Short of self-doubt, ladies? Insufficiently burdened with anxieties about your skin, hair, bottom, shoe size? Fear not, for an exciting new insecurity is now creeping across the pelvic floor of the nation: labial reduction surgery on the NHS has increased by 500 per cent in 10 years. Last year alone, 2,000 such operations were carried out and many more were done privately, at a cost of between £2,000 and £4,000. Most, says a leading gynaecologist, were unnecessary.
Nor do such alterations stop at the inner labia, in its infinite variety. One surgeon in Canada is proud of his two-in-one procedure, nicknamed the Toronto Trim. This costly butcher will not only slice away at the inner labia, but he'll also snip off that untidy clitoral hood, converting the female undercarriage into something resembling that of a Barbie doll.
But where has it come from, this deep-down neurosis, that leads young women – in Sarah Creighton's study, the average age was 23 – to consider surgery that, like any intervention carries risks, is painful, and not necessarily permanent in its effects?
Only one in every 11 interviewed by Dr Creighton had significant asymmetry, which is usually an aesthetic rather than medical issue. A very few women suffer discomfort as a result. Nonetheless, nearly half the prospective patients went ahead with the operation. Online, women give each other tips on how to get referred for surgery: tell your GP you get infections. Don't say that you just don't like your shape.
Women's self-awareness has apparently been heightened by television programmes that delight in physical abnormality, by advertisements for private surgery on parts they had not previously thought deficient, and by easy online access for men and women alike to pornography, where they encounter fannies manicured out of all recognition.
I swim every morning and see more naked women every day than the average GP – all shapes, all colours, all ages. Of course, there are no two the same, even on the outside, so to believe there is a "right" shape for their inner recesses would be as odd as believing that every face must be identical. And yet, there are women growing up who, while both better informed about sex and confident in their sexuality than their mothers and grandmothers, are, paradoxically, more ashamed of their adult bodies. Pop videos have led them to believe that beneath the neat little gold lamé crotch of a Beyoncé or Rihanna stage costume is the same, featureless plateau, and they fret that they are made differently.
Many of the younger women at my gym have Brazilian waxes, giving them a childlike appearance. I have heard several talk cheerfully about their breast enlargements or reductions. None has actually shown off her designer vagina, yet.
And who is it for, this infantilised body? In a Cosmopolitan online discussion on labial reduction, one post-operative woman had clearly been under pressure from her boyfriend's "remarks about my inner labia being too large... [Surgery] was SO worth it". Her log-on is "Emmiebaby".
But women are not babies, and they are rather well designed. Many can mount a bike, conceive, give birth, and do the splits with the same, adaptable kit. It is alarming that any should contemplate an operation akin to the female genital mutilation that is outlawed in the UK. And we should be concerned, too, about the false expectations of misled young men.
On his wedding night, the art critic John Ruskin, exposed until then to the cool marble Mons veneris of antique statuary, is supposed to have recoiled at the sight of his wife Effie's pubic hair. If young men, misguided by the worlds of porn and pop, make female sexual partners uncomfortable about their bodies, the ignorance of previous generations has not gone. It has merely mutated.