Plumbing the lower depths

Designer Vaginas, tonight, Channel 4, 10pm

California's Laser Vaginal Rejuvenation Centre offers a very special service to women whose bodies are kept in peak condition by a personal trainer and cosmetic surgeon, but worry about one last niggling imperfection. "They come to me," says its handsome director, Dr David Matlock, "and say¸ 'Doctor, I want to be 16 again'. And I can make them as tight as they want to be."

Genital cosmetic surgery, which includes tightening of the vaginal walls, labiaplasty ("improving" the appearance of the vulva) and even replacement of the hymen is the latest trend in surgical enhancement. The strange world of the "designer vagina" is exposed in Channel 4's documentary of that name, showing next week.

As if it's not bad enough to have to compare, usually unfavourably, our breasts and bottoms with those belonging to models and celebrities, we are now asked to take on board a sort of vulvic gold standard, as worn by the men's magazine centrefold. Just as for men, it's all about size, but in our case, ironically, it has to be small and neat. What could be more grotesque or self-hating than going under the knife to prettify oneself for the male gaze, or to tighten the fit for his extra satisfaction?

Well, yes, up to a point. Men, after all, have been undergoing painful cosmetic genital surgery for years. Now the spotlight has been turned on female sexual response and dysfunction, an area long neglected by science.

Perhaps it was inevitable that the vagina and its workings would be subjected to scrutiny, not least by many women themselves, for whom a fulfilling and active sex life is now a basic requirement.

Dr Matlock's patients are often mothers who have been left feeling disastrously stretched by childbirth, or with serious incontinence problems.

Other women complain that they have spent a lifetime feeling selfconscious about the shape of their labia, which can also cause discomfort and irritation during sport or when riding a bicycle. It is they, not their partners, who complain that having sex is like "waving a pencil around inside a cave", as one woman put it. It is difficult to dismiss them as dimwitted bimbos colluding in their own sexual oppression, especially when one patient reveals that after her vaginal rejuvenation, she "stopped counting" exactly how multiple her orgasms were.

Not everyone is so delighted. There is Rose, a British woman who decided to go to LA for surgery after the birth of her 10lb baby left her looking and feeling different internally, although the rest of her body had snapped back into shape. "I don't want having a baby to be the be-all and end-all," she says plaintively. Despite the fact that she still hadn't properly healed, as Dr Matlock had promised, six weeks after the procedure, and her GP was worried about scar tissue, she still maintains she would recommend it to anyone. Lori, an American, went to Dr Matlock because of incontinence problems, but succumbed, as she sheepishly admits, to the temptations of a labiaplasty and vaginal tightening. When she resumed sex with her husband, however, she found that, although she felt more friction, her ability to reach orgasm was unchanged.

However intelligent and articulate the women involved, one can't help feeling that our mania for perfection has gone too far. Surgery to correct real functional problems is obviously a good thing. Nor can one really argue with a woman who is minded to undergo a procedure that delivers a more intense sexual experience. In the programme, it is the patients who fall in between that one worries about, who confess that a tighter vagina and Playboy-style vulva is not necessarily the route to personal sexual Nirvana, but who feel younger, more feminine, more attractive - more acceptable, in a nutshell, to the opposite sex - after surgery. Besides, has anyone noticed that if the rage for penile enlargement and vaginal reduction continues at the current rate, sex will soon be physically impossible for fashionable Californians?

Designer Vaginas is on Channel 4 at 10pm, Tuesday, January 22.