Dealing with Aunt Flow

I haven’t had to deal with so-called feminine hygiene products AKA blood catchers for about 20 years.  I generally only take an interest when it comes to safety and environmental issues, like dioxins in tampons.

So when I was contacted by a journalist at CBC about Mensez Feminine lipstick I thought the product was a (bad) joke.  This guy wants women to glue their labia shut so they can let out their blood when they pee out their urine.  She sent me a few links to articles that methodically shredded this ridiculous (patented!) invention bit by unsavoury bit.

During the interview, she asked me for my first impressions.  What immediately came to mind was infibulation the most dramatic form of Female Genital Cutting, where the exposed part of a woman’s clitoris is removed, as well as her labia; and the remaining tissue is sewn together, leaving a small opening for urine and menses.  One of the results is back-up flow which can cause infection, especially when there are clots of blood that cannot pass through the opening.

Labiaplasty also crossed my mind – this cosmetic fiddling with women’s anatomy which sometimes results in loss of sensation due to scar tissue.  “Labiaplasty involves reducing or removing the labia minora—or inner lips—of the vulva.”

The journalist also asked me about available products and potential problems with them.  She wanted to know, for example, if girls were still frightened of using tampons.  We talked about how some moms worried about their daughters’ losing their virginity (tearing the hymen, that is, as opposed to having sex with a tampon) and Toxic Shock Syndrome.  We’ve known about dangers associated with tampons for nearly 40 years.

I told her that starting from the 1990s, we were bringing more environmentally friendly, reusable products into the classroom.

I started to wonder: aside from menstrual cups is there anything new in the world of blood catchers?  I found several web-sites with information on alternative products.  This one was particularly enlightening regarding “dirty cotton”.

Rachel Krantz’ personalized review of some natural products is a hoot.  Reading her account reminded me of my friend’s injunction not to wash your menstrual cup out in a public washroom (“It looked like I had killed a chicken”).

In the “old country”, my mother washed out bits of cloth.  I guess it was progress when I first got my period in grade 8, (1961) and we learned how to attach a pad to a sanitary belt .  I still remember the sensation of walking around listing from side to side because I couldn’t keep my legs together.

There are many areas around the world where menstrual hygiene is still a challenge.  But when I read about campaigns that help girls and women deal with their periods, I sometimes worry about pad and tampon companies profiting through NGOs’ distribution of their products.

So I was pleased to come across this refreshing innovation:

“To ensure girls get the protection they need, and don’t have to miss school just because they have their periods, Femme International provides kits to girls in East Africa that equip them with all the supplies they need. Each kit contains a menstrual cup or reusable pads, a bowl for washing the reusable cup, a small towel, a bar of soap and a handheld mirror.”

Here in Canada, it is a struggle for women in the North as well as poor and homeless women in the South.  When we make decisions about our own blood catchers, let’s also be conscious of the products that we give or send to our sisters.  We all have the same needs for comfort and safety.  And that means, no labia lipstick, unless they are seriously looking for some vajazzling.





Female genital modification – April 30, 2014

…the cutting edge of a double standard

In February, 2014, the Ontario’s Sexual Health Network organized an update on “female genital mutilation” (also known as “female genital cutting”). At the meeting, I raised the question that was so eloquently discussed in a paper on intersex surgeries about the cultural parallels between genital cutting practices in “developing” countries and genital surgery in “developed” countries. This issue was raised again in a recent discussion on CBC Radio’s program, The Current to which I listened attentively (yes, I took notes) as I am interested in these surgeries and have participated in two public discussions on the subject.

Listen to the CWHN podcast on “designer genitalia”

The Current invited the CEO of the Society of Obstetricians and Gynecologists of Canada (SOGC), Dr. Jennifer Blake, to speak about the SOGC guidelines on both female genital mutilation/cutting and female genital cosmetic surgery. They also invited Dr. Sean Rice, a plastic surgeon who performs labiaplasty as well as a triathlete who had requested—and was satisfied with—the surgery.

Labiaplasty involves reducing or removing the labia minora—or inner lips—of the vulva. Another common surgery is the reduction of the clitoral hood. The motivation for this surgery on a functional part of the body is generally either dissatisfaction with the appearance of the vulva or, in the case of labial reduction or removal, its interference with comfort, as was the case with the triathlete.

In the interview, Dr. Blake argued that women are made to feel inadequate about whether or not they look “normal.” In her practice, Dr. Blake tells adolescent patients that their inner labia will fill out and look more proportional as they continue the changes of puberty. She applauds initiatives like the Great Wall of Vagina for normalizing the diversity in genital appearance. Dr. Blake blames pornography in particular, for playing on women’s anxieties about what the vulva is supposed to look like. One wonders if this body anxiety can eventually lead to body dysmorphic disorder (where people think about their real or perceived flaws for hours each day); and whether this disorder is entirely a cultural creation of our society.

People associate female genital mutilation/cutting with Islam although it is practised by other religions and cultures as well. Although Muslim scholars are divided about the particulars, there is no Islamic religious basis to these practices. (“No verse of the Quran, or deeds or sayings of the Prophet, support FGM/C”). The practices are culturally driven.

In a film about female genital mutilation/cutting interviewees explain the norm for women’s genitals in their cultures; one woman interviewed in the film said the vulva must look “smooth and clean.” The societal implication for a woman who is not cut is tremendous in some cultures: in Somalia or Sudan, for example, she is not considered marriageable. Dr. Blake made the point that the same type of language is used with female genital cosmetic surgery. “The Barbie”—also known as “The Clam”—is a surgically created smooth version of a woman’s genitals. During the interview on The Current, the surgeon, Dr. Rice, took offense at this comparison between genital mutilation and genital cosmetic surgery, insisting that the issue of consent was central to cosmetic surgeries.

As a women’s health advocate since 1970, and formerly a counsellor in a sexual health clinic, consent—informed consent—has been paramount to my practice. On what basis does a woman make her decision about modifying her genitals? Where does she get her information aside from media images and biased advertisements for the surgeries? Part of the larger picture is our rigid cultural description of male and female genitals. What should they look like to be considered properly male or female?

In Ehrenreich and Barr’s article about the “selective condemnation of ‘cultural practices,’” they explore and critique the binary definitions of genitals and discuss how decisions are made about whether or not to modify the genitals of an intersex baby. The basis of the decision is shockingly simplistic.

If the penis of an intersex baby is too small (defined as under 2.5 cm stretched), the child is likely to undergo surgery to be transformed into a girl. Not surprisingly, the authors consider this rigid definition of biological male sexuality to be heteronormative. Similarly, a baby with what is considered to be an abnormally large clitoris would undergo a clitoroplasty to reduce the size of the clitoris.

These surgeries of “genital normalization” for intersex babies—an average of 3 to 5 surgeries per child—not only have repercussions emotionally, but also can impair sexual functioning because of scarring and nerve damage. Vaginoplasty to create an opening for an intersex child has a high failure rate in terms of the person’s ability to have/enjoy vaginal sex as an adult. Ehrenreich and Barr argue that North American medical practice as it applies to intersex children is not strictly based in science; nor is it culture-free. The authors make the point that we condemn the “cultural” practices of cutting in other countries while refusing to be self-critical about the cutting practices in North America, acknowledging them as a cultural practice as well.

Intersex children rely on their parents’ consent to the surgeries. Is a woman giving informed consent when she opts for labiaplasty if she does not know whether she will experience negative health effects when she reaches menopause, like a potential increase in vaginal atrophy? Moreover, clinics offering “mother/daughter specials” on genital cosmetic surgery are unlikely to discuss with either mother or daughter the potential damage to sexual sensation due to possible scarring and nerve damage.

In the article “Aesthetic Surgery of the Female Genitalia” published in Seminars in Plastic Surgery, the authors comment:

“The vulvar epithelium of labia minora is highly innervated and sensitive. During sexual arousal, the labia evert and contribute to erotic sensation and pleasure. Incision to any part of the genitalia could compromise this sensitivity and its sexual importance. Neuroma-like hypersensitivity has been reported after surgery.” In other words, when you cut during surgery, the result may be either insensitivity or hypersensitivity, neither of which is expected as part of the package.

In the 1970s, at a Geneva conference of the World Health Organization, feminists publicly decried female genital mutilation practices. Their sisters from countries where genital mutilation took place told them to stay out of it; that they would deal with the issue themselves. And they have been. In countries where genital mutilation/cutting is practised, slowly but surely, women are finding allies, including religious leaders, to put an end to these practices. Surely women in “developed” countries who long for designer genitals have something important to learn from them.