Female genital cosmetic surgery is on the rise. While these procedures are still relatively uncommon compared to breast augmentation and other cosmetic procedures, they are increasing at a fast rate. The most popular form, known as labiaplasty – the consensual surgical modification of the vulva – typically entails the removal of portions of the labia minora in order to make the vulva appear smaller and more symmetrical.
Although normal vulvas show considerable variation in color, size, and proportions, women whose labia fall within this normal range are increasingly seeking labiaplasty, raising concerns about the necessity of the procedure, as well as questions about why so many women are seeking it in the first place .
While women’s motivations for seeking labiaplasty have been examined in the medical literature, with results pointing to a wide range of reasons, less is known about how people of different genders perceive and respond to pre- versus post-operative labia. Our recent study, presented at the Society for the Scientific Study of Sexuality conference in 2019, offers some intriguing insight.
Our team studied perceptions of labia by showing participants 16 photos of labia. Participants were asked to rate each labia on perceptions of normalcy, ranging from very abnormal to very normal. Participants also rated the appearance of each labia on how well it suited both their personal ideal and a general, societal ideal. Participants for this study included 4,513 individuals recruited online as well as through a university student research pool. Most of these participants were male-identified (2,512) and ranged from 16 to 85 years of age.
What participants didn’t know was that the 16 photos they were shown depicted the labia of only eight women; one photo of each labia was from before undergoing labiaplasty, with a second post-op photo of each labia included as well.
So what did we find?
Overall, pre-operative labia images were rated significantly lower than post-operative labia across all three items of normalcy, personal ideal, and societal ideal. Put another way, participants reported more positive reactions to labia that had been surgically altered than they did to natural labia.
Gender seemed to matter, too. Specifically, women rated both pre-operative and post-operative labia significantly lower across all three items of normalcy, personal ideal, and societal ideal than did men. Averaging across pre-operative and post-operative images, participants who reported a gender identity outside of the binary (e.g., genderqueer, non-conforming) endorsed the most positive ratings for normalcy and personal ideals, while men endorsed slightly higher ratings for societal ideals overall.
These results suggest that women may be the harshest critics of their own bodies – perhaps due to internalization of popular cultural images, which rarely provide accurate depictions of women’s genitalia  .
We also found that while pornography use differed across genders – with men reporting the most frequent use – negative evaluations of pre-operative labia and more positive evaluations of post-operative labia remained even after controlling statistically for pornography viewing. Although exposure to pornography—and particularly heterosexual, male-oriented pornography—has previously been seen as one of the major sources perpetuating narrow ideals for labial appearance, our study found no evidence to support this link .
This is consistent with the results of a recent study on women seeking labiaplasty, which found that, among a sample of 124 women who consulted with a physician about this procedure, only about 1 in 10 of them reported that pornography played a role in their decision . Thus, women’s reasons for seeking labiaplasty do not appear to stem directly from porn in most cases, which tells us that the story is far more complex than a simple narrative about porn.
It’s important to note that, while the results of our research were drawn from a large and diverse sample, it wasn’t representative of the population. Further research is needed to better understand how the wide variation of natural labia is perceived in contemporary society, and how ‘idealized’ depictions of labia may potentially be harmful to women’s self-image.
Finally, given that we found people to rate post-operative labia as more “normal” in appearance than pre-operative labia, this points to a need for better education across genders regarding what a “normal” vulva looks like. The appearance of the vulva can vary widely, and many women who are seeking surgical alteration have vulvas that are perfectly normal to begin with. If we had better education about natural variation in genital appearance, we might see fewer women seeking medicalized interventions to achieve idealized genital appearances.
Thanks to Flora Oswald and Dr. Cory Pedersen for this guest post! Learn more about them below:
Flora Oswald graduated from the University of the Fraser Valley in 2018 with an honours degree in Psychology and a minor in Sociology. In 2020, she earned her M.S. in Psychology & Women’s, Gender, and Sexuality Studies from Penn State. Flora has received awards for her outstanding academics as well as for her support and advocacy for the LGBTQ+ community. Her research interests relate primarily to sexual and gender stereotyping and she is particularly interested in how sexuality stereotypes are mediated by the physical body. Flora is currently pursuing a dual title PhD in Psychology & Women’s, Gender, and Sexualities Studies at Penn State University.
Cory Pedersen earned her Ph.D. from the University of British Columbia in 2004 and has worked in the Department of Psychology at Kwantlen Polytechnic University since 2005. In 2011, Cory founded the Observations and Research in Gender and Sexuality Matters Lab to further her interests in human sexuality, providing students an opportunity to gain valuable research experience. Since its inception, several collaborative projects with the lab have been presented at psychology and sexology conferences, and in publication.
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 Clerico, C., Lari, A., Mojallal, A., & Boucher, F. (2017). Anatomy and aesthetics of the labia minora: The ideal vulva? Aesthetic Plastic Surgery, 41(3), 714-719. https://doi.org/10.1007/s00266-017-0831-1
 Bramwell, R. (2002). Invisible labia: The representation of female external genitals in women’s magazines. Sexual and Relationship Therapy, 17(2), 187-190. https://doi.org/10.1080/14681990220121293
 Nurka, C., & Jones, B. (2013). Labiaplasty, race and the colonial imagination. Australian Feminist Studies, 28(78), 417-442. https://doi.org/10.1080/08164649.2013.868332
 Sharp, G., Tiggemann, M., & Mattiske, J. (2016). Factors that influence the decision to undergo labiaplasty: Media, relationships, and psychological well-being. Aesthetic Surgery Journal, 36(4), 469-478. https://doi.org/10.1093/asj/sjv270
 Sorice-Virk, S., Li, A. Y., Canales, F. L., & Furnas, H. J. (2019). The role of pornography, physical symptoms, and appearance in labiaplasty interest. Aesthetic Surgery Journal, sjz254. https://doi.org/10.1093/asj/sjz254
Image Source: 123RF/Iaroslav Brylov
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