To understand the women’s experience of genital cosmetic surgery and also to figure out their understanding of and reasons for doing such surgical interventions, semi-structured interviews were carried out with them, which led to the emergence of the main themes, including “husband satisfaction” and “self-confidence”. Moreover, relevant subthemes and meaning units were extracted from the direct quotations which were retrieved from the participants’ stories, and the related conclusions of each theme were explored.
The first main theme: Husband Satisfaction
Based on the data extracted from the interviews, the main theme was “Husband Satisfaction” which included three subthemes, namely “ugly appearance”, “anxiety related to husband undesirable intercourse”, and “dyspareunia”.
The majority of the participants complained about their husband’s dissatisfaction with their intercourse, which made them feel anxious. They also stated that this condition made their relationship with their husband problematic, which in turn had negative effects on their life. Moreover, they were anxious about their marital relationship and satisfying their husband’s special needs. As they revealed, the ugly genital appearance was one of the causes of this problem. For example, Participant No. 1 stated:
“After my first childbirth, my genital area tore, but the midwife didn’t suture it, so I frequently experienced infection for nearly 7 years. Especially, I felt that gases came out of my vagina during intercourse, and my husband always complained about its appearance and grumbled. So, I decided to do genital cosmetic surgery after consulting with a gynecologist who guided me through and told me that nowadays many women in the world have such problems, but they resolved their problems through surgery. She also said that some women do such interventions just to change their body image. She suggested me surgery as the best way to get rid of my problem. Now after genital repair and such surgery, my partner is satisfied, but I’m in pain during intercourse”.
In the same regard, Participant No. 2 mentioned:
During my last delivery, I had laceration in my vagina and vulva when I was in the hospital. My midwife sutured it, but after I was discharged and while working at home, it opened and caused pain and infection for almost 3 years. However, last year another physician sutured and repaired it for the second time. Unfortunately, after two days, I fell off from a chair and it ruptured and caused sever pain again for several days. This time, I reject to repair it again because I have no luck. My husband complains, but I cannot change the condition, what can I do?
Moreover, Participant No. 5 mentioned a wonderful subject which reflected the subtheme of ugly appearance leading to female circumcision or delivery. In this regard, she narrated:
“I was married, but neither my husband nor I was satisfied with our intercourse, because when I was a small girl, my parents took me to a circumciser and she cut half of my genital labia in an irregular shape, so I did genital cosmetic surgery to repair it and decrease my husband’s complaints without notifying myself like some Kurdish women. We should remain silent and say yes to our husbands all the time”.
Furthermore, Participant No. 6 who aged 50 years with 7 children relate:
“Throughout all of my married life, I was unhappy with our intercourse because my husband was always nagging to me and said I was like a dry stick because I am one of hundreds of girls who was circumcised during childhood, which I thought was one of the reasons for his nagging. He closed his eyes to my real world as a woman and human and didn’t understand my condition. I also experienced frequent perineal lacerations, leading to 7 childbirths, which caused more problems for me. Anyway, I’m better now because I did surgery, and my physician repaired my genital parts, and both my husband and I are comfortable and I feel better”.
As revealed by the participants, women’s ability to satisfy their spouse effected their married life and relationship. They tried to retrieve the normal shape and size of their genital organ to satisfy their spouse’s desire.
The second main theme: Self-confidence
Some of the participants revealed their experience of prolapse of uterus or collection of fatty tissue in the genital area after delivery, leading to the extraction of subthemes, entitled “self-satisfaction, love, and attention”. In this regard, one of the participants talked about having pain and discomfort which had led to delivery complications and made her attend the gynecologist for surgery and repair her perineal area to improve comfortability for normal life and intercourse so as to gain her partner’s attention. She further added:
“After my childbirth, my uterus came down, so that I could feel it when I sat. This condition made me uncomfortable too much. I had pain which led to both uterine prolapse and hemorrhoid. To resolve my complications, I did surgery, and now I am satisfied with sexual activity with my husband. Unlike the past, I think he loves me more because he speaks with me more cordially”.
Participant No. 7 was divorced and she wanted to marry again, so she prepared herself for marriage by doing some plastic and cosmetic surgery to remove her fatty tissue from her abdomen and genital area following her fiancé’s request. Hymen is culturally very important for both partners, and it increases sexual satisfaction during their first intercourse. In this regard, she continued:
“After the proposal and engagement, my fiancé asked me to repair my genitalia, especially my hymen through hymenoplasty to be like before my first marriage. So, after I attended a physician, she repaired my vagina and did hymenoplasty. Now I’m feeling more confident, and I’m ready for marriage”.
Participant No. 4 who was an unmarried 23-year-old girl stated:
I want to marry, but I was thinking of doing labiaplasty before marriage, so I did it because I experienced circumcision during my childhood, leading to irregular size of my labia.
Regarding love and attention after genital repairing, Participant No. 9 revealed:
I’ve got 5 children. After delivery of each of them, I had many problems with urination and intercourse. My husband complained about dissatisfaction with our intercourse. I felt that he didn’t love me, because of our sexual problems. Those problems affected our married life and decreased my self-steam, especially during intercourse.
In the same regard, another participant stated:
“Immediately after my last childbirth, the physician sutured my episiotomy and used cosmetic technique for suturing and repaired it because I asked her to repair my perineal area, because it was the main reason for marriage problems between me and my husband after our previous childbirth. This cosmetic surgery raised love between us. I believe if the woman fails to satisfy her husband during sexual intercourse, they will face many problems in their married life”.
According to these narrations, Kurdish culture plays an important role in married life and dyadic relationship because man in cultures like Arab and Middle Eastern countries is the first person in family and woman should be responsible to provide his satisfaction in their married life without notifying her human right and sexual needs.