(049) HOW MUCH OF THE GENITAL AREA CAN WOMEN ACTUALLY SEE DIRECTLY WITH THEIR OWN EYES? AN ASSESSMENT OF GENITAL VISUAL FIELDS IMPORTANT FOR CIS-GENDER AND TRANS-GENDER WOMEN

Abstract

Abstract Introduction Many urologic surgeries and urologic conditions that urologists manage (e.g. STD’s, genital pain and injury, wound care) involve the genital area. Throughout the process of urologic care, urologists depend on patients to be able to assess the appearance of their genital area so that they can alert their urologist of worrisome changes. Urologists assume that patients can see their genital areas clearly. However, there is no literature to date that assesses how reliable this assumption is. That is, to date, we do not know how much of the genital area is commonly visible to people with female genital anatomy. Objective In the present work, we ask adult women to indicate how far posteriorly in their genital area they can see. We also query whether patient age and BMI predict visibility in genital sub-fields. Methods A total of 82 cis-gender and 12 transgender women participated in our study. No subjects had visual or ambulation deficits. Each was shown an anatomic illustration with genital anatomy subdivided into various subfields (anterior to posterior). Subjects were asked to circle each field that they are able to see with their own eyes, on their body, without the aid of a camera or mirror. Age, height, and weight were recorded. Logistic regression was performed for visibility by age and BMI. Results Average visibility decreased the more posteriorly the visual field was located. Visibility decreased precipitously for all fields posterior to the clitoris. For cis-gender women, 44-91% could not see their vulva below their clitoris (i.e. peri-urethral area, vaginal introitus, majority of their Labia, and anus. These results were more extreme for transgender women who have undergone vaginoplasty surgery. Interestingly, BMI was not a significant predictor of field-visibility. Conclusions Visibility of the genital areas posterior to the clitoris is limited among cis and transgender women. Visibility decreases the more posterior a visual field is, and elevated BMI significantly reduces genital visibility. Providers should bear in mind that many women cannot directly see a significant portion of their genital area. This is especially important during monitoring after genital area surgery, and may other urologic, primary, and gynecologic care conditions. This is the first study to describe how much of the genital area is directly visible to patients. Disclosure No.