Are Proposed Links between Pornography and Labial Surgery More Than Just Wild, Unmitigated Speculation?

The research on porn and labiaplasty appears to be like most other porn research: weak and, as far as results go, unconvincing. But, like other areas of porn research, that hasn't stopped some journalists, anti-porn activists, and scholars from making dramatic claims.
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Every now and again, fears of pornography are stirred, often by the religious right, under the guise of a "public health" crisis of some sort. Very recently the governor of Utah signed a decree declaring pornography a public health issue. Although claims of the ills of porn are typically far reaching, some of the usual horrors, such as violence toward women, have been largely questioned, in part because rates of such violence have plummeted during the era of internet porn. Teen pregnancy rates, likewise, are declining to historic lows, somewhat inconveniently for the "sky is falling" set.

Claims that viewing pornography may lead some women and teen girls to seek out elective surgery on their labia to obtain a "genital ideal" have been around since at least 2011. The argument is pretty straightforward: Viewing women with perfectly shaped labia leads young women and teen girls to seek out perfect labia of their own through elective, otherwise unnecessary surgery.

The notion that pornography might convince teen girls, in particular, to seek out brutal, painful, unnecessary surgery is intuitively horrifying. And, unlike violence toward women, the numbers appear to be going in the "right" direction, at least as far as the theory goes. As Newsweek in its not-at-all-clickbait titled article "Porn as Sex Ed: Online Smut Warping Teens' Views on Sexuality" notes, labiaplasty among teen girls increased from about 222 cases in the US in 2013 to 400 in 2014. Those numbers (in a country of 320 million people) are obviously very tiny. But are they indicative of a worrisome trend?

Both in the Newsweek article and the earlier 2011 article, claims of a link between such surgeries and pornography are entirely speculative. And they are based on at least a couple critical assumptions.

One assumption is that changes in surgery rates between 2013 and 2014 can be correlated with pornography, easy access to which has been around since the mid-1990s. Few people doubt that teens' access to pornography in modern times is historically unprecedented. But, if pornography were causing a "genital ideal" why would it wait until 2014 to do so? As I've noted elsewhere, the ability to causally link media, in general, to body dissatisfaction among teen girls is controversial, with mixed evidence. But even correlation here doesn't seem to be clear. Why would a correlation wait 20 years to kick in? Particularly, when we're talking about such small numbers (population wise), a year-to-year difference can be little more than a statistical blip. But even if the trend continues, increases in cosmetic surgery interest may reflect little more than increased availability of such surgery, and eased access to it, rather than a media effect.

A second assumption seems to be that teen girls watch a lot of porn and worry about how they compare to the actresses in it. Here's where I was most interested. What evidence is there to directly link, even correlate, girls' consumption of pornography to labiaplasty? The news articles I reviewed they seemed to fit a particular pattern: Clickbait headline, followed by some causal speculation about porn's effects, finally (if you read far enough) concluded with some tacit admissions that there is no actual, you know, evidence to base those speculations on. Despite its histrionic headline the Newsweek article eventually admits (correctly) that research evidence on pornography effects is mixed, and difficult to base causal assertions on.

Curious about this, I reached out to a colleague, Patrick Markey, who has done research on media effects on plastic surgery interest. He told me he was unaware of there having been much research connecting pornography to labiaplasty. Indeed a search of scientific databases didn't turn up anything. I then reached out to Dr. David Veale, who's comments in a 2011 Guardian/Observer article led me to believe he was conducting research in this area: "We haven't completed the research, but there is suspicion that this is related to much greater access to porn, so it is easier for women to compare themselves to actresses who may have had it done. This is to do with the increasing sexualisation of society - it's the last part of the body to be changed."

Dr. Veale informed me via email that he was not, in fact, doing research in this area. But he pointed me to studies by two research groups. Curiously, one of these specifically concluded that pornography was unlikely to be related to labiaplasty noting "We also found that while pornography was associated with openness to labiaplasty, it was not a predictor of genital satisfaction, casting doubt on a linear framework that positions pornography as the main driver for female genital cosmetic surgery." The other article, using self-report surveys, found small correlations between self-reported porn viewing and openness to labiaplasty in Australian women. Like the previous study, no links between pornography and genital satisfaction were found.

So both studies find little evidence to link porn use to genital satisfaction, a key component of much of the speculation I'd read in the news articles. Small correlations seem to exist between porn use and openness to labiaplasty, although this isn't tied to genital satisfaction. It's hard to interpret this. This could simply mean women are more open to labiaplasty for functional health issues rather than cosmetic ones. Or that more liberal women are both more open to pornography and plastic surgery. Overall endorsement of labiaplasty remained low (mean estimated likelihood of seeking labiaplasty in the future was 4.15% in the second study among all women, porn viewers or not.) What is most important is that none of the have ever linked pornography to actually getting labiaplasty.

What I came away with from all this is that, if society has a problem, it's not pornography. It's awful, misleading newspaper headlines based on zilch. Well, that and the continued abrogation of our responsibility as parents and within our educational system to responsibly educate our young about sexuality. To the extent that porn does teach our teens about sex it's only to the extent we otherwise do such a piss poor job of it as a culture.

Ultimately, the research on porn and labiaplasty appears to be like most other porn research: weak and, as far as results go, unconvincing. But, like other areas of porn research, that hasn't stopped some journalists, anti-porn activists, and scholars from making dramatic claims. After all, when has anyone ever let data get in the way of a good crusade?

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