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OK, those of you who went after me for juxtaposing FGM with sex-reassignment surgery, let's hear your thoughts on this.

On the one hand, we have FGM, which the individual submits to (or simply endures) because of family, husband, or cultural pressure, or outright coercion.

On the other hand, we have sex-reassignment surgery, which the individual chooses, and Brazil will now subsidize as an economic right.

Here's a third phenomenon: cosmetic vagina surgery. Apparently, it's voluntary (the woman asks for it), but it's also the result of cultural pressure. Not religious pressure, but aesthetic/commercial/body-imag­e pressure.

Is it a wrong, a right, both, or something in between?

...like any other cosmetic surgery, I don't think it's "wrong" so much as vain.

Anyone can understand cosmetic surgery which is necessary to fix some real fault - whether it's sagging jowels, a breast that's been damaged or removed due to cancer surgery, or damage from an accident.

The kind of cosmetic surgery that one only does to make oneself 'look better' is IMO purely a matter of choice, and arises out of vanity (or its flip side, self-consciousness). I'd put 'vaginal trims' or whatever they call them in that category.

Such surgery is essentially unnecessary, but a matter of personal choice. Myself, I see nothing wrong with variety and no need for absolute physical conformity. Especially when it comes to something that most other people aren't even going to be looking at...:)

"OK, those of you who went after me for juxtaposing FGM with sex-reassignment surgery, let's hear your thoughts on this."

HACK.

:P

Seriously, if you are going to be a real journalist, you have to ignore what message boards say.

Imagine that everyone's in the database, and that some bureaucrat (with less influence and ability to cry "victim," even, than a federal prosecutor) is on the receiving end of a ball thrown by the Chairman of the Committee for Sex-reassignment and after that chairman has met with the era's Jack Abramoff.

Abramoff, incidentally, was just an example; I could as easily have used the name of that other donor to Clinton's campaign, Hsu. I'm asking whether we're sure that Hillary Clinton, elected, would represent the first female President of the USA.

if anyone is forced to do something they dont want to their body- it's wrong.

if they are pressured into said acts due to an oppressive society and/or if they do not have a reasonable ability to make such a decision themselves- it's wrong

however, if someone chooses an elective surgery for reasons that make them feel better, that's simply their choice. there are reasons someone might want such a surgery that don't relate to "looking like porn stars" (seriously, are there a bunch of women watching porn saying, i want mine to look like hers? somewhere i'm sure there is, but i hardly think it's an overwhelming amount of the female population). perhaps medically after having a baby (and men never seem to understand what goes on down there especially during pregnancy. i mean, i've never been pregnant so i don't know), you might need some work done. perhaps if a woman has been a victim of rape. the point is that only doctors would really be able to address the need for such surgeries medically.

about people being influenced by the ads on tv? i believe in personal responsibility. and if you give people the excuse that the tv made them do it, then they will use it. just like the dog ate my homework. if you dont have the common sense to know that you dont have to buy everything you see on television, if you have no more impulse control as a child than you did as an adult, well then i wipe my hands clean of you.

I think the question is to vague and general to be answered. Asking, "Is cosmetic vaginal surgery good or bad?" is like asking "Is cosmetic facial surgery good or bad?" Are you thinking of Michael Jackson, someone with a harelip, or what?

Restoring the signs of virginity are important for protecting Muslim young women from being murdered by their fathers. Unless you're on the father's side, what's wrong with that?

As for outer cosmetic surgery to restore a more youthful appearance, how is that different from having a face-lift?

I'm sure you remember the case. Cases in which dysmorphia impacts core identity are not cases of Body Dysmorphic Disorder. David Reimer had a profound, chronic adjustment disorder secondary to the ablation of his penis, and the subsequent attempts to compensate for this injury.

We have a collective moral obligation to ameliorate human suffering when we can. We do not have a collective moral obligation to indulge compulsions related to unrealistic ideals regarding physical attraction, however. If people want to pursue idiosyncratic ideals re. physical perfection on their own, then they are certainly free to do so. But this is a form of suffering that is more easily corrected by modifying the underlying belief, and it is this focus that is likely to produce the most favorable outcome. The best available evidence suggests that modifying individual beliefs about gender identity is, in most cases, nearly impossible.

For issues such as "revirgination", the most efficacious interventions which could be assumed to promote the most favorable outcome are social. The same is true for involuntary female genital mutilation. In those situations, core identity is not conflicted. The conflict is between the person and the people around them, not between the mismatch between subjective identity and objective morphology.

Though you can draw whatever peripheral analogies you like, the evidence for a biological substrate for gender identity is compelling. I've never seen any evidence that there is a biological substrate related to predilection for plastic surgery that is not related to more general OCD, exacerbated by social perception. Surgical correction is more likely to lead to more surgeries than it is to eventual satisfaction in these cases, because the underlying problem is not that there is something specific wrong, but that there is something generally wrong, with varying specific manifestations over time.

Enough is enough, Will. Lets go ahead and treat Dysmorphia surgically when we can. Lets treat the Body Dysmorphic Disorder nonsurgically when we can. This is the standard of best practice as we have it today. Trying the "treat" sexual preference and gender identity by changing core beliefs does not work. It's as insane to expect people to deny core aspects of themselves to conform to prejudiced cultural attitudes in these cases as it is in cases of female genital mutilation.

So I guess in a way, your comparison stands on that basis. It's insane for us to expect people to deny core aspects of themselves because those aspects make us uncomfortable, and the outcomes are grim. But it's also insane for us to actively facilitate someone's betrayal of their core aspects as well (ie. suicide). How to tell the difference? Well, there's research and reason. Lets rely on those in these ambiguous situations, and make the decisions that maximize individual and social outcomes.

Saletan is grasping at straws on this one. Cosmetic vagina surgery is in no way related to FGM or sex reassignment. It is related to boob and nose jobs. The cultura issues surrounding it are no different from those surrounding other types of cosmetic surgery just because it involves the genitals.

Having purchased a new nose a few years back, I would never say that cosmetic surgery is a bad thing in and of itself. Pinning a kid's ears, repairing cleft palates, all good things. There's nothing positive in letting a kid suffer socially because of something so easily corrected.

Yes, there are people addicted to surgery, who insist on procedure after procedure and end up going to more and more unscrupulous surgeons, but this is a mental illness, not a cosmetic issue. (And it would make an interesting article someday in the future, don't you think?)

I ran the vaginal surgery idea past a bunch of friends, both male and female, and the comment that every single one of them made had to do with the "ick" factor. Also, healing must be a bear. The pain following surgery must be horrendous.

In the end, though, it's up to the individual. I think it's yucky, but what can I say about anyone else?

"Having purchased a new nose a few years back"

I just have to say: ick.

Cosmetic vaginal surgery is no different from tummy tucks or breast augmentation. It's all from societal pressure to look and be a certain way. If women are so insecure and shallow as to feel that they need to keep up with Miss Jones below the belt, that's on her.

I think the difference between that and female genital mutilation is that a.) it actually does something very harmful to the female (i.e., eliminates almost all sexual enjoyment) and b.) is done as a direct attempt to control and coerce female by outsiders. It's more than just peer pressure: its gonna happen whether or not the female wants it. It is typically done at a young age when the girl can't really make up her own mind about the procedure and may not even yet know what she'll be missing the rest of her life. She is no more choosing to have her clitoris (and sometimes outer labia) removed any more than she chose her own parents. Female genital mutilation is barbaric; vaginoplasty is imbecilic.

"Pinning a kid's ears, repairing cleft palates, all good things. There's nothing positive in letting a kid suffer socially because of something so easily corrected."

Interesting point here. We accept elective surgery on children and infants who are incapable of consent in order to make their appearences more socially acceptable. (Cleft palattes I think are medically problematic, so I probably wouldn't include them here.) We reason that their lives will be better off if they appear a certain way.

Why can't a woman's life be better off for having elective cosmetic surgery? For those labeling these women as weak-willed or vain, so what if they are? Or are only the strong-willed, independent and "intelligent" women allowed to feel good about their bodies?

This also reminds me of the children's author who was under attack for using the word scrotum in a children's book. Or the theatre company who had to take down the word vagina from their signs advertising the vagina monologues. All it does is reinforce the idea that genitals are something dirty or shameful. If it is acceptable to change other parts of my body, then my genitals should be no different.

Oh and Bill, I totally expect to see similar attention paid to cosmetic phalloplasty and whether men are being deluded into thinking they need larger penises. I get so many damn emails about it, I'm starting to feel left out.

When will I start seeing the unsolicited emails telling me how to get a tighter and younger-looking labia?

If that's the best you can do, best go hang out in the library some more.

I should have added that I have not regretted it for one second.

Oh, you misunderstood. If anyone wants to have plastic surgery, they should knock themselves out - go for whatever the Mastercard will bear.

As for kids, I've seen ears that are truly disfiguring. That surgery is generally done on children, not infants and I've seen it make a huge difference for the kids. The change in them is truly magical. I would never allow a kid to go through life being mocked and abused by others over something so simple. Kids are cruel, that part isn't myth.

I also think, though, that many people tend to minimize the fact that plastic surgery is still surgery. Healing hurts. Scarring can happen. The majority of breast implants have to be removed or extra work done over time - it isn't a permanent thing. I know getting my nose done hurt like a bugger for about three weeks post-op.

As for being weak-willed or vain, I'll take it. I hated my nose for my entire life, and as soon as I could afford to do something about it, I did. It has utterly changed my life, not because the surgery actually made that big a difference in the way I look, but because I feel like it did.

I also know for a fact that bodies are all different, and results will not be the same for all people. As with any procedure, I think plastic surgery should be taken seriously. Choosing a doctor is paramount, and I don't think that getting new boobs from a guy that advertises on a billboard on the freeway is the way to go. Call it a hunch.

As for cosmetic vaginal surgery - I have the same reaction to that that most men have to the notion of having their penis tattooed. It makes me want to cross my legs and not think about it too much.