Predictors and Outcomes of Labiaplasty

Author: Gemma Sharp

Sharp, Gemma, 2016 Predictors and Outcomes of Labiaplasty, Flinders University, School of Psychology

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Labiaplasty is the most popular form of female genital cosmetic surgery and involves the surgical reduction of the labia minora. It is performed primarily for aesthetic reasons and has become increasing popular in Western countries. However, little is known about the factors that influence women’s interest in labiaplasty, and research on its psychological outcomes is limited. Thus the first aim of the thesis was to investigate factors which influence women’s attitudes toward labiaplasty. The second aim was to investigate the psychological outcomes of labiaplasty, particularly psychological well-being and sexual well-being. These aims were addressed in a series of studies utilising correlational, experimental, longitudinal, and qualitative research designs.

The thesis consists of five papers (four published and one accepted for publication). The first two studies involved general community samples of women. The first examined predictors of consideration of labiaplasty using a sociocultural framework. The results showed that three classes of predictor, namely, media exposure, peer influence, and intimate relationship quality, influenced labiaplasty consideration both directly and indirectly. As media exposure was the strongest predictor of labiaplasty consideration identified in Study 1, Study 2 examined the effectiveness of two online resources (photographs and video) aimed at educating women about the lack of female genital appearance diversity shown in the media. The results showed that the video resource significantly improved women’s perceptions of genital appearance diversity as well as their awareness of digital editing of genital images in the media.

Study 3 examined the factors which influence women’s decisions to undergo labiaplasty and Study 4 involved a longitudinal follow-up of these women after surgery to examine the psychological outcomes of labiaplasty. Study 3 showed that women seeking labiaplasty had been exposed to a greater volume of media images of female genitals than women who were not interested in labiaplasty. In addition, although they did not differ in the quality of their intimate relationships, women seeking labiaplasty were less likely to be involved in an intimate relationship prior to surgery. The findings from Study 4 showed that these women experienced a significant reduction in their dissatisfaction with their genital appearance 6 months after labiaplasty, but there were no significant changes to their psychological well-being or intimate relationship quality.

Study 5 involved a retrospective qualitative examination of women’s motivations, expectations and experiences undergoing labiaplasty. Five themes were identified: “media influence,” “negative commentary,” “physical vs appearance reasons,” “satisfaction with surgery,” and “sexual well-being”. Media representations and negative comments from intimate partners contributed to women’s concerns with their labial appearance. Most women were very satisfied with their surgical results and improvements in their sexual well-being, however, some still experienced emotional discomfort around sexual intercourse.

Overall, the findings of the studies extend our knowledge about the factors which influence women’s decisions around labiaplasty and the effects on their psychological and sexual well-being after undergoing this procedure. Accordingly, the results contribute to our theoretical understanding of the psychological underpinnings of labiaplasty and provide practical implications for how women and health professionals might make more informed decisions around labiaplasty.

Keywords: Labiaplasty, Female Genital Cosmetic Surgery, Sociocultural, Media, Psychological Well-Being, Sexual Well-Being.

Subject: Psychology thesis

Thesis type: Doctor of Philosophy
Completed: 2016
School: School of Psychology
Supervisor: Dr Julie Mattiske