Designer Vaginas are All the Rage – But Will You Be Raging Afterwards?

Vaginaplasty by any other name would still sound awful—a “trim job?” A “tidy, tighten and tuck?” Would you prefer a spiffy “vaginal rejuvenation?” Perhaps a beefier G-spot would augment your sex life? Bothered by having misplaced your hymen—no problem, you can have a surgical revirginisation! (Whoever said you can never return to innocence apparently didn’t have a good plastic surgeon). And, of course, there’s the increasingly popular partial excision of those pesky protruding inner lips. For more and more women, surgery seems to promise the cute and perfect genitalia of their dreams.

But why are women flocking to doctors to have their genitals redesigned? Didn’t Mother Nature do a good job?

Apparently not. At least, not by the standards of Internet porn, according to which Mama Au Natural was sloppy, unsymmetrical and sometimes excessive in her vulva variations. Luckily, we have modern medicine to come to the rescue and fix all those droopy labia and floppy vaginas.

Vulvar and vaginal plastic surgeries are quite the fashion now. The ads assure women that they no longer need to feel embarrassed by their ugly vulvas. A simple surgical procedure, a little snip to remove excess tissue (it’s doesn’t serve any function, after all) and voila – you can have a vulva to be proud of! Don’t worry about loss of sensation, nerve damage, scarring, sexual dysfunction or future birth problems. Trust me, the docs say, it’s safe! (Besides, who cares how it works, as long as it looks good.)

A new study by Liao and Creighton that’s about to be published in the British Journal of Obstetrics and Gynaecology, (BJOG) calls the medical bluff about the “low-risk” nature of cosmetic labial surgery. In an extensive review of the literature over the past 59 years, they reveal an unsurprising (to me, at any rate) lack of evidence on the safety and long-term consequences of such procedures.

Are these operations really safe? No one actually knows, but since the amount of genital tissue removed in cosmetic labial surgery is comparable with several types of female genital mutilation, we can guess that similar problems could arise, such as birth complications like perineal trauma, postpartum hemorrhage and increased neonatal death. And sexual health and pleasure issues? Well, no one’s actually checked.

While doctors have a multitude of anecdotal claims about sexual satisfaction, they have no actual data to back up their assertions. Co-author of the study, Sarah Creighton, consultant gynecologist at University College Hospital, said, "This paper offers a critical review of available scientific knowledge on labial surgery and identifies a shocking lack of solid evidence. Some studies have laid claims to 'successes' despite suspect methodology, and some have not bothered to define how the conclusions had been derived. Anecdotes proliferate in the literature. Risks and complications are rarely documented.”

As to why women are seeking these procedures in escalating numbers, co-author Lih-Mei Liao, consultant psychologist at University College London, said, "Healthy women are commercially targeted for invasive and irrevocable surgery to the labia minora. Advertisements promote labial surgery as easy answers to women's insecurities about their genital appearances—insecurities that are fuelled by the very advertisements that prescribe a homogenized prepubescent genital appearance standard for all women."

I couldn’t have said it better myself! The wide and glorious range of normal, healthy genitalia is a deep dark secret. It’s like imagining that fashion models and TV actresses represent the normal range of women’s body types and beauty. At least you can walk down a street and know that beautiful women come in all shapes and sizes, but how would you know about the parts that are kept private?

Prof. Philip Steer, BJOG editor-in-chief, said, "Commercial images and social pressures often serve to distort public perceptions about what is physically normal. Healthy messaging about the normal variation in female genitalia, as well as body shape and size more generally is needed and important.” You tell ‘em, professor!

Women, the vagina Mother Nature designed for you over all those millions of years of evolution is perfect. It’s as beautiful as any other flower be it a frilly rose or an elegant tulip.

Women are unwittingly falling prey to limited cultural ideas of genital acceptability—they should be svelte and symmetrical, carefully manicured or hairless, and definitely discreet.

And in order to get the genitals of their dreams and of porn fantasy, they’re willing to take risks—including the possibilities of decreased sexual pleasure, birth complications and ongoing medical issues. Of course, they don’t know they’re taking those risks. So, let the designer vagina buyer beware!

Reference
Liao L, Michala L, Creighton S. Labial surgery for well women: a review of the literature. BJOG; DOI: 10.1111/j.1471-0528.2009.02426.x

That Trigger Moment

Every relationship has its "trigger moments." Our partner says something, and we contract; we get hurt or angry or upset. Maybe you're sharing something that happened to you, and instead of responding empathetically, he goes off into some anecdote about something similar that happened to him. Or maybe she interrupts you ... again.

When a person has been triggered, the usual responses are fight or flight. You withdraw or you attack.

Withdrawal is often silent, accompanied by feelings like, "He (or she) will never give me what I want, so I'll just go away." Attack language goes along the lines of, "There you go again! Can't you ever let me finish a sentence without interrupting?" (Beware those "ever" and "never" words, by the way: they're regressed words, words that emerge from our two-year-old self.)

There's a third way. Instead of throwing fat into the fire by reacting, um, reactively, ask for what you want. One might think of this as the "grown-up way," and it's pretty amazing how difficult it can be to do this. Those old childhood reactivity patterns are buried deep in our beings. But it is very freeing, and great for the relationship too, if you can bring yourself to ask (politely!) rather than react.

Sheri and I have a code for this: we call it a "do-over." Let's say I interrupt Sheri, and she gets annoyed. (This never happens, of course; this is totally hypothetical!). Instead of getting pissy with me, she takes a breath, lets her annoyance go, and asks for a do-over. In response, I take a breath (instead of getting annoyed with her annoyance, another possible pattern) and say, "Sure." This time, she says what she wants to say till the end, I don't interrupt her, and a pleasant transaction has been un-derailed.

This requires a significant measure of self-awareness. We both have to catch ourselves before we slip into reactive, retreat-or-lash-out mode. The person who was initially triggered needs to do this, and so does the person who now has the option of being triggered by their partner's reactivity. Old habits die hard, and they also undermine harmony in relationship. As the meditation teacher Joseph Goldstein has said, citing a sign in a Las Vegas casino, "You have to be present to win."

In this case, being present means noting when you get triggered and not slipping into a fight or flight response. It means asking, politely and lovingly, for what you want. And it also means meeting that request in the same spirit -- not reactively, but with loving generosity.

All relationships have triggers. Precisely because of this, they offer an opportunity to become more self-aware, more emotionally mature, and more loving toward our partner (and ultimately toward ourselves).

How do you handle that trigger moment?

Soul Mates and Beyond

Everyone wants a soulmate, right? Sure they do! Here's the thing, though: that "perfect" match may not be the mate that's your best partner in this life.

Let's start by getting our definitions clear. Here's how Wikipedia defines soulmate: it's "somebody with whom one has a feeling of deep and natural affinity, love, intimacy, sexuality, spirituality, and/or compatibility." A soulmate is a partner who feels right, through and through. With a soulmate, everything is improbably easy. There's no noise in the signaling: your cues are picked up, and honored, as they were intended to be. A soulmate feels like your "missing half." He or she makes you feel complete.

It's a beautiful dream, and one that animates much if not most of our romantic questing. Unfortunately, the dream of the perfect partner is, well, imperfect.

For one thing, issues arise even between soulmates. There was never yet a relationship that came completely free of tension: there are no "soulmate exemptions." Second, and even more fundamentally, the best and highest purpose of relationship may not be to get along well, with a minimum of disruption. In fact, it may be precisely the opposite--to challenge us to grow beyond our current limitations.

And this requires a measure of conflict, unhappiness and tension. Banal though the term has come to be, "personal growth" is something real and valuable. We are always becoming; ideally we are always becoming more. We are becoming more wise, more integrated, more complete. Personal growth thus defined is one of our life missions--and it is also a mission of relationship. David Snarch, author of the book Passionate Marriage, calls relationships "people-growing machines." It's an interesting and provocative term. When we rub up against our partner (and not in a way that feels good!), we are being offered an opportunity: to become more than we were.

Relationships can collapse because of too much conflict, and also because of too little. Yes, Virginia, there is an unhappiness trap: it can be wise to get out when the going gets too painful. But there's also a soulmate trap, and as unlikely as it may seem, it can also be the path of wisdom to get out when the going is too easy.

The best relationships produce pearls out of the grit of conflict--and leaven the challenges with large and frequent doses of laughter, humility and love.

A Peek at Women’s Anatomy of Arousal

What’s Really Down There May Surprise You!

Being an educated person, you probably think you have a pretty good understanding of both models of the standard sexual equipment, whichever version you happen to own or like to visit. It may surprise you to know that our accepted cultural ideas and images of genitals are missing a lot of really good stuff.

What’s Missing From This Picture?

Believe it or not, the majority of contemporary books and illustrations of female genital anatomy leave out most of the equipment responsible for arousal and orgasm. When these specialized sexual structures are omitted from the images and text, they’re also absent from our mental model. This limits your ability to access your full sexual potential—it’s kind of like a psychological chastity belt.

There is much more to women’s pleasure than the clitoris, and there’s more to the clitoris than meets the eye. This ultra-sensitive sweet button is only the tip of the female volcano, just one component of a whole network of erogenous structures. And we're not just talking the G-spot here. Women have an interlocking set of sexual pleasure parts, most of which are unknown or misunderstood.

In fact, women have just as much erotic equipment in their bodies as men do. That’s right. The female apparatus is equivalent in size to that of the male—it’s just not as obvious. Pound for pound, inch for inch, women have the same amount of the good stuff as guys.

Playing the Whole Instrument

Since we don’t know about all of these yummy parts, we’re operating with a limited mental model. It’s as if we’ve been trying to play the piano and make beautiful music but are only aware of a quarter of the keys. With most of the keyboard missing, we can still make lovely music, but the range is restricted.
When we discover the complete network of structures and understand how the connected system works together, it’s as if we now know where all the keys are (plus the foot pedals!). Then we can learn how to fully play our instrument and make a much wider, more expansive range of music. Some songs that seemed well outside our ability now become possible. We may not be able to play a Mozart sonata or have fifteen-minute orgasms right away, but we can see that it’s possible to get there.

It’s no wonder so many women face challenges in accessing their full arousal and becoming orgasmically proficient. They haven’t been using their whole instrument! When we don’t know what’s there, we don’t know how to thoroughly play with it and neither do our partners, whether they’re male or female. And of course we can’t teach them, if we don’t know ourselves.

When your mental model is congruent with your experience, the impact can be enormous. Often, it’s only in retrospect that you see what you were missing before. The power of having a mind map that matches your reality and accurately reflects your body and its abilities can’t be overstated—your sex life becomes full of new understandings of who you are and how you operate,  a luscious tapestry of “Aha!” and “Oh my god!” moments.

For women to reach their full sexual potential, they need to discover this network of erogenous circuits. When that whole system is fully utilized, it becomes considerably easier for women to expand their arousal, access amazing orgasmic states and discover their deep and wondrous wildness. When you know all your parts and give them the attention they so richly deserve, your music can become a powerful symphony of ecstasy.

We're B-a-a-a-a-ck!

Hi everybody:

After an extended blogging hiatus, we're back. We haven't been on vacation in the interim: anything but. Sheri's new book has been published (to very positive responses, we're delighted to say!), the website has undergone an overhaul (can something undergo an overhaul?), and we've been as busy as bees being entrepreneurs.

But blog we must. So here we are, back again, with a renewed commitment to create an ongoing record of our thoughts about sex, sexuality and relationships; about the life of the business; and about sexuality in our culture, as evidenced by the media reports that come across our desks.

Today, for instance, the venerable New York Times has an article on another venerable figure: Hugh Hefner. (For those curious about the difference between the two, the Times is older and takes italics; Hefner is randier.) The article has a great title: "The Loin in Winter." That about says it, right? The impression that emerges of His Hughness is a complex and mostly endearing one, if one's in a mood to be generous about foibles and such. Hef appears to be mostly in denial about his age (83), though he's bought a crypt next to Marilyn Monroe's, just in case. The Playboy mansion is a bit down on the heels: the folks there have even started charging for attendance to their parties, which used to be invitation-only (up to a whopping $10,000 per bash!). Our First Playboy plays on, though, with three live-in girlfriends, aged 23, 20 and 20 (the latter two are twins: that kinky Hugh!). Let's see, get him one more 20-year-old and their ages would match his!

Although Hef is sustaining himself with Viagra, Playboy Magazine doesn't have any pharmacological recourse and is falling on hard times, too. The magazine has lost money seven quarters in a row and recently reduced its guaranteed-reader number by close to half. The magazine has a really, really big marketing challenge: there's too much all-out smut available for free. The times have changed, more than a little. This is something Hefner is very much aware of. The article makes clear how much he longs for what he calls the "thicker cultural porridge" of earlier times. Which would include, apparently, much less all-out porno, available 24/7 for free.

At this point, the Loin in Winter is a walking embodiment of sexual nostalgia. There was a time, boys and girls, when revealing at a breast (or two), nipples included, constituted a fundamental challenge to our conventional mores. There was a time when it was exciting and outlandish for a man (and a magazine) to proclaim that sex was fun and should by all rights be celebrated.

We've come a long way ... sort of. Because the flip side of Hef's story is his objectification of sex, and more specifically of women. Hef, along with the early James Bond, is the man whose groin shows up but whose other parts remain unavailable.

Today's post-Playboy sexual culture is at the same time smutty and shameless (and not in a good way), and it is also much more integral and respectful in the sense that it has moved beyond a "use and move on" approach to sex. These are better times and worse times. And Hugh Hefner, meanwhile, now stands as an icon of bygone and naive times: the Era of the Playboy.

If there's still an echo of that value system, it's to be found in gangsta culture, with its playahs, pimps and hoes. And somewhere else, too: guys, let me ask you a straight question. How many of you would like to spend a night with three young, beautiful blondes, including two sisters? You don't have to tell your partner. You don't even have to say it out loud. What's that? Yup, I thought so. It'll be our little secret, okay?

Hugh Hefner is so yesterday, and Hugh Hefner is forever.