Across the globe, women face a myriad of unspoken expectations, a landscape dotted with landmines of shame and societal scrutiny. One example of unspoken expectation is the high value of virginity that is deeply ingrained in Khmer women's perception of themselves and others due to the effects of the virginity culture in Cambodia. As a result, many women struggle with body insecurities rooted in societal norms and in men’s sexual preconceptions and expectations of women's appearances, including of their intimate parts. That is why many Cambodian women choose to explore solutions to tighten their vagina - in particular after childbirth that widens the vagina or before getting married as proof of virginity - to fulfill the desires of their spouse and/or for aesthetic pleasing reasons. One of the options women go for takes a disturbing physical form: vaginal tightening surgery or what we call in its medical term “perineorrhaphy”.
What is perineorrhaphy?
Perineorrhaphy, also known as perineoplasty, is a “biomedical surgical procedure that seeks to tighten the muscles at the opening of a woman’s vagina following a vaginal birth.”
Even though this surgery can seem like a harmless procedure to repair injured tissues after childbirth, beneath the surface, other problematic underlying factors encourage women to go through perineorrhaphy: societal pressures and cultural norms to conform with notions of virginity and feminine purity.
“Two clamps are placed on the labia minora. We close and put two fingers in the vagina. We ask the wife if this is the size of her husband's penis. If she says yes, we sew up to here.” (Obstetric gynecologist, Phnom Penh, 2014, cited here)
Moreover, the procedure is not without side effects as it can cause vaginal opening looseness or tightness, incontinence, a damaged or scarred perineum, vaginal warts, decreased sexual sensation, or pain with penetration, to name a few.
“This is my story. When I gave birth to my second child, I thought I wouldn't want any more children. And I thought I'd like to do perineo at the same time as giving birth. I asked for a nice suture [de oy saat]. And then the woman doctor cut my perineum. And it became too small. And then I had dyspareunia Pain during intercourse. for a long time, for a long time. Because every time we have intercourse, it tears, because the labia minora are too small, it's not resistant. So after intercourse it's torn, you have to abstain for two or three days. To relieve all that. It's very, very difficult.” (Obstetrician gynecologist, 40, Phnom Penh, 2015, cited here).
Despite side effects and potential risks of surgery interventions, perineorrhaphy can be beneficial when performed for genuine medical reasons. But in Cambodia, people frequently undertake it for aesthetic reasons, motivated by the ingrained idea that vaginal tightness is a sign of beauty, purity and value.
“I had a C-section for the third child because I got sewn up to look good [de oy saat] after the second delivery, so I don't want to damage the vagina” (Woman, 36, Phnom Penh, 2015, cited here)
Virginity culture and gender roles pressure Cambodian women
This problem has its origins in Cambodia's cultural heritage. Virginity is often seen as a woman's most precious asset, closely tied to her family's honor and her ability to get married. This connection feeds a powerful mixture of insecurity, fear, and guilt that pushes women to seek out "corrective" procedures, such as vaginal tightening surgery as “hymenoplasty,” which are performed to tighten the hymen, mostly before women’s marriage, and “perineoplasty” which are performed after childbirth. Furthermore, women also feel pressure to conduct such surgery to satisfy their husband’s sexual pleasure, believing that having a tight vagina would help women keep their husbands at home:
“If you don't help women, it's difficult for relationships. Because sometimes her husband will look elsewhere. I think that sex life is important and that men will look for other women if their vagina is too large. Prostitutes have tight vaginas” (cited here)
According to Klahaan’s report on Virginity Culture, 74% of survey participants consider that most men prefer virgin brides. In Cambodia, premarital love is seen as shameful and a source of stigma for young women. As an interviewee explained:
“Our culture is conservative and we value women based on their virginity. If they lose their virginity, they also lose their value. Women would also be branded as easy women” (cited here)
Even though no scientific evidence supports that claim, respondents often reported that ‘people can know’ if a woman is still a virgin, in a physical sense: “As a man, they have nothing to lose when they have sex before marriage. For example, no one would know and no one can identify whether a man is still a virgin… This is totally different from women. People can know – especially her partner/husband if a woman is a virgin, or not” (cited here). That fear can lead women to go for surgery or alternative measures to avoid the ‘disgrace’ of being recognised as non-virgins.
What can be done? Where to start?
Undergoing surgery should be a personal choice mainly based on medical needs. When it comes to doing vaginal tightening surgery for aesthetic reasons or to appear virgin, one has to deconstruct the underlying harmful pressure to conform with images of virginity, and how it translates into a societal problem. Shifting our narrative becomes essential. For example, by shifting the focus of the discussion from attaining unrealistic and unnatural beauty standards to accepting body change and embracing the beauty of diversity and uniqueness of our vagina, we may empower women to prioritize their physical and mental health. That way, the questions we ask oursleves are no more: how can I look like that? Instead, we say: How do I learn to love my body and appreciate the story it tells (like childbirth)?
Rather than focusing on how our vagina might look, let's make open discussions regarding pelvic floor dysfunction a priority. We should focus on education by giving women accurate knowledge about its issues, its effects, and any possible risks, giving them the power to decide what to do on their bodies.
Rather than playing by the rules of a system of oppression that objectify and control our bodies, let’s cultivate body positivity and have deep discussions about social expectations, beauty, sex, marriage and childbirth. Tearing down the rule, the norms, the representations that surrounds us is not an easy task. However, we believe we can get there, one step at the time. First we question. Second, we start taking small actions.
Let's raise the banner of body positivity, not just for ourselves but for everybody to experience love for their body and sexual pleasure on their terms. Together, we can build a world where natural bodies are a celebration, not a battlefield, and where everybody is a beautiful, powerful vessel for joy and fulfillment.