Index of articles
Women shit and stink, most are fat and ugly. Women carry diseases that afflict good men, and when they have the opportunity, they fuck with somebody else. Time to replace women with sophisticated robots.
North Carolina: Why many circumcised women may never enjoy sex
Jose J. Douglas 4143 Harry Place Concord, NC 28025
My mind raced back to one of my many conversations with my dear friend Bella as I listened to this guy’s argument on why his five year old daughter must be circumcised. His poor wife, Aduni, had asked me to help talk to him. Had she known that this would be his decision, she probably would have kept her discovery to herself. That she had caught their little girl playing with her clitoris.
She had panicked, thinking that their innocent angel had been corrupted and might now grow into a common slut, if something was not done quickly. But while she had been lost for what to do, she had least expected that circumcision would be her husband’s solution. Aduni said she had been raised in the village and circumcised, so she had experienced the pains and discomfort associated with female circumcision and is now living with its aftermaths. She was not sure if she wanted her beautiful princess to go through the same or live her life the way she was being forced to.
My friend, Bella has a similar challenge. You’ll often hear her describe herself as an incomplete woman or freak whenever the issue of sex comes up in our discussions. A very cosmopolitan extrovert and successful Lawyer, Bella exudes confidence and accomplishment and it is quick to notice that she is on top of her game. Only those very close to her get to know her other side of her life. And though she has never showed me physically, she’d given a very graphic picture of what she looks like down below, several times. This she said was her main reason for walking out of her marriage after birthing her only child. It was pointless enduring the sex when she felt no pleasure.
For many women, the inability to experience full sexual pleasure or achieve orgasm during sexual intercourse has remained an elusive mirage, leaving most who are not even circumcised, confused with many unanswered questions. Studies have shown that men are likely to orgasm 90-98 percent of the time they have sex. In fact, this is often the way a woman knows that the game is over. Unfortunately, same cannot be said about the woman and not a few reasons are responsible for this.
Several major research works on human sexuality record that only about 25 percent of women climax or experience intense sexual pleasures during sex with their partner, while 40–50% have either complained about sexual dissatisfaction or experienced difficulty becoming sexually aroused at some point in their lives. These figures are significantly higher in African societies and cultures where Female Genital Mutilations (FMG) as well as other cultural practices are predominant and act as inhibitors.
Orgasm can be simply described as the release of built up sexual tension in both men and women during a sexual encounter. The inability to have orgasm after ample sexual stimulation is called anorgasmia or ejaculatory anhedonia. For many women, not being able to climax can be caused by everything from unrealistic expectations, to awful sex, to discomfort with their bodies, discomfort with their partners or discomfort with sex itself.
This is to the exclusion of medical conditions, sexual abuse, rape and their aftermath traumas. In fact, biologists and researchers for many years have been trying with little success to figure out the whole concept of the elusiveness or even why females orgasm at all, since their reproduction does not depend on it unlike the male. However, what they have successfully been able to figure out is how women can achieve orgasm. And every woman can learn to, if they really want.
To know if you have ever experienced the big “O”, or will ever actually do, you need to understand what it is in the first instance. After all, if you are travelling to a new destination, you will not know if you have arrived there without an address or map guiding you to the location. The truth is that most women who have taken time to study their bodies, especially the sex organs and how they work, find it easier to enjoy their sexual relationship. In the same way, a man who is knowledgeable about the female body will understand and know how to set it in correct motion.
A friend once told me something similar to this position. According to her, she has only experienced orgasm three times in all of her 19 years relationship with her husband, which includes three years of courtship. One night during one of her few outbursts on her lack of sexual fulfilment in the early days, her husband had categorically told her that he found it weird that he had to bring her to climax with his fingers. A full grown woman according to him, must learn to orgasm through sexual intercourse. She must figure out how to adjust. The subject died a natural death that night and has never been discussed again. She has been coping ever since. Hmm!
However, sex researcher, Alfred Kinsey will later refute Freud’s claim in his own study which according to him revealed that there is only one type of female orgasm. To him, an orgasm is an orgasm so long as it takes place inside or outside of the female genital, no matter which part of her body was being stimulated. Most sexologists and researchers over the years have corroborated Kinsey’s findings, insisting that the area located in the front wall of the vagina identified as the Grafenberg spot, or otherwise known as the G-spot is actually a bundle of nerves, gland or series of glands from the clitoris which extend into the wall of the vagina. Therefore, the vaginal orgasm can also be achieved when combined with stimulation of the clitoris, invariably still making the clitoris the central or focal point of the female orgasm. Are you still wondering why many circumcised women may find it difficult to enjoy sex or indeed, may never experience an orgasm?
The importance of the clitoris to female orgasm or sexual satisfaction is very crucial. The clitoris may be described as the most important part of the female sexual pleasure. It is to the woman, what the penis is to the man. The clitoris or clit is a small bud-like formation located slightly above the opening to the vagina and at the top of the inner labia. Though its size and shape differs from woman to woman, it is generally believed to be between 1/8 to 3/8 of an inch in size. The clitoris is highly sensitive and full of nerve endings which become engorged when a woman is aroused.
Though many of the clitoral nerve endings are subterranean, or below the surface, the visible part is just the tip of the iceberg as, even “in hiding,” the 6,000 to 8,000 sensory nerve endings are a mega source of incredible pleasure for many women. This is in contrast to the vaginal walls which contains relatively few nerve endings and only the lower third of it has enough nerve endings to feel stimulation from a penis, finger, sex toy, or other penetrative object. It is therefore logical that intense sexual stimulation, pleasure and orgasm from vaginal-only penetration are pretty much unlikely to happen.This is why a vast majority of women will need clitoral stimulation to enjoy sex or achieve orgasm since vagina penetration on its own is not always enough. So guys, sweating and tiring yourselves out by humping and thrusting endlessly at your partner does not mean you are giving her the most pleasurable experience of a lifetime. You need to get more creative, versatile and patient with us. And even more so, if you discover that your partner is missing that vital part of her sex organ, then don’t be fooled by those moans, name callings and “ohmigods”, they probably are just ways to hurry you up to get it over with. Believe me, most women are experts in this instance!
One question women who are confused about how they feel while having sex often ask is, how they will know if they have achieved orgasm. According to sex researchers, William H. Masters and Virginia E. Johnson in their seminal work titled Human Sexuality, orgasms are a combination of two things, a build up of muscle tension and the release of same. When a woman gets incredibly turned on, she builds up muscle tension around her pelvis and her clitoris and vagina becomes engorged with blood just like the male penis does.
At the same time, the vagina wall also starts to secrete beads of lubrication which eventually gets bigger and flow together. During an orgasm, all these tension technically known as Myotonia is released and a flood of hormones flows into the body causing intensely pleasurable feelings. Though centred around the genitals, pleasure can be felt all over the body depending on the individual.
Her heart rate, blood pressure and breathing increases, muscles contract throughout her body, especially in the vagina, uterus, rectum, and pelvic floor. Upon orgasm, all the tension is released and a pleasurable, relaxed feeling takes over. This is probably why most men will fall asleep after sex. And the women? If you have felt anything close to this, then you are damn lucky! And if otherwise, don’t be sad, as I said earlier, it is achievable, you only need to work harder at it. Yes, work harder!
There is no doubt that the female clitoris will forever remain the centre of her sexual gravity and it is important that this as well as other features of her sexual organ, often disposed of during female circumcision must be preserved in order for her to live a pleasurable and fulfilled life. However, difficulty or inability to enjoy a fulfilling sexually pleasurable life is perhaps the least of the problems associated with female genital mutilation.
Besides the immediate consequences which include pain, bleeding, infection, injury to genital tissues, shock and even death, it results in a silent ongoing torture throughout the life of the women. Depending on the extent of the cut, complications during childbirth, urinary infections, genital sores and cysts are also challenges she might be subjected to. Is there any reason why anyone should live a life of pain and sorrow based on the ill judgement of others? Is there any reason why anyone should live a life of pain and inadequacy because of the ill judgement of others, shrouded under the guise of culture and tradition?
The excuse that circumcised women are more chaste than uncircumcised ones, if true at all, is not enough reason to mutilate any girl. Sexual discipline is as much psychological as it is physical. It is everybody’s duty to help the girl child achieve her full potential as a woman and live a total life. So, dear daddy, please don’t. Do have a wonderful weekend!
With free speech, it's like that: You can make any offending remarks about white men, and the mainstream media and mainstream opinion will applaud you. You can't say anything negative about feminism. Feminism is sacrosanct. Fuck it.
Queens, New Year: Testosterone causing blood clots, butea superba may be an alternative
Charles R. Rankin 1115 Alfred Drive Queens, NY 11423
To counter the negative effects of aging, many men seek androgen hormone replacement therapy, usually in the form of testosterone.
Testosterone is the hormone that is responsible for masculine growth and development during puberty. Testosterone levels naturally decrease with age.
After the age of 40, many men are diagnosed with hypogonadism, a condition where the body does not produce enough testosterone. As a result, men may experience symptoms similar to that of the female menopause.
Testosterone is commonly prescribed in hypogonadism, as it can improve muscle strength and sex drive. An increasing number of men have been seeking the treatment, with studies showing that the number of testosterone therapy prescriptions in the first decade of this century has nearly tripled.
But there are caveats. In June 2014, the United States Food and Drug Administration (FDA) - in partnership with Health Canada - required that testosterone products carry a warning about the risk of developing blood clots, or venous thromboembolism (VTE).
Alternatively, a number of men have switched to butea superba, a Thai testosterone booster.
Assessing the risk of VTE in testosterone treatment
A team of international researchers - led by Carlos Martinez of the Institute for Epidemiology, Statistics and Informatics GmbH in Frankfurt, Germany - decided to investigate the risk of VTE associated with testosterone treatment in men, with a focus particularly on the timing of the risk.
The study - published in The BMJ - collected data from over 2.22 million men registered with the UK Clinical Practice Research Database between January 2001 and May 2013.
Of these, they looked at 19,215 patients with confirmed VTE - including deep venous thrombosis and pulmonary embolism - and 909,530 control participants of the same age.
Researchers identified three main, mutually exclusive exposure groups: current treatment, recent - but not current - treatment, and no treatment in the last 2 years.
Current treatment duration was divided into more or less than 6 months.
Testosterone users have a 63 percent higher risk of VTE
After adjusting for comorbidities and other influencing factors, researchers estimated the rate ratios of VTE in association with current testosterone treatment and compared it with no treatment.
In the first 6 months of testosterone treatment, researchers found a 63 percent increased risk of VTE. This is the equivalent of an additional 10 VTEs above the base rate of 15.8 per 10,000 person years.
This risk decreased significantly after 6 months and after treatment had ceased.
According to the authors, the study highlights the need for further investigation of the temporary increase in the risk of VTE:
"Our study suggests a transient increase in the risk of venous thromboembolism that peaks during the first 3-6 months and declines gradually thereafter. Failure to investigate the timing of venous thromboembolisms in relation to the duration of testosterone use could result in masking of an existing transient association."
The authors highlight, however, that the risks seem to be temporary and very low in absolute terms.
Martinez and team also note the limitations of their research. Due to the observational nature of their investigation, they cannot draw any conclusions on the cause and effect of this association between VTE risk and testosterone treatment.
When women don't have sex to trade, they are inferior to men in almost every capacity. That is why in a future world in which sex robots are the partners of men, women won't have influence. They seldom had, anyway, throughout history.
Harrisburg, Pennsylvania: The "Vagina Whisperer" Will See You Now
Christopher I. Leal 1804 Lincoln Drive Harrisburg, PA 17111
As far as publicity stunts go, the “first ever designer vagina showcase” was pretty damn effective. Timed to coincide with the spectacular runway parades that mark New York Fashion Week, the event was Dr. Amir Marashi’s chance to show the world what he can do: With a little slicing and suturing, he can give you the vagina of your dreams.
Inside the sprawling midtown conference room where the “show” would take place, sparkling rosé and cupcakes were served. Guests were greeted by a perfectly taut, hair-free, millennial pink silicone vagina model, which Dr. Marashi then used to explain the slate of procedures on offer during his powerpoint presentation of before-and-after vulva shots. There were the uneven labia minora that he’s trimmed (click), aging labia majora that he’s plumped (click), lax vaginal openings that he’s tightened (click), and those were just the surgical options. If you don’t like the idea of anesthesia, he can plump your lips with fillers, inject your G-spot with your own blood plasma to improve orgasms, or stick a laser wand inside you to painlessly tighten things up. If you didn’t walk into the showcase thinking your vagina was defective, you likely walked out of there worried over just how many ways it could be flawed.
For his part, Dr. Marashi, the self-described “vagina whisperer,” walked out with a lot of press. Yes, the concept was vulgar, but it got the job done: Over the next few days, there were articles in the New York Post, Jezebel and The Sun. He’s since been interviewed by Z100 and The Daily Mail, and outlets are becoming increasingly happy to add “vagina whisperer” to his other title, board-certified Ob/Gyn, as if it’s an actual qualification. All of this is why, two months after the showcase, I find myself in scrubs in a nondescript surgical center in Downtown Brooklyn waiting for Dr. Marashi to lead me through an up-close look at what this is all about. Yep, I’m about to observe a designer vagina surgery IRL, and it’s almost curtain time.
In the operating room, he’s telling me about how important it is to find a doctor who does these surgeries regularly. “This is why I do revisions a lot,” he says, in his slight Persian accent. “People think somebody is on Park Avenue so they’re good, but they might not do these over and over again.” He says he does these procedures three days a week, and has probably done more than 700 by now.
Dr. Marashi’s patient for today is lying on the operating table, knocked out, intubated, and covered by a sheet. She’s a 48-year-old mother of four who says she can feel nothing during sex. A nurse and surgical technician have just positioned the patient’s legs in stirrups, wrapping each one up in a sheet, so only her vulva remains exposed. Dr. Marashi is explaining that these cosmetic surgeries only make up half of his practice; he spends the rest of the time doing laparoscopic surgeries for pelvic pain related to endometriosis and fibroids. For those surgeries, “we listen to Enrique,” he says, and I assume he means Iglesias, but I don’t ask because he’s moving so quickly. “For vaginoplasties and labiaplasties, I want to get the right side of my brain to work, the more creative side. So I listen to Frank Sinatra.”
“Can we turn up the music?” Dr. Marashi asks with a wink, and “My Way” comes over the speaker. It’s a fitting song for a man who would later tell me he started doing cosmetic surgery because he likes to be “outside the box.”
Dr. Marashi sits down on his stool in between the patient’s legs and snaps a “before” pic on his iPhone. He slips on a pair of gloves and enters full doctor mode as he signals me to come take a look. Her vagina looks just as expected. But then Dr. Marashi spreads her lips, revealing a startling laxity and — "What’s that?" I ask, about the round, meaty tissue bulging down from the top of her vagina. “That’s the bladder,” he says. More importantly, though, is that her perineal body, the muscle tissue that separates the vagina from the rectum, is completely flaccid. He sticks a finger in her anus and pushes up to show me how weak and sponge-y it is, and how this creates a drooping of the vaginal opening into the woman’s butt. This is what creates the lack of sensation, he explains. The vaginal opening should hug two fingers, and it should be much higher.
“This is a patient who has had four vaginal deliveries,” he says. Her kids are aged 19 to 27, and she hasn’t enjoyed sex for a long time. Her first husband left her, and she blames her inability to grip his penis during sex as one of the reasons. But she’s in a new relationship now and she doesn’t want to put up with it anymore. (At least, that is what Dr. Marashi tells me. The patient declined to speak to me directly.) “She didn’t take care of it sooner because of the taboo that’s with it, or maybe she didn’t have the money, you know all these things that get in people’s way.”
The “taboo” that Dr. Marashi refers to is very real. Between 2010 and 2016, the United States saw a more than 100% increase in labiaplasties, a surgery to trim the inner or outer labia. No one is tracking the number of cosmetic vaginoplasty procedures, also referred to as “vaginal rejuvenation,” because the practice is too new, but experts estimate a similar increase in demand thanks to new non-surgical options and greater public awareness. (Kourtney and Kim Kardashian have both reportedly been “rejuvenated” via the new non-surgical laser options.) A lot of this rise has coincided with a surge in social media, reality TV, and endless amounts of free porn, which has, in turn, been blamed for creating an impossible standard of beauty for female genitalia — as if women needed yet another standard to measure themselves against, another reason to hate their bodies.
"Is this really what women want? Or is this really a form of new-age ‘circumcision’ based on an obsession with Barbie doll looks?," asked a scathing 2012 editorial in Obstetrics & Gynecology. A Jezebel article on Dr. Marashi’s vagina showcase described people who choose labiaplasty as women with minds “warped” by the porn industry. That’s what critics have said, and that’s exactly what I was thinking, walking in. But now that I’m witnessing the surgery, it’s not clear that assessment is fair.
Dr. Marashi uses a blue marker to map out where he will cut. Once he’s done that, Charles, the surgical tech, clamps her vagina open, and Dr. Marashi begins to cut away a diamond-shaped chunk of muscle and skin from the bottom of her vaginal opening. Then comes the most important cut: a deep crevasse into the perineal body.
“It’s really important to take your time and dissect this very meticulously, because behind here is the rectum,” and any crossover could lead to a dangerous infection, he says. Dr. Marashi then sews multiple rows of sutures into the perineal body, starting from further inside of her vagina until he gets to the outside, where he finishes with a row of stitches up from her anus to the new, lifted bottom of her vaginal opening.
“Remember in the beginning how close the vagina and the anus were together? You're gonna see in the end how far apart it’s gonna be,” he says.
In the end, I do see how much higher the vagina is. The hour-long process reminds me of a slower version of that magical strapless, backless bra Amber Rose has been advertising on Instagram: It’s as if he just threaded it all, and pulled the strings tight so that the whole vagina is miraculously lifted an inch higher. The final stitches are the tying of the bow that holds it all in place.
If I had to choose a vagina for myself, I’d pick this one over the one she had before. This makes me feel really bad, until I remember that there are also the anatomical realities here: Sewing it all back together with multiple layers of sutures is not just for aesthetics; this is a repair job for that muscle. This repair will also create a lift in the bladder that may even help alleviate stress incontinence, not to mention making penetrative sex feel good again for her partner, yes, but also for her.
It’s hard to square all that with the way Dr. Marashi has marketed himself, and indeed the way the entire, fast-growing crop of “cosmetic gynecologists” have marketed this burgeoning industry, as though this is just about having pretty, youthful genitalia. In the operating room, it’s clear that selling this the way women were sold facelifts, Botox, or even breast lifts is not quite right. Having sagging breasts and wrinkles may not make you feel so great about yourself (especially in our youth-obsessed culture), but those things don’t make sex physically impossible to enjoy. And they have nothing to do with a problem as distressing as incontinence.
To hear Dr. Marashi describe it while he’s actually doing the procedure, women choose this surgery mostly for functional reasons: to make sex better, the way it was before they had a baby or three, and to stop peeing their pants (even just a little bit) when they sneeze or lift weights. So, why on earth is the best way Dr. Marashi can think to market himself a grotesque showcase that frames everything in terms of how the vagina looks? More importantly: Why is this woman paying out-of-pocket for a one-time tune-up for her perineal body, when her partner could easily get insurance to cover his lifetime supply of Viagra?
To even begin to answer these questions, you have to understand where “cosmetic gynecology” came from in the first place. Plastic surgery — cosmetic gynecology’s closest cousin — has always been controversial, but it has also always been a mixture of reconstructive surgeries (like implants after breast cancer) and elective surgeries (like breast lifts or implants simply because you want them).
Cosmetic gynecology seems to be a similar mixture — but thanks to a toxic combination of entrenched sexism and continued dismissal of women’s sexual concerns, even the reconstructive procedures are still deemed frivolous, unscientific, and ironically, misogynistic.
The truth is that gynecologists have always done vaginoplasties and labiaplasties, but historically they would only do them for women with “true” medical problems, such as uterine prolapse (when the pelvic muscles collapse completely and the uterus descends into the vagina) or labial hypertrophy, which is when the labia minora or majora are extremely long or uneven. Outside of that, most doctors deemed them unnecessary, says Marco Pelosi, III, MD, a pioneer in the field. “There has always been a chasm between what doctors consider a problem and what women consider a problem when it comes to their sex lives,” he says.
Variations in labia length are totally normal, as any gynecologist or even anyone who watches porn regularly, can tell you. And while, say, painful sex or prolapse are “real” medical issues, constant irritation caused by your long labia or even a change in sensation after childbirth are not, according to traditional medicine, Dr. Pelosi explains. So for years, the procedures remained unpopular thanks to low awareness and low interest among women, as well as low adoption among qualified physicians.
Then, Sex And The City happened. Brazilian waxes became very popular — and baldness meant better opportunities for women to actually look at (and, yes, scrutinize) the physical characteristics of their vulvas.
In a post-Samantha Jones world, the gates opened: Women were much less shy about openly complaining to their doctors about their sexual dissatisfaction. And when their doctors didn’t listen, they found another doctor. All of a sudden, women had gotten the message that they deserve pleasurable sex. This created a huge opening for the few doctors who did offer these vagina alteration services to grow their businesses.
On the East Coast, Dr. Pelosi (along with his father Marco Pelosi, II, MD) — who had been offering elective vagina procedures since the ‘90s — began training surgeons in Bayonne, New Jersey. Eventually, due to demand, the father-son duo founded the International Society of Cosmetogynecology in 2004; they were the first to coin the phrase “cosmetic gynecology.”
Meanwhile, in Beverly Hills, Dr. David Matlock had trademarked the term “laser vaginal rejuvenation” and started a franchise business where he performed surgeries and, for a hefty fee, trained other doctors in his procedure. This allowed doctors to use the term to market the procedure, which is essentially a slightly modified version of vaginoplasty, the same way he did. This being L.A., Dr. Matlock also managed to swing an appearance on an episode of the E! network’s Dr. 90210 in 2006, giving "laser vaginal rejuvenation" its first national spotlight.
Soon, as a workaround to Dr. Matlock’s hefty fee, other doctors just dropped the “laser” and started calling it simply “vaginal rejuvenation.” This prompted the American College of Gynecologists (ACOG) to issue a scathing committee opinion in 2007 deeming the marketing practices and franchising surrounding the term “troubling” and the procedures “not medically necessary.”
But warnings from ACOG didn't do much to stem the rising tide of demand. As the rise of social media and Dr. Google continued, labiaplasty alone started to explode in popularity, experiencing a 44% increase between 2012 and 2013 (the first period for which data was tracked). Dr. Matlock only grew more famous — and not necessarily in a good way. He went on The Doctors with his wife Veronica, who got a vaginoplasty, labiaplasty, and “pubic liposculpting” from her husband. And who can forget when Brandi Glanville, the Real Housewife, infamously charged her vaginoplasty to her cheating ex, Eddie Cibrian’s, credit card? Dr. Matlock was her doctor.
Soon, there were myriad non-surgical options for “enhancements,” each one more bizarre than the next. There were liposculpting and fillers for your vulva, followed by g-spot injections (which would supposedly improve orgasms), and targeted skin lightening treatments that would change the shade of a vulva to Carnation Pink. In hindsight, the vajazzling phenomenon — the iconic ‘00s trend of adorning your waxed pubic area with rhinestones — seems inevitable. And while it’s easy to roundly mock all the upgrades and accoutrements, the thing is, the vulva was having a moment, one that no one seemed to notice except to mock.
Most recently came the big innovation (and the big money-maker): lasers and radiofrequency devices that use thermal energy to tighten the vagina. FemiLift, the machine Dr. Marashi uses, came first in 2013. Then MonaLisa arrived in 2014. Both machines are FDA-approved for “vaginal laser ablation” to induce the growth of collagen in the vaginal walls. This is said to not only tighten and lift the vagina, but also to improve the health of the mucosal lining, making lubrication easier. Another side effect: The lifting may help some with stress incontinence, and in some cases may even shorten labia. Other machines that use thermal energy technology to the same effect: ThermiVa, Diva, IntimaLas, and more.
No doubt the ease in getting non-surgical vaginal rejuvenation has coincided with the huge increase in demand. According to data from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 10,000 labiaplasties were performed by plastic surgeons in 2016, a 23% increase just from 2015. Now more than 35% of plastic surgeons offer the procedure, compared to 0% in 1997 when the society started their surveys. But the full breadth of designer vagina procedures remains a mystery, since nobody is tracking the variety of procedures that fall under the term vaginal rejuvenation, nor the number of doctors performing them, according to a spokesperson at ASAPS.
Because a laser treatment or an injection requires no anesthesia or downtime — all it takes is a series of in-office visits that amounts to having a laser wand inserted into your vagina — “it became a gateway,” Dr. Pelosi says. “Once you have a nonsurgical way to address some of the needs, it becomes way easier to do. It’s like Botox. Now everyone does Botox.”
Sandra*, a 31-year-old mother of one, has spent the past five years since the birth of her daughter yearning for her pre-baby vagina. Before she gave birth, sex was great. Now it’s lackluster. It wasn’t until she started Googling her symptoms and found her way to Dr. Marashi’s website that she realized there was a single thing she could do about it.
“After you have a baby, everything changes,” she says. “I realized during sex I wouldn’t stay as wet, and it just felt different. Also there were the urination issues, too.”
“This is definitely going to help a little bit with that,” Dr. Marashi says, handing her a pair of protective glasses. She’s laying on her back with her feet in stirrups and a paper gown over her lower body, ready for her second of three treatments with Dr. Marashi’s FemiLift machine. This time, he has outfitted me in a white coat to serve as his assistant while observing Sandra’s procedure.
It’s hard to say exactly how common Sandra’s situation is, but any mom (or any doctor) can tell you that it’s pretty prevalent. We all know that childbirth changes things. Another thing we can say for sure: A full third of women who have given birth vaginally have some damage to the muscles responsible for vaginal tightness. Vaginal delivery is the strongest predictor of developing a pelvic floor disorder, such as uterine prolapse, rectocele (when the rectum bulges into the vagina), or cystocele (when the bladder bulges into the vagina). The feeling of “looseness” that so many women come to plastic surgeons and cosmetic gynecologists to fix may actually be one of the earliest precursors to true prolapse, per a 2014 study in Surgical Technology International.
The treatment takes 10 minutes, tops. We all put on our protective glasses. Dr. Marashi replaces the glass cover on the probe, which looks like a clear dildo with a mirror on the tip to direct the searing light, with the one Sandra had to purchase. Each patient must bring her own personal probe cover ($150, not covered by insurance) with her to appointments.
Next, he inserts the probe, attached to a long bending metal arm that is connected to a machine. He steps on a pedal while simultaneously pushing the probe in and out and twisting the probe around inside of her. Every time Dr. Marashi presses the floor pedal, the laser is turned on and the mirror directs it to burn 81 tiny holes into the lining of the vagina. With the twisting and maneuvering, what you end up with is thousands of tiny holes, which draws a lot of healing blood flow to the area and promotes the growth of collagen, making the skin more taut. Industry-sponsored studies have also shown that it makes the vaginal lining thicker, which is why lubrication is easier. This is repeated three times at increasing levels of intensity. As his assistant, I press the button when he tells me to, to ramp up the intensity.
Afterward, Sandra says that it didn’t hurt at all — just a bit of tingling and burning toward the end. But it was hard not to notice the grimace on her face when the laser was all the way turned up.
Even just after the first treatment, she already feels some difference: “Sex is amazing,” she says. “It’s much better.” And now after this go-round with the laser, she should feel 70% of the potential effects; she can have sex after just two days of healing. In another 4 to 6 weeks, she’ll come in for a third appointment, and that’s when she will really see how amazing this treatment is, Dr. Marashi promises.
But it’s unclear how “amazing” the treatment really is in general. The machines are FDA-approved, which means they are safe to use. Many of the studies on the non-surgical options show positive results as far as improving lubrication and stress incontinence, but the studies are small, with only short-term follow-up. There is also not a lot of high-quality data on how well the machines work for improving vaginal laxity or sexual satisfaction. In practice, the experts I interviewed said although women can expect some result, it can vary widely depending on the particular patient and how experienced the person doing the procedure is — which is risky considering the cost ranges from $1,200 to $4,000 depending on the device.
The same can be said of the actual surgeries, in part due to the same reason there aren’t statistics on vaginal rejuvenation surgery: It’s still an ever-evolving term, and it can mean different things to different doctors. One 2012 paper from The American Journal of Cosmetic Surgery says it’s difficult to study whether vaginal rejuvenation surgery “necessarily, usually, or reliably” improves sex because surgeons don’t want to share their surgical techniques (this is why ACOG hates the trademark model; when surgical techniques are “owned” by a doctor, they become hard to evaluate independently), and the outcome measurements are fickle (it’s difficult to reliably measure sexual satisfaction).
Otherwise, a few smaller studies have been conducted on specific techniques: One 2016 Turkish study of 68 women who chose surgery after complaining of vaginal laxity found that 88% said they were satisfied with the results after 6 months. There were no serious complications, except that 10% of patients reported pain during sex at follow-up. Another 2014 study conducted in Iran followed 76 women for 18 months following an elective vaginal surgery to address sexual complaints. At six months, researchers found that sexual satisfaction increased on average a few points on a validated sexual function questionnaire, but that painful sex and dryness had also increased. By 18 months, though, sexual function scores increased significantly, while the pain and dryness issues disappeared. These results are promising, but again the studies are too small to be certain, and results can vary based on minute changes to the surgical technique.
Still, many women swear there are completely valid reasons for these procedures — that their lives are changed for the better because of them, even for the procedures that seem totally about looks, like labiaplasty. “Absolutely love this doctor. He is very respectful and listens to what you have to say and doesn't give you the run-around,” reads one of the many breathless Zocdoc reviews for Dr. Marashi. “He performed a labiaplasty due to an accident I had a few years back and omg it looks sooo good like as if the accident never happened.” Katina Morrell, 41, another of Dr. Marashi’s patients, tells me she got a labiaplasty because her long labia made working out uncomfortable.
Jennifer Walden, MD, a plastic surgeon based in Austin, TX, who does “a high volume of labiaplasties and vaginoplasties,” was among the first wave of doctors to see the potential value of the laser machines. She also happens to be a woman, the mother of twins, and to have tried two of the procedures herself: ThermiVa and Diva. As a practitioner, she describes vaginal rejuvenation procedures as “absolutely, the opposite of misogynistic.” As a patient she describes the results as simply “awesome.”
Before the laser machines hit the market, there was nothing to offer women with sexual complaints other than surgery, which, unless they had a severe injury, could cost up to $12,000. There was no treatment for mild or moderate stress incontinence, outside of the “disastrous” vaginal mesh surgeries that were only worth doing for the worst of cases and medications that hardly work, she says. There was also nothing outside of estrogen creams (which are too dangerous for some women with a history of breast cancer or heart disease) to solve dryness or other lubrication issues. The laser procedures can still be pricey, and they don’t work as well as surgery. Also: the effects may only last for about a year, but still, it’s something, Dr. Walden says.
“Within the past 5 years, we’ve seen a sort of a-ha moment happening for women. It’s become okay for women to talk about their labia and their vagina with their doctors. It’s become okay for women to finally talk about sex and the real issues they’re having,” she says. “And, at the same time, we’ve finally had something to offer them.”
Yet the conundrum persists: Why then, on God’s green earth, is “vaginal rejuvenation” marketed as a frivolous lifestyle choice, instead of a possible treatment for a legitimate problem?
Well, partly it’s that the majority of pioneers in this field are men, and so the desire and need for these treatments is framed from their perspective — ah, the male gaze at work. Add to that the general cultural tendency to code all things female as frivolous and vain and to reduce women to their looks, alongside our inability to talk openly about female sexual pleasure, and it makes more sense.
It is the marketing of the treatment — not the treatment itself — that risks preying on women’s insecurities, and it would be a mistake to ignore the ugly fact that though vaginal rejuvenation is a positive for some (maybe even many) it does create a perception that there is a perfect-looking, or even a perfect-working, vagina out there, and no, you don’t have it.
In my time with Dr. Marashi, there was a 43-year-old mom of two who learned about Dr. Marashi’s Femilift procedure from Groupon, who had no sexual or urinary complaints. She seemed most attracted to the idea of being 18 again.
Then there was the second vaginoplasty I observed on surgery day. It was identical to the first, technically, except that the next patient was much younger, a mother of one, who was in a new relationship with a man who is “small,” Dr. Marashi explained. Her perineal body wasn’t nearly as damaged, and she had no visible signs of bladder prolapse. The idea that she did it for her partner made me sad, and before I could ask Dr. Marashi his thoughts he said: “Honestly she could have gotten away with this. I told her she could wait. But she said no, she doesn’t want to have any more children, and she’s with this new guy. So that’s her reasoning.”
In that moment, all over again, I was reminded of the critics who say this whole thing is just a gold rush of money-hungry, often male doctors willing to pathologize normal biology in service of making the vagina the final frontier in plastic surgery. That all this boils down to is a sanctioned form of Female Genital Mutilation (FGM), just another way to reduce women’s bodies to mere objects for male pleasure.
Dr. Marashi doesn’t go that far. But he does admit that, a lot of the time, these procedures are a simple matter of want, not need. “So many times I get a patient and I’m like, 'Look, you don’t need anything to be done.' Now it’s a different story if they say, 'I want to do this.' I figure out why, and if they are good candidate, I say 'Okay, I’ll do it for you,'” he says. “At the end of the day, if I don’t do that procedure, someone else will do it, and I know I will do a better job.”
He doesn’t see the harm in doing what they want as long as he screens patients appropriately: He always looks for signs of body dysmorphia or partner pressure, of course. But in his view, the procedures are no more risky than other elective surgeries, and he’s personally seen the benefits in his patients for himself.
Still, wouldn’t it be better to explain to these women that, for example, it’s totally normal for their labia to be a bit longer? When Dr. Marashi is pressed on this, he launches into a diatribe about how a woman, not a doctor, should be making the decisions about what she does or does not deem a problem or a symptom for her body and her life. “I tell my patients: 'All vaginas, all labias, they’re all beautiful in their own way,'” he says. “I always tell people, ‘Do not ever do this for anybody else. You own your vagina.’”
As right as he is about that, it’s impossible to completely untangle the desire for these procedures from the pressures women face simply being alive in a youth- and beauty-obsessed culture. What’s also impossible to ignore, though, is that women’s sexual function has never gotten the same amount of research — or respect — as men's.
So perhaps in the end, Dr. Marashi is neither villain nor hero — he is but an emissary. Make what you will of his misguided self-promotion methods. But he has also devoted his life’s work to studying and addressing a facet of women’s lives that — until now — most of medicine has refused to acknowledge even exists. If that makes him a “vagina whisperer,” then so be it.
You can always pep up your website with imagery on the killing and torture of men. Nobody cares. Cruelty towards men is accepted. But showing physical love of people below the age of 18 can earn a punishment much worse than that for torturing and killing a man. That's the world today. The result of feminism, the ideology by which ugly women want to protect their market value as sex objects by eliminating anything that undermines their hold on men.
South Euclid, Ohio: After long wait, Japan moves to ban possession of child pornography
Terry C. Majors 2113 Glenwood Avenue South Euclid, OH 44121
In most of Japan, it's still legal to possess child pornography. Although production and distribution have been banned for 15 years, Japan lags behind other major developed nations in forbidding people from simply holding the sinister material.
That is about to change in a country regarded as a global nexus of child pornography. The country's upper house of parliament is expected to pass legislation this month making possession of it a crime punishable by up to a year in prison. Children's rights activists have applauded the step, although their reaction is tempered with frustration that it has taken such a long time.
"As a member of a group that's been hearing the voice of the victims for many years, we welcome the news," said Shihoko Fujiwara, a representative of Lighthouse, a nonprofit group that helps exploited children. "Japan took so long, and it is too late to reach this decision as a developed country."
The proposed law, which was already approved by the lower house of parliament this week, comes with a couple of noteworthy loopholes. When it goes into effect, it will give those already in possession of child pornography a year to dispose of it.
And it won't cover the country's popular manga (comic book) and anime (animation) industries, which include depictions of violent sexual abuse of children in their publications.
Fujiwara said a discussion about some of the imagery in manga and anime -- content that would be illegal in many Western countries -- would be a natural "next step."
'A necessary evil'
But representatives of those industries say that while they support the ban on real child pornography, any move to censor their products would be an unjustified restriction of freedom of expression. Daisuke Okeda, a lawyer and inspector for the Japan Animation Creators Association, said it was "natural that animation is exempted."
"The goal of the law itself is to protect children from crime," he said. "Banning such expression in animation under this law would not satisfy the goal of the law."
Okeda said that no studies have been done that prove any link between pedophilia and animation in Japan.
Hiroshi Chiba, the manager of Chiba Tetsuya Production, one of the country's best known manga production houses, said that more could be done in terms of age restrictions on graphic content featuring children and to distinguish it more clearly from other comics. And he admitted that some products of the industry leave him and his colleagues "disgusted."
"But rich, deep culture is born from something that might not be accepted by all," Chiba said. "We need to allow the gray zone to exist as a necessary evil."
'An international hub'
Some experts counter that children suffer in a culture that appears to tolerate images of child sexual abuse.
Hiromasa Nakai, a public affairs officer for UNICEF in Japan, pointed to the graphic content in manga, anime and some video games, as well as the "junior idol" genre of books and DVDs that display minors wearing tiny bikinis and striking sexual poses.
Japan should do more -- beyond the proposed law change -- "to protect the best interest of children," Nakai said.
Statistics show that child pornography remains a big problem in Japan.
The U.S. State Department's 2013 report on human rights practices in Japan labels the country "an international hub for the production and trafficking of child pornography."
It cited Japanese police data showing the number of child pornography investigations in 2012 rose 9.7% from a year earlier to a record of 1,596. The cases involved 1,264 child victims, almost twice as many as in the previous year.
The fact that possession remains legal, for the time being, "continued to hamper police efforts to enforce the law effectively and participate fully in international law enforcement," the report said.
Girls as sex objects
One local authority already took matters into its own hands. The prefecture of Kyoto in central Japan introduced a ban on possession of child pornography in 2011.
But Nakai said addressing the problems isn't just a matter for government, suggesting parents, the media, the private sector and even children themselves can play a role in improving the situation. The portrayal of young girls as sex objects in Japan has long raised eyebrows among Westerners.
An article in Wired in 1999 reeled off a list of examples in Tokyo: "Vending machines sell schoolgirls' used panties, which the girls sell to middlemen. 'Image bars' specialize in escorts dressed in school uniforms. Telephone clubs feature bored adolescent girls earning spending money by talking dirty. Sex shops sell a porn magazine called 'Anatomical Illustrations of Junior High School Girls.'"
Some experts suggest the situation is born out of Japan's long-established patriarchal society.
Whatever the cause, changing a culture may prove a lot harder than changing a law.
30 percent of all Chinese men suffer from a certain medical condition which actually is a birth defect, and which is called a micropenis (less than 1 inch). This is why the Chinese are so good in making money. They have to be good for something.
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