The study "Expectations and Experience of Labial Reduction: A Qualitative Study" (2007) reported that the women who underwent labiaplasty had great expectations for the elimination of pubic discomfort and pain, improved cosmetic appearance of the vulva, and improved sexual functioning. Most of the women experienced improved self esteem; yet the study also reported that formal psychological counselling before the surgical operation about what to expect and what not to expect from a labia minora and clitoral prepuce reduction procedure might better serve the prospective patient by assisting her in establishing realistic expectations for her genital beauty and mental health after such a procedure. Partial or total hoodectomy is classified by the World Health Organization as female genital mutilation (FGM) Type 1A. The American College of Obstetricians and Gynecologists (ACOG) published "Committee Opinion No. 378: Vaginal "Rejuvenation" and Cosmetic Vaginal Procedures" (2007), the college's formal policy statement of opposition to the commercial misrepresentations of labiaplasty, and associated vaginoplastic procedures, as medically "accepted and routine surgical practices". The ACOG doubts the medical safety and the therapeutic efficacy of the surgical techniques and procedures for performing vaginoplastic operations such as labiaplasty, vaginal rejuvenation, the designer vagina, revirgination, and G-spot amplification, and recommends that women seeking such genitoplastic surgeries must be fully informed, with the available surgical-safety statistics, of the potential health risks of surgical-wound infection, of pudendal nerve damage (resulting in either an insensitive or an over-sensitive vulva), of dyspareunia (painful coitus), of tissue adhesions (epidermoid cysts), and of painful scars. The dorsal nerves of the clitoris travel above the clitoris along the clitoral body. Permanent injury to these nerves can occur with clitoral hood reductions.