Both ABOG and ACGME told USPI that OB/GYNs can do labiaplasties and clitoral hood reductions despite no training or education in surgical anatomy

I’ve been talking to the board of the largest ambulatory surgery provider (USPI) about changing their privileging policies nationwide. The good news is they are taking it seriously. The bad news is both ACGME and ABOG have told them that residency training and board certification qualifies OB/GYNs to do labiaplasties and clitoral hood reductions.

This is not acceptable.

OB/GYNs are generally not trained to do these procedures during residency. The only vulvar surgerys listed in ACGME’s application for accreditation are “radical vulvectomy” and “simple vulvectomy.” The literature on both lacks consideration of detailed anatomy, as incisions are made based on margins. Furthermore, OB/GYNs lack education in the surgical anatomy involved. As previously discussed, the distal course of the dorsal nerve is consistently absent from OB/GYN textbooks and journals. ABOG refuses to add it to board exams. Detailed anatomy is almost never discussed in peer reviewed literature on techniques for clitoral hood reductions. Many OB/GYNs doing these surgeries even claim the labia minora play no role in sexual function and that there is no risk of loss of sensation.

I just dissected my first cadaver last night. The 2 dorsal nerves are extremely superficial, traveling above the body, and would not be difficult to damage during clitoral hood…