June 12, 2000

Just like a virgin?

Surgeons restore hymens for cultural reasons and tighten vagina walls for better sex


The Toronto sales clerk, who insists on anonymity, explains in hushed tones how in her Middle Eastern Muslim culture, a woman's future can hang, literally, by a membrane. Specifically, the hymen, the translucent tissue partially covering the vaginal opening in most females until it is ruptured, usually by sexual activity. In some societies, the hymen must be intact in unmarried women as proof of virginity. Without it, the 18-year-old clerk says, women are shunned as whores -- in extreme cases even murdered by male relatives to restore family honour.

That is why the young woman, who came to Canada four years ago and will enter an arranged marriage in September, searched desperately for eight months before finding a plastic surgeon who would restore her hymen -- for $2,000. She learned from her family doctor nearly a year ago that her hymen had been damaged in an intimate encounter with a boyfriend she'd been meeting without her family's knowledge for two years. "My first thought was that I'd have to kill myself to avoid hardship and shame for myself and my family," she says. That was before she found her saviour in Toronto plastic surgeon Robert Stubbs. "Now," says the betrothed, "I can feel safe."

Stubbs, also known for his technique to lengthen penises, reconstructs hymens two ways. He either stitches the membrane back in place if it is not too damaged, or he attaches a flap of skin from the vaginal wall across the opening. The process takes one to two hours, and patients can return to work the next day. But the procedure is just one of the many elective surgeries increasingly available to women willing to pay thousands of dollars for alterations to their sexual organs. Among the others are labia reduction and, primarily for women who have lost some tone after giving birth, so-called vaginal rejuvenation, or tightening.

"I'm getting calls from around the world asking about hymen reconstruction," says Stubbs. He receives about 20 inquiries a year, and has performed a dozen over the past two years. Most requests come from women from Muslim cultures. But not all. Stubbs operated on a Russian musician in her early 40s, who wanted her hymen restored as a symbolic gesture before her second marriage. She and the groom had been lovers before she defected from Russia in the late 1970s. After marrying other partners and divorcing, they reunited in Canada a decade later.

Overall numbers of operations are hard to come by because, says Stubbs, some doctors won't admit they perform hymen reconstructions. "There's a hypocrisy in the profession," says Stubbs, who has no qualms about performing the surgery. "Each woman has to be looked at within the context of her cultural demands. If a doctor will take a bump off her nose, why feel uncomfortable about restoring a membrane in her vagina?"

In mainstream Western culture, designer labias and resculpted vaginas are now part of the growing list of attainable ideals featured in women's magazines. Surgeons and satisfied patients tout laser vaginal rejuvenation as a way to improve a woman's sexual gratification. Practitioners use absorbable sutures to tighten vaginas stretched through aging, childbirth or even smoking, which destroys connective tissue. The surgeons then remove excess tissue with a laser.

Samantha Gonzales, 29, a Vancouver mother of three, underwent the procedure after delivering twins from her last pregnancy. She no longer had a pleasurable sensation during intercourse with her husband of seven years, Carlos. "I lost my confidence to feel and give pleasure," she says. After the $4,500 operation and three months of recuperation, sex is "fantastic" again, she says. The doctor who performed the operation, Vancouver-area gynecologist Roy Jackson, says some of his patients have had four or five other gynecologists reject their requests for vaginal reconstruction or labia and clitoral reductions. "These women come to me saying they feel less feminine and attractive," he says. "Why shouldn't women have a choice?"

Other specialists, however, question whether medications such as Viagra or surgery are the answer to sexual problems. "There are so many ways people could pleasure each other and show affection and love without having a hard penis and tight vagina," says Dr. Gisele Bourgeois-Law, a Winnipeg gynecologist who specializes in women's sexual counselling. She questions whether surgically tightening the vagina could significantly increase a woman's pleasure. The greater friction may give more sensation, she says, but not in cases where nerves have been damaged by the stretching associated with childbirth.

Often, says Bourgeois-Law, a woman's sexual pleasure is inhibited by factors that aren't physical. "Women coming to me with sexual problems are juggling family and career and they're exhausted," she says. "And they wonder why they're not interested in sex." Bourgeois-Law turned down the only woman who has asked her for vaginal reduction, because the patient's concern was not for her own well-being but for her ability to give her husband pleasure. Gonzales, too, had her husband in mind when she had the operation. "I noticed sometimes that he wasn't happy with the sex," she says. "I like to be with my partner with the confidence that he feels as much pleasure as I do, and not give him any reason to mess around outside the marriage."

Is surgery an appropriate treatment? "If women are deriving pleasure from it, then OK," says Lesley Biggs, head of the department of women's and gender studies at the University of Saskatchewan. But it raises other questions, she says, adding: "You also have to look at how notions of pleasure are socially constructed." The factors influencing women to seek surgery may seem questionable to some, but for the young salesclerk and Gonzales, at least, the operations made perfect sense.

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