{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:03:08Z","timestamp":1789718588103,"version":"4.0.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bioethical Inquiry"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cosmetic gynaecological procedures such as labiaplasty are commonly evaluated through frameworks of voluntary informed consent and adaptive preference. These approaches assess whether a patient\u2019s preference for a procedure has developed under conditions of adequate understanding and voluntariness. While necessary, this focus on preference formation does not exhaust what is ethically at stake in a given case. To account for this further dimension, this paper develops an account of affective embodiment as a way of describing lived bodily orientation, interpreting how social norms surrounding vulvar aesthetics become organized through vigilance, hyperawareness, and perceived abnormality prior to and alongside clinical deliberation. Drawing on accounts of affect, I argue that vigilance, hyperawareness, and perceived abnormality can structure how the body is inhabited over time, shaping the field within which preferences for such procedures emerge. The paper concludes that ethical deliberation in cosmetic gynecology should attend to the embodied patterns of distress through which intervention comes to appear necessary, rather than treating consent and preference formation as ethically exhaustive.<\/jats:p>","DOI":"10.1007\/s11673-026-10627-8","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:19:49Z","timestamp":1789715989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expanding Clinical Deliberation: Affective Embodiment in Cosmetic Gynaecology"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6220-6480","authenticated-orcid":false,"given":"Shadi","family":"Heidarifar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"10627_CR1","doi-asserted-by":"publisher","DOI":"10.1215\/9780822388074","volume-title":"Queer phenomenology: Orientations, objects, others","author":"S Ahmed","year":"2006","unstructured":"Ahmed, S. 2006. Queer phenomenology: Orientations, objects, others. Durham, NC: Duke University Press."},{"issue":"1","key":"10627_CR2","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/AOG.0000000000003617","volume":"135","author":"American College of Obstetricians and Gynecologists","year":"2020","unstructured":"American College of Obstetricians and Gynecologists. 2020. Elective female genital cosmetic surgery: ACOG Committee Opinion Summary, Number 795. Obstetrics & Gynecology 135(1): 249\u2013250.","journal-title":"Obstetrics & Gynecology"},{"key":"10627_CR3","unstructured":"American Society of Plastic Surgeons. 2023. Plastic surgery statistics report 2022. Arlington Heights, IL: American Society of Plastic Surgeons. https:\/\/www.plasticsurgery.org\/news\/plastic-surgery-statistics. 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Sexualities 8(4): 407\u2013424.","journal-title":"Sexualities"},{"key":"10627_CR7","unstructured":"British Association of Aesthetic Plastic Surgeons. 2023. BAAPS annual audit 2022\u20132023. London: British Association of Aesthetic Plastic Surgeons. https:\/\/baaps.org.uk. Accessed May 24, 2026."},{"issue":"2","key":"10627_CR8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s00404-021-06270-w","volume":"305","author":"O Dworakowski","year":"2022","unstructured":"Dworakowski, O., M. Dr\u00fcge, M. Schlunegger, and B. Watzke. 2022. Body dysmorphic disorder of female genitalia: A qualitative study of Swiss obstetrician\u2013gynecologists\u2019 experiences and practices. Archives of Gynecology and Obstetrics 305(2): 379\u2013387.","journal-title":"Archives of Gynecology and Obstetrics"},{"key":"10627_CR9","volume-title":"A history and theory of informed consent","author":"RR Faden","year":"1986","unstructured":"Faden, R.R., and T.L. Beauchamp. 1986. A history and theory of informed consent. New York: Oxford University Press."},{"key":"10627_CR10","volume-title":"Ecology of the brain: The phenomenology and biology of the embodied mind","author":"T Fuchs","year":"2018","unstructured":"Fuchs, T. 2018. Ecology of the brain: The phenomenology and biology of the embodied mind. Oxford: Oxford University Press."},{"issue":"2","key":"10627_CR11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1080\/14616660500200223","volume":"7","author":"FJ Green","year":"2005","unstructured":"Green, F.J. 2005. From clitoridectomies to \u201cdesigner vaginas\u201d: The medical construction of heteronormative female bodies and sexuality through female genital cutting. Sexualities, Evolution & Gender 7(2): 153\u2013187.","journal-title":"Sexualities, Evolution & Gender"},{"key":"10627_CR12","unstructured":"Heidarifar, S. 2024. 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This article does not report research involving human participants, human data, or biological material.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The author declares that there are no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"As a non-native English writer, I used OpenAI\u2019s ChatGPT model for linguistic and style editing. The ideas, structure, and arguments in this paper are entirely my own.","order":4,"name":"Ethics","label":"Use of Artificial Intelligence","group":{"name":"EthicsHeading","label":"Declarations"}}]}}