Abstract
The study investigated negative genital self-image in women and determined the effect of education on natural/normal female genital appearance diversity on the change in women’s genital self-image. The type of research is a mixed method descriptive study. The participants were 259 women living in Turkey. In the first stage of the study, female genital self-image levels and body appreciation levels were evaluated. In the second stage of the study, women were interviewed thoroughly about negative female genital self-image, and then, visual education presentation was made on natural/normal female genital diversity. One week after the presentation, the women’s genital self-image levels were re-evaluated. In the first phase of the study, the mean Female Genital Self-Image Scale (FGSIS) total score was 22.07 ± 4.07 and the mean Body Appreciation Scale (BAS) total score was 42.40 ± 8.13 of the women. Higher FGSIS and BAS scores showed an increase in women’s positive genital self-image and body appreciation. The relationship between the FGSIS and the BAS scale scores of the women was found to be significantly correlated (r = 0.401, p < 0.001). In the second stage of the study, four main themes were examined as “positive thoughts,” “size and image,” “metaphors related to genital organs,” and “negative thoughts.” In conclusion, in the first phase, it was determined that women’s feeling of discomfort with their sexual organs during sexual intercourse, comparing their genital organs with other women’s genital organs, thinking of genital organ aesthetic surgery, and BAS scores were associated with FGSIS scores. In the second phase, women’s positive or negative feelings and thoughts about their genital self-image were revealed.
Similar content being viewed by others
Data availability
Turkish data are available.
Code availability
Not applicable.
References
Alleva JM, Tylka TL, Kroon Van Diest AM (2017) The Functionality Appreciation Scale (FAS): development and psychometric evaluation in U.S. community women and men. Body Image 23:28–44. https://doi.org/10.1016/j.bodyim.2017.07.008
Alomair N, Alageel S, Davies N, Bailey JV (2020) Factors influencing sexual and reproductive health of Muslim women: A systematic review. Reprod Health 17(1):1–16
Amos N, McCabe M (2016) Positive perceptions of genital appearance and feeling sexually attractive: is it a matter of sexual esteem? Arch Sex Behav 45(5):1249–1258. https://doi.org/10.1007/s10508-015-0680-4
Andrade C (2021) The inconvenient truth about convenience and purposive samples. Indian J Psychol Med 43(1):86–88. https://doi.org/10.1177/0253717620977000
Andrew R, Tiggemann M, Clark L (2016) Predicting body appreciation in young women: an integrated model of positive body image. Body Image 18:34–42. https://doi.org/10.1016/j.bodyim.2016.04.003
Anli G, Akin A, Eker H, Ozcelik B (2015) The validity and reliability of the Turkish version of the body appreciation scale. J Acad Soc Sci Stud 6(36):505–505. https://doi.org/10.9761/jasss2906. (In Turkish)
Barbara G, Facchin F, Meschia M, Vercellini P (2015) “The first cut is the deepest”: a psychological, sexological and gynecological perspective on female genital cosmetic surgery. Acta Obstet Gynecol Scand 94(9):915–920. https://doi.org/10.1111/aogs.12660
Benabe E, Fuentes Y, Roldan G, Ramos M, Pastrana M, Romaguera J (2021) The perceptions of female genital self-image and its associations with female sexual distress. Int J Gynecol Obstet. https://doi.org/10.1002/ijgo.13827
Böhm C (2018) What women want: Designing an education material about the female genitals for young women. Dissertation, University of Linköping
Borms R, Geuens S (2023) Talking sexuality. In: Geunes S Polona Mivšek, A., Gianotten, W. (eds) Midwifery and sexuality, 1th edn. Springer Cham, pp 309–324
Çiftçi H, Pelit ES, Katı B (2018) Kadın cinselliğinde kültürel farklılıkların rolü. Androl Bül. https://doi.org/10.24898/tandro.2018.98852
Coelho C, Giatti L, Molina M, Nunes M, Barreto S (2015) Body image and nutritional status are associated with physical activity in men and women: the ELSA-Brasil study. Int J Environ Res Public Health 12(6):6179–6196. https://doi.org/10.3390/ijerph120606179
Delaney C (2018) Tohum ve toprak. İletişim, İstanbul
DeMaria AL, Hollub AV, Herbenick D (2012) The Female Genital Self-Image Scale (FGSIS): validation among a sample of female college students. J Sex Med 9(3):708–718. https://doi.org/10.1111/j.1743-6109.2011.02620.x
DeMaria AL, Meier SJ, Dykstra C (2019) “It’s not perfect but it’s mine”: genital self-image among women living in Italy. Body Image 29:140–148. https://doi.org/10.1016/j.bodyim.2019.03.011
Ellibeş Kaya A, Doğan O, Yassa M, Başbuğ A, Özcan C, Çalışkan E (2020) Do external female genital measurements affect genital perception and sexual function and orgasm? J Turk Soc Obstet Gynecol 17(3):175–181. https://doi.org/10.4274/tjod.galenos.2020.89896
Erdoğan S, Nahcivan S, Esin MN (2014) Hemşirelikte araştırma. In: Erdoğan S, Nahcivan N, Esin MN (eds), 4th edn. Nobel, İstanbul, pp 333–358
Eryılmaz N, Kosretas B, Ataman SA (2021) Sexual health education at home and at school. Genel Sağlık Bilim Derg 3(2):152–159. https://dergipark.org.tr/tr/download/article-file/1603527
Fahs B (2014) Genital panics: Constructing the vagina in women’s qualitative narratives about pubic hair, menstrual sex, and vaginal self-image. Body Image 11(3):210–218. https://doi.org/10.1016/j.bodyim.2014.03.002
Fernando AN, Sharp G (2020) Genital self-image in adolescent girls: the effectiveness of a brief educational video. Body Image 35:75–83. https://doi.org/10.1016/j.bodyim.2020.08.007
Fredrickson BL, Roberts T-A (1997) Objectification theory: toward understanding women’s lived experiences and mental health risks. Psychol Women Q 21(2):173–206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x
Fudge MC, Byers ES (2020) An exploration of psychosocial factors associated with female genital self-image. Gend Issues 37(2):153–172. https://doi.org/10.1007/s12147-019-09242-2
Grower P, Ward LM (2018) Examining the unique contribution of body appreciation to heterosexual women’s sexual agency. Body Image 27:138–147. https://doi.org/10.1016/j.bodyim.2018.09.003
Halcomb E, Hickman L (2015) Mixed methods research. Nurs Stand 29(32):41–47. https://doi.org/10.7748/ns.29.32.41.e8858
Halliwell E (2015) Future directions for positive body image research. Body Image 14:177–189. https://doi.org/10.1016/j.bodyim.2015.03.003
Hamurcu P, Öner C, Telatar B, Yeşildağ Ş (2015) Obezitenin benlik saygısı ve beden algısı üzerine etkisi. Türk Aile Hekim Derg 19(3):122–129
Herbenick DL (2009) The development and validation of a scale to measure attitudes toward women’s genitals. Int J Sex Health 21(3):153–166. https://doi.org/10.1080/19317610903149692
Herbenick D, Schick V, Reece M, Sanders S, Dodge B, Fortenberry JD (2011) The Female Genital Self-Image Scale (FGSIS): results from a nationally representative probability sample of women in the United States. J Sex Med 8(1):158–166. https://doi.org/10.1111/j.1743-6109.2010.02071.x
Jawed-Wessel S, Herbenick D, Schick V (2017) The relationship between body image, female genital self-image, and sexual function among first-time mothers. J Sex Marital Ther 43(7):618–632. https://doi.org/10.1080/0092623X.2016.1212443
Kalaaji A, Dreyer S, Maric I, Schnegg J, Jönsson V (2019) Female cosmetic genital surgery: patient characteristics, motivation, and satisfaction. Aesthetic Surg J 39(12):1455–1466. https://doi.org/10.1093/asj/sjy309
Komarnicky T, Skakoon-Sparling S, Milhausen RR, Breuer R (2019) Genital self-image: associations with other domains of body image and sexual response. J Sex Marital Ther 45(6):524–537. https://doi.org/10.1080/0092623X.2019.1586018
Kreklau A, Vâz I, Oehme F, Strub F, Brechbühl R, Christmann C, Günthert A (2018) Measurements of a ‘normal vulva’ in women aged 15–84: a cross-sectional prospective single-centre study. BJOG: Int J Obstet Gynaecol 125(13):1656–1661. https://doi.org/10.1111/1471-0528.15387
Laan E, Martoredjo DK, Hesselink S, Snijders N, van Lunsen RHW (2017) Young women’s genital self-image and effects of exposure to pictures of natural vulvas. J Psychosom Obstet Gynecol 38(4):249–255. https://doi.org/10.1080/0167482X.2016.1233172
Myers TA, Crowther JH (2007) Sociocultural pressures, thin-ideal internalization, self-objectification, and body dissatisfaction: Could feminist beliefs be a moderating factor? Body Image 4(3):296–308. https://doi.org/10.1016/j.bodyim.2007.04.001
Puhl RM, Luedicke J (2012) Weight-based victimization among adolescents in the school setting: emotional reactions and coping behaviors. J Youth Adolesc 41(1):27–40. https://doi.org/10.1007/s10964-011-9713-z
Satinsky S, Reece M, Dennis B, Sanders S, Bardzell S (2012) An assessment of body appreciation and its relationship to sexual function in women. Body Image 9(1):137–144. https://doi.org/10.1016/j.bodyim.2011.09.007
Schick VR, Calabrese SK, Rima BN, Zucker AN (2010) Genital appearance dissatisfaction: implications for women’s genital image self-consciousness, sexual esteem, sexual satisfaction, and sexual risk. Psychol Women Q 34(3):394–404. https://doi.org/10.1111/j.1471-6402.2010.01584.x
Sharp G, Tiggemann M (2016) Educating women about normal female genital appearance variation. Body Image 16:70–78. https://doi.org/10.1016/j.bodyim.2015.11.006
Silva Gomes TB, Brasil CA, Barreto APP, Ferreira RS, Berghmans B, Lordelo P (2019) Female genital image: is there a relationship with body image? J Turk Soc Obstet Gynecol 16(2):84–90. https://doi.org/10.4274/tjod.galenos.2019.49799
Smith NK, Butler S, Wagner B, Collazo E, Caltabiano L, Herbenick D (2017) Genital self-image and considerations of elective genital surgery. J Sex Marital Ther 43(2):169–184. https://doi.org/10.1080/0092623X.2016.1141820
Sönmez V, Alacapınar FG (2014) Bilimsel araştırma yöntemleri. Anı, Ankara
Stratton S (2021) Population research: convenience sampling strategies. Prehosp Disaster Med 36(4):373–374. https://doi.org/10.1017/S1049023X21000649
Tiggemann M, Boundy M (2008) Effect of environment and appearance compliment on college women’s self-objectification, mood, body shame, and cognitive performance. Psychol Women Q 32(4):399–405. https://doi.org/10.1111/j.1471-6402.2008.00453.x
Tylka TL, Wood-Barcalow NL (2015) What is and what is not positive body image? Conceptual foundations and construct definition. Body Image 14:118–129. https://doi.org/10.1016/j.bodyim.2015.04.001
Veale D, Eshkevari E, Ellison N, Costa A, Robinson D, Kavouni A, Cardozo L (2014) Psychological characteristics and motivation of women seeking labiaplasty. Psychol Med 44(3):555–566. https://doi.org/10.1017/S0033291713001025
Waltner R (1986) Genital identity: A core component of sexual- and self-identity. J Sex Res 22(3):399–402. https://doi.org/10.1080/00224498609551319
Woertman L, van den Brink F (2012) Body image and female sexual functioning and behavior: a review. The J Sex Res 49(2–3):184–211. https://doi.org/10.1080/00224499.2012.658586
Yurteri-Kaplan LA, Antosh DD, Sokol AI, Park AJ, Gutman RE, Kingsberg SA, Iglesia CB (2012) Interest in cosmetic vulvar surgery and perception of vulvar appearance. Am J Obstet Gynecol 207(5):428.e1-428.e7. https://doi.org/10.1016/j.ajog.2012.06.056
Zangeneh S, Savabi-Esfahani M, Taleghani F et al (2023) A silence full of words: sociocultural beliefs behind the sexual health of Iranian women undergoing breast cancer treatment, a qualitative study. Support Care Cancer 31:84. https://doi.org/10.1007/s00520-022-07502-8
Zwier S (2014) “What motivates her”: motivations for considering labial reduction surgery as recounted on women’s online communities and surgeons’ websites. Sex Med 2(1):16–23. https://doi.org/10.1002/sm2.20
Acknowledgements
We would also like to extend our deepest gratitude to beautiful women who are valuable with their thoughts and feelings and we respect.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
“Female genital self-image and body appreciation in Turkish women: a mixed methods study” was presented as an oral presentation at the 1st International National Sivas Midwifery Congress 09–10 May 2022. The oral presentation was awarded the second prize.
Supplementary information
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Koçak, V., Aksoy, Y.E. Female genital self-image and body appreciation in Turkish women: a mixed methods study. Arch Womens Ment Health 27, 219–232 (2024). https://doi.org/10.1007/s00737-023-01397-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-023-01397-y