This Issues Paper critically explores female genital cosmetic surgery in the Victorian context: to better understand what it is, who is undertaking it, and their reasons for doing so. The incidence of female genital cosmetic surgery appears to be increasing. This trend has been the subject of substantial analysis and opinion, but there is a lack of rigorous evidence on risks, efficacy, complications, and patient satisfaction. This Issues Paper considers how both individual and sociocultural factors are likely to contribute to the emerging trend, and how professional bodies, health professionals, and advocates might respond. It is intended as a starting point for further conversation, evidence-gathering, and action.