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Abstract

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. Our objective was to determine if visual depictions of the vulva differed according to their source so as to alert medical professionals and their patients to how these depictions might capture variation and thus influence perceptions of "normality". We conducted a comparative analysis by measuring (a) published visual materials from human anatomy textbooks in a university library, (b) feminist publications (both print and online) depicting vulval morphology, and (c) online pornography, focusing on the most visited and freely accessible sites in the UK. Post-hoc tests showed that labial protuberance was significantly less (p < .001, equivalent to approximately 7 mm) in images from online pornography compared to feminist publications. All five measures taken of vulval features were significantly correlated (p < .001) in the online pornography sample, indicating a less varied range of differences in organ proportions than the other sources where not all measures were correlated. Women and health professionals should be aware that specific sources of imagery may depict different types of genital morphology and may not accurately reflect true variation in the population, and consultations for genital surgeries should include discussion about the actual and perceived range of variation in female genital morphology.