12:25am Friday 03 April 2020

Modified images appear to change perceptions of normal female genitalia

Researchers from The University of Queensland’s School of Psychology published the findings today (20 December) in BJOG: An International Journal of Obstetrics and Gynaecology.

Requests for labiaplasty (reducing and making the labia minora symmetrical) has become the most widely performed female genital cosmetic procedure covered by Britain’s National Health Service over the past decade.

Lead researcher Claire Moran said the number of procedures increased five-fold between 2001 and 2010.

Researchers looked at whether exposure to images of modified vulvas influenced women’s perceptions of what is considered normal and desirable by society.

The study included 97 women aged 18 to 30 years, who were randomly assigned to three groups to view a series of images in two screenings.

The first screening exposed one group to a series of images of surgically modified vulvas, one group to a series of non-modified vulvas, and the third group viewed no images.

During the second screening, all groups then viewed a series of mixed images of both surgically modified and non-modified vulvas. The women then rated each image according to their perception of “normality” and “society’s ideal”.

“We found that women who had initially viewed the modified vulvas identified the modified images in the second screening as more normal than the non-modified vulvas,” Ms Moran said.

“This was significantly different from the control group participants, who initially viewed no images, and were 18 per cent less likely to rate the modified vulvas as normal. 

“Furthermore, when asked to rate the images according to society’s ideal of genitalia, women in all three groups rated the modified images as more like society’s ideal than the non-modified vulva images.”

Again, women who initially viewed the modified images were 13 per cent more likely to rate the modified vulvas as more society’s ideal than the control group. 

“Our results showed that exposure to images of modified vulvas can significantly influence women’s perceptions of what is considered a normal and desirable vulval appearance,” Ms Moran said.

“These findings further heighten concerns that unrealistic concepts of what is considered normal may lead to genital dissatisfaction among women, encouraging women to seek unnecessary surgery.

“This research is the first to document the extent to which exposure may impact women’s genital dissatisfaction and more needs to be done to promote awareness and education around genital diversity in our society.”

BJOG deputy editor-in-chief Pierre Martin Hirsch said the study’s conclusions may explain the increase in requests for female genital surgery in Britain’s NHS and why some women feel the need to seek labiaplasty and other unnecessary gynaecological procedures for aesthetic purposes.

“These findings are concerning for healthcare professionals because genital cosmetic surgery can have short-term risks, including bleeding and wound infection, but there are currently no data on the clinical effectiveness of these procedures or the longer-term physiological and psychological effects on women,” Mr Martin Hirsch said.

“It is important that healthcare providers counsel women on the normal variations in genital appearance and ensure they are well informed of any associated risks for surgical procedures.”

Media: Claire Moran, ph +353 86 378 8868 (both numbers are in Ireland), [email protected] or co-author Professor Christina Lee, ph +61 7 3365 4910, [email protected], Kristen Bastian, Senior Marketing and Communications Officer, (07) 3346 9279, [email protected]

Royal College of Obstetricians and Gynaecologists PR officer Rebecca Jones in London, + 44 (0)20 7772 6444, mobile + 44 (0)7986 183 167

[email protected]


The Royal College of Obstetricians and Gynaecologists and the British Society for Paediatric and Adolescent Gynaecology recently published an ethical opinion paper and a position statement, respectively, addressing the issue of female genital cosmetic surgery and its availability through the NHS – read more here.

BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. 


Claire Moran and Christina Lee. What’s normal? Influencing women’s perceptions of normal genitalia: An experiment involving exposure to modified and non-modified images. BJOG2013 http://dx.doi.org/10.1111/1471-0528.12578

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