 11 September 2013 (UTC)

Are there any images on commons you would be okay with? Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:33, 11 September 2013 (UTC)
 * As far as I can tell, every single before-and-after image was uploaded by plastic surgeons in private practice. :( Ideally I'd like to get an image from a neutral source. Failing that, what would you think of this, with the PowerPoint context removed? Andreas JN 466 16:44, 11 September 2013 (UTC)
 * Yes I think that image with some cutting and pasting would be fine. We must keep in mind that the only people doing these operations and thus in a position to take pictures are plastic surgeons in private practice. The public surgeons do not really do these operations much if at all. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:28, 11 September 2013 (UTC)


 * I would also prefer an image from a source that isn't a plastic surgeon in private practice, but in the meantime if others agree about the image Jayen linked to, I'd be fine with that. SlimVirgin (talk) 18:41, 11 September 2013 (UTC)
 * I will do some work on the image then. As for commercial plastic surgeons being the only ones doing this type of operation, this would appear to be untrue; Iglesia mentions a number of cases where a labiaplasty is medically indicated, and covered by insurance. She also mentions that the American College of Obstetricians and Gynecologists (ACOG) is "essentially [...] against procedures that are not medically indicated or do not have significant safety and effectiveness data to support them." Andreas JN 466 00:41, 13 September 2013 (UTC)

Lead section
- you had a concern about the lead section? -- Callinus (talk) 01:59, 30 August 2015 (UTC)


 * Yes, as seen here, here, here, here and here. There is currently significant material in the lead that is not summarized lower in the article, which is at conflict with the WP:Lead guideline. The lead summarizes the article, and usually should not include content that is not also lower in the article.


 * It seems like the other WP:Med editors who watched this article are no longer watching it, and that I'm the only WP:Med editor left watching it. Either that, or the others watching it don't feel like dealing with it at this time.


 * On a side note: Since this article/talk page is on my WP:Watchlist, there is no need to WP:Ping me to it. Flyer22 (talk) 02:07, 30 August 2015 (UTC)


 * The RACGP paper here should satisfy MEDRS. The crap about Nina Hartley is only included once - the argument that pornography is bad is given undue weight in that section - the key issue is that pornography is digitally manipulated and that young people have inadequate sex education and media literacy while being exposed to more commercial advertising than previous generations. -- Callinus (talk) 03:04, 30 August 2015 (UTC)
 * Note that the Nina Hartley material is only included once. I'll just take out the anti-porn remark by Linda Cardozo - there are more reliable sources debating the ethics of this, and it's not just internet porn. -- Callinus (talk) 03:06, 30 August 2015 (UTC)


 * You've made the lead more lead-compliant by addressing some of the lead material lower in the article, and moving other lead material down. I appreciate that. Flyer22 (talk) 05:00, 30 August 2015 (UTC)

External links modified
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Per the new article Are plastic surgeons nip/tucking ads into high-profile Wikipedia articles?
The answer is yes they are trying. Not just this topic but 1,000s to 100,000s of others. WP:COIN is busy. Doc James (talk · contribs · email) 10:20, 18 October 2017 (UTC)
 * No argument there. Gråbergs Gråa Sång (talk) 10:57, 18 October 2017 (UTC)
 * I´m a little surprised that a google-news search for ""Otto Placik" wikipedia" was empty. Gråbergs Gråa Sång (talk) 11:29, 19 October 2017 (UTC)

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A Commons file used on this page has been nominated for deletion
The following Wikimedia Commons file used on this page has been nominated for deletion: Participate in the deletion discussion at the nomination page. —Community Tech bot (talk) 22:37, 7 August 2019 (UTC)
 * Ausprägung der Labia Minora.jpeg

Removal of a Shameless piece
Julietdeltalima, regarding this, what issue do you have with the Shameless source? How does it not pass WP:Reliable sources in this case? Regarding blogs, see what WP:NEWSBLOG states. If the section is going to use sources such as those from Slate, I don't see why Shameless should be singled out. Furthermore, as seen here, it's still currently used in the article. If these media sources were used for medical material, I would see the point of removing them; this is per WP:MEDRS. But these media sources are used for the Criticism section, which is mainly about societal issues.

Please don't WP:Ping me if you reply. Flyer22 Frozen (talk) 00:38, 7 March 2020 (UTC)

Semi-protected edit request on 7 April 2021
Section: criticism

"The WHO writes that the term is not generally applied to elective procedures such as labiaplasty.[46]"

Hello fellow editors. In this article I find source number 46 contradicting. The WHO report does not mention that the term "Female Genital Mutilation" does not apply to elective procedures such as labiaplasty. Kindly look into this. Riverfan3000 (talk) 15:26, 7 April 2021 (UTC)


 * ❌: Please see above where it says "the request must be of the form 'please change X to Y'." All you have said is that something is wrong and to look into this. bop34 • talk • contribs 16:37, 7 April 2021 (UTC)

Lifestyle
Nike rosh Motshegoa (talk) 07:02, 18 May 2021 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 July 2019 and 23 August 2019. Further details are available on the course page. Student editor(s): Juliechaeoon.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 08:51, 18 January 2022 (UTC)

FGM section
We currently say "" but I don't see where the source actually says that. What it actually says is While this can probably be said to support cosmetic labiaplasty and some other procedures not being considered FGM, I can't find the word elective used anywhere in the source. Yet this seems to be an important distinction, my understanding is in a lot of the West, a doctor who performs anything generally considered FGM even if it's on an adult with no indication of undue pressure being placed on them can easily face criminal charges even though this may seem to be an elective procedure. Indeed I've seen it suggested (and our article sort of hints at this) that you could perform the exact same surgery (on an adult in both cases) as a simple cosmetic surgery and be fine but if it's being done for cultural or religious reasons, you may be in big trouble. For that matter something which appears to have less potential for harm the same. (Hymen repair seems to be one exception.) And we haven't even touched on the apparent terrible regulation of such mostly cosmetic procedures being performed on children as well as misleading advertising or information calling into question informed consent.) Anyway rant over, how do editors think we should improve this sentence? Is just removing elective enough? Nil Einne (talk) 17:29, 13 March 2022 (UTC)