Social Media, Validation & Clitoracy
Well, this week we had an unusual topic. We touched on cosmetic surgery, and my guest was Jessica Pin. Now, Jessica, at the very tender age of 17 or 18, decided that she needed some cosmetic surgery done.
That cosmetic surgery happened to be a labiaplasty, which is a re-contouring of or reduction of the labia that is at the opening of the vagina.
Firstly, this is an interesting story on many fronts. The first one is cosmetic surgery and how ubiquitous it has become. But what would drive a young woman to feel that her vagina needed some kind of re-contouring, that it was not “normal”? (In inverted commas). One can only imagine the role that social media or the Internet may have played in that decision.
Interestingly, in Jessica’s case, her father was a plastic surgeon. He didn’t do the procedure but probably had normalised cosmetic surgery to some degree. I think in my own practise I’ve observed, in fact, I recently had a patient who was in their late thirties who had, since the age of 21, been getting Botox injections in her face to reduce the muscles of the jaw and reduce the contours of those muscles.
She felt they were too big. So from the age of 21 to the age of 39, she was getting Botox injections every 4 to 6 months. I have many other patients. Actually, I should correct that. Not that many patients because I think patients that are attracted to a holistic practise may not feel compelled to do that.
I have had some young women who have regularly had lip fillers put in had Botox injections. And I’ve obviously been seeing many personalities who have also had that done as well. So it’s become normalised.
In Jessica’s case, the procedure went wrong. Not only did she have a labiaplasty, which was done by an obstetrician gynaecologist, but she and her father also looked to find what they believed would be the very best in America. This was happening in America, and they chose an obstetrician gynaecologist who was at the very top of their game.
While the procedure was being done, the obstetrician took it upon himself to also do a clitoral hood reduction and, in the process, damaged, in fact, possibly severed the dorsal nerve, which then meant that she could no longer have any orgasm because of the lack of sensation in the clitoris.
Now, this raised another issue which I thought was worth sharing with you, and that was something that had gone wrong and how that was dealt with by the medical professional, in particular medical professionals, but then other medical professionals along the way who told her that there was really nothing wrong and that she should get a boyfriend and everything would be alright.
Importance of validating a patient’s experience
This comes back to a much bigger story about validating a patient’s experience. Now I’ve had this discussion with several practitioners over the last few months. The one that stands out is the wonderful podcast I did with the integrative doctor from southern Queensland, Dr Sanjeev Gupta, and he talked about the importance of validating a patient’s experience.
I know in my own practise where we set aside an hour for a new patient exam, and people are often surprised that they would do that. Why would you take an hour? Well, when you start to take a person’s medical history, then that requires some time and discussion. If you are aware of which questions to ask, tying things together often surprises patients, but it’s an important way of drawing together a patient’s experience.
When a patient tells you or me as a practitioner that something is not right, that they are in pain. In the dental world, if I took an X-ray, even if I took a 3D X-ray and everything looked perfect, and the procedure that had been done looked perfect, the fact that the patient is still experiencing pain is very relevant and dismissing a patient’s concern by saying, “Oh, there’s nothing wrong with you.
Go and get a boyfriend.” Or, in a dental sense, “Oh, there’s nothing wrong with you. I can’t see any infection.” The simple fact is a patient is experiencing something that needs to be heard.
If the practitioner involved does not know what is causing that problem, I think it behoves practitioners to say, “You know, I don’t know what the problem is, rather than dismissing it as being all in the patient’s head. I thought that was a very important aspect of it. The first part was about what would drive someone to make that kind of decision.
The second part was when something goes wrong or even when it doesn’t. If a patient experiences a certain feeling of pain and discomfort, even if the practitioner doesn’t know what that is, I think that needs to be listened to and heard.
If the practitioner doesn’t know what the problem is, rather than dismissing it as it’s all in your head, there’s nothing wrong. Say, “I don’t know.” That’s a very liberating thing for a health practitioner to say. I don’t know.
Look, as health practitioners, we are privileged to have people come to us to look after them. I’m always humbled by that. I always take that responsibility very seriously. If I don’t know something I’m willing to admit, I do not know, or I will find out more about it, or I will refer them to a practitioner who would know. I never say, and I don’t believe practitioners should ever say, “There is nothing wrong with you. Just go on, you know, you’re fine.” So there was that.
And then, on top of that, Jessica started to explore why something like this could happen and found that, in fact, in the world of gynaecology and obstetrics, the knowledge of the internal reproductive organs is very high, but the external parts of the vagina, the clitoris, the labia are not well understood nor well taught.
In fact, she found many gaps in medical education at that level about the distribution of the dorsal nerve, which supplies the clitoris. This was a whole journey which she had been campaigning for, to have a greater understanding of the external anatomy of a woman’s vagina, to be better trained and better understood, because they did not pick their surgeon lightly.
They picked who they believed to be one of the top surgeons in America. And that’s what went wrong. Firstly, the unsolicited use or, you know, decision to reduce the clitoral hood is mind-boggling in itself.
But then the denial of the patient experience and the clear ignorance of the anatomy of the area, which was later confirmed in her exploration of medical education in general. And she’s been very busy now she’s in her thirties, and she’s been advocating for that validation and that education to be improved.
The last thing that she has taken on is what she describes as clitoracy. That is a knowledge of the clitoris and an understanding for both men and women of its extent and its power, and that is what the clitoracy is all about.
That has led me to another episode which is coming up very soon, I had the privilege, and the pleasure of talking to a sex therapist, psychotherapist Ian Kerner, who has written over 14 books starting in 2005 with She Comes First and his most recent book, Tell Me About The Last Time You Had Sex, where we talk about sex scripts and clitoracy.
Look, sex is an important part of everyone’s life. Unfortunately, cosmetic surgery is becoming part of too many people, I believe, in one’s life. Medical validation of patients’ experiences is something that goes on all the time for many different conditions. Medical education, I believe, can always be improved, particularly in the area of nutritional and environmental medicine.
It’s almost that the pharmacological and surgical approaches are extremely well taught in medicine, but how to keep people healthy or how to bring them back to health rather than just manage chronic disease perhaps could do with some improvement. Anyway, I thought it was a very interesting topic. I wanted to share it with you. I hope you agree. I hope this finds you well. Until next time.
This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.