Who says that the practice of medicine has to have any relationship to the treatment of real illnesses and injuries?

Designer vagina surgery is big business: according to the American Society for Aesthetic Plastic Surgery, in 2009 female consumers spent an estimated $6.8m (£4.4m) on these procedures (the figure counts only plastic surgeons, not gynaecologists). Its popularity is rising in the UK, too – in 2008, the NHS carried out 1,118 labiaplasty operations, an increase of 70% on the previous year. And figures released this year show that plastic surgery company the Harley Medical Group received more than 5,000 inquiries about cosmetic gynaecology in 2010, 65% of them for labial reduction, the rest for tightening and reshaping.

The only reason I know about cosmetic vaginal surgery is that, while researching my latest book, I was given temporary faculty status at the medical school of the university where I teach creative writing, so I could observe obstetrics and gynaecology students. Somehow, I began to get spam emails addressed to Dr Lee, extolling the revenue expanding virtues of learning vaginal rejuvenation. And it's clear at this conference that the bulk of participants are indeed not plastic surgeons but run-of-the-mill obstetricians and gynaecologists who see this as their passport out of traditional practice.

When I ask these doctors about the drastic switch from delivering babies to doing cash-only cosmetic surgeries, many seem uncomfortable. A few sheepishly say they are just exploring their options. The ones already practising cite the rising costs of malpractice insurance, dwindling insurance and government reimbursements (in the US healthcare model, nine months of prenatal care and a normal vaginal delivery nets these primary care providers less than $2,000 [£1,288]). Others talk of a desire for more control over their schedule, rationalising the switch as a family values move.

But the irrefutable fact of the matter is that these cosmetic procedures can make you rich. As one speaker makes a presentation about his successful cosmetic-gyn practice, the wallpaper from his laptop appears on screen: various shots of him with his Porsche. The message is simple. A straightforward labiaplasty, done in-office, in a few hours, nets about $5,000 (£3,222). Enough customers and you, too, can live the good life.

Does one have to be a feminist to find this appalling? Apparently, this is the future of medicine, manipulating the emotional inadequacies of patients about their physical condition so as to persuade them to pay substantial sums of money for unnecessary surgical procedures. Of course, I recognize that this is perversely analogous to the execrable explosion of the number of plastic surgeons willing to perform cosmetic eye surgery for Asians. But be careful about reading the article in its entirety, you will just get angrier, especially if you stay with it until the doctor's joke about how pleased a patient's husband was after a vaginal rejuvenation procedure.

Labels: Feminism, Health Care, Neoliberalism, Postmodernism