Dear Julia,

I was just surfing the net and read your question. As I am a ped.surgeon I would like to  answer you.

There is no "physiological " need for clitoroplasty. To reduce the size of someone`s clitoris is cosmetic surgery and I think this should be done only at the request of this person, not by the judgement of some surgeon. Clitoroplasty has nothing to do with your daughter`s ability to menstruate...

About inner labia; I can not answer your question because every child is "unique" and surgical procedures have to be "tailor made". Skin grafts can be used in several ways but around genital area it is allways better if one can use local skin flaps for instance to widen the vaginal opening. Skin grafts are mainly used if there is no vagina and we have reconstruct it totally. I f the problem is the narrowing of her vaginal opening I would strongly suspect that only some minor surgery is required.

As general I would like to point out to you that after surgery the genitalia of your daughter are still not "normal" - if there ever is a norm in these issues - and surgery has small risks. Physiological needs are sometimes absolute indications for surgery but I would be extremely careful not to do cosmetic procedures at a time when your daughter can not give her "informed consent" to cosmetic surgery.

With best regards,

Mika Venhola, Finland