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Another challenge doctors face is that cosmetic genital surgery can sometimes veer into dangerous and illegal territory. Where are they getting their information from in the first place? Otherwise, personally, I wouldn't do it. Pretty, pink and tucked away—like the vaginas you see in porn—equals good. Have their boyfriends or partners passed comment? Tozer counsels against unnecessary surgical interventions: particularly when the patient is so young. Amongst the recommendations include screening teenage girls for body dysmorphic disorder, and providing "reassurance" that the changes young girls are experiencing in their bodies are, in fact, totally normal.

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Amiyah. Age: 27.
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More young girls than ever before are seeking cosmetic genital surgery to address perceived problems with the appearance of their vulvas.

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Elliana. Age: 24.
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But the numbers are really small—I'd say in the last ten years, I've only encountered about three women who've asked for it. Such is the scale of the problem, the American College of Obstetricians and Gynecologists recently issued new guidance about what to do when teenage girls ask for cosmetic genital surgery. One had asymmetry, meaning that the labia was really large on one side and small on the other. Tozer's advice to young girls who're struggling to accept how they look down there?

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