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Part of it is coming from pornography that makes women feel their labia are somehow abnormal or unattractive, Blake said. “And it’s a really vicious circle, because this is one of the operations women who are actually in the pornographic film industry are now expected to have,” she said.

“What bothers me most is that women are being made to feel insecure and unhappy about a perfectly normal, healthy part of their body and will submit themselves to costly surgery when we just don’t know what the long-term impact is going to be,” Blake said.

Some Canadian gynecologists are travelling to the U.S. for training in the surgeries, though Blake said they are “by no means in the mainstream.”

This is one of the operations women who are actually in the pornographic film industry are now expected to have

The procedures involve labiaplasty, where the labia minora, the small inner folds of the vulva, are trimmed and made more symmetrical, as well as laser procedures for “vaginal relaxation syndrome.” Labiaplasty costs about $4,500, and vaginal tightening up to $5,500.

According to recently published guidelines from the Canadian society of gynecologists, no available long-term data exists on the safety and efficacy of the procedures. The doctors’ body also says there is little evidence to support claims the surgeries improve sexual satisfaction or self-image.

Risks can include bleeding, infections and scarring.

The guidelines say the procedures should only be performed if medically warranted, for example, in cases of pelvic prolapse or injuries following childbirth.