{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:13:26Z","timestamp":1790104406669,"version":"4.0.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Women with more negative genital self-image are more likely to experience sexual dysfunction, less likely to protect themselves from sexually transmitted infections and unwanted pregnancy, and more likely to consider labiaplasty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>This study investigates whether women\u2019s genital self-image can be promoted via exposure to natural vulva diversity and information about genital appearance and function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An online experiment was conducted as a two-arm randomized controlled trial including a vulva photographs only, photographs and information, and a control condition. Participants were 563 women aged 18\u201368\u00a0years (M\u2009=\u200927.6, SD\u2009=\u20098.3)<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The primary outcome was the Genital Self-Image Scale; secondary outcomes included the Female Sexual Function Index, sexual health behavior, and interest in genital plastic surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Results indicated a significant main effect of time. Genital self-image increased significantly in all conditions immediately after the intervention (all p\u2009&amp;lt;\u2009.01, all partial \u03b72\u2009\u2265 .03). In the group with vulva photographs, this increase remained stable at 2-week follow-up (p\u2009&amp;lt;\u2009.05, partial \u03b72\u2009=\u2009.02). Only women in the vulva photographs and information group showed a significantly more positive genital self-image at 8-week follow-up (p\u2009&amp;lt;\u2009.01, partial \u03b72\u2009=\u2009.05). Confirming the experimental effect, we found a significant group x time interaction (p &amp;lt;\u2009.001, partial \u03b72\u2009=\u2009.015). Planned contrasts indicated a significant group difference in genital self-image in the intervention groups vs. controls immediately after the intervention (p\u2009&amp;lt;\u2009.01, d\u2009=\u2009.53) and at the 2-week follow-up (p\u2009=\u2009.042, d\u2009=\u2009.41). No group differences were found at the 8-week follow-up (p\u2009&amp;lt;\u2009.60). The combined condition of photographs with information was not superior to photographs only at any time point. There were no effects on secondary outcomes (all p\u2009&amp;gt;\u2009.20).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Translation<\/jats:title>\n                  <jats:p>The results underscore that women\u2019s genital self-image can be improved rapidly and cost-effectively with education.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>This study is the first to examine the changeability of genital self-image in a large convenience sample using an experimental design. The intervention effect could only be shown in the short term. However, the effect was particularly impressive given that women\u2019s genital self-image was relatively positive prior to the intervention. The results may not generalize to women with a less positive genital self-image or those considering labiaplasty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Exposure to photographs of natural vulvas with or without information about genital diversity and function is a useful tool for improving genital self-image in adult women, potentially benefiting sexual health and well-being.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf111","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T12:30:49Z","timestamp":1748262649000},"page":"1226-1235","source":"Crossref","is-referenced-by-count":1,"title":["Promoting women\u2019s genital self-image with vulva photographs and information about genital appearance and function: an online experiment"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3900-5875","authenticated-orcid":false,"given":"Stefanie","family":"Gonin-Spahni","sequence":"first","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Schmuki","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucca M","family":"Brandner","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mich\u00e8le","family":"Borgmann","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens A","family":"Haupt","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7884-3222","authenticated-orcid":false,"given":"Jennifer","family":"Inauen","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern , Berne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"issue":"5","key":"2025070100264477100_ref1","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1111\/j.1743-6109.2010.01728.x","article-title":"Development and validation of the female genital self-image scale","volume":"7","author":"Herbenick","year":"2010","journal-title":"J Sex Med"},{"issue":"6","key":"2025070100264477100_ref2","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1080\/0092623X.2019.1586018","article-title":"Genital self-image: associations with other domains of body image and sexual response","volume":"45","author":"Komarnicky","year":"2019","journal-title":"J Sex Marital Therapy"},{"issue":"3","key":"2025070100264477100_ref3","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1471-6402.2010.01584.x","article-title":"Genital appearance dissatisfaction: implications for Women's genital image, self consciousness; 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