Women's perceptions of what is considered normal and desirable female genitalia may be influenced by exposure to modified images, according to psychologists writing in BJOG: An International Journal of Obstetrics and Gynaecology.

Requests for labiaplasty - reducing and making the labia minora symmetrical - have become a fad and are now the most widely performed female genital cosmetic procedure covered by Australian government health care over the past decade, increasing five-fold between 2001 and 2010. 

The psychologists from University of Queensland looked at whether exposure to images of modified vulvas influenced women's perceptions of what is considered normal and desirable by society. The study included 97 women aged 18 to 30 years, who were randomly assigned to three groups to view a series of images in two screenings.

The first screening exposed one group to a series of images of surgically modified vulvas, one group to a series of non-modified vulvas, and the third group viewed no images.

During the second screening, all groups then viewed a series of mixed images of both surgically modified and non-modified vulvas. The women then rated each image according to their perception of 'normality' and 'society's ideal'.

The results were that women who had initially viewed the modified vulvas identified the modified images in the second screening as more normal than the non-modified vulvas. This was significantly different from the control group, who initially viewed no images, and were 18% less likely to rate the modified vulvas as normal.  

Furthermore, when asked to rate the images according to society's ideal of genitalia, women in all three groups rated the modified images as more like society's ideal than the non-modified vulva images. Again, women who initially viewed the modified images were 13% more likely to rate the modified vulvas as more society's ideal than the control group.

Claire Moran, lead author of the paper, said, "Our results showed that exposure to images of modified vulvas can significantly influence women's perceptions of what is considered a normal and desirable vulval appearance. These findings further heighten concerns that unrealistic concepts of what is considered normal may lead to genital dissatisfaction among women, encouraging women to seek unnecessary surgery.

"This research is the first to document the extent to which exposure may impact women's genital dissatisfaction and more needs to be done to promote awareness and education around genital diversity in our society."