On further reflection that what annoyed me most about PZ's post was the following line:
That women feel compelled to get their genitals sculpted to fit some inappropriate ideal is criminal (the rest of the article at that link talks about how society discards porn stars).
People change to conform to society's requirements all the time; calling some changes "criminal" while accepting others without question is utterly arbitrary.
I bet you that PZ finds it necessary to be civil to the idiots he has to work with at the university; is he "compelled" to do so by society, and is the resulting state of affairs "criminal"? What's the difference between a porn star getting her labia trimmed and PZ failing to call out some douchenozzle colleague? I'd argue that the long-term societal costs of enabling idiocy far outweigh the social costs of lookism; the latter only thrives because we tolerate idiocy in the first place.
Really I think there's a subtle form of bigotry at play here; the only way that PZ's complaint stands up is if we see the porn star's choice as somehow less valid. We don't believe that anyone would rationally choose to have labiaplasty, therefore the porn star is acting irrationally under the unbearable weight of societal compulsion. However, everyone agrees on the necessity of getting along with colleagues, so putting up with the doofus in the office is a necessary compromise. In order to avoid cognitive dissonance we deny the porn star's ability to make decisions for herself while telling ourselves that we're just being civil. Not cool.