EXCLUSIVE

IT’S a question that might shock — what should a woman look like down under?

Researchers trying to understand a nearly threefold increase in Medicare claims for female genital surgery are asking 3,000 men and women about their attitudes, and what they think is normal.

OPINION: Why are women putting their privates under the knife?

Medicare claims for female genital surgery have nearly tripled in a decade, with concerns building that taxpayers may be paying for designer vaginas.

A recent Flinders University survey found almost one in five women were interested in a labiaplasty.

And doctors are being asked to perform the surgery on girls as young as 13.

The internet and M-rated soft pornography, which is governed by laws that require photo shopping of images to remove crucial parts, have been blamed for misconceptions about what is normal.

And experts are concerned women who opt for surgery may have their capacity for sexual pleasure impaired or destroyed.

Monash University researcher Dr Maggie Kirkman is interviewing 30 women and about why they had cosmetic surgery and, is surveying 1,000 people about their attitudes to such surgery.

Survey respondents will also be asked what they consider to be normal looking female genitalia.

“We want to find out do they think there is a standard for genitalia, do you think there is a point at which it’s abnormal and needs to be modified,” Dr Kirkman says.

“It’s not clear this surgery is coming from men’s comments; women say I want the change, my boyfriend’s fine with it,” she said.

“Just as women are made to think other parts of their bodies are not normal,” she said.

The Royal Australian College of General Practitioners - which recently introduced new guidelines on genital surgery - says that “it appears that in response to changing cultural norms, this surgery is increasingly being sought by women who want to either feel ‘normal’ or look ‘desirable’”.

It says labiaplasty is the most common form of genital surgery requested and performed, accounting for about 50% of the procedures performed.

Doctors who do the surgery don’t need any special qualification; they can be straight out of medical school, and there are currently no evidence-based guidelines that support the cosmetic procedures.

The researchers originally wanted to ask questions about the appearance of men’s genitalia as well, but the survey was already too long, says Dr Kirkman.

She has detected a growing belief that pubic hair is seen as unhygienic, but the Barbie doll look being sought by women leaves them at risk of dermatitis and pimples.

Others are opting for treatments that change the colour of the skin in their anal genital area.

“We know of some case report in England and the US mothers are turning up with their daughters in puberty worried they have a visible labia minora when they are 12 and 13 years old,” she said.

The number of Medicare claims for female genital surgery grew by 140 per cent from 640 cases in 2000, to 1,565 claims in 2011.

Cosmetic surgery is not covered by Medicare, and some of these cases would be repairs after injury or accident or sex changes, says Dr Kirkman.

However, she says in the past women were able to claim their genitalia rubbed when they wore tight clothes or they were suffering psychological damage and get the surgery paid for by Medicare.

New rules have tightened claims criteria and surgeons must submit photographs to justify the claim.

TAKE PART IN DR KIRKMAN’S SURVEY