Gross Anatomy

by Mara Altman

  “Does that mean that you think toe is sexy?” I asked.

  I’d always considered toe to be something goofy—something that passersby chuckled about rather than something that they stared at forlornly. Toe, to me, doesn’t have the allure of cleavage—maybe because it’s unintentional. The woman touting her cleavage wears it deliberately, or at the least, with awareness. The woman with camel toe does not. She has the equivalent of the inadvertent plumber’s crack. She becomes fair game for a recurring thread on Perez Hilton’s blog, Guess the Celebrity Camel Toe! In one such picture, Iggy Azalea is shown wearing tight orange spandex shorts. “Oops” is written in white and an arrow points to her two little lumps.

  But Han saw it differently. For her, it is something sacred that should be guarded and kept private at all costs. Only the most intimate of relations should know its whereabouts. “That’s your boyfriend’s toe. That’s your husband’s toe. It was your father’s toe,” she said, bringing home her point. “Toe is too personal for just anyone.”

  “I think my husband would laugh if I had toe.”

  “He might laugh, but then he’d say, ‘Let me get at that toe!’”

  We had to agree to disagree. To Han, toe was too provocative, something that bystanders shouldn’t see. Our crotch tremors—anywhere from 2.8 to 9.3—were an entirely personal affair best left inside our underwear. To me, toe was awkward and embarrassing, similar in feeling to smacking into a very clean piece of glass that I’d thought was an open door. But what really struck me about this conversation and what I continued thinking about as I walked back home was the women Han had mentioned earlier, those women who so loathed their toes that they got surgery. If that is true, that is some serious dedication. I had to know, what was actually happening up on those stirrups and inside those doctor’s offices?

  * * *

  I cast my net wide, contacting seven plastic surgeons who were known for trimming and “rejuvenating” women’s genitals. I contacted so many because I figured that if I was lucky, maybe I’d get one to call me back. I thought that by the nature of what they do, they would be guarded. They were mutilating women’s vaginas—ruining our individuality by making our genitals match some porn-star prototype. I judged the surgeons, and so did my friends. We got up on our high horses. When I found that altering women’s genitals was the fastest-growing surgical aesthetic procedure in the United States, we said to one another, “Can you believe this bullshit?” But to my surprise, all the surgeons I asked to interview were more than happy to give me time. They were generous and open. It was all very confusing. They didn’t think they were doing anything wrong.

  After I chatted with four surgeons, I decided to visit one in particular, Dr. Red Alinsod, a pioneer pussy stylist. I wanted to learn why he does what he does as well as experience a vulva consultation for myself—how would he propose getting rid of my camel toe?

  I arrived at his headquarters in Laguna Beach, California, at seven a.m. on a Thursday. He’s so busy and booked with dissatisfied vulva owners that he had to meet me before his office officially opened. Before the consultation, we chatted at his desk. There was nothing in the room that gave away his profession. I had been hoping there’d be something worth noting, like a bronzed statue of his favorite vaginal creation with a placard that said “Best in Show,” but instead there were only papers, books, and a computer. Alinsod wore blue scrubs and had an affable countenance, and he always bookended his lighthearted comments with “That’s a joke I like to tell.” He also had such a sincere face—cherubic cheeks and a near-constant grin—that, and I never thought I’d say this about the arrangement of anyone’s facial features, I would immediately trust him with a scalpel near my clitoris.

  Alinsod wasn’t always in this line of work. He’s a urogynecologist by training and used to do primarily reconstructive surgeries—“When a vagina prolapses, it looks like an inside-out sock is hanging between your legs, and my job was to put that back where it belongs”—but now his business is made up of 90 percent elective aesthetic vulvovaginal surgeries. “It’s like art,” he said. “I get to create something that’s beautiful and functional after the trauma of childbirth or even changes of menopause, or whatever the reason is.”

  Because he enjoys the surgeries so much, he chose to work in a beach community. “You have to provide what the area needs, and Southern California in particular is very, what do you call, focused on appearance.”

  I was surprised he said that; it was just so unbelievably honest. He was pretty much saying he targeted a population inclined toward self-consciousness.

  Alinsod is known especially well for his “Barbie Look” procedure, which includes cutting down the labia minora so that the little wattles don’t peek out from the majora, which are the puffy outer lips that grow hair. The medical terminology for the procedure is labiaplasty, and it is the most popular of all the vulvovaginal surgeries, of which there are about six variations.

  “So you call it the Barbie surgery?” I asked. When I saw the term on his website, I was annoyed, almost offended.

  “The terminology came about when I was practicing in Los Angeles, before I moved here,” he said. “I didn’t invent it. My patients would just come into my office and tell me, ‘I want to look like Barbie.’”

  “But Barbie doesn’t have a vagina.”

  “That’s my exact point right there,” Alinsod said. “She does not have a vagina or labia, so I would say to the patients, ‘You want to look like Barbie?’ And they would say, ‘Yeah, I want to look just like Barbie,’ and I would say to them, ‘Barbie doesn’t have labia,’ and they would say to me, ‘Exactly.’”

  He explained that all the surgeries he performs were borne from his patient’s desires. In other words, he simply supplies the demand. “I had women asking me, ‘Can you do this? Can you do this?’” he said of the days before labiaplasty became more mainstream.

  When I did more research, I suspected more and more that women want this surgery because of what they see in porns and pop culture. Mature minoras are often airbrushed out of pictures, giving the idea that models do not have them, but it’s not just aesthetics; some say it’s also practical because long minoras can become uncomfortable—can get twisted and chafed—during exercise and even sex.

  After we talked a bit more, I said, “Are you ready to take a look at mine now?”

  * * *

  On the way to the consultation room, we passed many paintings, which were all abstract interpretations of the female body. The pieces seemed to divulge a subconscious message: We, too, are artists who can reshape the human form.

  I changed into a blue smock and sat on the examination table until Alinsod returned with a nurse. He flipped up the steel stirrups. I placed a foot into each. “Scoot all the way down to the very end,” he said, as he handed me a small mirror so that I could follow along with an up-close view of my genitals.

  Earlier, he’d told me that Brazilian waxes were so popular that he hadn’t seen pubic hair in decades. In fact, he blamed waxing for the uptick in vulvar surgeries, which was something I’d heard from other surgeons. “Shaving started this whole business,” he said. “We didn’t focus down there the same way when it was covered with hair, but now people can see that they have longer minoras and asymmetry, a wide clitoral hood, or a mons pubis that is puffy.”

  So not only is the lack of bush causing more severe camel toes, as Han had noted earlier, by no longer acting as a buffer between pant and twat crack, but it’s also supposedly some of the impetus behind some women’s desire to hack off what’s revealed beneath. In other words, seeing their genitals without any hair in the way has caused some to be more critical about, and therefore also want to change, its appearance.

  We need to save ourselves. Bring back the bush!

  As Alinsod leaned forward to check me out, I felt like I had to warn him. “I know it’s been a while,” I said, “are you ready to see some pubes?”

  “You’re completely fine,” he sa
id, laughing.

  I laughed, too, but then he ruined the mood when he said, “I actually see hair all the time on my elderly patients.”

  With the end of a Q-tip, he traced my anatomy, showing me all the parts and what he can do to them with a scalpel. Though all the procedures pertain to different areas of the vulva, there was a common theme: to reduce, to shrink, and to lessen. The penis-clad among us have the exact opposite desire: to enlarge, to enlarge, and (wait for it) to enlarge. It made me think about my subway commute: Men manspread onto multiple seats while women take up as little space as possible.

  After a while, he moved down to the bottom of my genitals. “That’s the perineal skin,” he told me, pointing to the area between my vaginal opening and anus. The skin was thin and had folds so small that I wouldn’t have noticed them had he not pointed them out. “It’s a normal skin fold,” he said, but he mentioned that many patients have him remove the minuscule wrinkles. “They think it looks like a hemorrhoid and they don’t want that hemorrhoid look.”

  Ridiculous! I knew what real hemorrhoids looked like, and these little folds were kid’s play. These folds were for novices. Clearly, some people should not be allowed access to hand mirrors.

  Alinsod went over several more procedures—the minimizing of the clitoral hood and vaginal tightening—but then finally got to the topic that had initially inspired the visit.

  “So if I said, ‘I don’t like my camel toe,’ what would you do for me?”

  He took one side of my outer lip between his gloved fingers. “As you get to your fifties, this starts to sag like this,” he said, pulling my lip away from my body. “And the space between here and here becomes longer and longer,” he said, pointing at the base of my vulva to the apex of the stretched lip.

  He went on to explain that to get rid of camel toe, he makes an incision along the inside base of the lip and another along the ridge of the lip where the hair starts to grow. “I remove that whole section,” he said, pointing to the inside of my outer lip, the part that is pinkish, a bit shiny and sensitive. “That’s a lot of tissue,” he said.

  He told me that about 5 percent of his patients are born with an extra fat pad inside the outer lip. “It makes it look like their majoras are testicles,” he said. “It’s huge. They get huge and make women feel very self-conscious.”

  “So would the surgery be worth it for me?” I asked.

  He knew this was a journalistic endeavor and I was speaking hypothetically. “I would tell you that what you have is a normal variant and you absolutely do not need surgery,” he explained. That being said, he told me that he’d be happy to operate on me if I wanted it anyway. “If you wanted to reduce it for cosmetic reasons, just like people with completely normally functioning noses want to remove a hump on the bridge—you have to think of this that way—I could help with that.”

  He told me that he does an average of four to six camel toe–ectomies each month and that none of the surgeries, as long as they are performed correctly, should affect sensation during sex. “The women are so pleased afterward.”

  I attempted to verify Alinsod’s claim, so a few days later, I spoke with a woman, thirty-three-year-old Nicole Sanders, who had had labiaplasty of the minora and majora as well as a clitoral-hood reduction. Another labiaplasty specialist, Michael Goodman, had hooked me up with her. Besides feeling comfortable wearing tighter pants, she said she’s also a lot happier. “It used to cause me pain and insecurities,” she said about what she considered to be her oversize vulva. “I didn’t want anyone to ever look at me when I was naked, but now that has changed. I feel really, really proud. It may sound very strange to say that, but I feel proud about how I look now—really confident.”

  I still felt so skeptical, but if these vaginoplasties made women more confident, who was I to say that it was wrong. Maybe the surgeries weren’t as bad as I thought?

  * * *

  I visited Dr. Lara Devgan at her office on the Upper East Side of Manhattan. I specifically sought her out, as she’s a self-identified feminist. In other words, she’s not just another dude who cuts pussies off. She’s a woman who believes fiercely in women’s equality but who also performs roughly eight to twenty vulvovaginal procedures a month at seven to eleven thousand dollars a pop. I wanted to understand how she rationalized performing them.

  Upon my arrival, Devgan and I retreated to her inner sanctum, a quiet space away from the bustle of her practice. The green walls were dotted with tasteful light fixtures, giving off the flattering glow that is customary in high-end fashion boutiques. This woman was clearly a powerhouse; she managed to have a successful plastic surgery practice while being a mother of four, and she was currently baking her fifth beneath her white doctor’s coat.

  As I sat across from her, I was trying to balance my desire for deep and skeptical inquiry with my awe—she had clearly mastered life.

  After a half hour of small talk, I finally hit her straight on: “How is this something that is right and good for women?”

  She went forth into a staggeringly persuasive rant. “Labiaplasty is one of those things that if it’s not bothering you, it sounds crazy,” she said. “It sounds like female genital mutilation and it sounds like a third-world phenomenon and sounds like it’s something that should never happen, but if it bothers you and you’re looking in the mirror every day and you’re trying to decide how you’re possibly going to wear that swimsuit for your high school swim meet or how you’re going to be intimate with your partner on your wedding night or how you’re just going to get through your day and get on the subway without adjusting yourself in public and without causing bleeding or chafing in your private parts. If you’re in that camp, this is not something that seems frivolous. But you know, those people who have the luxury of thinking that this is something that is flippant and unnecessary are people who happen to have the luxury of not being in this situation.”

  After mulling over what she said, I felt guilty and closed-minded. I had arrived at Devgan’s office hyperjudgmental of others and now I was leaving hypercritical of myself. Maybe I’d been able to view the world only through my own very specific vulvar experience. Who was I to judge, anyway? Maybe I was part of the problem. Women are shamed enough for not reaching impossible physical standards; should they then be shamed again if they try hard to attain them?

  Alinsod, when I’d posed the same question in his office, had another effective argument. He’d told me that he used to constantly get calls from angry feminists, telling him he was the harbinger of evil. “It was really weird to me because here are feminists calling me to get me to reduce choice for women,” he said. “If I would have listened to them, I would have eliminated a chance for women to improve their lives. It doesn’t make sense to me.”

  He told me about a twelve-year-old girl who was on her school swim team. One day, when she got out of the pool at a meet, her inner labia were sticking out and down the side of her leg for everyone to see. “Her mother was horrified,” he said. “She ran to cover her with a towel.” The mother, soon after, rushed her daughter in to see Alinsod—to remove her inner lips—in order to save her daughter from future humiliation.

  Even though I was pleased that the young girl didn’t have to be embarrassed any longer, I also felt something more complicated well up. There was a disconnect. She was embarrassed not because there was anything wrong with her, but because of how we’ve come to narrowly define femininity—that our genitals are the right size only if they happen to fit into the itty-bitty crotch space allotted inside an itty-bitty bathing suit. Something about that felt uncomfortable and reductive to me.

  Our vulvas are somehow supposed to defy the laws of physics. They, with their many folds and abundant flesh, are expected to maintain the same look as a doll made of seamless plastic. It’s like asking an English muffin to forgo its quintessential Nooks & Crannies. The Nooks & Crannies are what makes the English muffin an English muffin.

  So after speaking to surgeons, people
who profit from what they do, I realized that I might be getting a biased opinion. It was like asking an oil company about the impact that dredging has on the environment—“All the animals are totally fine! Don’t worry!” Metaphorically speaking, I needed to get the perspective of an environmentalist. Were the animals really okay?

  * * *

  I trolled books and studies for reliable pussy conservationists and quickly connected with Jane Caputi, a women’s studies professor for more than twenty years and the author of Goddesses and Monsters: Women, Myth, Power, and Popular Culture. I called her up to speak about camel toes and whether or not labiaplasty was leading us down a dangerous road.

  She, in turn, dove right into a short history lesson. “One of the words for vulva is ‘pudenda,’ and ‘pudenda’ comes from the Latin root of which word?”

  I knew the word—had even used it before—but was unsure of its origins. “I don’t know,” I said.

  “‘Shame,’” she said.

  I didn’t believe this—it seemed too impossibly “on the nose”—so I looked it up on my computer as we spoke, and surprise, surprise, this woman who had written four books on feminism was correct.

  “It comes from shame,” she reiterated. “Women are supposed to be ashamed of their vulvas.” She said that in the distant past, many cultures believed in the goddess and that the vulva was a symbol for power; it was considered sacred. “Not sacred as in untouchable and pure,” she said, setting me straight. “We’re talking the Force.” She went on to explain that patriarchal cultures took the vulva’s sacredness and made it obscene and repulsive. “One could very much imagine a culture where showing the outline of the vulva could be considered very erotic and attractive and clothing would be designed to highlight that, right?” she said.

  I could see it. I mean, why not? That had been one of the things that confused me from the start. We think breast cleavage is hot, so why does hot suddenly stop at pussy bulge?