Genital plastic surgery has become so common among Australian women that the State's universal health insurance scheme (Medicare) now insists physicians send them photos of their patients' genitals before they will fund an operation.

Those photos are reviewed by a panel of experts before a decision is made.

Doctors in Australia say more women are presenting to them looking to change the appearance of their genitals, and they say they don't know why it is happening.

They have responded by publishing guidelines on how to deal with female patients seeking elective procedures.

What is it?

Female Genital Cosmetic Surgery is any procedure that reshapes or changes the appearance of the healthy genitalia of women and is carried out for non-medical reasons.

According to figures from Medicare, the number of women undergoing FCGS in Australia has increased dramatically in recent years.

The Royal Australian College of General Practioners says it is a cultural change that is causing women to seek operations that will make them feel 'normal' or look 'desirable.

The RACGP has produced guidelines because of the volume of requests patients are making.

The document they have produced is described as a resource for doctors and other health professionals who need direction on how to deal with woman who are concerned about their genitalia.

Attitude change

There are concerns that the normalising of pornography and intimate waxing are causing women to become increasingly conscious of the appearance of their genitalia.

Research being carried out by Monash University in Australia seeks to establish the attitudes men and women there have to female genitals and cosmetic surgery.

The information gathered will be used to draw up educational programmes for use in schools and online, public health campaigns, and professional development for doctors and beauty therapists.