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What drives parents to kill their own children?

IT’S unfathomable, inexcusable, sickening.

The act of killing an innocent child is something most of us cannot comprehend. But an average of 25 children are killed each year by a parent in Australia, with children under the age of one at the highest risk of victimisation.

On Sunday morning, 14-month-old Sanaya Sahib was found dead in Darebin Creek, in Melbourne’s northeast. After days of unanswered questions surrounding the little girl’s grim discovery, police charged her 22-year-old mother with the toddler’s alleged murder.

Police allege Sofina Nikat confessed to the murder on Tuesday night, with Detective Senior Sergeant Stuart Bailey telling an out-of-court-sessions hearing that Ms Nikat had made a “full confession” over the death of her daughter.

The day after charges were laid, Ms Nikat did not appear in the Melbourne Magistrates Court amid concerns over her mental state.

“In most cases, there is a strong mental health issue, which is very sad but that’s the reality,” Dr Jack White, Forensic Psychologist, told news.com.au.

Defence counsel Michael McNamara confirmed that Ms Nikat was examined by a doctor and a psychiatric nurse on the morning of the hearing, and was excused from attending the court proceedings.

It is understood that medical experts were concerned about what kind of effect the court proceeding would pose on her.

“Usually the mother is experiencing severe mental health problems. In fact, I don’t know any cases that don’t have a mother with problems,’’ Dr White said.

“Sadly mothers are the ones that are more common [to killing their children]. But with fathers, it can be a revenge response.”

In 2009, Arthur Freeman threw his four-year-old daughter, Darcey, off Melbourne’s Westgate Bridge, in front of her two younger brothers and shocked witnesses.

His “inexplicable” actions were met with grief, horror and anger across the country, and in 2011 he was sentenced to 32 years prison for murder.

During a 2015 inquest in to Darcey’s death, it was revealed that doctors were warned Mr Freeman was violent, but did not report him to authorities. It was also made evident that the then 37-year-old was angry and upset about receiving reduced access to Darcey, after a long custody dispute.

“I saw [Darcey’s mother] Peta Barnes on 13 April 2007 and she disclosed problems with her angry, irrational husband who shoves and pushes her and is often angry at the kids,” one doctor’s statement said.

The morning Mr Freeman threw Darcey off the bridge, the inquest heard that he had called a friend in tears about losing a custody battle.

Senior Sergeant Damian Jackson told the inquest, in July 2015, that Mr Freeman had never provided an account of what happened that morning.

In an interview with The Age, Dr Ben Buchanan, of the Victorian Counselling and Psychological Services said that when there is violence in the home, usually towards the spouse, it can drive some fathers to kill their own children.

“The best predictor of future behaviour is past behaviour,’’ Dr Buchanan said

“Physical abuse towards the partner is absolutely a sign of a propensity to use physical force against the children.’’

Dr Buchanan also admitted that men who kill their children often see a part of their partner within the child.

“Our children represent our spouses, they’ve got that symbolic representation of the mother but they are more vulnerable,’’ he said.

“In the cases I’ve seen, it’s very rare for them to blame the children; the children are a proxy by which they’re getting back at the mother.’’

And while neither cases are categorised as filicide, when the parent murders a child and follows with suicide, Sam van Meurs, a psychologist at Canberra Clinical and Forensic Psychology points out, said in an interview with Kidspot that a mother who kills her children and then herself can often have a different motivation than a father in the same situation.

“For example Donna Fitchett killed her two children in 2005 and left a note to her husband that said, ‘I just couldn’t abandon our beautiful boys’,” Mr Van Meaurs said.

“In contrast, men are more likely to kill their children for revenge or to punish their partners or ex-partners.”

According to the most recent World Health Organisation statistics, there are around 31,000 homicide deaths of children under the age of 15 in the world each year.

In Australia between 2009-10 and among children aged 0-14, there were 24 deaths due to homicide and the rate of homicide was highest among infants less than one year old.

Jack Levin, an American criminologist, told USA Today that mothers who murder tend to kill their newborns on impulse. “The day a child is born is the day a child is most likely to be killed by a parent,” he said.

Dr Phillip Resnick, director of forensic psychiatry at Case Western and is a leading expert on parents who kill their children, agreed.

“Younger children are much more likely to be killed than teenagers,” Dr Resnick said.

In an interview with TIME magazine, Dr Resnick spoke of the 40 to 60 cases he had worked on in the US that involved parents who killed their children.

In the US, the figures are staggering. About 250 to 300 children are murdered by their parents each year.

While each tragedy falls under vastly different circumstances, Dr Resnick said there are usually five characteristics in which parents kill their children.

“The first is “altruistic.” The classic case is the mother who plans to take her own life and believes that the children are better off in heaven with her,” Dr Resnick said.

“Number Two is the case in which the parent is acutely psychotic. The third type is fatal battering [the child does something to anger the parent and they react]. The fourth is [to get rid of] an unwanted baby, for example an infant born out of wedlock. The final category is spousal revenge, [in which a parent kills the children to hurt the partner], typically after infidelity,” he said.

While admitting the method of preventing crimes that involve parents murdering their children is a “complicated” one, Dr Resnick said access to mental health institutes as well as awareness of depression is mandatory in understanding what drives adults to harm their offspring.

“If a woman is very depressed and she has young children and makes a suicide attempt, there is 1-in-20 chance [in America] that she will try to take the kid with her. Specific inquiries about thoughts of harm toward children should occur in any evaluation of a seriously depressed [mother],” he said.

Dr White agrees, saying Australia needs to address its mental health facilities, and increase support for unstable parents.

“In some ways our mental health system is struggling, and sadly a lot of people don’t get the treatment they require,” he said.

“In the area of mental health, and a mother is not coping, they need to be provided with more assistance.”

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Global warming will destroy Europe because it will bring tens of millions of refugees. Terrorists just have to burn forests, even in Papua or Brazil.

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Virginity for sale to the highest bidder: Teenager, 18, becomes the latest to offer herself to paying perverts on website that boasts it has doctors verify girls have not had sex

An 18-year-old girl has put her virginity up for auction through a sinister website that boasts about having doctors who can verify that the girls have not had sex.

Kim, who is half Austrian and half German, decided to sell her body through the agency Cinderella Escorts to fund her studies, a flat and a car.

Bidding for the 5ft 8in student starts at £86,640 (100,000 Euro), of which 20 percent will go to the agency, according to local media.

According to German media, she contacted a specialist escort agency selling virgins for millions with the words: 'Hello, my name is Kim and I would like to sell my virginity.'

The young woman has decided to auction her virginity so she can study somewhere in Germany or in the Austrian capital of Vienna.

The Cinderella Escorts website claims her virginity is proven with a doctor's certificate and a potential buyer can also do their own tests to 'inspect' the girl.

On their website, Kim states she likes drinking orange juice and loves Greek food and roses.

Kim said: 'I would like to study in Germany or Vienna. With the money I can buy a flat, pay my tuition fees and afford a car.'

The student was inspired by Aleexandra Khefren, a 18-year-old Romanian model who sold her virginity for £2million (2.3 million Euro) to an unnamed businessman from Hong Kong.

News about Khefren and the virgin escort agency went viral across the world and also came to the attention of Kim.

She said: 'So is it really worth more than 2.3 million euro to give my virginity to a man who might eventually leave me anyway? To be honest, I do not believe it.'

Kim says she is willing to meet with the highest bidder anywhere in the world as long as all travels are paid for.

The teenager added that she is not afraid of the stranger as the agency has said she can 'break off' the meeting at any time.

Despite her family threatening to disown her over the deal, 18-year-old Aleexandra announced she was selling her virginity in 2015.

'I wanted to sell my virginity with Cinderella Escorts rather than giving it to a future friend who might have left me anyway,' she told The Star. 'And I think many other girls have the same attitude.

'How many would possibly forgo their first time in retrospect if they could have 2.3 million euros (£2m) instead?'

Khefren said that the businessman is 'very friendly' and that though she's spoken to him, when she meets him in person for the first time, she will be accompanied by Cinderella Escorts staff.

She caused outrage when she appeared on the TV show 'This Morning' to talk about her controversial plan.

Presenter Holly Willoughby and Phillip Scholfield were left shocked - as were many viewers who expressed their disgust and sadness at her scheme.

The teen did not tell her parents what she was doing and they exploded with fury after discovering her plan.

MailOnline exclusively revealed how they had a tearful confrontation with her at their rented apartment in Bucharest, Romania.

Her policeman father Toni and mum Elena begged her not to go through with the sale of her virginity.

And despite the threat from her father that he would disown her she refused to back down saying it was her body and she could do as wanted.

Last year, Khefren gave a phone interview to Romanian TV station STIRI where she talked about her desire to sell herself - while bizarrely insisting she doesn't consider herself a prostitute.

The starting auction price for her virginity was put at €1million Euros - about £865,000 - by the German-based escort agency handling the sale. Khefren has said she is curious about sex and that she hoped the man who takes her virginity will wine and dine her prior to going to bed.

'We will go to a hotel in Germany, have dinner and then it will happen,' she said last year. 'I am very curious about how sex is. I have not experimented. I don't know what is it.'

While most people would consider selling her virginity for money, Khefren insisted she was not a prostitute.

'I will not become a w***e. I am intelligent,' she said. 'This is an opportunity and I take it.

The man behind Germany's most famous escort website is a 26-year-old man who still lives in his mother's basement.

Jan Zakobielski outed himself as the man behind the multi-million pound operation which he runs from his parent's house in in Dortmund, German, both of them unaware of his business.

He said: 'No one makes these young women do anything they don't want to do. They have their own minds and their own opinions on sexuality.'

When the 26-year-old was confronted by MailOnline, he pleaded to talk away from his home, saying: 'My parents don't know what I'm doing.'

Despite admitting being behind the 'sale' of Romanian teenager Aleexandra Khefren and three other young women, he insisted he was not exploiting them.

The German runs the agency on a laptop computer while his partner, also called Jan, fields calls made to a mobile phone number listed for the company.

Zakobielski said the success of his business showed there was a demand. 'No-one makes these young women do anything they don't want to do. They have their own minds and their own opinions on sexuality,' he told MailOnline.

'I have had no run-ins with feminists or anybody else. I am not do anything wrong.'

Zakobielski said other women had sold their virginity in the past and claimed his agency gave them a layer of protection.

'There are many organisations selling virginities underhand. The girls are totally unprotected in such cases. We, on the other hand, go public and stand as an official and legal agency for the girls. Better than underhand, or what?'

Zakobielski said there was a rigorous vetting process before an encounter was allowed to take place.

'We from Cinderella Escorts reject 80 percent of all applications from young women. More than 30 young women have already applied to us.

'Before a meeting a girl has to sign that she does not have sex without condoms. We accompany them to the meeting and are in the vicinity if problems arise'.

Zakobielski said the women could cancel their 'meetings' at any point if they felt uncomfortable or the customer was 'unkempt or not a gentleman'.

He went on: 'We also reject girls where we feel that someone else is behind it and they do not want to sell their virginity on their own.

'A girl does not just have to give us a certificate that she is a virgin, she has to pay Cinderella Escorts for a meeting with a psychologist.

'If they do not give us a certificate that the girl has no mental problems and is intellectually fully accountable and adult, then we do not allow any meeting.'

Men who want to have sex with the escorts on the site have put down a 40 per cent deposit by transferring the funds to Cinderella's bank account prior to the meeting. The remaining money is paid in cash to the women at the point of sale of sex.

Prostitution is legal in Germany and Zakobielski denies that he is a pimp.

'We are very successful and take calls all the time. People are very interested in paying for the virgins.

We have had calls from China, India, America. All over the world. It is our job now to sort out the genuine ones.'

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‘People will come back from the dead’ Surgeon in ZOMBIE breakthrough

Sergio Canavero plans to carry out the first transplant of a cryogenically frozen brain to a living body.

The Italian neurosurgeon revealed the timetable as he discussed the world’s first head transplant that is due to take place in China in 10 months.

Canavero revealed he wants to do the procedure of reawakening a frozen human brain and placing it in a donor body in less than three years.

Speaking to German magazine Ooom, he said “We will try to bring the first of the company’s patients back to life, not in 100 years.

“As soon as the first human head transplant has taken place, i.e., no later than in 2018, we will be able to attempt to reawaken the first frozen head.”

And Canavero thinks his procedure could also answer questions about the existence of God, adding: “The head transplant gives us the first insight into whether there is an afterlife, a heaven, a hereafter, or whatever you may want to call it, or whether death is simply a flicking off of the light switch and that’s it.

“If we are able to prove that our brain does not create consciousness, two things will happen: religions will be swept away forever. Secondly, we will ask ourselves what the meaning of life is.

But his plans may not actually be so mad scientist.

A successful head transplant was recently carried out with rats.

The heads of smaller rodents were successfully transplanted onto the necks of larger rats it was revealed in a study published in CNS Neuroscience and Therapeutics.

Canavero wrote at the time: “Despite these exciting animal experiments, the proof of the pudding rests in human studies.”

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Shockwave therapy is the new Viagra. It actually cures erectile dysfunction and causes. You can do your own shockwave therapy. Just dangle your dick in front of the subwoofer, and turn your ghetto blaster to full power.

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Botox Could Be the New Penis Wonder Drug

Most people think of Botox as a cosmetic drug that does just one thing—it temporarily reduces the appearance of fine lines and wrinkles on the face by paralyzing the underlying muscles. As it turns out, Botox can do so much more: In recent years, doctors have found that it can be useful for treating a wide range of medical conditions, including chronic migraine headaches, an overactive bladder, excessive sweating, and even crossed eyes.

But that's not all. Botox, it turns out, also has the potential to help men who have concerns about the appearance and function of their penises. Here are three surprising things Botox can do down there.

It can increase flaccid penis size.

A recent survey of more than 4,000 US men found that guys' biggest complaint about their genitals was the length of their flaccid (non-erect) penises. More than one-quarter of respondents wanted theirs to be longer.

For a man who wishes he was more of a "shower," there aren't a whole lot of options on the market, short of expensive and risky surgical procedures and stretching devices that need to be worn several hours per day for months on end. Botox, however, could change that.

In a 2009 study, researchers used Botox to try and help guys who had a "hyperactive retraction reflex." In other words, these were men who experienced a lot more "shrinkage" (in the words of George Costanza) than others. Doctors made four injections around the base of the penis, with the goal of paralyzing the muscles responsible for the shrinkage reflex, known as the tunica dartos. And it worked.

Average flaccid size was about half an inch larger after the injections, and the guys didn't shrink as much in response to cold temperature. Most participants were happy with the outcome. However, it's important to note that erect size didn't change, and the effects were temporary—they lasted up to six months. So this isn't a one-shot deal—it's something you'd need to do at least a couple of times per year, just like if you were treating forehead wrinkles.

It might help guys last longer in bed.

Premature ejaculation is the most common sexual problem reported by men. There are tons of treatments out there for it already, including "delay sprays," Kegel exercises, and behavioral methods like the stop-start technique, but Botox might be another viable option in the near future.

In a 2014 study, researchers injected Botox into the bulbospongious muscle of male rats. This muscle sits at the base of the penis (see here) and is involved in ejaculation. Using Botox to paralyze this muscle can make sex last longer: For rats that received a placebo shot, their average time to ejaculation was six and a half minutes, compared to ten minutes for those that got a full dose of the drug.

There's a clinical trial underway right now to see if it works just as well in humans. We should know the results later this year, which will also tell us whether or not repeat doses are required, or if a single treatment might be enough for guys to learn more ejaculatory control.

It could help treat erectile dysfunction, too.

A new paper published in The Journal of Sexual Medicine argues that Botox could be a "game changer" when it comes to treating erectile dysfunction (ED). The thought here is that Botox could be used to paralyze the smooth muscles inside the erectile chambers of the penis. By relaxing these muscles, blood should be able to flow into the penis more easily.

A small study conducted in Egypt that was reported last year provided some initial support for this idea: Men with ED who received a Botox injection demonstrated improvements in penile blood flow. One patient, however, experienced priapism afterward—a prolonged erection that wouldn't go away on its own. This tells us that dosage is going to be very important: Too much muscle relaxation isn't a good thing.

Larger clinical trials should be underway soon, but in the meantime, it's important to highlight that any effects are going to be temporary and that once the Botox wears off, erectile difficulties will return because those muscles will start contracting and impeding blood flow again. Although it's not a permanent fix, Botox could be more appealing to some guys than Viagra due to convenience: Rather than popping a pill every time they want to have sex, they could just get a couple of shots per year.

While scientists will undoubtedly continue to explore these and other effects of Botox on the penis, this doesn't necessarily mean patient demand will follow. Indeed, we don't know yet how many men are actually going to take advantage of these discoveries in the future. After all, if you want to experience any of the benefits of "bonetox," you have to be cool with someone sticking a needle in your junk.

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Educated women are sexually less attractive, so let's stop that nonsense of sending every girl to school.

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The "Vagina Whisperer" Will See You Now

As far as publicity stunts go, the “first ever designer vagina showcase” was pretty damn effective. Timed to coincide with the spectacular runway parades that mark New York Fashion Week, the event was Dr. Amir Marashi’s chance to show the world what he can do: With a little slicing and suturing, he can give you the vagina of your dreams.

Inside the sprawling midtown conference room where the “show” would take place, sparkling rosé and cupcakes were served. Guests were greeted by a perfectly taut, hair-free, millennial pink silicone vagina model, which Dr. Marashi then used to explain the slate of procedures on offer during his powerpoint presentation of before-and-after vulva shots. There were the uneven labia minora that he’s trimmed (click), aging labia majora that he’s plumped (click), lax vaginal openings that he’s tightened (click), and those were just the surgical options. If you don’t like the idea of anesthesia, he can plump your lips with fillers, inject your G-spot with your own blood plasma to improve orgasms, or stick a laser wand inside you to painlessly tighten things up. If you didn’t walk into the showcase thinking your vagina was defective, you likely walked out of there worried over just how many ways it could be flawed.

For his part, Dr. Marashi, the self-described “vagina whisperer,” walked out with a lot of press. Yes, the concept was vulgar, but it got the job done: Over the next few days, there were articles in the New York Post, Jezebel and The Sun. He’s since been interviewed by Z100 and The Daily Mail, and outlets are becoming increasingly happy to add “vagina whisperer” to his other title, board-certified Ob/Gyn, as if it’s an actual qualification. All of this is why, two months after the showcase, I find myself in scrubs in a nondescript surgical center in Downtown Brooklyn waiting for Dr. Marashi to lead me through an up-close look at what this is all about. Yep, I’m about to observe a designer vagina surgery IRL, and it’s almost curtain time.

In the operating room, he’s telling me about how important it is to find a doctor who does these surgeries regularly. “This is why I do revisions a lot,” he says, in his slight Persian accent. “People think somebody is on Park Avenue so they’re good, but they might not do these over and over again.” He says he does these procedures three days a week, and has probably done more than 700 by now.

Dr. Marashi’s patient for today is lying on the operating table, knocked out, intubated, and covered by a sheet. She’s a 48-year-old mother of four who says she can feel nothing during sex. A nurse and surgical technician have just positioned the patient’s legs in stirrups, wrapping each one up in a sheet, so only her vulva remains exposed. Dr. Marashi is explaining that these cosmetic surgeries only make up half of his practice; he spends the rest of the time doing laparoscopic surgeries for pelvic pain related to endometriosis and fibroids. For those surgeries, “we listen to Enrique,” he says, and I assume he means Iglesias, but I don’t ask because he’s moving so quickly. “For vaginoplasties and labiaplasties, I want to get the right side of my brain to work, the more creative side. So I listen to Frank Sinatra.”

“Can we turn up the music?” Dr. Marashi asks with a wink, and “My Way” comes over the speaker. It’s a fitting song for a man who would later tell me he started doing cosmetic surgery because he likes to be “outside the box.”

Dr. Marashi sits down on his stool in between the patient’s legs and snaps a “before” pic on his iPhone. He slips on a pair of gloves and enters full doctor mode as he signals me to come take a look. Her vagina looks just as expected. But then Dr. Marashi spreads her lips, revealing a startling laxity and — "What’s that?" I ask, about the round, meaty tissue bulging down from the top of her vagina. “That’s the bladder,” he says. More importantly, though, is that her perineal body, the muscle tissue that separates the vagina from the rectum, is completely flaccid. He sticks a finger in her anus and pushes up to show me how weak and sponge-y it is, and how this creates a drooping of the vaginal opening into the woman’s butt. This is what creates the lack of sensation, he explains. The vaginal opening should hug two fingers, and it should be much higher.

“This is a patient who has had four vaginal deliveries,” he says. Her kids are aged 19 to 27, and she hasn’t enjoyed sex for a long time. Her first husband left her, and she blames her inability to grip his penis during sex as one of the reasons. But she’s in a new relationship now and she doesn’t want to put up with it anymore. (At least, that is what Dr. Marashi tells me. The patient declined to speak to me directly.) “She didn’t take care of it sooner because of the taboo that’s with it, or maybe she didn’t have the money, you know all these things that get in people’s way.”

The “taboo” that Dr. Marashi refers to is very real. Between 2010 and 2016, the United States saw a more than 100% increase in labiaplasties, a surgery to trim the inner or outer labia. No one is tracking the number of cosmetic vaginoplasty procedures, also referred to as “vaginal rejuvenation,” because the practice is too new, but experts estimate a similar increase in demand thanks to new non-surgical options and greater public awareness. (Kourtney and Kim Kardashian have both reportedly been “rejuvenated” via the new non-surgical laser options.) A lot of this rise has coincided with a surge in social media, reality TV, and endless amounts of free porn, which has, in turn, been blamed for creating an impossible standard of beauty for female genitalia — as if women needed yet another standard to measure themselves against, another reason to hate their bodies.

"Is this really what women want? Or is this really a form of new-age ‘circumcision’ based on an obsession with Barbie doll looks?," asked a scathing 2012 editorial in Obstetrics & Gynecology. A Jezebel article on Dr. Marashi’s vagina showcase described people who choose labiaplasty as women with minds “warped” by the porn industry. That’s what critics have said, and that’s exactly what I was thinking, walking in. But now that I’m witnessing the surgery, it’s not clear that assessment is fair.

Dr. Marashi uses a blue marker to map out where he will cut. Once he’s done that, Charles, the surgical tech, clamps her vagina open, and Dr. Marashi begins to cut away a diamond-shaped chunk of muscle and skin from the bottom of her vaginal opening. Then comes the most important cut: a deep crevasse into the perineal body.

“It’s really important to take your time and dissect this very meticulously, because behind here is the rectum,” and any crossover could lead to a dangerous infection, he says. Dr. Marashi then sews multiple rows of sutures into the perineal body, starting from further inside of her vagina until he gets to the outside, where he finishes with a row of stitches up from her anus to the new, lifted bottom of her vaginal opening.

“Remember in the beginning how close the vagina and the anus were together? You're gonna see in the end how far apart it’s gonna be,” he says.

In the end, I do see how much higher the vagina is. The hour-long process reminds me of a slower version of that magical strapless, backless bra Amber Rose has been advertising on Instagram: It’s as if he just threaded it all, and pulled the strings tight so that the whole vagina is miraculously lifted an inch higher. The final stitches are the tying of the bow that holds it all in place.

If I had to choose a vagina for myself, I’d pick this one over the one she had before. This makes me feel really bad, until I remember that there are also the anatomical realities here: Sewing it all back together with multiple layers of sutures is not just for aesthetics; this is a repair job for that muscle. This repair will also create a lift in the bladder that may even help alleviate stress incontinence, not to mention making penetrative sex feel good again for her partner, yes, but also for her.

It’s hard to square all that with the way Dr. Marashi has marketed himself, and indeed the way the entire, fast-growing crop of “cosmetic gynecologists” have marketed this burgeoning industry, as though this is just about having pretty, youthful genitalia. In the operating room, it’s clear that selling this the way women were sold facelifts, Botox, or even breast lifts is not quite right. Having sagging breasts and wrinkles may not make you feel so great about yourself (especially in our youth-obsessed culture), but those things don’t make sex physically impossible to enjoy. And they have nothing to do with a problem as distressing as incontinence.

To hear Dr. Marashi describe it while he’s actually doing the procedure, women choose this surgery mostly for functional reasons: to make sex better, the way it was before they had a baby or three, and to stop peeing their pants (even just a little bit) when they sneeze or lift weights. So, why on earth is the best way Dr. Marashi can think to market himself a grotesque showcase that frames everything in terms of how the vagina looks? More importantly: Why is this woman paying out-of-pocket for a one-time tune-up for her perineal body, when her partner could easily get insurance to cover his lifetime supply of Viagra?

To even begin to answer these questions, you have to understand where “cosmetic gynecology” came from in the first place. Plastic surgery — cosmetic gynecology’s closest cousin — has always been controversial, but it has also always been a mixture of reconstructive surgeries (like implants after breast cancer) and elective surgeries (like breast lifts or implants simply because you want them).

Cosmetic gynecology seems to be a similar mixture — but thanks to a toxic combination of entrenched sexism and continued dismissal of women’s sexual concerns, even the reconstructive procedures are still deemed frivolous, unscientific, and ironically, misogynistic.

The truth is that gynecologists have always done vaginoplasties and labiaplasties, but historically they would only do them for women with “true” medical problems, such as uterine prolapse (when the pelvic muscles collapse completely and the uterus descends into the vagina) or labial hypertrophy, which is when the labia minora or majora are extremely long or uneven. Outside of that, most doctors deemed them unnecessary, says Marco Pelosi, III, MD, a pioneer in the field. “There has always been a chasm between what doctors consider a problem and what women consider a problem when it comes to their sex lives,” he says.

Variations in labia length are totally normal, as any gynecologist or even anyone who watches porn regularly, can tell you. And while, say, painful sex or prolapse are “real” medical issues, constant irritation caused by your long labia or even a change in sensation after childbirth are not, according to traditional medicine, Dr. Pelosi explains. So for years, the procedures remained unpopular thanks to low awareness and low interest among women, as well as low adoption among qualified physicians.

Then, Sex And The City happened. Brazilian waxes became very popular — and baldness meant better opportunities for women to actually look at (and, yes, scrutinize) the physical characteristics of their vulvas.

In a post-Samantha Jones world, the gates opened: Women were much less shy about openly complaining to their doctors about their sexual dissatisfaction. And when their doctors didn’t listen, they found another doctor. All of a sudden, women had gotten the message that they deserve pleasurable sex. This created a huge opening for the few doctors who did offer these vagina alteration services to grow their businesses.

On the East Coast, Dr. Pelosi (along with his father Marco Pelosi, II, MD) — who had been offering elective vagina procedures since the ‘90s — began training surgeons in Bayonne, New Jersey. Eventually, due to demand, the father-son duo founded the International Society of Cosmetogynecology in 2004; they were the first to coin the phrase “cosmetic gynecology.”

Meanwhile, in Beverly Hills, Dr. David Matlock had trademarked the term “laser vaginal rejuvenation” and started a franchise business where he performed surgeries and, for a hefty fee, trained other doctors in his procedure. This allowed doctors to use the term to market the procedure, which is essentially a slightly modified version of vaginoplasty, the same way he did. This being L.A., Dr. Matlock also managed to swing an appearance on an episode of the E! network’s Dr. 90210 in 2006, giving "laser vaginal rejuvenation" its first national spotlight.

Soon, as a workaround to Dr. Matlock’s hefty fee, other doctors just dropped the “laser” and started calling it simply “vaginal rejuvenation.” This prompted the American College of Gynecologists (ACOG) to issue a scathing committee opinion in 2007 deeming the marketing practices and franchising surrounding the term “troubling” and the procedures “not medically necessary.”

But warnings from ACOG didn't do much to stem the rising tide of demand. As the rise of social media and Dr. Google continued, labiaplasty alone started to explode in popularity, experiencing a 44% increase between 2012 and 2013 (the first period for which data was tracked). Dr. Matlock only grew more famous — and not necessarily in a good way. He went on The Doctors with his wife Veronica, who got a vaginoplasty, labiaplasty, and “pubic liposculpting” from her husband. And who can forget when Brandi Glanville, the Real Housewife, infamously charged her vaginoplasty to her cheating ex, Eddie Cibrian’s, credit card? Dr. Matlock was her doctor.

Soon, there were myriad non-surgical options for “enhancements,” each one more bizarre than the next. There were liposculpting and fillers for your vulva, followed by g-spot injections (which would supposedly improve orgasms), and targeted skin lightening treatments that would change the shade of a vulva to Carnation Pink. In hindsight, the vajazzling phenomenon — the iconic ‘00s trend of adorning your waxed pubic area with rhinestones — seems inevitable. And while it’s easy to roundly mock all the upgrades and accoutrements, the thing is, the vulva was having a moment, one that no one seemed to notice except to mock.

Most recently came the big innovation (and the big money-maker): lasers and radiofrequency devices that use thermal energy to tighten the vagina. FemiLift, the machine Dr. Marashi uses, came first in 2013. Then MonaLisa arrived in 2014. Both machines are FDA-approved for “vaginal laser ablation” to induce the growth of collagen in the vaginal walls. This is said to not only tighten and lift the vagina, but also to improve the health of the mucosal lining, making lubrication easier. Another side effect: The lifting may help some with stress incontinence, and in some cases may even shorten labia. Other machines that use thermal energy technology to the same effect: ThermiVa, Diva, IntimaLas, and more.

No doubt the ease in getting non-surgical vaginal rejuvenation has coincided with the huge increase in demand. According to data from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 10,000 labiaplasties were performed by plastic surgeons in 2016, a 23% increase just from 2015. Now more than 35% of plastic surgeons offer the procedure, compared to 0% in 1997 when the society started their surveys. But the full breadth of designer vagina procedures remains a mystery, since nobody is tracking the variety of procedures that fall under the term vaginal rejuvenation, nor the number of doctors performing them, according to a spokesperson at ASAPS.

Because a laser treatment or an injection requires no anesthesia or downtime — all it takes is a series of in-office visits that amounts to having a laser wand inserted into your vagina — “it became a gateway,” Dr. Pelosi says. “Once you have a nonsurgical way to address some of the needs, it becomes way easier to do. It’s like Botox. Now everyone does Botox.”

Sandra*, a 31-year-old mother of one, has spent the past five years since the birth of her daughter yearning for her pre-baby vagina. Before she gave birth, sex was great. Now it’s lackluster. It wasn’t until she started Googling her symptoms and found her way to Dr. Marashi’s website that she realized there was a single thing she could do about it.

“After you have a baby, everything changes,” she says. “I realized during sex I wouldn’t stay as wet, and it just felt different. Also there were the urination issues, too.”

“This is definitely going to help a little bit with that,” Dr. Marashi says, handing her a pair of protective glasses. She’s laying on her back with her feet in stirrups and a paper gown over her lower body, ready for her second of three treatments with Dr. Marashi’s FemiLift machine. This time, he has outfitted me in a white coat to serve as his assistant while observing Sandra’s procedure.

It’s hard to say exactly how common Sandra’s situation is, but any mom (or any doctor) can tell you that it’s pretty prevalent. We all know that childbirth changes things. Another thing we can say for sure: A full third of women who have given birth vaginally have some damage to the muscles responsible for vaginal tightness. Vaginal delivery is the strongest predictor of developing a pelvic floor disorder, such as uterine prolapse, rectocele (when the rectum bulges into the vagina), or cystocele (when the bladder bulges into the vagina). The feeling of “looseness” that so many women come to plastic surgeons and cosmetic gynecologists to fix may actually be one of the earliest precursors to true prolapse, per a 2014 study in Surgical Technology International.

The treatment takes 10 minutes, tops. We all put on our protective glasses. Dr. Marashi replaces the glass cover on the probe, which looks like a clear dildo with a mirror on the tip to direct the searing light, with the one Sandra had to purchase. Each patient must bring her own personal probe cover ($150, not covered by insurance) with her to appointments.

Next, he inserts the probe, attached to a long bending metal arm that is connected to a machine. He steps on a pedal while simultaneously pushing the probe in and out and twisting the probe around inside of her. Every time Dr. Marashi presses the floor pedal, the laser is turned on and the mirror directs it to burn 81 tiny holes into the lining of the vagina. With the twisting and maneuvering, what you end up with is thousands of tiny holes, which draws a lot of healing blood flow to the area and promotes the growth of collagen, making the skin more taut. Industry-sponsored studies have also shown that it makes the vaginal lining thicker, which is why lubrication is easier. This is repeated three times at increasing levels of intensity. As his assistant, I press the button when he tells me to, to ramp up the intensity.

Afterward, Sandra says that it didn’t hurt at all — just a bit of tingling and burning toward the end. But it was hard not to notice the grimace on her face when the laser was all the way turned up.

Even just after the first treatment, she already feels some difference: “Sex is amazing,” she says. “It’s much better.” And now after this go-round with the laser, she should feel 70% of the potential effects; she can have sex after just two days of healing. In another 4 to 6 weeks, she’ll come in for a third appointment, and that’s when she will really see how amazing this treatment is, Dr. Marashi promises.

But it’s unclear how “amazing” the treatment really is in general. The machines are FDA-approved, which means they are safe to use. Many of the studies on the non-surgical options show positive results as far as improving lubrication and stress incontinence, but the studies are small, with only short-term follow-up. There is also not a lot of high-quality data on how well the machines work for improving vaginal laxity or sexual satisfaction. In practice, the experts I interviewed said although women can expect some result, it can vary widely depending on the particular patient and how experienced the person doing the procedure is — which is risky considering the cost ranges from $1,200 to $4,000 depending on the device.

The same can be said of the actual surgeries, in part due to the same reason there aren’t statistics on vaginal rejuvenation surgery: It’s still an ever-evolving term, and it can mean different things to different doctors. One 2012 paper from The American Journal of Cosmetic Surgery says it’s difficult to study whether vaginal rejuvenation surgery “necessarily, usually, or reliably” improves sex because surgeons don’t want to share their surgical techniques (this is why ACOG hates the trademark model; when surgical techniques are “owned” by a doctor, they become hard to evaluate independently), and the outcome measurements are fickle (it’s difficult to reliably measure sexual satisfaction).

Otherwise, a few smaller studies have been conducted on specific techniques: One 2016 Turkish study of 68 women who chose surgery after complaining of vaginal laxity found that 88% said they were satisfied with the results after 6 months. There were no serious complications, except that 10% of patients reported pain during sex at follow-up. Another 2014 study conducted in Iran followed 76 women for 18 months following an elective vaginal surgery to address sexual complaints. At six months, researchers found that sexual satisfaction increased on average a few points on a validated sexual function questionnaire, but that painful sex and dryness had also increased. By 18 months, though, sexual function scores increased significantly, while the pain and dryness issues disappeared. These results are promising, but again the studies are too small to be certain, and results can vary based on minute changes to the surgical technique.

Still, many women swear there are completely valid reasons for these procedures — that their lives are changed for the better because of them, even for the procedures that seem totally about looks, like labiaplasty. “Absolutely love this doctor. He is very respectful and listens to what you have to say and doesn't give you the run-around,” reads one of the many breathless Zocdoc reviews for Dr. Marashi. “He performed a labiaplasty due to an accident I had a few years back and omg it looks sooo good like as if the accident never happened.” Katina Morrell, 41, another of Dr. Marashi’s patients, tells me she got a labiaplasty because her long labia made working out uncomfortable.

Jennifer Walden, MD, a plastic surgeon based in Austin, TX, who does “a high volume of labiaplasties and vaginoplasties,” was among the first wave of doctors to see the potential value of the laser machines. She also happens to be a woman, the mother of twins, and to have tried two of the procedures herself: ThermiVa and Diva. As a practitioner, she describes vaginal rejuvenation procedures as “absolutely, the opposite of misogynistic.” As a patient she describes the results as simply “awesome.”

Before the laser machines hit the market, there was nothing to offer women with sexual complaints other than surgery, which, unless they had a severe injury, could cost up to $12,000. There was no treatment for mild or moderate stress incontinence, outside of the “disastrous” vaginal mesh surgeries that were only worth doing for the worst of cases and medications that hardly work, she says. There was also nothing outside of estrogen creams (which are too dangerous for some women with a history of breast cancer or heart disease) to solve dryness or other lubrication issues. The laser procedures can still be pricey, and they don’t work as well as surgery. Also: the effects may only last for about a year, but still, it’s something, Dr. Walden says.

“Within the past 5 years, we’ve seen a sort of a-ha moment happening for women. It’s become okay for women to talk about their labia and their vagina with their doctors. It’s become okay for women to finally talk about sex and the real issues they’re having,” she says. “And, at the same time, we’ve finally had something to offer them.”

Yet the conundrum persists: Why then, on God’s green earth, is “vaginal rejuvenation” marketed as a frivolous lifestyle choice, instead of a possible treatment for a legitimate problem?

Well, partly it’s that the majority of pioneers in this field are men, and so the desire and need for these treatments is framed from their perspective — ah, the male gaze at work. Add to that the general cultural tendency to code all things female as frivolous and vain and to reduce women to their looks, alongside our inability to talk openly about female sexual pleasure, and it makes more sense.

It is the marketing of the treatment — not the treatment itself — that risks preying on women’s insecurities, and it would be a mistake to ignore the ugly fact that though vaginal rejuvenation is a positive for some (maybe even many) it does create a perception that there is a perfect-looking, or even a perfect-working, vagina out there, and no, you don’t have it.

In my time with Dr. Marashi, there was a 43-year-old mom of two who learned about Dr. Marashi’s Femilift procedure from Groupon, who had no sexual or urinary complaints. She seemed most attracted to the idea of being 18 again.

Then there was the second vaginoplasty I observed on surgery day. It was identical to the first, technically, except that the next patient was much younger, a mother of one, who was in a new relationship with a man who is “small,” Dr. Marashi explained. Her perineal body wasn’t nearly as damaged, and she had no visible signs of bladder prolapse. The idea that she did it for her partner made me sad, and before I could ask Dr. Marashi his thoughts he said: “Honestly she could have gotten away with this. I told her she could wait. But she said no, she doesn’t want to have any more children, and she’s with this new guy. So that’s her reasoning.”

In that moment, all over again, I was reminded of the critics who say this whole thing is just a gold rush of money-hungry, often male doctors willing to pathologize normal biology in service of making the vagina the final frontier in plastic surgery. That all this boils down to is a sanctioned form of Female Genital Mutilation (FGM), just another way to reduce women’s bodies to mere objects for male pleasure.

Dr. Marashi doesn’t go that far. But he does admit that, a lot of the time, these procedures are a simple matter of want, not need. “So many times I get a patient and I’m like, 'Look, you don’t need anything to be done.' Now it’s a different story if they say, 'I want to do this.' I figure out why, and if they are good candidate, I say 'Okay, I’ll do it for you,'” he says. “At the end of the day, if I don’t do that procedure, someone else will do it, and I know I will do a better job.”

He doesn’t see the harm in doing what they want as long as he screens patients appropriately: He always looks for signs of body dysmorphia or partner pressure, of course. But in his view, the procedures are no more risky than other elective surgeries, and he’s personally seen the benefits in his patients for himself.

Still, wouldn’t it be better to explain to these women that, for example, it’s totally normal for their labia to be a bit longer? When Dr. Marashi is pressed on this, he launches into a diatribe about how a woman, not a doctor, should be making the decisions about what she does or does not deem a problem or a symptom for her body and her life. “I tell my patients: 'All vaginas, all labias, they’re all beautiful in their own way,'” he says. “I always tell people, ‘Do not ever do this for anybody else. You own your vagina.’”

As right as he is about that, it’s impossible to completely untangle the desire for these procedures from the pressures women face simply being alive in a youth- and beauty-obsessed culture. What’s also impossible to ignore, though, is that women’s sexual function has never gotten the same amount of research — or respect — as men's.

So perhaps in the end, Dr. Marashi is neither villain nor hero — he is but an emissary. Make what you will of his misguided self-promotion methods. But he has also devoted his life’s work to studying and addressing a facet of women’s lives that — until now — most of medicine has refused to acknowledge even exists. If that makes him a “vagina whisperer,” then so be it.

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Francisco Sanchez Oria (51 Mount Sinai Drive, Unit 04-04, Singapore) aims to establish himself as sex guru. He writes about himself: “Fran now spend most of his time helping men and women achieve their peak sexual performance though coaching and supplementation.” As credential, he publishes an article on the benefits of masturbation.

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Unchecked immigration will destroy Europe and the U.S.

Back when I was in school, I performed a scientific experiment in which I poured a liquid of one color into a beaker that contained liquid of a different color. At first the liquid in the beaker was diluted, but as I kept pouring, the poured liquid eventually overtook the liquid in the beaker, creating an entirely new substance.

That's what is happening in Europe as thousands of migrants flee their home countries, seeking refuge in the European Union. Germany, alone, is expected to have received 800,000 migrants by the end of the year, four times last year's number.

German Chancellor Angela Merkel has suspended the EU's Dublin Regulation for Syrian migrants. Under the rule, writes The Telegraph, "...migrants can only apply for asylum in the first EU member state they enter, and face deportation if they try to apply in another. But Germany ... has now ordered its officers to process applications from Syrians even if they have made their way through other EU countries."

Critics of the Dublin Regulation have called it expensive and ineffective. Many Syrian migrants reach Greece first, but decline to seek asylum there, preferring to push on toward Hungary, which is considered the gateway to Europe. Merkel has said she might reinstate border checks, which was a regular practice before the EU was created. She should.

That most of these migrants come from Muslim countries raises several important questions. The first is how many actual or potential terrorists are among them? Second, why would Muslims, many of whom believe the West is decadent and anti-God, want to come toEurope? Third, why haven't these migrants sought refuge in other Muslim countries, which one might think would be their first priority?

No nation, no continent, can survive uncontrolled immigration, especially when it involves people whose language, religion, culture and worldview differ -- in some cases radically -- from the countries to which they are migrating. Uncontrolled migration in Europe and illegal immigration in the United States spell an eventual death knell for both countries, which is, no doubt, the intent of ISIS, which is reportedly backing this flood of humanity. Will those flooding Europe eventually embrace European values, or when their numbers grow to the point where they form a significant percentage of the population, will the migrants demand that their values and religion dominate?

In the U.S., cries of "racism" in the immigration debate have replaced sound reason. But this isn't about discriminating against people of a different language or color; it is about preserving what we have, not only for those of us who have contributed to making America what it is, but also for immigrants who would not only like to partake of our success, but contribute to it. If nations want to preserve the lifestyles and culture which they and their forebears have worked and fought to create and sustain for themselves, their posterity and for immigrants, borders must be controlled and assimilation must be a top priority for those who are allowed to enter. Otherwise, nations become disunited with competing subsets jostling for power, influence and benefits.

Those who support "open borders" have an obligation to tell us when enough is enough. Must we wait until the American "liquid," which contains the values, faith and prosperity from capitalism that built and sustained us through wars and depressions, is replaced by a different "liquid"? What happens when the "takers" outnumber the "makers"? If we wait for that day to arrive before we act, it will be too late.

Yes, give us your tired, your poor, your huddled masses yearning to breathe free -- but legally, in an orderly fashion and not en masse. And let's also learn what these migrants and immigrants likely mean by "freedom." If they mean Sharia law, that is not freedom for Europe, or for America.

If the EU and the U.S. fail to address this very real crisis, we and they are assisting in national suicide.

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Why is sex so important? Because life is so full of shit, that without sex, it's just not worth living.

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