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Labia surgeries may be driven by unnatural images

By Shereen Jegtvig

New York (Reuters Health) - Women who were initially exposed to images of surgically modified female genitalia were more likely to consider them 'normal' and 'ideal' when later comparing them to unaltered genitalia, Australian researchers report.

Labiaplasty is an increasingly popular cosmetic surgery to reduce the size of a woman's labia minora and make them more symmetrical so they don't protrude beyond the labia majora.

The number of labiaplasties performed by the UK National Health Service has risen five-fold since 2001, according to the new study's authors.

"I think that the rise in genital cosmetic surgery for women is a very worrying trend. There seems to be massive misconceptions around perceptions of normal genital appearance and I wanted to explore this further," Claire Moran told Reuters Healthy by email.

Moran is a doctoral candidate in the School of Psychology at the University of Queensland. She led the study.

Generally, there are no health reasons to have the surgery, it's only for the sake of appearance. So the researchers wanted to know what drives women's perceptions of what looks good down there.

"There are misconceptions around normal genital appearance. This is due to airbrushing, lack of exposure to normal women's genitals, greater genital visibility due to Brazilian and genital waxing and the general taboo around discussing genitals and genital appearance," Moran said.

The results of the new study were published in BJOG: An International Journal of Obstetrics & Gynaecology.

Ninety-seven Australian women ages 18 to 30 years old were divided into three groups. In the initial stage of the study, one group of women was shown almost three dozen images of modified female genitalia; another group was shown images of unmodified genitalia. A third group was not shown any images.

Next, all three groups were shown a mix of images of modified and unmodified genitals and asked to rate them for the degree to which the vulva 'looks normal' and 'represents society's ideal.'

All three groups rated the images of the modified vulvas as more like society's ideal than the unmodified vulvas.

Women who had viewed the images of the modified genitalia first during the initial stage of the study also rated the modified vulvas as more 'normal' than the unmodified genitals. But women who had seen the photos of unmodified genitalia first tended to rate them as normal in the second stage.

The researchers suggest that young women may not realize that normal genitalia vary considerably in appearance.

"The reality is that when it comes to women's genitals, as with other body parts, diversity is what is normal. The results demonstrate that exposure to one kind of image impacts women's perceptions of normal," Moran said.

"It is important to understand whether women are seeking elective genital surgeries because they want their vulvas to appear 'normal' or because they want them to be consistent with an 'ideal'. If they want to change their labia color, shape or size because they find them to be abnormal, concerns about potential variation may be addressed by showing women a variety of genital images," Vanessa Schick told Reuters Health by email.

Schick co-authored "Read My Lips: A Complete Guide to the Vulva and Vagina." She was not involved in the new study.

"There a number of books, websites, posters and projects devoted to helping women 'normalize' their genital appearance. If women are electing to have surgery in order to match a genital ideal, it may be more difficult to counter those women's concerns. My colleagues and I are currently working on trying to better understand a mechanism through which this could be achieved," Schick said.

"Results of this important study provide concrete evidence that the vulva images to which women are exposed can impact their perception of norms and ideals for vulva appearance," Sarah Calabrese told Reuters Health in an email.

Calabrese is a clinical psychologist at Yale University who also was not involved in the new study.

"This is especially disconcerting given that for many women, the narrow and unrealistic range of vulvas presented in mainstream U.S. pornography may be the only images that they see," she said.

"The vulva is unlike most other body parts, which remain visible even when clothed; while a woman can look around and see the size and shape of other women's waists, breasts, and so on, they don't have the same opportunity to view other women's vulvas and therefore are less likely to have a realistic sense of the natural diversity of vulvas in the female population," Calabrese said.

SOURCE: http://bit.ly/1cW0hY9 BJOG: An International Journal of Obstetrics & Gynaecology, online December 19, 2013.

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