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Notes
1. I placed the term cosmetic surgery in quotes to highlight that it relies on, and buys into, the very separations between what are seen as culturally located, and thus different, practices that with this paper I seek to render problematic. I use the acronym ‘FGCS’ for female genital ‘cosmetic surgery’ (the quotes to highlight the situated and contested nature of the designation ‘cosmetic surgery’) throughout this paper.
2. While its use is contested, I will use the acronym FGM, but in scare quotes, as, for the most part, it is this term that operates as the rhetorical opposite of FGCS.
3. While I do not want to be taken as condoning these practices, it is important we recognise that terms like genital cutting, ‘circumcision’ and ‘female genital mutilation’ cover a wide range of practices, performed at different ages, in different contexts.
4. It is also worth considering Pedwell's interesting paper for a critique of such ‘analogue’ and ‘continuum’ approaches to analysing ‘FGM’ and Western body modification practices, and the reification of the ‘fetishized figure of the African ‘victim of female genital mutilation’ (2007, 63) when used to enable critiques of Western practices. Pedwell is particularly critical of the foregrounding of gender and erasure of other axes of embodied differentiation, and a political analysis which also excludes factors like histories of slavery and colonisation (see, for example, Njambi Citation2004), not to mention the global capitalist economic system (Gill Citation2007). Pedwell argues that cosmetic surgery should be treated explicitly as a raced practice.
5. The Editor of Reproductive Health Matters, Berer (Citation2007) located this practice within a long history of Western surgical abuse of women's bodies (see also Adams Citation1997).
6. Neither have these laws been interpreted as criminalising intersex surgeries, and this double standard has similarly been noted (Chase Citation2005).
7. These different (and racist) ‘rules’ around choice and white/non-white women's bodies have been argued to be ethically unsustainable (S.W. Davis 2002).
8. Rose's work (1996, 1999) around the production of the self suggests that people are governed through their freedoms and aspirations, not in spite of them (Baker Citation2008).
9. For other arguments around normalisation and cosmetic surgery, see Dull and West (Citation1991), and McNamara (2006) specifically in relation to FGCS. Fraser (Citation2003a) also considers the (related) use of ‘natural’ discourse.
10. For more discussion on agency in cosmetic surgery, see Fraser (Citation2003a).
11. Here I briefly summarise the methods used, and participants, for person-generated data. (1) Survey data were collected using a tool designed by Virginia Braun, which included primarily quantitative questions with five response categories from ‘strongly agree’ to ‘strongly disagree’. Questions focused on perceptions of, and experiences with, female and male genitalia, and thoughts about genital cosmetic surgery. Participants were 104 UK and 29 NZ undergraduate students (mean age 22) who volunteered to complete it either as part of a participant pool programme, for which they earned credit (UK), or voluntarily (NZ). The majority (106) were female. (2) Interview data were collected using a semi-structured approach, with interviews conducted by Virginia Braun. Participants were 15 surgeons performing female genital cosmetic surgery. Surgeons were located in the United States (five), the United Kingdom (four), Canada (two), Australia (two) and New Zealand (two); twelve were male, three female. Nine were plastic surgeons (one was also a urologist), six were gynaecologists. The average time of doing ‘cosmetic’ genital procedures was over 11 years (range 25 to 2 years). The estimated total number of FGCS procedures performed ranged from over 1,000 to fewer than 50.
12. One area in which ‘choice’ does not function effectively as a rhetorical bottom-line argument is in the abortion ‘debate’ in the United States, where legislation based on the woman's ‘right to choose’ is constantly under threat from ‘right to life’ (for the foetus) arguments. Thanks to Ann Weatherall for making this point.
13. Discourse around FGCS tends to be heterosexist, assuming a heterosexual female subject, and my analysis here focuses on the heterosexual context.
14. In a recent report on the motives for labiaplasty of 131 patients, only 6.9 per cent reported the influence of others as a factor in their decision to seek FGCS (Miklos and Moore Citation2008, 1493).
15. We not only do this work ourselves; we pay others to work on our interiors and exteriors as well. Spending on practices such as cosmetic surgery, manicures or therapy has become a 'legitimate' or 'reasonable' spend on self-improvement, performed via the work of others.
16. Cosmetic surgery remains a strongly gendered domain, dominated by women, and, I would argue, requires a gendered analysis. The context and practice of men's cosmetic surgery is still different from women's (see K. Davis Citation2002; Atkinson Citation2008).