She was just 17 when he agreed to perform a labiaplasty on her. Like many naive young women, she thought her labia minora were not supposed to stick out.
She had read online, on surgeons’ websites and in peer-reviewed medical literature, that protruding labia minora were considered “unfeminine” and “embarrassing.” She read they were caused by excess male hormones (untrue) and excess masturbation (preposterous).
He had been recommended by the head of the OB/GYN department as the best OB/GYN surgeon at Baylor Hospital in Dallas. She was confident she was in good hands. They waited until after she turned 18 to do the procedure.
He completely removed her labia minora, performed a clitoral hood reduction without her consent, and cut the dorsal nerves of her clitoris. The glans of her clitoris would never be sexually sensitive again. Cunnilingus would never again be pleasurable.
He had only done a labiaplasty twice before. Like most OB/GYNs who do these procedures, he had not been trained to do them. He never disclosed that anything had gone wrong, but he stopped doing these surgeries after that.
She knew she had lost sensation but didn’t understand what that meant. She assumed everything would work out when she started having sex. She thought it was her fault. She didn’t know enough about her anatomy to understand he had done a separate surgery without her consent. She started seeing a new doctor because she was so uncomfortable. The new doctor was his partner. Upon seeing an 18 year old with completely amputated labia minora, she said nothing.
Later, the young woman worked up the courage to ask her doctor if her surgery had caused her difficulty with orgasm. She could not feel anything without a vibrator, she said. Despite the visible scars reaching well into her clitoral hood, her female doctor told her her surgery could not have affected her sexual function.
The original male doctor meanwhile became president of the Texas Medical Association.
The young woman finally found her clitoris. The glans was not sensitive like it was supposed to be. She went to a new female doctor. The new doctor also told her her surgery could not have affected her sexual function. She suggested she fall in love. Though the new doctor was “horrified” that all her labia minora had been amputated, she did not tell her she could report it.
The young woman started doing research. Eventually she figured out a clitoral hood reduction had been performed without her consent. Given the course of the dorsal nerves along the clitoral body, she figured out they must have been injured.
The young woman did a lot of research. She realized the course of the dorsal nerves was never mentioned in literature on clitoral hood reductions. It was never shown in OB/GYN journals. It was never shown in OB/GYN textbooks. She also learned that the sexual function of the labia minora was rarely described. She thought her doctor must not have realized they were important. How else could he have completely amputated them? She thought he must not have realized the dorsal nerves were at risk. She decided this error must have occurred because her doctor didn’t know the anatomy.
She wrote him a letter telling him what he had done and asking him to help her change training standards to protect other patients.
He responded reminding her that the surgery was her choice. He reminded her that she had requested her labia minora not stick out. He had only tried to give her what she asked for.
He told her he stayed far away from her clitoral hood and frenulum. But there were scars to prove otherwise.
The young woman became emotionally unstable after reading this letter. She wanted to report him but was told the board would likely blame her and take his side. She had never had what happened to her confirmed by a doctor, so she went to see one. It was confirmed. This was what she had needed to give legitimacy to her complaint, she thought.
But it became unbearable. No one around her seemed to understand the magnitude of what had happened. People asked her what the big deal was. People asked her why she needed justice. When she tried to talk to therapists, they asked about her feelings about her mother. It had taken 7 years to finally get it confirmed. She had hoped it was fixable somehow. It wasn’t fixable.
She felt ashamed. How could she have been so stupid to not file a lawsuit when there was still time? She read research on resilience. Based on all the parameters surrounding her trauma, she did not think she could ever be okay. It was like getting horribly raped in a world where rape isn’t considered a crime. She read she needed acknowledgment, support, etc. Most of all, she needed to change the problem of pervasive systemic negligence. But no one was even seeing it. She didn’t like the wreck of a person she was becoming.
One night she set Joy Division “Atmosphere” on repeat, took 60 Vicodin, some Xanax, some Benadryl hoping that would help stop her heart, and as much whiskey as she could drink. Her dad checked on her in the middle of the night. He took her to the hospital.
She was afraid to report after that. She was afraid of getting told it was her fault. She was afraid of people defending her doctor. One OB/GYN she had gone to had said:
“You should have known all surgery carried risk. You can never completely control a result.”
It had been wrong site surgery. That should never happen. But she was afraid of this. She was afraid even doctors wouldn’t understand the difference between the labia minora and the clitoral hood.
She told herself she would report him when she got more stable. Back then there was no statute of limitations. She thought she had time.
When she finally got the courage to report, they had passed a new statute of limitations. She missed it by a week.
So she started coming up with new ideas for how to stand up for herself. She wrote a letter to the head of patient safety at the hospital. He agreed to meet with her. But she was too afraid. She thought if she wrote down everything she needed to say, complete with references, this would help. She started writing.
But she hated writing. She’d never been any good at it.
She wrote what she called, “A Clinical History, Causal Analysis, and Proposed Solutions.” She wrote a background of the anatomy and prevalence of labiaplasty. She wrote a clinical history of herself. Then she broke down all the causal factors accordingly: 1. Motivation 2. Cause of surgical error 3. Failure to disclose or report
Then she wrote a proposal. Solving problems at every error point was important. She got a bit overwhelmed. There were so many problems.
She got very stuck. She kept getting dizzy. She’d get angry at herself for getting dizzy. She was being weak, she thought.
People asked when she was ever going to do anything worthwhile. They told her she was lazy. She didn’t deserve to live in such a nice apartment, they said. She didn’t deserve to wear such nice clothes, they said. She didn’t deserve vacations. She should be ashamed of herself for not having a career like everyone else. They told her she wasn’t dealing with this well. When was she ever going to learn to deal with anything? She mostly kept to herself. When she tried to date, issues would come up. Men told her they couldn’t date her because she was emotionally unstable. One said he’d rather date a barista with a plan.
The worst part isn’t what happened. The worst part is how much I came to hate myself for not handling it better. I’m working on that.
My doctor isn’t some random “bad apple.” He is an extremely reputable OB/GYN. He has been president of the Texas Medical Association and president of the Dallas County Medical Society. Other doctors still talk about his “integrity” and “selflessness,” as they give him awards. He was also featured in Time Magazine for delivering the first uterus transplant baby.
But honestly, the worst part isn’t what happened to me. The worst part has been everything that has happened since in my struggle to get acknowledgment and to address the systemic negligence that continues to put others at risk.
If I could get my doctor to acknowledge what he did, he has the political power to help change training standards to keep other patients safe. Instead, he refuses to acknowledge it. Though his colleague has explained to him that I have visible scars proving what he did, he insists he didn’t do it. He says I must have had a second surgery or that I operated on myself.
Perhaps the worst part is how medical leadership has stood by him and refused to even talk to me about changing curriculums and board exams because of who my doctor was. This happened due to systemic negligence that will not change as long as people refuse to admit there is any problem. Doctors continue to do vulvar cosmetic surgeries (and treatment of hypertrophy) without training.
Even with my dad as the head of the plastic surgery department at the same hospital where my doctor works, we cannot get through to him. The OB/GYN department refuses to speak to either me or my dad. After I asked them to teach clitoral neurovascular anatomy, they called legal to make sure they can’t get sued for not teaching it.
Update: We are publishing a cadaver dissection study of the neural anatomy of 10 clitorises, of which we took excellent photos. There is a new head of the OB/GYN department who wants the residents to learn it. I also got a form letter from ABOG, in which they claim to be working on new board exam questions.
Second update: I have gotten authors of two major OB/GYN textbooks (Te Linde, Williams) to publish detailed clitoral anatomy. I also convinced an OB/GYN to oversee a study published in AJOG. And finally, my study was published in The Aesthetic Surgery Journal.
However, I have not been successful at changing privileging. To this day, someone as equally as unqualified my doctor can still get privileges to do labiaplasties at the surgery center where mine occurred and at many others. USPI, the biggest ambulatory care provider in the US, declined to require training in these procedures. Another problem is many of these are performed in private offices, where there is generally no oversight.
Labiaplasty is still the fastest growing cosmetic procedure, as it has been for almost 2 decades.
If you or a friend has a similar story, please contact me. One expert I talk to believes there are thousands like me. Based on the other stories I have gotten, it is typical for women to get gaslighted in these situations and told their issues are psychological. This happens due to pervasive ignorance of vulvar anatomy and female sexual function in medicine.
I need more women who are willing to be interviewed by a journalist. 🙏🏻
Edit: thanks everyone so much for all the upvotes and supportive comments! I don’t know if I’m allowed to share this, but my Instagram is @jessica_ann_pin. I talk about this and related issues there. This is my latest post showing how cross sections of the penis are always shown in anatomy textbooks but cross sections of the clitoris are shown in 0 anatomy textbooks:
Third update: I have gotten 18 medical textbooks to agree to updates. 4 have now been published. I’ve also gotten Medscape, UpToDate, and WebMD to agree to updates.
ABOG now requires urogynecologists to learn clitoral innervation as part of their maintenance of certification. They have made it incentivized learning for gynecologists. They still refuse to make it required learning for gynecologists.
ACOG still refuses to dictate the innervation of the clitoris be taught in all OB/GYN residency programs. Here is my petition to change this. It has 27,000 signatures so far.