Out of the blue, Lauren, a smart and adorable 21-year-old patient of mine, thinks the lips of her vagina are too big. Her older boyfriend of four months, Jake, apparently made comments about her plus-size vaginal lips, telling her, "You don't have a sexy cooch"—this after Lauren had her clit pierced at Jake's request. I did Lauren's first gynecological exam and Pap smear when she was seventeen, and I can't help think about how she graduated in the top tenth percentile of her high school, earned a black belt in Tae Kwon Do and received a full scholarship to the University of Pennsylvania, but ended up attending the local city college so she wouldn't leave her single mom alone. When I think of this, I want to give Jake more than a piece of my mind, since Lauren tearfully went on about how ashamed she felt. She asked how she could get "the perfect vagina." I hugged her and reassured her that she was perfect in every way, especially her vagina. Having three sons who hated it when I started talking about the vagina made me mother Lauren more than usual. The time I spent giving Lauren straight talk about what a "perfect" vagina really looked like felt essential to her empowerment as a strong, healthy, "perfect" woman.
You know the saying "No two snowflakes are exactly alike?" Well, the expression could just as easily refer to vaginas. There is no one right way for a vagina to look, meaning that there's no such thing as a perfect one. If anyone should know that, it's an OB-GYN who's been seeing patients and their vaginas for nearly three decades.
The labia, or lips—which is where most of the issues are for the majority of female patients—vary from person to person. In fact, even the separate parts of the same vagina are not exactly the same. Just as our two eyes are not identical, nor our ears or breasts, our two lips are not identical, nor are they symmetrical to each other. This is considered to be completely normal; different is normal. I'll tell you (in short) what I told Lauren: The only qualities that make a vagina "perfect" are good health and confidence.
These days, social media allows all of us to compare ourselves to others in every way possible, including our vaginas. So I wasn't all that surprised when another of my young patients—one a few years younger than Lauren—asked if I thought her lips were "abnormally large." She went on to say her boyfriend (again with the "expert" boyfriend) told her that her lips were too big compared to others he'd seen. When I asked her who the "others" were, it turned out they were the women on the porn sites he visited. Sadly, I wasn't at all shocked to hear this, because, unfortunately, he's the norm, not the exception.
Dr. Gail Dines is a professor of sociology, modern-day hero and a leading anti-porn feminist to tie the "porn monster down that has taught our girls to hypersexualize and pornify themselves." Dr. Dines is on a mission of education, within which she and her group Cultured Reframed plan to use a public health approach similar to how my generation was educated about drinking alcohol and driving. She won't be the only one wanting to reclaim our young girls and boys!
There's no denying it. Porn is everywhere. Dr. Dines puts a perspective on this issue of accessibility of porn when she tells us, "Porn sites get more visitors each month than Netflix, Amazon, and Twitter combined." A recent statistic found that 70 percent of children ages 8 to 18 report having unintentionally stumbled across pornography online. The average age for a child to be exposed to pornography now is 11 years old. This means that our children are often "learning" about "normal" sexual behavior and physical appearance from the likes of Jenna Jameson and John Holmes. Many women (and men) now expect, even want, all vaginas to look like Jenna's does. Girls and guys alike visit porn and other sexually graphic websites, and not just to get off but also to see what the perfect vagina and the ideal penis look like.
As a result of social media, some women have been made to feel vagina insecurity. And I'm not just seeing this in patients, either, although it's definitely something that comes up regularly in my examining room. It's everywhere. An internet search of the word "vagina" brings up a variety of links, many leading to everyday women showing off their vaginas: YouTube videos of women talking about vaginal rejuvenation, websites devoted to discussing and examining anything vagina-related, and, of course, porn sites. These are the reference points that young women—women of all ages, really—now use when seeking the ideal of the perfect vagina. Adolescent boys are having the same issues regarding the size and length of their penises, even though, like vaginas, no two penises or scrotums are the same.
This is where I come in—with my agenda of vagina empowerment! I want to reduce your anxiety and help you have more realistic expectations about what's normal by giving you an accurate view of the vagina in general. Believe me, the perfect vagina is actually a medical norm and not an aesthetic ideal.
Here is an overview of what normal anatomy looks like for the female external genitalia.
As Close to Perfect As Perfect Gets
What we think of as the vagina actually includes the outer labia majora (lips), inner labia minora (lips), clitoris (clit), clitoral hood, opening to the urethra, and opening to the vagina. You need to get to know and love all parts of this fascinating area of your body. Know what your "normal" is so you will know when something is not normal or when a potential problem arises.
Our Version of Perfect
Much as women have always compared their bodies and breasts to models and movie stars, now the vagina is up for inspection. I hear comments like: "My lips are too big," "too bumpy," "too dark," "too uneven," "too in the way." Or "My boyfriend/girlfriend tells me my labia are not pretty" or "not sexy." More and more, my patients are asking me what the perfect vagina looks like and how they can get one. Women of all ages, including adolescents, are now aware of cosmetic genital procedures that vow to make the vagina beautiful, even perfect. I get a lot of inquiries about these alterations and what they can and can't do. While my goal is to care for my patients and make their lives better, from their health and well-being to their level of self-esteem and sexual pleasure, I sometimes have to dole out some tough love when it comes to their quest for the perfect vagina. If having surgery will make a patient feel happier and more confident, I can absolutely see the benefit. And yet, I always caution her to really think her decision through before she does anything drastic. I ask my patients to honestly consider the following:
"Is this absolutely necessary?"
"What does the perfect vagina really look like anyhow?"
"Does Jenna Jameson have the perfect vagina? Really?"
"How will my life (and sex life) be improved by having a different vagina?"
Even minor surgery can lead to complications. And if this quest is undertaken for the wrong reasons, or with unrealistic expectations, even a positive outcome can be disappointing. I think it's important to remember that the media's perception of genital anatomy is often not representative of the general population. Real indications that something is actually wrong with your vagina include discomfort, pain, itching, odor, or discharge. Short of that, the issue you're obsessing about might just be in your mind. So, before you do anything cosmetic and permanent, think about it, talk to your doctor, talk to your friends—have a long, hard, compassionate look at your vagina. Know what you're really dealing with before you embark on a drastic plan. In other words, educate yourself.
Excerpted from She-ology: The Definitive Guide to Women's Intimate Health. Period., by Sherry A Ross, with the permission of Savio Republic. Copyright © 2017.