Labiaplasty: Mind the Gap-How the Female Genital Cosmetic Surgery Industry Has Exposed Gaps in Modern Medical Anatomy Education.

Anatomy is often considered to be a static discipline, but advances in radiological and surgical techniques regularly change structural viewpoints, and the modern anatomist teaches into an ever-changing socio-political context. This chapter focuses on specific challenges faced by the modern anatomist when teaching female genital anatomy in response to the increasing popularity of the female genital cosmetic surgery (FGCS) industry and the diversification of gender in contemporary society. A qualitative methodological approach was used to explore how female genital anatomy is represented in contemporary scientific literature, anatomical textbooks, and anatomy education. An evidence base for normal female genital anatomy was identified using 12 population-based studies that recorded genital dimensions and confirmed that a wide variation is normal. An analysis of 78 historic and contemporary anatomy texts mapped representations of female genital anatomy over time and confirmed that the spectrum of normal genital appearance is not acknowledged in English-language anatomy textbooks. A series of semi-structured interviews with Australian anatomists identified barriers and facilitators for teaching genital anatomy. Barriers included lack of connection to contemporary clinical practice, technical difficulty and time involved in updating presentations, the crowded curriculum, and personal reticence about teaching genital anatomy. Themes around inclusivity also emerged during the interviews, with anatomists reporting reluctance to experiment with inclusive terminology as another barrier to teaching genital anatomy. The binary language and singular structural arrangements traditionally contained in lectures and textbook chapters on "Female Genital Anatomy" are nowadays rendered exclusive and incomplete. It is imperative that the modern anatomist, when developing anatomy curricula and resources, considers the importance of teaching about anatomical variation and using inclusive language given that many contemporary societies are embracing nonbinary views of gender.