The first boy Vanessa had sex with mocked the way her genitals looked. He went on to tell his friends, and Vanessa was bullied on a school bus.
She was 13.
"It was very scarring for me," Vanessa*, now 29, told The Feed.
"If you're vulnerable enough to show someone a part of your body that no one else gets to see, and they turn that against you, it's a horrible feeling."
The experience had a profound impact on her confidence and self-perception.
This insecurity followed her through subsequent high school years and into adulthood, seeping into every relationship she had, even though no other partner commented on her appearance.
She shied away from sex, avoided opening her legs, and wouldn't let her partner perform oral sex.
"In my head, they were thinking it was disgusting," she said.
"I realised that no amount of self-love or reassurance from my partner at the time — my now husband — could make me comfortable with it."
Two years ago, Vanessa underwent a labiaplasty — a procedure to reduce the size of the inner lips of the vulva, costing her $8,000.
She said it was the best decision she ever made.
"I no longer think about how much I hate my body every day. I finally look in the mirror and love the way I look, and feel sexy," she said.
Labiaplasty is a procedure to modify the labia. Source: Getty / Pramote Polyamate
Recent studies indicate Vanessa's experience is shared by an increasing number of women.
Almost a quarter of women aged 18-24 feel anxious, embarrassed or unhappy about the appearance of their labia, according to a Women’s Health Victoria and YouGov survey of 1,000 women published last month.
The demand for cosmetic genital procedures has been increasing since the 2000s, according to The University of Melbourne — with the most common being labiaplasty.
However, the exact number of people who have had it done is unknown as the surgery is mostly performed through the private healthcare system.
What's driving the rise in labia surgery?
Associate Professor Gemma Sharp of Monash Univeristy, who has conducted extensive research into genital self-image, said negative comments made by sexual partners are a key driver in women getting labiaplasty.
Pornography has played a big role in setting body image expectations for young people, she said.
"People in pornography are generally attractive – that's what people want to consume when they're looking at sexually explicit materials. But the vast majority of people in pornography have had some kind of cosmetic intervention," she said.
Fashion trends that favour activewear have also influenced genital appearance.
"It's not just how the genitalia [looks] naked, it also how it is clothed.
"I've heard people receiving comments when they've been wearing yoga pants saying: 'Maybe you shouldn't wear those — your lumps and bumps can be seen'," Sharp said.
Sharp said concerns around body image typically begin at the age of puberty and can have devastating sexual and psychological health effects in the short and long term.
Psychologist Gemma Sharp said pornography is influencing how people view their bodies. Source: Getty / Marcus Brandt
This is partly why she is teaching young Australians the reality of how women look.
"We show diversity and then we challenge them to consider why this ideal came about. Why is it, for example, [that] large eyes are considered attractive? So why is a large labia not considered attractive?"
Public awareness campaigns, such as The Great Wall of Vulva and Labia Library are aiming to normalise and embrace genital diversity.
Some experts say the rising popularity of activewear has played a role in the increasing number of labiaplasty procedures. Source: Getty / Laura Du Ve
Why are women undergoing labiaplasty?
Plastic surgeons echo Sharp's statements, saying many women opt for labiaplasty after receiving hurtful comments at a young age — often influenced by porn.
"Many, maybe all teenage boys, have seen porn and they're coming to school and making comments. Somebody hears that once and they never forget it," said Dr Jayson Oates, a plastic surgeon in Perth.
Social media has increased interest in this private procedure as more influencers and celebrities share and document their experiences online, plastic surgeon Dr Amira Sanki said.
"Women are influenced by the people around them," Sanki said.
"It can be in a positive way if someone's having a functional problem.
"It can give them the confidence to ask about the procedure, but it can also be in a deleterious way in that someone who's perfectly normal starts thinking about the possibility of them being abnormal through the suggestive process of social media."
While there are legitimate functional reasons to undergo labiaplasty, Oakes said appearance remains the primary reason women decide to have the procedure.
'Cosmetic cowboys'
plastic surgeons Mark Ashton and Mark Lee wrote that doctors with minimal surgical training exploited Australian regulations that allowed them to use a local, rather than the "medically appropriate general anaesthetic in a licensed hospital".
They state this allows "cosmetic cowboys" to operate within their own facilities for lucrative results.
They are calling for regulatory reform to avoid instances where women received "botched surgery".
While Vanessa's decision was over a decade in the making, she said it was ultimately for her and no one else.
"I don't think everyone needs to get it done — but if you genuinely hate that part of your body and you think about it every single day, why would you not?"
*To protect their identity, interviewees' names have been changed for this story.
