Walden Rachel L, Abdulcadir Jasmine, Earp Brian D
Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA.
Department of Obstetrics and Gynecology, University Hospitals of Geneva, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Arch Sex Behav. 2025 Jan;54(1):95-106. doi: 10.1007/s10508-024-03021-1. Epub 2024 Oct 23.
Labial hypertrophy, which lacks an accepted definition, is generally understood to refer to morphological and aesthetic characteristics of the labia believed to deviate from a perceived norm. Such ostensive deviation has the potential to affect many domains of a person's well-being, as does its surgical treatment, labiaplasty. Nearly 24,000 labiaplasty procedures were performed in the United States in 2022, representing a greater than three-fold increase since numbers were first reported in 2013. Nearly 20% of these procedures were performed on minors, and cases have been reported in children well before complete pubertal development or the age of personal consent. In this article, we explore the indications that are used to designate labiaplasty as "medically necessary" in minors, a status that, we argue, is required for such procedures to avoid fitting the definition of "medicalized FGM" (i.e., "female genital mutilation") according to the World Health Organization. As a part of this, we consider the particular ways in which outcomes are measured in this population. We shed light on persistent methodological shortcomings in the research on labiaplasty, discuss ethical and legal implications, and make recommendations to improve the relevance, reliability, and generalizability of future investigations into this increasingly common, controversial surgical procedure.
阴唇肥大尚无公认的定义，一般认为是指阴唇的形态和美学特征被认为偏离了某种公认的标准。这种明显的偏差及其手术治疗阴唇整形术都有可能影响一个人幸福的许多方面。2022年，美国进行了近24000例阴唇整形手术，自2013年首次报告相关数据以来，增长了三倍多。其中近20%的手术是针对未成年人进行的，而且在儿童完全青春期发育之前或达到个人同意年龄之前就有相关病例报告。在本文中，我们探讨了将阴唇整形术指定为未成年人“医疗必需”的指征，我们认为，要使此类手术避免符合世界卫生组织定义的“医疗化女性生殖器切割”（即“女性外阴残割”），就需要这一地位。作为其中一部分，我们考虑了在这一人群中衡量手术效果的具体方式。我们揭示了阴唇整形术研究中持续存在的方法学缺陷，讨论了伦理和法律问题，并提出建议，以提高对这一越来越常见且有争议的外科手术未来调查的相关性、可靠性和普遍性。
