A new survey has found that almost one quarter of women aged 18-24 feel anxious, embarrassed or unhappy about the appearance of their labia, which can have damaging impacts on their physical, mental and sexual health and wellbeing.
The research by Women’s Health Victoria and YouGov shows that a significant number of Australian women and gender diverse people are seeking out female genital cosmetic surgery on their labia, with evidence suggesting that the prevalence of mainstream porn and online media are some of the key drivers, particularly amongst younger people.
Better education of Australian GPs on labia diversity, more inclusive relationship and sexual education in all schools, and faster progress on the Australian Government’s regulation of young people’s access to online pornography, are crucial if we are to address the shame and anxiety that is driving labiaplasty rates, the leading feminist health organisation said.
Published to mark the 10th anniversary of Women’s Health Victoria’s ground-breaking Labia Library health site, the Real Bodies: Understanding and Celebrating Labia Diversity report includes a survey of more than 1,000 respondents in Australia aged between 18 and 50.
Worryingly, one in ten respondents (the equivalent of more than half a million women) say they have had or have considered having labiaplasty, one of the fastest growing cosmetic procedures amongst young people in Australia and worldwide.
Labiaplasty is the most common form of female genital cosmetic surgery (FGCS) and involves the removal or altering of tissues from the labia – the folds of skin that sit on either side of a person’s vaginal opening. The procedure has significant risks and has not been proven to help with body image, sexual satisfaction or self-esteem.
The research found that for Gen Z, labia shame is significantly heightened, with almost one in four (23%) people aged 18 to 24 reporting they feel anxious, unhappy or embarrassed about how their labia looks, and more than a third (35%) associating their labia with negative words such as ‘weird’, ‘disgusting’ or ‘ugly’.
Body image anxiety – particularly around women’s genitals and reproductive body parts, which carry additional layers of shame, stigma and secrecy – can have profound and lifelong impacts on a person’s life.
More than four in 10 (43%) survey respondents who reported being anxious or embarrassed by their labia said they had put off seeing a GP for sexual and reproductive health issues or a pap smear because of this shame; almost 6 in 10 (57%) said it had impacted their mental health and more than 6 in 10 (62%) said they had put off having sex as a result.
Labia Library ambassador Dr Melissa Kang is a practising medical doctor for marginalised young people, particularly on adolescent sexual health, an award-winning author and the longest-serving expert behind the iconic Dolly Doctor column. She says: “The reality is, more than half of all people with vulvas have visible, or protruding labia minora, and many have labia that are asymmetrical.
“The labia are such an incredibly important body part, protecting the urinary opening, the vaginal opening and the clitoris. They’re also full of nerve endings that play an important role in sex. What we need to talk about more, especially with young women and girls (cis and trans inclusive), is how labia are diverse and unique, and come in all different shapes, sizes and colours. And really emphasise to young people, including boys and young men, that there is actually no medical definition of what ‘normal’ labia look like because there simply is ‘no normal’.”
Experts and medical professionals say the prevalence of mainstream porn – in which performers’ labia are often airbrushed, filtered, and even surgically altered, portraying an idealised and unrealistic image of what labia or vulvas ‘should be’ – is one of the key drivers of labia shame.
Online pornography is one of the most influential sources of (mis)information on sex and body image for young people in Australia today. Another factor is the increasing amounts of time many people are spending online and on social media, which can be saturated with cosmetic surgery advertising and false information on body image norms.
In fact, almost one in five (19%) Gen Zs surveyed say they obtain their information on what their genitals ‘should look like’ through porn, and almost a third obtain it from social media. Almost half (46%) of those who said they had considered labiaplasty said their decision was influenced by what they had seen in mainstream porn or social media.
A new campaign by Women’s Health Victoria, launched as part of its online health resource the Labia Library, is aiming to re-ignite a conversation that embraces the diversity of labia. Its mission is to confront the shame, anxiety and worry that many people associate with their labia through education and by showing that unrealistic depictions in mass media and pornography are not the norm.
“Communicating and celebrating the diversity of labia online is important to fostering positive conversations regarding perceptions of labia and to encourage acceptance of differences,” said Kate Johnston-Ataata, Manager of Policy, Health Promotion and Advocacy at Women’s Health Victoria.
“The Labia Library is a trusted, credible and one-of-a-kind resource that brings together diverse images of labia with practical, evidence-based information about this part of the body. Access to high quality, candid sexual and reproductive health information can have an enormous and positive impact on women, trans and gender diverse people’s health and wellbeing, and their ability to have pleasurable and respectful intimate relationships. It’s these kinds of deceptively simple resources that can really make a difference when we talk about gender equality,” Johnston-Ataata added.
Libby Payne, a 24-year-old respectful relationships and consent advocate, participated in the Labia Library’s 2024 advisory panel. “Although conversations around sex and body positivity have come such a long way, my generation still don’t often talk about labia. Many people my age don’t know the difference between the vagina and the vulva, let alone that labia come in all shapes and sizes.
“When we fail to provide sex and relationships education that includes the true diversity of human bodies it’s no wonder young people assume the genitals they see in porn are the norm. While there is great porn that can boost self-confidence and pleasure, there is still a lot out there that can be damaging. The unrealistic body standards that are modelled both within porn, and in our social media advertising can cause young people to be concerned their own vulva doesn’t look right, or is misshapen. The young people I work with list the endless pressures they feel are placed on how their bodies should look, such as being hairless or having a ‘tucked-in’ slit. Increasingly I’m hearing they are anxious and embarrassed about their body as they are worried their partner is comparing it to what they have seen in porn. We cannot leave our young people thinking their bodies are wrong: we must encourage conversation that normalises and celebrates the differences in size, colour, symmetry, and shape of the vulva and labia.
Other key findings:
- More positively, a third of respondents aged 18-50 said they feel happy, confident and associate their labia with words such as ‘pleasure’, ‘healthy’ and ‘protection’.
- More than a fifth (22%) who had considered labiaplasty said this was due to pain or discomfort.
- Three in 10 (30%) who had given birth vaginally, said that this experience positively impacted how they feel about their vulva and labia appearance.
Women’s Health Victoria are calling for better education amongst GPs and doctors about labia diversity: currently, vulva and labia diversity is not covered in GP training, and medical texts used in training for GPs and health professionals in training show a single stereotypical representation of a vulva and labia. With a better understanding of the diversity of vulval anatomy, GPs will be better equipped to support patients with anxiety about the appearance of their vulva, including referral to mental health support as needed.
The organisation also encourages integration of education on vulva diversity into relationship and sexuality education (RSE) in all schools; faster progress on the Australian Government’s regulation of young people’s access to online pornography; and that the inclusion of realistic depictions and discussions of bodies and genitalia – in particular, of vulvas and labia – be incorporated into public health campaigns.
SOURCE: Monash University