Functional need or personal choice: Medical professionals' understanding and framing of performing female genital cosmetic procedures

Background:
Female genital cosmetic procedures (FGCPs) are becoming increasingly common but remain highly stigmatised and contested. This raises the question of how healthcare professionals justify performing FGCPs in such a context.

Objectives:
To understand how medical professionals (MPs) justify their involvement in FGCPs within a context of social and professional scrutiny.

Design:
Qualitative interview study using discursive thematic analysis.

Methods:
We conducted 11 in-depth interviews with plastic surgeons and gynaecologists performing FGCPs in Belgium and the Netherlands.

Results:
MPs employ two main discursive framings to justify performing FGCPs. The women’s health framing depicts FGCPs as addressing issues that were considered functional and fulfilling “genuine” medical needs, while the women’s choice framing emphasises a woman’s autonomy to make decisions about her body, even in the absence of functional concerns. Both framings are shaped by and rely on a series of juxtapositions which MP negotiate in their framings: functional versus aesthetic; patient choice versus medical decision-making; and medical versus cultural.

Conclusion:
MPs frame FGCPs in terms of women’s health and choice, helping to legitimise them as ethical care. These framings, however, obscure key tensions – between function and aesthetics, autonomy and clinical judgement, and medical versus cultural motivations. Examining these discursive dynamics reveals how FGCPs are made acceptable within a contested field.