Girls as young as nine are 'seeking vagina surgery'

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Crouch, who chairs the British Society for Pediatric and Adolescent Gynecology, says that in her work for the NHS she is yet to see a girl who actually needs the operation and that it should only be performed when girls have a medical abnormality.

"I have seen patients aged between 16 and 21 who have never had a boyfriend because they are so concerned about this".

"I just picked up from somewhere that it wasn't neat enough or tidy enough and I think I wanted it to be smaller", she explained to the media outlet.

She said: "I'm seeing young girls around 11, 12, 13 thinking there's something wrong with their vulva - that they're the wrong shape, the wrong size, and really expressing nearly disgust".

She suggested that part of the problem is young girls being exposed to unrealistic images on social media and in pornography.

Dr Crouch said: "Girls will sometimes come out with comments like "I just hate it, I just want it removed".

Naomi Crouch, a leading adolescent gynaecologist, told the BBC about the worrying trend and admitted that she is concerned Global Positioning System are referring young girls for unneeded labiaplasty - an operation where the lips of the vagina are shortened or reshaped.

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More than 150 of those girls were under 15. Their perception is that the inner lips should be invisible, nearly like a Barbie, but the reality is that there is a huge variation.

The NHS says it only carries out the procedure for clinical conditions - such as the labia causing discomfort - and not for cosmetic reasons. Clinical commissioning groups have been able to refer only patients who are experiencing physical pain or emotional distress. "It's very normal for the lips to protrude". But Dr De Zulueta says some girls know they need to overstate their physical symptoms to get the surgery.

Dr. Naomi Crouch, who is a gynecologist for adolescents, told the BBC that more and more girls under the age of 18 were seeking the surgery.

In 2013 the Royal College of Obstetricians and Gynaecologists (RCOG) said "the practice of labiaplasty is now widespread". It is thought that many more labiaplasty procedures are carried out by private clinics but there are no figures available on these procedures.

"These decisions are not always based on informed understanding of the normal variations that exist, but are influenced by images in popular culture, such as the mass media, adverts for cosmetic surgery and pornography", she said.

In adolescence, the labia are still growing - with the inner lips growing first - so it is normal for them to appear prominent.

Surgery will probably lead to scarring and - as the labia are still developing - could lead to it becoming asymmetrical in adulthood.

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