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The SOGC says it does not support the operations unless medically necessary, and calls on physicians to refrain from advertising the services or suggesting they boost sexual satisfaction.

“The proliferation of non-medically indicated surgery to the genital area is of great concern,” says the statement.

Other critics have gone further, arguing that cosmetically altering the vagina or vulva is akin to female genital mutilation, a painful, involuntary practice in some cultures that Canada and other countries have outlawed.

Some of the Canadian doctors who perform the cosmetic work, however, say the procedures are no different from any other aesthetic surgery, and that they screen out patients who may be influenced by psychological trouble or outside pressure.

“The demand is so high, there are days when we will do three of these in a row,” said Dr. Anthony Lockwood of Winnipeg’s First Glance Aesthetic Clinic.

In the locker-room now, nobody has pubic hair any more. Now you see everything, and they’re far more self-conscious about it

“Good or bad, it’s just a fact of life with the mass media and Internet now. The ability to look at images of naked male and female bodies is a lot greater for everybody. So they’re comparing themselves to what they’re seeing.”

Also behind the demand is another genital-related trend, he said – keeping the area bare.

“In the locker-room now, nobody has pubic hair any more. Now you see everything, and they’re far more self-conscious about it.”

If well-trained specialists like him do not preform the procedures, women will either go offshore or underground to less-qualified practitioners, said Dr. Lockwood, a plastic surgeon.