I don't wanna make anyone who watches this feel bad,

it's just such an intimate thing.

Vulva, vulva, vulva, vulva.

It's like hard to breathe.

- [Merle] What do you think this weekend is gonna be?

- I would expect crying, maybe even nudity,

and maybe even touching oneself.

- [Man] So are you alone in this tree house?

- [Pamela] I am.

- [Man] Oh!

(gentle music)

- Hello, I'm Merle, and today,

I'm going to be airing my largest insecurity

on the internet.

This is something that I've never really talked about.

It's going to be an experience for all of us.

Okay, I'm gonna do that again.

I'll do a happy one.

I was a really naked kid growing up

and I loved to be naked, I would run around the house naked,

so my mom was super body positive

and she always would encourage me as a little girl

to take a mirror and go explore you know,

go look at yourself and I would do that.

The first thought was like, cool,

this is me, this is what this is.

Somewhere over time, I would look at myself

and I'd think, am I different?

Am I the only one who looks like this?

Am I the only one who feels this way?

In photos online or in pornography,

I would see what I thought was the normal vulva

that was very neat, hairless pink, no drama, like a line.

And I don't know about you,

but I have way more going on down there.

You know what I did to try to find out if I was normal,

and if my body was normal, I went on the internet.

I remember typing in what does a normal vagina look like?

(upbeat music)

It really did not help.

- Labiaplasty is actually one of the

fastest growing cosmetic procedures

out of all cosmetic surgery,

there's even reports that girls as young as nine years old

are inquiring about getting labiaplasty

and changing their bodies because

they feel like they're not normal.

- This led me to think, who wrote

the rule book on what is normal?

How is this happening and nobody's talking about it?

So I decided I should go talk to a surgeon.

- Labiaplasty has been around just for a few decades.

The first report in the medical literature

was about in the early 80s.

Of course, there have been other forms

of labiaplasty just in terms of cultural,

you know, female circumcisions, or genital mutilations.

Usually when people just say labiaplasty,

they're referring to the labia minora,

and though that's the inner leaf lit of lips,

and it's the thinner tissue that

tends to protrude if there's any issue.

I mean what issue is there?

(laughs)

- I see patients, sometimes where the labia minora

is longer or asymmetrical, and it bothers them.

Those are patients that we can fix their labia surgically

but it's not recommended unless it bothers them.

- So I actually tend to see patients

that are a little bit younger.

So patients who are teenagers who're either brought

in by their parents, usually their mom.

Parents, especially the mothers,

are actually very supportive of their daughters.

I do notice that usually it's that the patients

or the daughters are more nervous,

because they're younger,

they've never had any type of surgery

and you're talking about surgery in your genital area.

So it's an area that they're already

not very comfortable with,

they're not very experienced with,

and it can get patients pretty nervous.

- Labiaplasty is not a benign procedure.

In the wrong hands patients can have scar tissue formation,

they can have chronic pain,

and their sensitivity in that area can be affected.

There's always risk of bleeding, there's risk of infection,

and in certain types of labiaplasty patients

are at risk of the suture opening up.

- Some possible complications of the labiaplasty

include, of course, having a symmetry at the end.

I mean the goal is to make sure that your labia

are as symmetric and aesthetically pleasing as possible.

- [Merle] How do we decide what normal is?

- I would consider a normal or average appearing vulva

to be one where the labia minora do not protrude

past the labia majora or if they do protrude,

it's just slightly you know less than a centimeter.

(gentle music)

If you're below four centimeters,

it's not considered like hypertrophy,

like there's a deformity, but you can still get it done.

- [Merle] What's the youngest that you've performed

the procedure on?

- In my practice is 18 but I just did it in a 15 year old.

- [Interviewer] So Merle, how are you feeling about this?

- I'm like crying.

I get nervous when I think about like young girls

hearing that there's like some kind of a standard

or some kind of a regular or normal

when it doesn't feel like that's anybody's position to take.

I just, I don't, like the idea that people

are gonna watch this and feel the way that I feel right now.

I have very conflicting feelings on labiaplasty.

I'm not here to tell anyone what to do with their body,

but I don't think it's something

that should be taken lightly.

And for me, I wanna try to do it the homeopathic way

and learn to embrace what I've got.

So that led me to go to a weekend

immersive experience with Pamela Madsen.

Okay, I'm already blushing, yeah I'm nervous,

I wanna ask you how you feel about Amy doing this video

and be me going on this retreat

where I think I'm gonna be naked a lot with a lot of women.

- I can tell you as much as possible,

how beautiful I think you are.

But of course at the end of the day,

you know, it's a mindset that if it was so easily fixable,

just by someone else's words then it would be,

but I know something else has to click in your own head.

Are you scared that people are gonna think I'm weird

and now you're dating me?

- Oh I already knew you were weird

before I started dating you and I love you because of it.

(rock music)

- We can talk about sex all we want,

but sometimes you have to get in there and feel our bodies.

Hey, I'm Pamela Madsen

and I am a sexuality

educator for women.

Women are taught from their first breath

to be frightened of their bodies.

We are covered up, our bodies are talked about.

Women are cultured into body disconnection.

So we don't really get to see other women's vulvas,

so we have no idea what a normal vulva is.

So here's the truth.

There is no normal vulva.

- Viva la vulva!

(laughs)

- There are no two vulva's that are alike.

You have big inner labia and small inner labia

and big clits and small clits

and you come in all different colors.

Isn't that amazing?

And we think there's only one kind of vulva

because we're only showed the one

in the little girly magazine,

where some man decided that was the perfect vulva.

My favorite story is I was in fertility,

being at a dinner with reproductive endocrinologists

and one was showing off about his new

really fabulous labiaplasty program that he had.

And I looked at him and said, so why are you doing that?

Like what is the reasoning behind

cutting off women's inner labias?

So he said to me with a very straight face,

well women with large inner labias

are uncomfortable wearing blue jeans.

- So functional reasons for labiaplasty

could be that the patient is having pain.

- They feel uncomfortable.