Borgmann, Michèle (2025). Promoting women’s genital self-image with vulva photographs and information about genital appearance and function: An online experiment. The Journal of Sexual Medicine, 22 (7), pp. 1226-1235. 10.1093/jsxmed/qdaf111

Text Gonin-SpahniEtAl2025_GenitalSelfImageExperiment.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (553kB)

Background
Women with more negative genital self-image are more likely to experience sexual dysfunction, less likely to protect themselves from sexually transmitted infections and unwanted pregnancy, and more likely to consider labiaplasty.

Aim
This study investigates whether women’s genital self-image can be promoted via exposure to natural vulva diversity and information about genital appearance and function.

Methods
An online experiment was conducted as a two-arm randomized controlled trial including a vulva photographs only, photographs and information, and a control condition. Participants were 563 women aged 18–68 years (M = 27.6, SD = 8.3)

Outcomes
The primary outcome was the Genital Self-Image Scale; secondary outcomes included the Female Sexual Function Index, sexual health behavior, and interest in genital plastic surgery.

Results
Results indicated a significant main effect of time. Genital self-image increased significantly in all conditions immediately after the intervention (all p < .01, all partial η2 ≥ .03). In the group with vulva photographs, this increase remained stable at 2-week follow-up (p < .05, partial η2 = .02). Only women in the vulva photographs and information group showed a significantly more positive genital self-image at 8-week follow-up (p < .01, partial η2 = .05). Confirming the experimental effect, we found a significant group x time interaction (p < .001, partial η2 = .015). Planned contrasts indicated a significant group difference in genital self-image in the intervention groups vs. controls immediately after the intervention (p < .01, d = .53) and at the 2-week follow-up (p = .042, d = .41). No group differences were found at the 8-week follow-up (p < .60). The combined condition of photographs with information was not superior to photographs only at any time point. There were no effects on secondary outcomes (all p > .20).

Clinical Translation
The results underscore that women’s genital self-image can be improved rapidly and cost-effectively with education.

Strengths & Limitations
This study is the first to examine the changeability of genital self-image in a large convenience sample using an experimental design. The intervention effect could only be shown in the short term. However, the effect was particularly impressive given that women’s genital self-image was relatively positive prior to the intervention. The results may not generalize to women with a less positive genital self-image or those considering labiaplasty.

Conclusion
Exposure to photographs of natural vulvas with or without information about genital diversity and function is a useful tool for improving genital self-image in adult women, potentially benefiting sexual health and well-being.

Interest & Impact

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