Gonin-Spahni Stefanie, Schmuki Maria, Brandner Lucca M, Borgmann Michèle, Haupt Clemens A, Inauen Jennifer
Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Berne, Switzerland.
J Sex Med. 2025 Jun 29;22(7):1226-1235. doi: 10.1093/jsxmed/qdaf111.
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.
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.
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).
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 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).
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.
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.
生殖器自我形象较为负面的女性更有可能经历性功能障碍，在预防性传播感染和意外怀孕方面保护自己的可能性更低，并且更有可能考虑进行阴唇整形手术。
本研究调查通过接触自然外阴的多样性以及有关生殖器外观和功能的信息，是否可以提升女性的生殖器自我形象。
进行了一项在线实验，作为双臂随机对照试验，包括仅展示外阴照片、展示照片并提供信息以及一个对照条件。参与者为563名年龄在18至68岁之间的女性（M = 27.6，标准差 = 8.3）。
主要结果是生殖器自我形象量表；次要结果包括女性性功能指数、性健康行为以及对生殖器整形手术的兴趣。
结果显示时间有显著的主效应。在干预后所有条件下，生殖器自我形象均立即显著提高（所有p <.01，所有偏η²≥.03）。在外阴照片组中，这种提高在2周随访时保持稳定（p <.05，偏η² =.02）。只有在外阴照片和信息组中的女性在8周随访时显示出显著更积极的生殖器自我形象（p <.01，偏η² =.05）。证实了实验效果，我们发现了显著的组×时间交互作用（p <.001，偏η² =.015）。计划对比表明，干预组与对照组在干预后立即（p <.01，d =.53）和2周随访时（p =.042，d =.41）在生殖器自我形象上存在显著组间差异。在8周随访时未发现组间差异（p <.60）。照片与信息相结合的条件在任何时间点都不优于仅展示照片的条件。对次要结果没有影响（所有p >.20）。
结果强调，通过教育可以快速且经济高效地改善女性的生殖器自我形象。
本研究首次使用实验设计在大型便利样本中研究生殖器自我形象的可变性。干预效果仅在短期内得以显示。然而，鉴于女性在干预前生殖器自我形象相对积极，该效果尤其令人印象深刻。结果可能不适用于生殖器自我形象较不积极或考虑进行阴唇整形手术的女性。
接触自然外阴照片，无论是否附带有关生殖器多样性和功能的信息，都是改善成年女性生殖器自我形象的有用工具，可能有益于性健康和幸福感。
