Sex tests have a long and dubious record in the history of sport: first introduced in the 1960s to prevent men from posing as women, many ‘butch’ women have had their gender assessed, their medals stripped, and their careers and self-identity torn to pieces.

The IAFF has come under a storm of criticism, especially in South Africa where Semenya’s countryfolk have sprung to her defence, denouncing the tests as unjust and racist. The criticism is fair: if they insist on testing, they ought to have done so beforehand, rather than after her victory and publicly humiliating her. But moreover, the IAAF‘s approach is deeply flawed because they are trying to determine if Semenya is a ‘boy’ or a ‘girl’, when she could be neither.

The traditional view of gender has been that having an X and a Y chromosome makes one male, and having two X chromosomes female – but this is a gross oversimplification. ‘Hermaphrodites’ have long been known to us – they feature in stories and myths dating back millennia. But over the past several decades scientists have come to recognize up to a dozen different biological states – many of them subtle and identifiable only with genetic tests – that cannot be neatly classified as ‘male’ or ‘female’.

These range from ‘girls’ who hold just one X chromosome, ‘girls’ who carry XYchromosomes but develop physically as female (due to an insensitivity to the effects of testosterone), ‘boys’ that are XX but whose adrenal glands produce so many masculinizing hormones that they develop to look male, and boys that have an extra X chromosome. Sometimes the external genitals of ‘intersexuals’ look like normal vaginas or penises, but sometimes they blur the lines and lie somewhere in between.

According to the Intersex Society of North America an estimated one in 100 births can be considered to be intersexual – and this doesn’t even account for transgendered individuals who are biologically ‘normal’ XX or XY but psychologically identify with the other gender.

There is certainly no evidence that Semenya is intersexual, but it would not be implausible.

Leonard Chuene, the President of Athletics South Africa, was quoted as saying: ‘The only scientist I know, the only scientist I believe in is the parents of the child. Show me a scientist who knows her better than her mother who raised her for 18 years.’

Such a view reflects hostility, suspicion and distrust of modern ‘science’ that is widespread. But it is not ‘science’ that is to be criticized, but rather the way that it is used. ‘Science’ is not good or bad, racist or sexist, biased or unbiased. People are, and it is people who conduct science.

So much of what is investigated and what is determined by science is dictated by societal context, especially when it comes to human nature. At various and regrettable times in our history medical doctors and scientists have tried to use the tools of their trade to prove that one race was superior to another, or that homosexuality could be ‘fixed’ with the right treatment.

But as society evolves, so does the scientific consensus. While sexual orientation was often ‘blamed’ on parents and upbringing, scientists have since found that homosexuality is not only widespread in other animals, but is also linked to specific genes – reaction in gay communities is often enthusiastic because such studies are seen as validation of their life choice (‘See? I was born this way – it’s perfectly natural.’)

It is becoming more and more apparent that intersexuality is widespread, and that the black and white distinction between male and female is crude. And treatments are evolving: doctors would in the past, as a rule of thumb, assign a gender (usually female) to an intersexual baby with surgery and hormone treatment, but physicians and scientists are now widely questioning this practice: frequently children grow up confused and unhappy because they do not identify with the gender that was chosen for them.

Moreover, modern science can also improve the lives of intersex individuals in new ways: thanks to chromosomal identification, testicles that develop internally in ‘girls’ and breast tissue in ‘boys’ that are highly prone to developing cancer can be removed pre-emptively. Hormone shots can often alleviate cognitive and behavioural problems and improve their overall health. The list goes on.

But physical biology aside, ‘gender’ is still a complex question, and many would still like to believe that it is purely a social construct, with no grounding in our physical makeup: in other words, if we were all raised under equal conditions, we would none of us feel ‘boyish’ or ‘girlish’.

But this idea, as appealing as it may be to our postmodern sensibilities, is not supported by modern scientific findings: neurologists have even documented differences in how our brains are structured and wired. Men and women, simply put, are not the same, and no amount of philosophical theorizing will make us so.

That being said, there are always exceptions: as biologists say, ‘exception is the rule’. Some women have brains that more resemble a typical male brain than a female, and vice versa. Studies have indicated, for example, that the brains of gay men more typically resemble the brains of straight women than of straight men.

And as intersexuality shows, exception is indeed the rule: up to one per cent of us – some even peg the estimate at two per cent – do not neatly classify as male or female, from true hermaphrodites to people with ‘ambiguous genitalia’. For good reason, many intersexuals feel that we should recognize that there is a third category to gender, rather than trying to pigeonhole all of us into one of two strict definitions.

The more we put human sexuality under the microscope, the more we realize that humans come in far more than just two flavours. ‘Gender’ comes in many colours, spreading across a broad spectrum – not a black and white ying-yang. The more we learn, the more we realize how diverse we really are.

Competitive sports has gleaned so much from the tools and findings of science, from high-tech equipment and apparel to highly sophisticated nutrition and training regimes (and of course, doping).

Sports associations like the IOC and the IAAF are more than willing to use the tools of modern science to single out and disqualify athletes, and yet are so reluctant to recognize the natural diversity that modern science has revealed. Rather than cherrypicking what they like from biological studies, to the humiliation and denigration of talented women like Semenya, they could accept that the question of gender is far too complex to be determined by a few tests – and perhaps come up with a new set of rules to accommodate and celebrate people who don’t fit neatly into our outdated notions of gender.

Three years ago, Regina Netto felt as if her vulva was on fire, “like somebody had lit up a flame down there.” It was so bad that most days the 38-year-old from Laval, Que., could barely walk. And sex? Forget about it.

Her doctor thought she had a urinary tract infection – but treatment for that only worsened her pain. Blood and urine tests for a UTI came up negative, and then a cystoscopy (examination of her bladder with a small camera) showed nothing.

Thinking she had interstitial cystitis (a chronic bladder disease), a urologist prescribed Ms. Netto medication – but that didn’t work either. Nor did visits to an acupuncturist, naturopath, osteopath or physiotherapist. She saw eight different gynecologists and urologists in search of relief.

Finally, she says, “A family doctor and a gynecologist told me that there was nothing wrong with me and that I needed to see a shrink.”

Ms. Netto had a real condition, called vulvodynia, meaning chronic vulvar pain. But there is no test for it, and while there is some faint visible redness in some women, on the surface most women with vulvodynia look completely normal. This makes the condition difficult to diagnose and leaves sufferers prone to hasty dismissal by their physicians. Most GPs – and many gynecologists – are not even aware of its existence.

But research is now uncovering the concrete, physical markers of vulvodynia, giving therapists the tools they need to develop effective treatments.

In 2006, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians felt the need to print an educational piece on the condition in their monthly newsletter, sent to 150,000 physicians, with information on how to diagnose and treat it.

“Vulvodynia, like many conditions, has historically suffered from a lack of understanding,” says Lori Heim, a director of the AAFP. “But it is real – it is not a psychological condition. And now more is known about it, its extent, and how to diagnose and treat it, so we decided to provide our members with education because the information has evolved.”

“One of the difficulties is that there is no test for vulvodynia,” says Marc Steben, a family physician and clinical researcher of vulvodynia in Montreal. “The diagnosis is one of exclusion.” In other words, when you can’t peg the problem as anything else – say, a yeast imbalance, a bladder infection or interstitial cystitis – then it could be vulvodynia.

If all the tests turn up negative, says Alan Gerulath, a gynecologist at St. Michael’s Hospital in Toronto, properly diagnosing vulvodynia is “based on symptoms, primarily burning – but not itching – discomfort.”

More than a single ailment

To complicate matters, vulvodynia is not just one simple ailment, but an umbrella term for a number of conditions – which may be why the National Institutes of Health in the United States says the condition affects an estimated one in six women at some point in their lives.

One group of women, with what is dubbed “vulvar vestibulitis syndrome,” suffer pain just at the opening of their vaginas, usually only with physical contact. Vestibulitis tends to strike early in life, usually before 25, and because the pain is localized it is easier to diagnose, Dr. Gerulath says.

More difficult to pinpoint is “generalized vulvodynia,” which causes burning pain in the entire vulva without any contact, sometimes 24 hours a day. This commonly starts between the ages of 35 and 44.

Research has shown that all women with vulvodynia have a higher density of nerve endings in their vulvas. And scientists have documented genetic differences in women with vulvodynia that cause them to respond abnormally to infection and injury.

For many women, an injury – say a chronic yeast infection or childbirth – sparks an immune- and nervous-system response that fails to turn off. The initial problem has disappeared, but their nerves continue to fire pain signals to their brains.

Drugs that control levels of hormones, neurotransmitters and other biochemical messengers are frequently prescribed, such as estrogen creams, anti-epileptics such as gabapentin, and tricyclic antidepressants such as amitriptyline (in doses too low to have an antidepressant effect, but enough to dampen the nerve signals).

Allan Gordon of the Wasser Pain Management Centre in Toronto finds that about one-third of his vulvodynia patients respond to medication. But “there have been very few good, appropriate clinical trials – a lot of the ideas are based on anecdotal evidence about what seems to work,” he says.

In another possible clue to the brain’s role in vulvodynia, Canadian researchers published a study last month in the scientific journal Pain that demonstrated evidence of altered brain structure in women with provoked vestibulodynia (a newer and more accurate term for vestibulitis). They found that 14 women who had suffered from PVD had more grey matter in the regions of their brains associated with pain and stress.

What this actually means is “purely speculative at this point,” says Petra Schweinhardt of McGill University, one of the study’s co-authors. It could mean that women who have suffered from PVD experienced changes in their brains as a result of their pain, or it could mean they were born this way. “It could be one or the other, but our speculation is that the increased grey matter might represent an inflammatory response by cells in the brain,” Dr. Schweinhardt says.

Surgical option

Because so little of what is known is conclusive, finding the right solution for each patient is a matter of trial and error, involving a mixture of physiotherapy, diets, drugs and therapies such as acupuncture. As a last resort, some women turn to surgery and have small chunks of their vulvas removed – a procedure recommended only for women with pain in small, specific spots.

But Howard Glazer, a neurophysiological psychologist from Toronto who operates a private clinic for urogenital pain in New York (and who co-authored a paper in the journal Obstetrics and Gynecology on treatment options), says he has seen a lot of women still in pain after surgery.

He is equally disapproving of drugs. He says the best option is to help the body to heal itself by increasing blood flow to the vulva, and therefore the delivery of oxygen and the body’s own repairing mechanisms. He does this by first mapping the physiology of his patients with a sensitive probe, then teaching them how and where to exercise their vaginal muscles to increase blood flow appropriately.

Controversial therapy

More controversially, he also tells his patients to get back in touch with their sexuality, pronto, and have “a minimum of three to five orgasms a week,” since arousal also increases blood flow.

“[Dr.] Glazer’s idea might be a little overstated – I wouldn’t want to put all the onus on the patient – but this could be good as a secondary therapy,” Dr. Gerulath says. “Anything that relieves muscle spasms can help.”

“I wouldn’t recommend intercourse if it is very painful – that would be counterproductive – but I do think that engaging in sexual activity can be helpful, by exercising and helping to improve blood flow,” Dr. Gordon says. “It is still speculative at this point if it will ‘heal’ them, but it is possible. There are a number of anecdotal reports that suggest sexual activity, masturbation and orgasm can be helpful.”

Naturally, many women suffering from the condition have little interest in sex. But Dr. Glazer argues that anxiety weakens the immune system and exacerbates the condition, so he advises his patients to overcome their fear with counselling and patience.

Although Dr. Gerulath feels the best treatments could lie in future drugs that help the nervous system, he acknowledges that vulvodynia is “a problem with the way the brain receives and interprets pain signals. Certainly there are a lot of examples of mind-body interactions, and absolutely you can influence your own symptoms,” he says. “But as to what techniques work, that is a whole other can of worms.”

To think of vulvodynia as “psychological” just because it has a psychological component is a gross oversimplification, Dr. Glazer says. “This does not for a second mean that vulvodynia is ‘all in their heads’ – that is not how the body works. The simplistic thinking that something is either ‘real’ or ‘in your head’ should have died out in the 1950s.”

Lisa Hunt, who suffers from vulvodynia, spent five years looking for a doctor in Calgary who could help her. After a battery of tests by a number of doctors, she too was given dismissive treatment by her GP.

“He told me flat out that this is not a ‘medically recognized condition’ and that it was all in my head,” the 28-year-old says.

With Dr. Gordon at the Wasser clinic, she says she feels lucky because she is “finally seeing a doctor who knows more about this than I do.”

She was 19, visiting a Calgary physician about her chronic tonsillitis. After examining her throat, he told her to stand in the centre of the room and asked her to take off her top. She
did.

She started to feel uneasy. But, she thought, he’s a doctor. He must have a good reason for asking, right?

Then he asked her to take off her bra and said he needed to listen to her heart and lungs. With his head and one hand against her back, he groped her breasts with the other hand.
For 10 minutes.

“You must be thinking, why would you stand there and let this man do this to you?” says Beth (not her real name). “Well, I was raised in a Catholic 1960s home: doctors and priests are infallible and don’t you dare question them.”

When she left the office, Beth felt sick. The same doctor was going to operate on her in a week. If he grabbed her breasts when she was awake, what would he do when she
wasn’t? Instead of being angry with the doctor, however, she became angry with herself. “I thought, how dare I think that about a doctor?”

Several days later, sitting in Calgary’s Grace Hospital waiting for her surgery, she broke down. A nurse wandered in and Beth told her what happened. The nurse promised her: “Don’t you worry. You will not be left alone with him.”

True to her word, nurses made sure she was never alone with him during her stay. “It was like this sisterhood of nurses protecting me. That was the first time I felt the power of women supporting each other,” recalls Beth.

For 13 years, not a word passed her lips. A part of her still thought she must have misunderstood, or it must have been her fault in some way. Then, when she was in her early 30s, she saw a counsellor and realized she had been assaulted. Now 39, Beth says, “it breaks my heart that I would have allowed that.”

Beth’s story is not unique. Even the 2000-year-old Hippocratic oath refers to sex with patients as an “intentional injustice” and prohibits it. However, according to a 1991 Ontario telephone survey, eight percent of female respondents over the age of 15 had been sexually harassed or abused by a physician. Behaviour ranged from inappropriate comments and groping to sexual relationships. Perhaps even more revealing was an Ontario Medical Association survey conducted the following year in which 11 per cent of doctors said they had knowledge concerning a colleague who had sexual contact with a patient.

How do they get away with it? For starters, experts on sexual abuse report that those who are in positions of authority – clergy, teachers and health professionals – make up a disproportionate percentage of offenders.

According to Saskatchewan law professor Marilou McPhedran, one of Canada’s top experts on the sexual abuse of patients, doctors in particular are given a very high level of trust. “The abuse can therefore happen relatively easily, because people come to them in a state of vulnerability. They say things to a health professional they would say to nobody else – this ramps up the potential for the abuse of power and trust.”

And because doctors are held in such high regard, victims feel less willing to come forward and report the assault. “What has been the most telling is the fact that the ‘mister stranger danger’ was, and continues to be, the stereotype of an assailant. That was what we were combating all the time – somebody with a position in the community was not considered suspicious,” according to Pat Marshall, a co-founder, along with McPhedran and others, of the Metropolitan Action Committee on Violence Against Women and Children (METRAC), one of Toronto’s first organizations devoted to ending violence against women.

“This all goes back to what has historically been a profound misunderstanding of sexual abuse involving breach of trust. The impact of those breaches of trust are misunderstood and trivialized, and yet are so long-lasting and intense. When your basic trust foundations are gone, the whole world becomes topsy-turvy,” says Marshall, an anti-violence advocate for over 30 years.

Many victims do not even realize at first that they have been assaulted. However, they suffer the same repercussions as other victims of sexual assault: shame, confusion, guilt, self-doubt, anxiety, depression and even suicidal thoughts. Their health is likely to deteriorate because they may also avoid doctors altogether – some women go decades without seeing a physician.

If the problem is so serious, why aren’t more doctors punished?

The only authority that can strip a doctor of their medical licence is a self-governing provincial college of physicians and surgeons. The same goes for nurses, psychologists, chiropractors, dentists and other health professionals.

According to many who work in the field, the self-regulation of the medical profession is one of the biggest factors.

“I think it is idiotic that sexual abuse falls under self-regulation,” says Susan Armstrong, a violence counsellor in Vancouver. “For a botched operation, I buy that you need another medical professional to assess what is appropriate. But you don’t need a medical background to know whether someone’s hand should be on my breast.”

Historically, provincial colleges have not been eager to investigate the abuse of patients by their members. Dr. Gail Robinson, a psychiatrist and another co-founder of METRAC, recalls what happened in Ontario 20 years ago.

“When we first went to the college about these issues, they tried to minimize them. We knew for years that they had been getting complaints and that they had been dismissing them,” recalls Robinson. To its credit, the organization appointed a task force of lawyers, counsellors and psychiatrists in 1990. McPhedran led the task force and Robinson and Marshall were two of its members.

The task force produced a groundbreaking report that came to the conclusion that the only way to fix the problem was to enact a law based on the policy of zero tolerance of sexual abuse. Any regulated health professional (including nurses, dentists, chiropractors, psychologists and more than 20 other disciplines) found guilty of acts that constitute the sexual abuse of a patient should be stripped of their license, period, said the report. Even if the sex appeared to be consensual, the report continued, a strict barrier was needed to protect patients because of the inherent power imbalance between a health care provider and a patient.

Despite fears the report would gather dust, many of the task force’s recommendations were incorporated into various provincial laws, including the Regulated Health Professions Act of 1994. The Ontario law is clear. A physician found guilty of sexual abuse – which can include anything from sexualized behaviour and inappropriate touching to sexual intercourse – faces disciplinary penalties, with the toughest being a five-year mandatory revocation of his licence if found guilty of any of the following: “sexual intercourse, genital to genital, genital to anal, oral to genital, or oral to anal contact, masturbation of the [doctor] by, or in the presence of the patient, masturbation of the patient by the [doctor], encouragement of the patient by the [doctor] to masturbate in the presence of the [doctor].” Doctors guilty of so-called lesser sex offences may have their licence suspended for six months or more, or conditions may be attached to their licence by the college. For example, a physician could be prohibited from conducting physical examinations of female patients without a nurse present.

Adds Kathryn Clarke, senior communications coordinator for the Ontario College of Physicians and Surgeons: “In cases where sexual abuse of a patient has been proven, the doctor cannot apply for reinstatement until five years have elapsed.” However, Clarke goes on to say, the mandatory penalty of revocation is not applicable to all cases of sexual abuse, and the discipline committee “uses its discretion” when imposing penalties.

Ontario’s zero-tolerance approach influenced similar laws in P.E.I., New Brunswick, Alberta and B.C. And in a groundbreaking 1992 Supreme Court of Canada case, Norberg v. Wynrib, the court found that “where such a power imbalance exists, it matters not what the patient may have done, how seductively she may have dressed, how compliant she may have appeared, or how self-interested her conduct may have been – the doctor will be at fault if sexual exploitation occurs.”

Some 16 years later, however, some of the original task force members say the promise of zero tolerance has not been fulfilled and the few advances made by the college have largely been eroded.” The pendulum has swung back everywhere, the issue has largely disappeared,” observes McPhedran.

A glance at the College of Physicians and Surgeons of Ontario annual report from 2006 shows that few complaints reached the discipline committee. Of the 2,364 investigations the college made into public complaints in 2006 (42 of which involved sexual abuse complaints), fewer than half were forwarded to the college’s complaints committee. The college’s complaints committee took no action in three-quarters of the 1,033 of the complaints. And just 33 cases, or 3.2 per cent of the all complaints made, were sent on to the discipline committee (the annual report does not specify the outcome of cases involving sexual abuse).

One way the current system avoids sending doctors to a discipline committee hearing is to shunt complaints into alternate dispute resolution – a form of private mediation that tries to create a mutually satisfying solution between a complainant and physician. Although alternative dispute resolution is cheaper and quicker, blame is never assigned and patients usually have to agree not to discuss the abuse they experienced or how the case was resolved. So these cases stay off the public record.

There are further problems with Ontario’s system and with others across the country. One is that if a doctor appeals the decision of the college, he can usually continue to practice during the years that appeal may drag on. Patients, on the other hand, do not have the ability to appeal. Second, physicians can rely on their legal insurance plan run by the Canadian Medical Protective Association to cover their costs, but patients have no such support. Third, those who bring complaints forward are only allowed in as witnesses at the proceedings; they cannot bring forth evidence or ask questions of the doctor and his witnesses.

“The justice equation is unbalanced,” observes McPhedran. “Money, power and authority have access to money, power and authority -
that’s how it works.”

Another shortcoming is that there is no direct compensation for victims, unless a victim wins a civil suit, which they must fund themselves. However, Ontario does require the college to set up a fund to pay for some therapy and counselling for some sexually abused patients. It has paid out more than a million dollars for more than 100 applications since 1994.

And yet, even when a physician is found guilty, the ordeal can be horrendous for victims. More than 20 years after a Toronto pediatrician grabbed Sharon Danley’s breasts and stuck his tongue down her throat when he was supposed to be examining her disabled two-and-a-half-year-old son, she filed an official complaint with the College of Physicians and Surgeons of Ontario.

In 1993, the doctor was found guilty by the College. Yet, Danley says that, after four years of having her personal life scrutinized, watching other victims denied the opportunity to testify and then seeing the doctor receive a three-month suspension of his licence, it felt as though she had been “emotionally gang-raped.”

“The tribunal was much worse than the actual violation. The system absolutely traumatizes you. At the time, I was still under the delusion that they would do something. Now, I just wish I had had a Tony Soprano in my life – at least then I would have had some justice.”

Perhaps most troubling of all is that unless a doctor (or any other health-care provider) is found guilty after a full disciplinary hearing at the college, a complainant cannot find out whether other complaints have been made against a doctor.

When Karen found out that several sexual complaints with the College of Psychologists of Ontario had been filed against her psychologist, she was outraged. Her therapist coerced her into a sexual relationship that lasted several months. What made her even angrier was that, when the college eventually did take away his licence to practise as a psychologist, he was still allowed to treat patients as a “therapist.”

“I went through hell, and he was still treating patients,” she says.

In part because complaints against those providing therapy are common, Ontario’s Health System Improvements Act of 2007 brought in a new requirement which requires that anyone practicing under the title of “psychotherapist” must belong to a regulated health profession -
one of the existing colleges or the new College of Psychotherapists being established under the act.

The Criminal Code of Canada does contain prohibitions on sexual assault involving non-physical coercion by authority figures. And often, doctor-patient sexual abuse cases could qualify for a straight charge of sexual assault. South of the border, 22 U.S. states have made sex between a psychotherapist and a patient a felony punishable by up to 15 years in prison.

Gary Schoener, a psychologist who helped form the Minnesota law, believes that coercion is difficult to prove. “You would have to show beyond a reasonable doubt that the sex was accomplished only because of the power differential,” says Schoener. “Not just that it played a role, but that it was the reason the sex happened. And remember, the benefit of the doubt would go to the defendant doctor – this is not the lower level of proof needed to take [away] a licence or registration, or even win in a civil case.”

Ultimately, the fact that health professions in Canada are allowed by provincial governments to act as investigator, prosecutor, judge and jury when there are allegations of abuse by their own members is the greater concern, according to McPhedran.

“It all basically comes down to the same thing,” she says, “layer upon layer of privilege and access that is built on the subjugation of women…But that’s old news.”

The weirdest thing has happened to me. When I was 14‚ my breasts were the perfect size. Now they’re too small.

Let me clarify: I don’t mean that they shrank‚ or that I think they’re too small‚ or that any of my partners have thought they were too small. I mean that according to the people who make the things I wear over my breasts‚ they are too small. Almost every single bra available for sale is designed to make my chest look bigger. But why?

Ten years ago‚ almost everything on the racks was made to fit my breasts the way they really are. Lacy‚ spandexy‚ sporty‚ silky‚ satiny‚ wired — throughout my teens‚ I could always find something that fit comfortably and made my small breasts look pretty. Although stores sold a variety of padded and push–up bras‚ they were never the main attraction.

Now the vast majority of what you see in mainstream stores is lined with foam in one way or another. The most common are “moulded cup” or “contoured” bras‚ which have a uniform layer of foam throughout the whole cup. Lingerie companies don’t use the word “padded” to describe these‚ because they don’t have a thick pad of foam at the bottom the way push–up bras do. But these bras still change the size and shape of the breasts within. Face it: they’re padded.

I don’t like them. They look fake and make me feel silly. When I put one on‚ anyone can tell I’m wearing something extra. They don’t move with my body. If I lie on my side‚ I slide out of the stiff‚ inflexible cups. It’s like my breasts are supposed to mould themselves to the bra‚ not the other way around.

My friends who have big breasts aren’t fond of padding either. Take Jana Shoemaker‚ for example. The 26–year–old law student used to be a DDD and couldn’t fit into anything chain stores sold. After having a breast reduction‚ she found it thrilling to be able to purchase C cup bras for less than $100.

“But then padding really took off — all padding all the time‚” she says. “The padded bras I bought did not last very long. In less than a year‚ the padding loses its shape; it gets bunchy and lumpy.”

She’s right — now it’s all padding‚ all the time. I didn’t realize just how popular padding was until I went shopping recently for a low–cut lace underwire bra with wide–set straps‚ a classic style that makes me feel curvy and feminine without making me feel inadequate. I figured it wouldn’t be hard to find one in less than an hour in downtown Toronto. I was wrong.

Unpadded bras have almost completely disappeared. You can still find good unpadded designs at high–end boutiques‚ but many cost $100 or more. Stores targeting younger (i.e.‚ less wealthy) shoppers usually offer bras with moulded cups. Stiff‚ round bras are arranged in big circles on display tables‚ each bra nestled into the one in front of it‚ like spoons in a cutlery drawer. While shopping in these stores‚ the message becomes clear: women may come in all shapes and sizes‚ but we’re ultimately supposed to look the same.

Mainstream bra sellers such as the Gap‚ Jacob and La Vie En Rose carry very few designs made without lining. And usually the few unpadded bras they do stock are poorly made: the lace is cheap and scratchy or the stitching is poorly done.

I spent three hours going from store to store without finding anything I liked‚ getting sweatier‚ crankier and more frustrated. Every store was packed to the rafters with padded bras‚ and nobody thought this was unusual. Salespeople looked at me with blank stares when I asked for an unpadded bra. Fresh–faced 14–year–old shoppers swirled about the racks‚ eager to hide their brand new breasts behind padded shields.

In a moment of desperation‚ I went into La Senza‚ a store I typically avoid because of the prominent padding in their window displays. (Also‚ La Senza Girl sells padded bras for preadolescents‚ which bothers me on so many levels.) They had only one unpadded design in the whole store. Keeping an open mind‚ I tried it on.

Ouch! The bra had that most heinous of design flaws: a seam that ran right over my nipple‚ without a piece of soft fabric considerately sewn over it to shield me from chafing. No wonder the kids weren’t buying it. I almost had a tantrum‚ right then and there. Didn’t anybody think unpadded bras were worth making anymore? I called the store’s corporate headquarters to find out‚ mentioning that I was writing an article for Shameless

The public relations rep apologetically told me that after inspecting the Shameless website‚ La Senza declined to speak with me. I was stunned‚ as it’s the first time the magazine has been outright refused an interview. I wonder what these padding–pushers have to hide. Maybe the company is just shy of indie media after the bad press it got several years ago about the Thai sweatshops its bras were made in.

Calvin Klein‚ a company that has always made sexy and affordable unpadded bras — although they‚ too‚ have a history of using sweatshops — was more accommodating. The company has discontinued a lot of their classic unpadded designs‚ but are coming out with new styles for younger women that will only be thinly contoured. I suppose that’s a start. But must they put the foam in there? Why can’t they just let us look like ourselves?

Jennifer Klein (no relation to Calvin)‚ who owns Secrets From Your Sister in Toronto‚ enlightens me: one of the main reasons many girls prefer padded bras is because they hide their nipples.

I suspected girls were flocking to padding because they wanted bigger breasts‚ but nipple concealment? I never worried about my nipples showing through my shirts when I was in high school.

“I always tell my customers‚ ‘People are not looking at your nipples — they’re looking at your breasts‚’” Klein says. “I try to discourage girls from hiding their nipples. They are a natural part of your body. We are pro–nipple.”

I’m glad to hear somebody is. Aren’t nipples supposed to be beautiful? And boys have them‚ too‚ so what’s so embarrassing?

Forty years ago‚ pert nipples were okay‚ while visible bra straps were the worst fashion sin. These days‚ women co–ordinate the colour of their bra straps with their outfits and worry instead about visible nipples and panty lines. It seems we’re supposed to be ashamed of wearing underwear‚ but proud of wearing padded bras. I think something is wrong here.

Alexandra Armillas thinks so‚ too. A designer with decades of experience (including a 20–year stint with Christian Dior)‚ she teaches lingerie design at the Fashion Institute of Technology in New York City. “It has been my mission in life to teach my students that Victoria’s Secret is not lingerie‚” she says. “I am not a proponent of padding. I come from a generation that called them ‘falsies.’”

But the rise of breast implants in the 1980s‚ the relaunch of the Wonderbra in the early ’90s‚ and the subsequent popularization of the padded bra by lingerie giant Victoria’s Secret completely changed the market — now about 90 percent of bras for sale are padded.

York University psychologist and feminist Leeat Granek attributes the rise of padding to the lucrative market for these bras: teens and preteens. “This padding phenomenon is part of the sexualization of young girls in general‚” she says. “They are growing up with the message that they need to look sexy all the time — and you can sell more products if you can convince them that they need something in order to look good.”

It reminds me of what media theorist Jean Kilbourne says about advertisers: they take something away from you in order to sell it back to you. For example‚ douche ads make women feel like their vaginas are not normal and clean so we’ll go out and buy douche to make our vaginas feel normal and clean.

I think the same thing is happening with padded bras. The message is that if our breasts aren’t perfectly spherical (which few breasts naturally are)‚ we aren’t beautiful. But‚ if we buy the right bra‚ we too can be perfectly round and therefore beautiful.

Whether girls are trying to hide their nipples‚ make their breasts look rounder‚ or look older and more sexual‚ one thing is for sure: very few young women wear unpadded bras anymore.

When Armillas surveys her first–year students‚ almost every single one has only ever worn padded bras. “They have never put on a bra to feel beautiful‚” she laments. “They were never taught to celebrate having small breasts like they should.” And there is plenty to celebrate‚ says Armillas‚ who has small breasts herself.

“When I was young‚ I had perfect‚ beautiful breasts. But if you think I knew that at the time‚ I did not. I never appreciated them whatsoever‚ until they changed.”

That‚ to me‚ is the saddest thing about the padding bonanza: girls are hiding their bodies behind foamy disguises during the very time in their lives when they have the least reason to.

HOW TO HOLD UP YOUR BREASTS WHILE LETTING THEM BE THEMSELVES

Want to treat your bosom buddies with the respect they deserve? There are several ways to support and flatter small– and medium–sized breasts without padding.

* If you can afford it‚ seek out boutiques that stock European and pricier lingerie‚ where you’ll find classic designs made with silk‚ satin and lace. You may pay more than at a chain store‚ depending on what they carry‚ but a well–made bra will make you feel good no matter what your size. Plus‚ it’ll last forever if you take good care of it. If these shops are out of your price range‚ check second–hand stores for gently used upscale–brand bras.

* Cut out the wire. Even a padless bra can be too restrictive if it has an underwire‚ depending on your body shape. There’s an easy way to fix this problem: cut a little slit in the fabric where the end of the wire is. Slide out the wire‚ leaving only a tiny hole in the bra. If you want to change it back‚ just slide the wire back through the hole and seal it with a couple of stitches — no harm done. (My mother‚ who designed clothing‚ taught me this trick.)

* Shelf tanks. They’re not for everybody‚ but if you have small breasts‚ they are very comfy. They hug your breasts gently and allow them to hang the way they want to. You can layer these under just about anything.

* Stretchy yoga tops. I don’t mean the high–tech stuff they sell at Lululemon Athletica. I mean light T–shirts and tanks made of nothing but soft‚ stretchy fabric. Shelfless‚ strapless‚ seamless. Astonishingly comfy and surprisingly supportive. I’ve seen very busty girls wear these comfortably without a bra.

*Camisoles. A lot of stores are trying to pass off standard–issue tank tops as “camisoles‚” but don’t be fooled. A real camisole is a silky or lacy undershirt that‚ if well made‚ will support your breasts on its own with good stitching and a bit of elastic or wire. Quality camisoles might cost a bit‚ but you can almost always find them at good vintage stores.

A SHORT HISTORY OF BREASTS: BIGGER WASN’T ALWAYS CONSIDERED BETTER

2500 BC (Ancient Greece): Women on the island of Crete wear leather bands underneath their breasts (which were left naked) to shove them upward and make them look bigger.

450 BC to 285 AD (Roman Empire): Women are encouraged to make their figures look more masculine by wearing tight–fitting bands of fabric or leather around their breasts to flatten them.

300 to 1000 (Middle Ages): Breasts are generally ignored‚ much like the rest of the body‚ which medieval Christianity considers sinful. Breasts are neither smushed down nor shoved out; most women just wear loose–fitting blouses.

1000 to 1400 (Renaissance): As the arts flourish‚ so does fashion and the attention given to the female figure. But in keeping with the spirit of Christian modesty‚ women wear tight–fitting bodices that minimize their breasts.

1400 to 1800: After two thousand years of being downplayed‚ breasts start to get more attention: bodices have evolved into corsets‚ the most evil of all female garments. Corsets tend to flatten the lower half of the breasts‚ while shoving the upper half up‚ creating round‚ plump cleavage. Women spend 400 years trying to make their waists look impossibly small by forcing their bodies into steel cages‚ frequently suffering broken ribs and damaged lungs.

1890s: French corset makers begin to experiment with new designs that support the breasts from the shoulders‚ instead of shoving them up from below. They don’t get much attention.

1913: American socialite Mary Phelps Jacob‚ unhappy with the idea of wearing a bulky corset under her sheer silk dress‚ fashions a makeshift bra from two silk handkerchiefs and a ribbon. She then sells her design to Warner Brothers Corset Co.‚ and the rest‚ as they say‚ is history.

1914 to 1918: Women finally stop wearing corsets. With all the young men at war‚ women take over their factory jobs and need more physical mobility.

1920s: Curves are out of fashion and the androgynous “flapper” look is in. Brassieres‚ which at this time tend to flatten breasts‚ become popular for the first time. Women spend the next 10 years trying to make their breasts look smaller.

1930s: Curves are back in! Bras are created to accentuate instead of minimize. The cup system is developed.

1950s: Curves are still in — really in. Padded bras are introduced to help small–breasted girls achieve the pointy “sweater girl” look. Women spend the next 10 years trying to make their breasts look bigger.

1960s: Liberation is in‚ and for many women‚ this means bras are out. They don’t literally burn them (that’s just a myth)‚ but a lot of women do throw all their bras into the trash.

1970s: Aerobics are in‚ Lycra is invented and the sports bra hits the market. Bra sales climb.

1980s: Curves are in again‚ but not the natural kind. The advent of silicone implants allows a whole generation of women to actually make their breasts bigger (instead of just pretending they are).

1994: Wonderbra reintroduces the padded bra. The company had made them since the 1960s‚ but by the early 1990s the bras weren’t selling well. Wonderbra relaunches the product with a racy new advertising campaign and aggressive marketing. Sales shoot through the roof‚ and other lingerie makers (most notably Victoria’s Secret) follow the trend.

2007: The majority of bras in mainstream stores are padded; stores that target younger women sell almost no unpadded designs whatsoever.

AIDS is everyone’s responsibility; at the moment‚ men and women account for about an equal number of AIDS cases worldwide. But every year‚ the percentage of women with the disease rises‚ as women can contract HIV from men twice as easily as men can from women. A woman’s vagina is simply more biologically sensitive to the virus than a man’s penis.

Worldwide‚ among people between 15 and 24 years old‚ women carry 62 percent of HIV infections. In Africa‚ it’s estimated that up to 70 percent of people infected with HIV are female. In much of Africa‚ women do not have the power to force their male partners to be monogamous or to wear condoms‚ and rape is shockingly commonplace.

Twenty years ago‚ the Holy Grail for AIDS scientists was a vaccine‚ but that has proven nearly impossible to develop. Now scientists say our best hope to stop the spread of AIDS is microbicides — chemicals that can kill the HIV virus (and other STIs)‚ which a woman can simply apply to the inside and/or outside of her vagina before sex to protect herself.

Unlike the dream of a vaccine‚ an over–the–counter microbicide is on the horizon: we could have one by 2010. About 60 different microbicides (which come in the form of gels‚ creams‚ sponges‚ suppositories and vaginal rings) are being developed by HIV researchers and tested in clinical trials around the world.

“It’s just so desperately needed‚ I can’t put words to it‚” Stephen Lewis‚ the United Nations special envoy for HIV/AIDS in Africa‚ and a big advocate of microbicides‚ told the Toronto Star. Bill and Melinda Gates and Bill Clinton‚ who were in Toronto this August for the International AIDS Conference‚ have also thrown their economic and political influence behind the development of a female–controlled microbicide.

Maybe now that such political and economic heavyweights are pushing for microbicides‚ the power of prevention will finally be put into women’s hands. But it shouldn’t have taken this long — HIV has been with us for 25 years‚ and other STIs have been around for thousands of years.

“When you think about it‚ we’re 25 years into a fatal pandemic without a woman–controlled prevention tool‚” Anna Forbes‚ deputy director of the Global Campaign for Microbicides‚ told the Star. “Would that have happened for men? I don’t think so.”

Like many women in their mid–20s‚ Linda was unhappy about a certain part of her body. It wasn’t small breasts‚ saggy thighs or acne–covered skin — the usual things women are made to worry about — rather‚ she was bothered by something most folks don’t see: her labia. Linda’s labia minora (the small flaps of skin on either side of the vaginal opening‚ inside the labia majora‚ the outside lips with hair on them) had always bothered her. “It was physically uncomfortable‚ and I didn’t find it very aesthetically pleasing‚” she says.

Her labia minora were long and protruded out of her labia majora. They rubbed against her clothing and made bike riding uncomfortable. But mostly‚ she didn’t like the way they looked. So Linda did what more and more women with long labia minora are doing: she went to a plastic surgeon and had them trimmed with lasers and scalpels for $4‚500.

Many plastic surgeons around the world will perform labiaplasty (surgery on the labia minora) to create what some call a designer vagina. This is just one of a number of cosmetic surgeries women can get between our legs. Options include having electrolysis to remove pubic hair (for that hairless‚ prepubescent look)‚ having the vagina tightened (after childbirth)‚ having the hymen “repaired‚” and now‚ if inside lips stick out of outside lips (which is common)‚ labia can be “beautified” by making the lips smaller.

Toronto plastic surgeon Robert Stubbs‚ who performed Linda’s labiaplasty‚ has done more than 205 labia minora shortenings‚ on women aged 14 to 60. His signature procedure — trimming the hood of the clitoris as well as the lips — has been nicknamed the “Toronto trim.” Very few of these trims have been done on women who experienced pain from their labia. “The majority are cosmetic‚” Stubbs says. “Women don’t want to compete with men with something large between their legs; they want something small‚ neat and tidy and tucked up out of the way.”

There are many reasons why a woman might consider having genital surgery. Gynecologists have started using techniques borrowed from plastic surgery to perform sex–change operations‚ repair ripped and torn vaginas after childbirth and rape‚ and improve the sexual and physical health of many women. Ultimately‚ it’s the individual woman’s decision to make.

What’s worrying is that most women who have labiaplasties do so for purely aesthetic reasons. While exact numbers are unavailable‚ it’s estimated that thousands of women have paid thousands of dollars and risked painful side effects to have the most sensitive part of their bodies cut up.

Many women who have publicly spoken about their labiaplasties use the same language as Stubbs. Take Patricia‚ a 32–year–old mother of two from New York City who had her labia shortened: “It was all hanging so he fixed all that‚ and it’s nice and it’s neat now.”

Bernard Stern‚ the Florida doctor who performed Patricia’s labiaplasty‚ says he’s operated on all kinds of women‚ including “Las Vegas showgirls‚ exotic dancers‚ a Playmate of the Year from Playboy‚ tons of doctors‚ nurses‚ midwives‚ attorneys‚ an attorney general for one of the municipalities here in Florida … professional athletes … triathletes‚ marathoners‚ junior Olympians‚ equestrians‚ Pilates instructors and personal trainers.” The oldest woman he’s operated on was 82‚ the youngest 16. He once did a 19–year–old and then her 40–year–old mother six months later. He argues that although only a minority of his patients experienced physical discomfort from their labia‚ some experience emotional stress: “Quite honestly‚ most of the people that come in here have stuff that’s just unbelievable‚ there’s no doubt‚ I mean [the labia are] totally uneven‚ one side’s huge‚ the other’s not … for some of them‚ this is a life–changing procedure.”

Of course‚ his opinion may have something to do with the big money involved. A labiaplasty surgeon can easily gross up to $250‚000 U.S. a month. Ask people with nothing to gain from the procedure — health professionals and sex experts‚ for example — and you get a different story. With surgery comes risk: labiaplasty can have side effects such as nerve damage‚ scarring‚ vaginal soreness and hemorrhaging. One gynecologist reports women losing sensitivity after surgery and experiencing pain during sex. The nerve networks of the female genitalia haven’t yet been accurately mapped. Cutting the lips could remove important and pleasurable nerve endings and replace them with numb scar tissue.

And doctors don’t agree on what degree of surgery is appropriate. Stubbs has removed the hoods from many women’s clitorises to make it easier for a penis to rub the clitoris during intercourse. But that hood exists to protect the sensitive clitoris when a woman isn’t having sex and Stern is against removing it: “The outcomes of clitoral surgery are so variable‚ much more painful because of all the nerve endings around it‚ and I’ve seen horrible scarring from other people’s [unhooding] surgery.”

Beyond physical risks‚ many criticize genital surgery on principle. “I think it is sick and reprehensible that doctors would perform surgery on women’s vaginas to improve their patients’ self–esteem‚” sex therapist Marjorie Rosen told the Allentown Morning Call‚ a Pennsylvania newspaper.

Simone Davis‚ a professor and gender theorist at Mount Holyoke College in Massachusetts‚ fears that labiaplasty makes all women look pretty much the same between our legs‚ even though we are born looking very different. Surgeons perpetuate the idea that there is a right and a wrong way for a woman to look‚ and the right way is to have a “clean slit‚” says Davis. “There’s a trend in the U.S. to wipe away all blemishes‚ and we do it with makeup‚ we do it with plastic surgery … Labia are neither inside nor outside‚ they are gateway tissues‚ and they kind of represent a part that is confusing.”

Davis points out that before the rise of pornography‚ most people were not exposed to images of female genitals. Most heterosexual women have only seen their own vaginas and picture–perfect porn images‚ making it easy to prey upon their insecurities and doubts. Although cosmetic labiaplasty is a new trend‚ people have been cutting up women’s vulvas for centuries in various regions of the world. In many parts of Africa and the Middle East‚ girls routinely undergo clitoridectomies (have their clitorises cut off) as part of coming–of–age rituals. In the most extreme version of female circumcision‚ as it’s often called — or female genital mutilation (FGM)‚ as the Canadian court system refers to it — the entire clitoris and all of the labia minora are cut off‚ and the vaginal opening is sewn partially together. The idea is that if a woman experiences pain rather than pleasure during sex‚ she will stay faithful to her husband.

Although FGM is illegal in both the U.S. and Canada‚ Davis says‚ “when you really look carefully at the language used in some of those laws‚ they would also make illegal the labiaplasties that are being done by plastic surgeons in the U.S.”

Europe and North America have a long history of women’s clitorises being removed. For example‚ a 19th–century English doctor performed a number of clitoridectomies to reduce “hysteria” and to combat “excessive” masturbation. He was criticized in England‚ but some American doctors enthusiastically began to slice women’s reproductive organs to try to “correct” female behaviour. They would remove the hood or the ovaries to “elevate the moral sense of the person.” The practice continued into the 20th century‚ often as a supposed cure for marital unhappiness.

In 1959‚ a doctor named W.G. Rathmann published an article in a respected scientific journal about a clamp he’d created to cut the hood off in one clean stroke. Rathmann felt that if a woman climaxed more easily‚ she and her male partner would be happier. One of his patients‚ he claims‚ had divorced four times before seeing him‚ and supposedly said she had “wasted four perfectly good husbands” by not having surgery sooner. This may sound old–fashioned‚ but modern–day doctor Stern also claims that for many‚ a labiaplasty or vaginal tightening can “save their marriage.”

Rathmann presented his ideas as though he was motivated by compassion for women. However‚ like many of his medical peers‚ he thought female genital surgery was the solution to not only sexual frustration and female insecurity‚ but also male ignorance and stupidity: “If the husband is unusually awkward or difficult to educate‚ one should at times make the clitoris easier to find.”

In the ’70s and ’80s‚ Ohio gynecologist James Burt performed more than 4‚500 of his own “surgeries of love” — most without consent. While women were on his operating table for other problems‚ such as incontinence‚ he would reposition their vaginas to a different angle and trim their clitoral hoods. He felt God had improperly designed a woman’s insides to suit a man’s pleasure‚ and saw himself as correcting the mistake.

Burt eventually lost his license. His patients wound up with horrendous infections‚ pain during sex‚ chronic bowel and urinary problems‚ loss of sexual sensation — and $20 million from the Ohio Supreme Court.

Today‚ for a mere $3‚500 to $7‚000‚ women are beating a path to the plastic surgeon’s door. “People say that what is so awful about [African] ritual cutting is that they do it without consent‚” says Davis‚ “but in the west‚ we do consent‚ and we even pay for the privilege!”

Is smaller really better? I pondered this one evening at the bar where I work‚ leafing through some plastic surgery material. Peaches‚ a muscular security guard covered in tattoos‚ looked over my shoulder at the photos.

“Is she getting her labia minora reduced?” he asked. “No way‚ man‚ she should be making them longer!” he added‚ and made some crude gestures to illustrate how much he liked oral sex with long lips. “It’s just sexy. See that?” he pointed to a woman with very long labia minora. “That is absolutely beautiful. The lips‚ for me‚ are a huge turn on.”

Many men feel the same way. After sex columnist Dan Savage advised a woman to go to Stubbs for her long lips‚ hundreds of male readers replied.

“I prefer long labia‚” wrote one reader. “I find they lend themselves more readily to being tugged‚ stretched‚ nibbled‚ etc.” Another told Savage: “You were much too hasty to recommend clipping her butterfly wings!”

Many cultures have taken labia love to the next level and actively massaged and stretched a girl’s labia from childhood on to make them as long as possible (most notably the Buganda people of Uganda). Labiastretching.com celebrates long labia in much the same way body modification enthusiasts have adopted the ear plugs of some African cultures to stretch their earlobes. The site features a photo gallery‚ advice on lengthening and erotic stories. And girls‚ if your labia are 10 centimetres or longer‚ you can enter a contest to win the title of the world’s longest labia.

I’m not about to stretch my labia down to my knees. Some photos on the site made me wince just thinking about tight pants. But I was delighted to see that at least some people don’t think my curtains need to be hemmed.

When I was 13‚ I didn’t like my labia. I remember sitting on my bed‚ looking at illustrations of women’s labia in a late edition of the Kinsey Report. I thought the long‚ foldy labia looked kind of strange compared to the nice‚ neat‚ miniscule labia minora that some women had. Suspicious‚ I grabbed a mirror and looked down. I was saddened to find that mine were more like the foldy ones.

For years‚ I was insecure. I was scared of what sex would be like and didn’t think young men (or women) thought of the space between a girl’s legs as pretty. Functional and pleasurable‚ maybe‚ but not nice to look at. And with foldy labia‚ how would I compare to the girls with neat‚ “clean slits”?

Like other insecurities‚ this one disappeared eventually. None of the men I have been with cared what my labia looked like. What’s more‚ the lips are meant to give you pleasure. They’re full of nerve endings and swell with blood during sex to give you extra sensation. Had I trimmed myself when I was a teenager‚ I would have missed out on a lot of fun.

So when I started perusing websites for this article‚ I was angered to find myself feeling like a scared 13–year–old again. Surgeons will tell you otherwise‚ but this industry thrives on female insecurity and often tries to convince us to fork over $5‚000 or more to feel better about ourselves. Many of the websites use language aimed at undermining female confidence‚ particularly when it comes to what men think about our genitals.

“Due to childbirth and aging the vagina can become stretched‚” states www.lipoman.com. “The loose feeling many women feel is noticed even more by their male partner during sexual intercourse … [and] commonly the unsightly appearance of the excess skin [of large labia] causes psychological damage that results in the loss of sexual desire for both partners.”

Davis visited an L.A. labiaplasty surgeon under the guise of wanting information: “He tried to convince me that to do the operation would not be being a woman hating herself‚ but [that] I was going to be liberating myself. He took the feminist language of choice‚ and he was giving it back to me as though I had the right to choose what kind of vagina I wanted.”

Look through plastic surgery literature and you will easily be able to find a few problems with yourself that a little laser could fix. I discovered that I’m a perfect candidate for breast implants‚ labia shortening and clitoral unhooding‚ which is deemed necessary by some doctors for women who usually only reach orgasm from direct clitoral stimulation instead of intercourse alone. Research has shown that three–quarters of all women need fingers‚ tongues or vibrators to reach orgasm. So in the eyes of some surgeons‚ the vast majority of us could use a little fixing.

“Plastic surgeons from the very beginning have employed medical language to make people feel uncomfortable about the shapes of their bodies‚” says Davis. “In the ’50s‚ when they started doing breast implants‚ they would use terminology like ‘micromastia‚’ meaning ‘flatchestedness.’ Suddenly it becomes like a disease to have small breasts.”
A similar language of disease — with words like “deformity” and “excess tissue” — is now used to sell genital cosmetic surgery.

I‚ for one‚ am not stuffing silicone in my breasts. I don’t believe it’s a feminist act‚ as some have described it‚ to surgically alter my body. I don’t have to go Brazilian to be sexy. And I’m not changing a thing about my labia — if you don’t like them‚ go find another pair.

– Zoe Cormier is a freelance writer based in Toronto and she loves her labia.