A woman who underwent cosmetic genital surgery after years of insecurity has called for tighter regulation of the procedure, saying it left her in chronic pain and questioning why it remains legal while female genital mutilation (FGM) is banned.
Riley Smith* said she first wanted labiaplasty at the age of 14, after becoming distressed about the size of her labia. She later had the operation at 22, describing it as being presented to her as a simple solution to a problem she had been encouraged to see as abnormal.
“I didn’t even know the word for what I was worried about back then,” Smith said. “I just knew I felt different, and that different meant something was wrong.”
Like many teenagers, Smith was navigating puberty, peer pressure and the early influence of online pornography and social media. She said offhand comments from friends, combined with images of women’s bodies presented as ideal, gradually shaped her perception of what was “normal”.
“When I tried to talk about it, the response I got made me feel vulgar and embarrassed,” she said. “It confirmed my worst insecurities.”
Campaigners argue that labiaplasty – a cosmetic procedure that alters the appearance of the labia – should be treated in law as a form of FGM, which the World Health Organization defines as any non-medical procedure involving the partial or total removal of external female genitalia.
By the time Smith sought out a private clinic in her early twenties, she said she was primed to believe surgery would be a solution rather than a risk. “I was told it would increase my confidence, make underwear more comfortable and improve hygiene,” she said. “I was described as the perfect candidate.”
She said she was not warned of potential complications and was reassured that it was “super simple surgery”. There was no discussion, she said, of how much tissue would be removed, or what that tissue was designed to do.
Following the operation, Smith said she felt “extremely drained and uncomfortable”. In the months that followed, she experienced persistent irritation, dryness and recurring infections, which doctors later attributed to the loss of protective tissue.
“I can’t sit comfortably for long,” she said. “Sex is now excruciating and mentally distressing. Penetration was never painful before. I feel angry at the surgeon, the system and myself.”
She described a sense of grief for a body she no longer recognises. “It’s not just physical pain,” she said. “It’s the knowledge that this was done to me when I was healthy.”
A doctor has since discussed the possibility of reconstructive surgery, using techniques developed for women who have survived FGM. Smith said she was struck by the contradiction. “How can something that needs to be repaired using FGM reconstruction techniques be considered harmless?”
A growing but contested practice
Labiaplasty has been one of the fastest-growing cosmetic procedures globally over the past decade, promoted as a solution for aesthetic dissatisfaction, discomfort during exercise or sex, or perceived hygiene issues. In the UK, it is legal for adults who consent, despite increasing scrutiny from women’s rights groups, medical ethicists and some clinicians.
Figures from the British Association of Aesthetic Plastic Surgeons show that 635 labiaplasty procedures were carried out in the UK in 2024, a slight decrease from the previous year. Private clinics typically charge around £4,000 for the procedure. On the NHS, labiaplasty is offered only in exceptional circumstances, such as to treat cancer or severe physical pathology.
Campaign group The Vavengers, which works to end violence against women and girls, is calling for labiaplasty to be criminalised in line with FGM legislation. Its chief executive, Sema Gornall, said the distinction between the two practices is rooted more in culture than in harm.
“There are more than 10,000 nerve endings in the female genitalia,” Gornall said. “We would never say you can consent to the removal of a healthy limb for aesthetic reasons. Yet we allow this because women have been taught to feel shame about their bodies.”
She argued that social media has played a significant role in normalising the procedure, particularly among young women. A search for labiaplasty on TikTok returns thousands of posts, many framed as empowerment or self-improvement. Google searches for “labiaplasty before and after UK” have increased sharply in the past year.
“This is not happening in a vacuum,” Gornall said. “It’s happening in a culture that profits from women’s insecurity.”
Consent, culture and law
The ethical debate surrounding labiaplasty often centres on consent — particularly when insecurity begins in childhood or adolescence.
Dr Kate Goldie Townsend, a lecturer in political philosophy at the University of Exeter who researches bodily autonomy and children’s rights, said labiaplasty mirrors many of the harms associated with FGM.
“These include bleeding, infection, scarring, chafing, loss of sexual function due to nerve damage, and psychological distress linked to regret,” she said. “The difference is how the practice is framed.”
Townsend said FGM is widely recognised as violence because it is associated with coercion, tradition and control. Labiaplasty, by contrast, is presented as choice — even when that choice is shaped by intense social pressure.
“The perceived benefits are largely socio-cultural,” she said. “Increased confidence comes from conforming to patriarchal beauty norms. That’s not a medical benefit.”
She added that the UK’s Female Genital Mutilation Act 2003 allows surgical procedures deemed necessary for physical or mental health, raising concerns that cosmetic genital surgery could, in theory, be justified for minors experiencing extreme anxiety.
“That should concern us,” she said. “It shows how fragile the distinction is.”
‘Pain doesn’t care why it was cut’
For survivors of FGM, the debate is not abstract.
Payzee Mahmod, an ambassador for The Vavengers who underwent FGM as a child, said the experiences described by women harmed by labiaplasty were painfully familiar. “I know women who live with pain every single day of their lives,” she said. “Not just during sex — just existing in their bodies.”
She rejected the idea that labiaplasty represents empowerment. “It’s decorated and masked as choice and freedom,” she said. “But it sits within the same patriarchal system that drives FGM.”
While she acknowledged that the contexts differ, she said the outcome for some women is the same. “Pain doesn’t care why the tissue was cut.”
Government and WHO response
The government said it has no plans to ban private labiaplasty for adults.
A Department of Health and Social Care spokesperson said: “Prioritising women’s health and safety is paramount. Labiaplasty is only available on the NHS in exceptional circumstances when patients have a clear clinical need.
“FGM is different. It is a crime, it is child abuse, and it can destroy lives. We will not tolerate practices that cause lifelong physical and psychological harm to women and girls.”
A spokesperson for the World Health Organization said its focus remains on preventing FGM and supporting survivors, adding that decisions around cosmetic surgery fall outside its mandate.
‘I don’t want this to happen to anyone else’
Smith says she is speaking out not to shame women who choose labiaplasty, but to challenge how it is marketed and regulated.
“I don’t think people are given the full picture,” she said. “This is sold like a beauty treatment. It’s not like getting your hair done. It’s permanent.”
She said she wishes she had been told, as a teenager, that vulvas vary widely and that variation is normal. “If someone had said that to me — really said it — I don’t think I’d be here now.”
Living with chronic pain has reshaped how she thinks about choice, consent and responsibility. “I can’t undo it,” she said. “But I can try to stop another girl feeling like her body is a problem that needs fixing.”
As scrutiny of cosmetic genital surgery grows, her experience raises uncomfortable questions about how society talks to girls about their bodies — and who profits from their discomfort.
“I thought I was fixing a flaw,” she said. “But the flaw wasn’t my body. It was the pressure to change it.”
*Name changed to protect identity.
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