Female Genital Cosmetic Surgery Exceptional

Total Page：16

File Type：pdf, Size：1020Kb

FEMALE GENITAL COSMETIC SURGERY EXCEPTIONAL FUNDING REQUIRED BaNES, Swindon and Wiltshire CCG (BSW) does not normally fund elective vaginal labial surgery, vaginoplasty or hymenorrhaphy. Clinicians must ensure there is a clear clinical rationale for any potential intervention, as all procedures that involve partial or total removal of the external female genitalia for non-clinical reasons are defined as Female Genital Mutilation and as such are against the law. (The Female Genital Mutilation Act of 2003) Clinicians must be alert to the possibility that some patients who seek revision surgery may do so as a result of previous interventions which are classed as unlawful under the Act. Background Labiaplasty A labiaplasty is a surgical procedure to reduce the size of the labia minora. Labiaplasty is generally a cosmetic procedure to change appearance alone and common consequence of childbirth is not sufficient reason to apply for funding. Labiaplasty is not normally supported or funded by the CCG. Vaginoplasty Non-reconstructive vaginoplasty or "vaginal rejuvenation" is used to restore vaginal tone and appearance. As this is generally considered a cosmetic procedure, vaginoplasty is not normally supported or funded by the CCG. Hymenorrhaphy Hymenorrhaphy, or hymen reconstruction surgery, is a cosmetic procedure and is not normally supported or funded by the CCG. This policy does not relate to reversal of female genital mutilation. This policy is informed by the NHS England (2013) Interim Clinical Commissioning Policy Labiaplasty, Vaginoplasty & Hymenorrhaphy. (Armed Forces Commissioning Policy Task and Finish Group) Reference: Policy Name Review Date Version BSW-CP046 Female Genital Cosmetic Surgery 2023 4.1 .

Copy Link

Recommended publications

Multisectoral Academic Training Guide on Female Genital Mutilation/Cutting
Multisectoral Academic Training Guide on Female Genital Mutilation/Cutting Directoras Adriana Kaplan y Laura Nuño Gómez Coordinadoras Magaly Thill y Nora Salas Seoane Multisectoral Academic Training Guide on Female Genital Mutilation/Cutting Multisectoral Academic Training Guide on Female Genital Mutilation/Cutting Directoras Adriana Kaplan y Laura Nuño Gómez Coordinadoras Magaly Thill y Nora Salas Seoane Neus Aliaga Sonia Núñez Puente Rut Bermejo Casado Laura Nuño Gómez Clara Carvalho Els Leye Giovanna Cavatorta Carla Moleiro Gily Coene Maya Pellicciari Ricardo Falcão Francesco Pompeo Lidia Fernández Montes Julia Ropero Carrasco Diana Fernández Romero Nora Salas Seoane Sabrina Flamini Cristina Santinho Michela Fusaschi Magaly Thill Cecilia Gallotti Valentina Vitale Adriana Kaplan Edición y revisión de la versión original en inglés Lucy Deegan Leirião This publication has been produced with the financial support of the Rights, Equality and Citizenship Programme 2014-2020 of the European Union. The contents of this publication are the sole responsibility of its authors and can in no way be taken to reflect the views of the European Commission. It is part of the Multisectoral Academic Programme to prevent and combat Female Genital Mutilation (FGM/C). © Los autores Editorial DYKINSON, S.L. Meléndez Valdés, 61 – 28015 Madrid Teléfono (+34) 91544 28 46 – (+34) 91544 28 69 e-mail: [email protected] http://www.dykinson.es http://www.dykinson.com ISBN: Preimpresión: Besing Servicios Gráﬁ cos, S.L. [email protected] Table of contents List of abbreviations ..................................................................................... 15 Institutions and authors ............................................................................... 17 Chapter I. Introduction to the Multisectoral Academic Training Guide on FGM/C .............................................................................. 25 Laura Nuño Gómez and Adriana Kaplan 1.
[Show full text]
Female Genital Cosmetic Surgery Exceptional
FEMALE GENITAL COSMETIC SURGERY EXCEPTIONAL FUNDING REQUIRED BaNES, Swindon and Wiltshire CCG (BSW) does not normally fund elective vaginal labial surgery, vaginoplasty or hymenorrhaphy. Clinicians must ensure there is a clear clinical rationale for any potential intervention, as all procedures that involve partial or total removal of the external female genitalia for non-clinical reasons are defined as Female Genital Mutilation and as such are against the law. (The Female Genital Mutilation Act of 2003) Clinicians must be alert to the possibility that some patients who seek revision surgery may do so as a result of previous interventions which are classed as unlawful under the Act. Background Labiaplasty A labiaplasty is a surgical procedure to reduce the size of the labia minora. Labiaplasty is generally a cosmetic procedure to change appearance alone and common consequence of childbirth is not sufficient reason to apply for funding. Labiaplasty is not normally supported or funded by the CCG. Vaginoplasty Non-reconstructive vaginoplasty or "vaginal rejuvenation" is used to restore vaginal tone and appearance. As this is generally considered a cosmetic procedure, vaginoplasty is not normally supported or funded by the CCG. Hymenorrhaphy Hymenorrhaphy, or hymen reconstruction surgery, is a cosmetic procedure and is not normally supported or funded by the CCG. This policy does not relate to reversal of female genital mutilation. This policy is informed by the NHS England (2013) Interim Clinical Commissioning Policy Labiaplasty, Vaginoplasty & Hymenorrhaphy. (Armed Forces Commissioning Policy Task and Finish Group) Reference: Policy Name Review Date Version BSW-CP046 Female Genital Cosmetic Surgery March 2023 4.1 .
[Show full text]
Brian D Earp, Jennifer Hendry, Michael Thomson Medical Law Review, Volume 25, Issue 4, Autumn 2017, Pages 604–627
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in “Medical Law Review, following peer review. The definitive publisher-authenticated version: Reason and Paradox in Medical and Family Law: Shaping Children's Bodies Brian D Earp, Jennifer Hendry, Michael Thomson Medical Law Review, Volume 25, Issue 4, Autumn 2017, Pages 604–627, The article is available online at: https://academic.oup.com/medlaw/article- abstract/25/4/604/3852239?redirectedFrom=fulltext REASON AND PARADOX IN MEDICAL AND FAMILY LAW: SHAPING CHILDREN’S BODIES Brian D. Earp, Jennifer Hendry & Michael Thomson ABSTRACT Legal outcomes often depend on the adjudication of what may appear to be straightforward distinctions. In this article, we consider two such distinctions that appear in medical and family law deliberations: the distinction between religion and culture, and between therapeutic and non-therapeutic. These distinctions can impact what constitutes ‘reasonable parenting’ or a child’s ‘best interests’ and thus the limitations that may be placed on parental actions. Such distinctions are often imagined to be asocial facts, there for the judge to discover. We challenge this view, however, by examining the controversial case of B and G [2015]. In this case, Sir James Munby stated that the cutting of both male and female children’s genitals for non- therapeutic reasons constituted ‘significant harm’ for the purposes of the Children Act 1989. He went on to conclude, however, that while it can never be reasonable parenting to inflict any form of non-therapeutic genital cutting on a female child, such cutting on male children was currently tolerated.
[Show full text]
Asymptotic Medicine by Karmen Lončarek [email protected]
HeAltH of tHe HeAltH SySteM 83 doi: 10.3325/cmj.2009.50.83 Asymptotic Medicine By Karmen Lončarek [email protected] Medicine and “Big Pharma” (1), as its strongest ally, are rap- although extreme, example: suppose there was a medi- idly reorienting toward treating the healthy people, which cation that could make everybody’s skin color exactly the is well reflected in the Ray Moynihan’s term of disease same. If everyone took the medication, discrimination mongering (2) and Richard Smith’s list of non-diseases (3). based on skin color would certainly be eliminated. How- The most obvious and commonest reasons for this trend ever, having the “wrong” skin color is not a “lifestyle prob- are profit (healthy people are more numerous and wealth- lem,” nor are aging, menopause, or shyness (13). Obviously, ier than ill people), defensive medicine (fear from lawsuits medicine plays a role of strong social regulator, concealing for malpractice) (4), greater personal satisfaction, and bet- some aspects of social injustice and inequality. ter health outcomes (generally, healthy people have bet- ter outcomes than the sick ones). However, there are some TECHNOLOGY OF USELESSNESS other, less obvious, reasons why physicians choose to treat healthy people. Besides physician-healthy patient relation, there is also a second important element of modern medicine – medi- Let us take a look at the list of the most prevalent medical cal technology. procedures (Box 1) and the most common pharmaceuti- cal interventions (Box 2) aimed at healthy people (lifestyle There are two scenarios about the future of technology – pharmacology), which pervade almost all medical special- one is that totally useful technology would finally bring us to ties (5-9).
[Show full text]
The Relationship Between Female Genital Aesthetic Perceptions and Gynecological Care
Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care By Vanessa R. Schick B.A. May 2004, University of Massachusetts, Amherst A Dissertation Submitted to The Faculty of Columbian College of Arts and Sciences of The George Washington University in Partial Satisfaction of the Requirements for the Degree of Doctor of Philosophy January 31, 2010 Dissertation directed by Alyssa N. Zucker Associate Professor of Psychology and Women’s Studies The Columbian College of Arts and Sciences of The George Washington University certifies that Vanessa R. Schick has passed the Final Examination for the degree of Doctor of Philosophy as of August 19, 2009. This is the final and approved form of the dissertation. Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care Vanessa R. Schick Dissertation Research Committee: Alyssa N. Zucker, Associate Professor of Psychology & Women's Studies, Dissertation Director Laina Bay-Cheng, Assistant Professor of Social Work, University at Buffalo, Committee Member Maria-Cecilia Zea, Professor of Psychology, Committee Member ii © Copyright 2009 by Vanessa R. Schick All rights reserved iii Acknowledgments The past five years have changed me and my research path in ways that I could have never imagined. I feel incredibly fortunate for my mentors, colleagues, friends and family who have supported me throughout this journey. First, I would like to start by expressing my sincere appreciation to my phenomenal dissertation committee and all those who made this dissertation possible: Without Alyssa Zucker, my advisor, my journey would have been an entirely different one. Few advisors would allow their students to forge their own research path.
[Show full text]
6 Oeming in VULVA VANITAS
IN VULVA VANITAS – The Rise of Labiaplasty in the West By Madita Oeming, University of Paderborn, Germany Abstract Since the turn of the 21 st century, more and more women choose to undergo Female Genital Cosmetic Surgery (FGCS) to fit a vulvovaginal aesthetic ideal. With a focus on reduction labiaplasty as the currently most widespread of these procedures, this article examines FGCS through a critical cultural studies lens to position it within larger feminist debates about body image, consumer culture, and female agency. A central question is where our Western ideal of female genital appearance comes from that incites the desire to undergo surgical body modification? Against the backdrop of post-colonial criticism, the article challenges the distinction between FGM in non-Western cultures and FGCS in the West through questioning the notion of informed consent associated with the latter. By bringing together otherwise separate voices from various disciplines, the overall aim is to present FGCS as an intricate interface between biology, psychology, culture, and media discourse. 1 “It’s time to let my labia rip and rearrange this.” – from “Pussy Manifesto” by Bitch & Animal 1 Try this: walk into a drug store, grab a shopping cart, and put inside every product designed to optimize the female-coded body. Spoiler alert! One cart will not be enough. Shampoo to make our hair shiny, lotions to make our skin smooth, toothpaste to whiten our teeth, concealer to hide our freckles, gloss to boost our lips, face masks to make us look like we had enough sleep, fake nails, fake lashes, fake tan – the assortment is as endless as its subtext is loud and clear: your body needs modification! A plethora of anti-something products provide an exhaustive list of things we are supposed to work on: frizz, cellulite, pimples, puffiness, dark circles, body hair, brittle nails, stretch marks, belly fat, to name just a few; and of course, any sign of aging whatsoever, from grey hair to wrinkles to saggy arm skin.
[Show full text]
FGM – Female Genital Mutilation Kvinnlig Könsstympning
Trollhättan, 17+18/11 2016 Senior FGM – Female Genital Mutilation Kvinnlig Könsstympning Dr. med. Johannes Leidinger, MD., MPH. Senior Consultant in Gynaecology and Obstetrics Överläkare på Kvinnokliniken Södersjukhuset Stockholm & Mälarsjukhuset Eskilstuna Lehrbeauftragter/Dozent der Ludwig-Maximilians-Universität München 16 days of activism 2016 From 25 November, the International Day for the Elimination of Violence against Women, to 10 December, Human Rights Day, the 16 Days of Activism against Gender-Based Violence Campaign is a time to galvanize action to end violence against women and girls around the world. http://www.unwomen.org/en/what-we-do/ending-violence-against-women/ take-action/16-days-of-activism#sthash.zXvSzU8E.dpuf Sexual Violence: ¨ Rape ¨ Indecent Assault ¨ Forced Marriage ¨ Sexual Slavery http://www.eldis.org ¨ FGM (Female Genital Mutilation) ¨ Forced Pregnancy ¨ Forced Abortion ¨ Sexual Harassment WHO: FGM ¨ „FGM comprises all procedures that involve altering or injuring the female genitalia for non medical reasons - , and is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women and girls.“ Program 18 Nov 2016, 9-12 am ¨ Nomenklatur ¨ Klassifikation ¨ Global Prevalens ¨ Förklaringsmodeller ¨ Medicinska komplikationer ¨ Nationell & internationell Lagstiftning ¨ Vård i Sverige – AMEL-mottagning – Operativa rekonstruktioner – Desert Flower Scandinavia ¨ Global perspektiv – Internationella strategier (WHO och NGOs) – Medicalization of FGM Terminology ¨ The expression ”Female Genital Mutilation" gained growing support from the late 1970s. The word ”mutilation” establishes a clear linguistic distinction from male circumcision, and emphasizes the gravity and harm of the act. ¨ In 1990, this term was adopted at the ”3rd Conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children”, in Addis Ababa, Ethiopia.
[Show full text]
GM EUR Generic Funding Request Form NOTE
2017-19 Effective Use of Resources Treatment Policies GM EUR Team Contacts Tel Email Version 5.7 Funding applications / Process 0161 212 6250 [email protected] List Last Updated 22 January 2019 Policy development 0161 212 6212 [email protected] Approval Funding Approval Category Notes Funding Request Forms Required Individual Funding Request A decision has been taken not to commission a specific treatment. Funding will only be approved if there is evidence of clinical GM EUR Generic Funding Request Form Yes (Exceptional Case) Approval (IFR) exceptional circumstances. NOTE: GM policies have specific funding request forms, please see the end column on the The Commissioner has specifically requested that funding is sought for a particular treatment. The treatment must not be Yes blue coloured rows below. Individual Prior Approval (IPA) undertaken without funding approval from commissioners. Exceptional circumstances do not always have to be demonstrated. PbR Excluded Lists Monitored Approval (MA) The specific treatment may be undertaken in line with agreed EUR policy criteria/routine commissioning arrangements provided the policy criteria is met, clinicians can refer patients without seeking approval. If the patient does not meet the policy NOTE: Only applies if the patient No PbR Excluded Devices List PbR Excluded Drugs List criteria clinicians should apply for Individual Funding Request (Exceptional Case) Approval. Audits may be undertaken to meets the policy critiera. ensure adherence with agreed commissioning arrangements.
[Show full text]
Labiaplasty / Vaginoplasty Commissioning Policy
Commissioning Statement: Condition or Labiaplasty / Vaginoplasty Treatment: Background: This commissioning policy is needed as cosmetic procedures are not routinely commissioned. Labiaplasty is a surgical procedure where the folds of the labia minora are partially removed, usually for cosmetic reasons alone to change appearance. Non-reconstructive vaginoplasty or "vaginal rejuvenation" is another cosmetic procedure used to restore vaginal tone and appearance Note: Female circumcision is prohibited in law by the Female Genital Mutilation Act 20031 and is the subject of multi-agency guidelines from the Department of Health. Patients who have undergone female genital mutilation should be referred to a specialist female genital mutilation clinic via NHS England. Commissioning The CCG will ONLY routinely commission reconstructive labiaplasty/ position: vaginoplasty: • Following surgery for cancer; • vaginal repair following delivery; • for dyspareunia caused by scarring from vaginal delivery (including Fenton‟s procedure); • for scarring caused by underlying dermatology condition such as Lichen Sclerosis NHS North Yorkshire CCG does not routinely commission labiaplasty/ vaginoplasty, for cosmetic reasons, as these procedures are considered to be of limited clinical value. This is in line with the Interim Clinical Commissioning Policy produced by NHS England. Requests for labiaplasty will be considered, via a request to the IFR Panel, for the following indication: • Where the labia are directly contributing to recurrent disease or infection Requests for vaginoplasty will be considered, via a request to the IFR Panel, for the following indication: • Congenital absence or significant developmental/endocrine abnormalities of the vaginal canal, The clinician needs to submit an application to the CCG‟s Individual Funding Request Panel (IFR) Referral Exceptional cases can be referred to the CCG’s Individual Funding Guidance: Request Panel for prior approval.
[Show full text]
Extensive Vulvar Hematoma As a Complication of Labiaplasty: a Case Report
Open Journal of Obstetrics and Gynecology, 2020, 10, 880-885 https://www.scirp.org/journal/ojog ISSN Online: 2160-8806 ISSN Print: 2160-8792 Extensive Vulvar Hematoma as a Complication of Labiaplasty: A Case Report Amal Al Mulla*, Humma Habib, Ousama Jarrad OBSGYN & Reproductive Medicine, Amina Hospital, Ajman, United Arab Emirates How to cite this paper: Al Mulla, A., Ha- Abstract bib, H. and Jarrad, O. (2020) Extensive Vul- var Hematoma as a Complication of La- Vulvar hematoma is an extremely rare complication outside obstetric prac- biaplasty: A Case Report. Open Journal of tice. Owing to the vulvar structure and its rich blood supply, hematoma can Obstetrics and Gynecology, 10, 880-885. reach an enormous size over a short period. Although direct trauma is the https://doi.org/10.4236/ojog.2020.1070082 anesthetic 31-year-old nullipara admitted for acute massive vulvar swelling as Received: June 8, 2020 a complication of labiaplasty. She scored 10 on the pain scale. Upon admis- Accepted: July 5, 2020 sion to the emergency department, she had normal vital signs and was imme- Published: July 8, 2020 diately started on intravenous acetaminophen and prophylactic antibiotics. The patient was subsequently transferred to the operating theater for exami- Copyright © 2020 by author(s) and Scientific Research Publishing Inc. nation and drainage of the hematoma under anesthesia. Reconstruction of the This work is licensed under the Creative labia was performed. The patient had a smooth postoperative course and was Commons Attribution International discharged on the 3rd postoperative day. We concluded that Anesthetic gyne- License (CC BY 4.0).
[Show full text]
Redundant Skin Surgery
Medical Coverage Policy Effective Date ............................................. 6/15/2021 Next Review Date ....................................... 6/15/2022 Coverage Policy Number .................................. 0470 Redundant Skin Surgery Table of Contents Related Coverage Resources Overview .............................................................. 1 Bariatric Surgery and Procedures Coverage Policy ................................................... 1 Blepharoplasty, Reconstructive Eyelid Surgery, and General Background ............................................ 2 Brow Lift Medicare Coverage Determinations .................... 5 Panniculectomy and Abdominoplasty Coding/Billing Information .................................... 5 Surgical Treatments for Lymphedema and Lipedema Treatment of Gender Dysphoria References .......................................................... 6 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description
[Show full text]
The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: an ICS/ISSVD Best Practice Consensus Document
Received: 30 November 2018 | Accepted: 3 January 2019 DOI: 10.1002/nau.23931 SOUNDING BOARD The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document Mario Preti MD1 | Pedro Vieira-Baptista MD2,3 | Giuseppe Alessandro Digesu PhD4 | Carol Emi Bretschneider MD5 | Margot Damaser PhD5,6,7 | Oktay Demirkesen MD8 | Debra S. Heller MD9 | Naside Mangir MD10,11 | Claudia Marchitelli MD12 | Sherif Mourad MD13 | Micheline Moyal-Barracco MD14 | Sol Peremateu MD12 | Visha Tailor MD4 | TufanTarcanMD15 | EliseJ.B.DeMD16 | Colleen K. Stockdale MD, MS17 1 Department of Obstetrics and Gynecology, University of Torino, Torino, Italy 2 Hospital Lusíadas Porto, Porto, Portugal 3 Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal 4 Department of Urogynaecology, Imperial College Healthcare, London, UK 5 Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 6 Glickman Urological and Kidney Institute and Department of Biomedical Engineering Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 7 Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 8 Faculty of Medicine, Department of Urology, Istanbul University Cerrahpaşa, Istanbul, Turkey 9 Department of Pathology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey 10 Kroto Research Institute, Department of Material Science and Engineering,
[Show full text]