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This book traverses Ancient, Medieval, Renaissance, classical and late modern eras in order to examine developments in the technologies and epistemologies that have shaped the context for current Western cosmetic surgical practices on the female genitals. In particular, it traces the historical threads linking the surgical management of the vulva to the cultural regulation of aberration and normality. It argues that the drive for genital perfection is deeply rooted in a changing array of historical practices and knowledges aimed at defining appropriate sex and sexuality, maintaining boundaries between male and female, masculine and feminine, and attributing differential value to sexed genitalia. The book also considers how race informs the categorisation of the appropriately gendered vulva. Additionally, classed identity is important in relation to the historical association of the working-class vulva with disease and contagion. This book is informed by interdisciplinary approaches drawing on cultural studies, feminist theory and historiographical methodologies. Traversing the histories of anatomical nomenclature, the colonial race sciences, sexology and masturbation panics, intersex case management, cosmetic surgery and pornography, this book argues that in order for scholars to come to a fuller understanding of the influences behind the current practice of female genital cosmetic surgery, we must consider how the vulva has been shaped by a history of ideas, largely developed in the medical field, about what constitutes 'normal' femininity.