By Kate Rancourt

**Just a note: Although we know that genital self-image matters for all people, this post focuses on genital self-image among persons with vulvas who identify as women.**

We often think about relationships as being between two people, but what about the relationship we have with the parts of ourselves: our hair, our stomach… even our genitals. Wait, did you just say my relationship with my genitals? – You bet I did!

For some women, their relationship with their genitals is unabashedly positive, but for many, that relationship can be a bit of a conflicted one: their genitals “should” be a source of pleasure, yet they are associated with a host of negative feelings like anxiety and disgust1. Genital self-image refers to the attitudes and feelings we have about our genitals, based on our experiences and interactions with them.2 Women’s genital self-image is influenced by many things, including smell, perceived taste, amount of pubic hair, colour, and shape or size (Keep an eye out for an upcoming post about these issues).

Perceptions of female genital appearance are a growing area of interest and concern in sexual health communities. The number of women in Western countries seeking female genital cosmetic surgery is growing at an alarming rate: from 2013 – 2014, there was a 49% increase in the number of labial reduction procedures conducted in the United States (5,070 to 7,535 procedures)3. Also known as ‘labiaplasty’, labial reduction is one of the most common female genital cosmetic surgeries. It is typically performed to reduce the degree to which the inner lips of the vulva (the ‘labia minora’) protrude or “stick out” beyond the outer lips (the ‘labia majora’). Although appearance-related concerns are not the only reason women seek labiaplasty (others include discomfort or irritation caused by the size of labia, or anxiety during sex), appearance concerns are a very common reason identified in scientific studies at this point.4

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Image source: https://www.thewomens.org.au

The truth about appearance-related concerns is that they typically stem from comparing ourselves to others. We generally do not want to be outside “the norm”, and for good reason – diversity is generally not embraced in mainstream culture, leading people to feel isolated or viewed negatively because of their appearance (ask any person with a unique facial feature, like a birthmark). But guess what? Women’s vulvas are diverse – they come in all shapes, sizes, symmetries, and colours (and if you need some proof of this, have a look at the diversity and beauty of real(!) vulvas at the labia library). Unfortunately, that is not what we are lead to believe.

Many women seeking labiaplasty for cosmetic reasons seek a homogeneous genital appearance where their labia minora are symmetrical and “tidy”, meaning that they do not protrude beyond the labia majora. This has been termed a “clean slit” or a “Barbie Doll” appearance. Unfortunately, this is what we’ve been taught to believe is the norm for female genital appearance, and it makes a lot of women feel ashamed, self-conscious, or embarrassed about their genitals. This “Barbie Doll” aesthetic appears to stem from many different influences, including limited diversity of vulvar appearance in magazines and pornography, and entrenched, negative ideals around female genitalia5.

Did you know: Censorship could be another contributor to the limited diversity of vulvas in media. In many Western societies, such as Australia, classification guidelines require soft-core porn magazines to digitally modify images of women’s vulvas so that they are “discreet” or “healed to a single crease” (meaning that they digitally remove protruding labia minora). Read more about that here.

So what does this mean for women with genital appearance concerns? Well, for one thing, it means that you are not alone. There are many women grappling with what it means to have a vulva that doesn’t look just like the pictures in porn, textbooks, magazines, or online. For some women, it’s a long journey to embrace having a vulva that is ‘just yours’. Having to walk that path is not your fault: Society is set up to make loving your vulva a really difficult job. And as frustrating as that is, taking the journey to love your vulva is a worthwhile one. After all, don’t we all just want to have a great relationship with all the bits and pieces of ourselves?

Sources

1 Fahs, B. (2014). Genital panics: Constructing the vagina in women’s qualitative narratives about pubic hair, menstrual sex, and vaginal self-image. Body Image, 11, 210-218.

2 Berman, L. A.,  Berman, J., Miles, M., Pollets, D., & Powell, J. A. (2003). Genital self-image as a component of sexual health: Relationship between genital self-image, female sexual function, and quality of life measuresJournal of Sex & Marital Therapy, 29, 11-21.

3 American Society for Aesthetic Plastic Surgery. (2014). 2014 ASAPS statistics: Complete charts. Retrieved from http://www.surgery.org/sites/default/files/2014- Stats.pdf

4 Veale, D., Eshkevari, E., Ellison, N., Costa, A., Robinson, D., Kavouni, A., & Cardozo, L. (2014). Psychological characteristics and motivation of women seeking labiaplasty, Psychological Medicine, 44, 555-566.

5 Mowat, H., McDonald, K., Dobson, A. S., Fisher, J., & Kirkman, M. (2015). The contribution of online content to the promotion and noramlisation of female genital cosmetic surgery: A systematic review of the literature, BMC Women’s Health, 15, 110-120

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