Genital Cosmetic Surgery Research Articles

Female genital cosmetic surgery: a social trend driving surgical practice.

Female genital cosmetic surgery: a social trend driving surgical practice.

Long-term Functional and Aesthetic Outcomes of Labiaplasty: A Review of the Literature.

The incidence of female genital cosmetic surgery (FGCS), and specifically labiaplasty, is on the rise. Common motivators for labiaplasty include hygiene concerns, functional impairment, difficulties with physical and sexual activity, and dissatisfaction with genital appearance, amongst others. However, there have been few reports on long-term functional and aesthetic outcomes and complications of labiaplasty. The aim of this literature review was to report on long-term outcomes of labiaplasty, as defined as ≥1 year post-operatively, to inform safety and efficacy recommendations for the procedure. A comprehensive literature review was conducted on Pubmed and Embase from inception to December 1, 2023 following PRISMA guidelines. Articles were selected according to predetermined eligibility criteria. A manual search was performed to identify additional relevant studies. Nine studies reported on the long-term postoperative complications associated with labiaplasty, with a cumulative total of 748 patients. The most commonly reported complications included postoperative asymmetry (n=45, 6.02%), scarring (n=14, 1.87%), and the need for revision surgery (n=42, 5.61%). Of note, the majority of patients (n=621 of 748) were not reported to have any postoperative complications. From the seven studies that examined psychological outcomes associated with labiaplasty, all studies reported improvement in sustained genital appearance scores as well as aesthetic and sexual satisfaction in the long-term.

Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study.

Individuals from different generations are interacting more and more today, and while each generation exists with its own characteristics, this situation causes intergenerational differences in every issue in social life. Considering the characteristics of different generations, it is predicted that individuals' views on genital cosmetic surgery may differ. This study was conducted to examine the views of women of different generations on genital cosmetic surgery and to determine their perspectives on genital cosmetic surgery. The population of the study consists of women from different generations. The sample of the study was formed using typical case sampling from purposive sampling methods. Data saturation was reached by conducting qualitative interviews with 15 women by selecting the snowball sampling method. Data were collected using a semi-structured individual interview form, and data analysis was performed using MAXQDA 2020. The opinions of women of different generations about genital cosmetic surgery were analysed under four themes and 13 categories as "Perception of Beauty", "Perception of Health", "Perception of Society" and "Perception of Need". The opinions of women of different generations about genital cosmetic surgery differ. It is thought that these differences may be caused by factors such as psychosocial, economic, environment, media, technological developments and culture. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Use of Artificial Intelligence in Female Genital Cosmetic Surgery

The Use of Artificial Intelligence in Female Genital Cosmetic Surgery

FGM and genital cutting across borders: cultural biases in the contestation of global human rights

ABSTRACT Global norms developed within the United Nations system have constructed female genital mutilation (FGM) exclusively as a set of non-Western practices. Consistent with these global norms, Western countries have adopted anti-FGM laws targeting non-Western practices while allowing Western genital modification procedures, including female genital cosmetic surgeries (FGCS), male circumcision, and genital ‘normalization’ surgeries performed on intersex children. These legal inconsistencies suggest that global governance of FGM represents an effort to maintain gendered and racialized social orders reflecting the values of dominant groups. This article examines global norms condemning FGM and anti-FGM laws in Western countries as sites of power and contestation of fundamental human rights.

Did She or Didn't She? Perceptions of Operative Status of Female Genitalia.

Although extensive research has explored why women undergo labiaplasty, little attention has been paid to societal and professional abilities to distinguish between altered and unaltered labia, impacting both patient concerns and broader societal perceptions. This study aimed to evaluate the accuracy of the general public and healthcare professionals in identifying labiaplasty and to pinpoint the misconceptions driving their perceptions. The goal was to inform more effective patient counseling strategies and challenge existing stigmas around cosmetic genital surgery. The authors conducted an online survey of 511 lay adults and a group of 21 gynecologists and aesthetic vulvar surgeons. The survey assessed the participants' ability to detect labiaplasty from images, focusing on aesthetic appearance, hair patterns, and size. The analysis involved Pearson correlation and Z-tests to compare perceptions against actual operative status. Analysis of the survey findings revealed a pronounced difficulty among participants in accurately discerning labiaplasty, with neither group showing a significant ability to identify surgical alterations. Misinterpretations were notably influenced by expectations of aesthetic appearance, with 49% associating an "odd" or "fake" look with surgery, and hair and size misconceptions also misleading respondents. Additionally, 20% of participants mistakenly related surgical changes to gender-affirming surgery or female genital mutilation. The study highlights a gap in the ability of both the general public and medical professionals to accurately identify labiaplasty, pointing to a broad misunderstanding of cosmetic genital surgery's visual outcomes. Addressing these misconceptions through targeted education could substantially improve patient counseling and help dismantle the stigmas associated with labiaplasty.

Labia minora hypertrophy: pathologizing diversity?

Labia minora hypertrophy can be characterized by the labial tissue extending beyond the labia majora; however, the exact definition of hypertrophy is a matter of debate. While the prevalence of labia hypertrophy is very common among women, taboo/controversial attitudes and surgical interventions still dominate. The recognition and study of labia minora hypertrophy will increase our knowledge of this underrepresented anatomic diversity. To provide a report of the current literature on labia hypertrophy and discuss the definition, etiology, attitudes, management, and medicalization surrounding labia minora hypertrophy and the implications. Comprehensive review of literature pertaining to labia minora hypertrophy. Labia minora appearance and measurements vary extensively, and hypertrophy is extremely prevalent in the population and largely nonpathologic. There remains a lack of standardized criteria to define labia hypertrophy. Attitudes surrounding labia hypertrophy differ globally, but in Western nations the overwhelming sentiment toward labia hypertrophy has largely been medicalized. Negative attitudes and unnecessary medicalization of nonpathologic instances of labia hypertrophy is unjustifiable and comes with potential risks. There remains an impending need to demedicalize nonpathologic elongated labia, educate the public on diverse genital appearance, and improve understanding of the long-term outcomes and risks of genital cosmetic surgery.

Female genital cosmetic surgery in Indonesia: a qualitative analysis of medical advertising on Instagram

Research on female genital cosmetic surgery usually comes from Anglophone countries. We investigated female genital cosmetic surgery in the predominantly Muslim South-East Asian country of Indonesia, aiming to identify the procedures offered by medical clinics on Instagram, how they are justified, and what they claim to achieve; and to understand what this means for women and their bodies. The 184 eligible posts from 19 clinics between 1 January to 31 March 2021 offered vaginoplasty, labiaplasty, hymenoplasty, and other procedures. Reflexive thematic analysis yielded three themes: Why you should have female genital cosmetic surgery, Indications for female genital cosmetic surgery, and What you will gain from female genital cosmetic surgery. Posts were similar to those identified in other countries, revealing implicit vulvar aesthetics, expectations that women choose to ‘improve’ their genitals, the need to please men, and that female genital cosmetic surgery is straightforward. Two differences from Anglophone advertising were the use of euphemisms to describe the vulva and an emphasis on physical ‘virginity’. Across countries, female genital cosmetic surgery advertising appears to arise from patriarchal constructs of women’s bodies and determination to control them. We contend that Indonesia shares with other countries the need for education—of medical practitioners and the general public—about sexuality and the vulva, and that the advertising of female genital cosmetic surgery should be regulated and rigorously monitored.

The Batalha Clitoropexy: Shortening an Elongated Clitoris - A Minimally Invasive Technique.

Female cosmetic genital surgery is becoming increasingly sought after by women who are concerned with the appearance of their vulva. Labiaplasty for the labia minora is undoubtedly the most commonly performed female cosmetic genital surgery. However, an increasing number of patients seen in our clinics in both Brazil and the United States are presenting with clitoral hypertrophy, specifically clitoral elongation. The elongated clitoris will usually protrude beyond the labia minora and majora and from the patient's perspective will give a less feminine appearance as they will often describe the protruding clitoris as feeling like they have a small penis. The surgical technique described here, Batalha Clitoropexy, is a minimally invasive surgical technique for clitoral length-reduction that does not require amputation or debulking. This technique is presented in the form of the detailed sequential steps needed to achieve satisfactory results. Photos taken before and after the procedure in a representative case show that the clitoral length has been shortened from 5.0 cm to 1.5 cm without the need of an invasive amputation or debulking clitoroplasty. Many patients with clitoromegaly or an elongated protruding clitoris do not need to undergo an invasive clitoroplasty. Specifically, patients with clitoral elongation or clitoral ptosis can be surgically treated with a less-invasive clitoropexy surgical procedure which can restore normal anatomic position to treat a protruding clitoris.

Comparative Investigation of Genital Self-image and Sexual Function in Women with and Without a History of Female Genital Cosmetic Procedures: A Cross-sectional Study.

Despite the increasing growth of female genital cosmetic procedures, the long-term effects of these procedures are not clearly understood. This study was conducted to compare the genital self-image and sexual function in women with and without female genital cosmetic procedures. This cross-sectional study was conducted on 315 participants (210 women without a history of genital cosmetic surgery and 105 women with it) in Alborz province, Iran, from early February 2023 to mid-May 2023. The sampling was done conveniently. Data collection instruments were Female Genital Self Image Scale and Female Sexual Function Index. Statistical analysis was done in SPSS 16 software using t-test, chi-square, and logistic regression, and P<0.05 was considered statistically significant. The use of laser to tighten the vagina with 77.77% and Perineoplasty with 29.2% were the main cosmetic procedures. The mean duration passed from the surgical procedures was 4.79±3.60 years, while it was 1.13±0.74 years for non-surgical procedures. Women with a history of genital procedures had a higher mean age (39.45±10.38, P=0.023). However, they were lower regarding the level of education (P<0.001), family income (P<0.001), and exercise (P<0.001). Also, they showed a higher number of pregnancies (P<0.001), deliveries (P<0.001), vaginal delivery (P<0.001), episiotomy (P<0.001), and neonates with a weight of ≥3.5 kg (P=0.002). In both groups, midwives and doctors were the most important sources of information about the appearance and function of reproductive system. However, the genital self-image and sexual function of the two groups did not differ significantly (P>0.05). No difference in sexual self-image and lack of difference in sexual function after cosmetic procedures show the need to pay attention to recommending and selecting these procedures. Public awareness about the diverse and natural forms of the female genitalia, education about the variety of the factors affecting sexual function, reduction of unnecessary interventions, increase in physiological births, retraining doctors and midwives, and multidimensional counseling can help to choose more appropriate candidates for cosmetic procedures.

A Decade of Lawsuits Against Surgeons Performing Female Genital Cosmetic Surgery (FGCS) in Tehran, Iran.

The objective of this study is to evaluate the legal proceedings that arise from Female Genital Cosmetic Surgeries (FGCS) and analyze the reasons why women file complaints against their surgeons. Additionally, we examined the outcomes of the legal decisions associated with these complaints. This descriptive cross-sectional study was conducted in Tehran province, Iran, from 2012 to 2021. The primary data source for this study was forensic medical records, which were reviewed to gather relevant information. The collected data included the characteristics of the participants, the reasons for lawsuits, the procedure setting, and the outcomes of the legal decisions. A total of 121 patients were examined in the study, revealing that Labiaplasty was the most prevalent procedure (49.6%), followed by vaginoplasty (19.8%) and perineoplasty (13.2%). The most common complaints were related to cosmetic concerns (57%), lack of recovery (26.4%), and sexual dysfunctions (22.3%). Healthcare providers were found liable for malpractice in 52.1% of cases. Additionally, having the surgery performed by a gynecologist decreased the risk of malpractice (β = 0.21, p= 0.034), while procedures in private clinics increased the risk (β = 2.95, p = 0.040). The study's findings emphasized the importance of providing women with comprehensive education and consultations to ensure they are well-informed about the potential outcomes and risks of FGCS. Furthermore, the study highlighted the significance of having these surgical procedures performed by skilled and experienced surgeons. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cosmetic male genital surgery: a narrative review.

Through the centuries the appearance of the male genitalia has always been an important concern for men, symbolizing virility, potency and sexual contentment. Correction of perceived deficiencies and deformities of the male genitalia can be addressed by aesthetic surgery as well as the enhancement its external aspect. If the social acceptance of cosmetic surgery, particularly of women's breasts, dates from the early 1950s, male intimate cosmetic surgery emerged from the shadows about 10 years ago with a medical community still very suspicious and reproachful. The present paper aims to describe and discuss the current state of the art regarding male intimate cosmetic surgery. A narrative review of the literature was performed using publications from January 2000 to September 2022. The publications were retrieved from the PubMed database using Medical Subject Headings (MeSH) terms and keywords. The authors' goal is to narrate the aesthetic non-surgical and surgical enhancement procedures of the male apparatus. This narrative review examines the diverse procedures associated with male genitalia aesthetics. Aesthetics of the male genitalia is now an unavoidable and important part of aesthetic surgery worldwide with an increasing demand. Nonsurgical and surgical techniques described in the literature should be reviewed.

Where is the mutilation? Understanding the High Court’s deliberation on FGM in Vaziri and Magennis

In 2015, Vaziri and Magennis – the first case on female genital mutilation (FGM) – was prosecuted in Australia. Three people were convicted. In 2018, the NSW Court of Criminal Appeal ruled that the judgment was a ‘potential miscarriage of justice’. The prosecution pushed for ‘leave to appeal’ to the High Court of Australia and for consideration of the meaning of mutilation. The appeal was held in 2019, and the NSWCCA judgment was overturned. In this article, I examine the absence of discussions of male circumcision and female genital cosmetic surgery in this case and ask not only what form of cut produces a legal definition of mutilation, but where this cut must be and on what form of body.

Maintaining vulvar, vaginal and perineal health: Clinical considerations.

Knowledge of female genital anatomy and physiology is often inadequate or incorrect among women. Precise patient-physician conversations can be inhibited by a reluctance or inability to speak accurately about the vulva and vagina, with the terms often being used interchangeably. There is a paucity of scientific evidence and clinical guidelines to support women and physicians in ensuring best practices in feminine hygiene. In this review, the unmet needs in the field are highlighted. Evidence is provided for the complex array of physiological and pathological systems, mechanisms and behaviours that either protect or, if inappropriate, predispose the vulva and vagina to infections, irritation or other conditions. The need for attention to perineal health is recommended, given the interdependence of perineal and vulvar microbiota and the risk of colonic pathogens reaching the vulva and the vagina. Differences in feminine hygiene practices can vary widely across the world and among varying age groups, and suboptimal habits (such as vaginal douching or the use of certain cleansers) can be associated with increased risks of vulvar and vaginal conditions. Critical areas for discussion when advising women on their intimate health include: advice surrounding aesthetic vulvar cosmetic trends (such as depilation and genital cosmetic surgery), bowel health and habits, and protection against sexually transmitted infections. Routine, once-daily (maximum twice-daily) washing of the vulva with a pH-balanced, mild cleanser is optimal, ideally soon after bowel voiding, when feasible. Due to the finely balanced ecosystems of the vulva, the vagina and the perineal area, a scientific and clinical perspective is essential when determining the most appropriate vulvar cleansers based on their components. Correct intimate care may contribute to improved genital and sexual health and overall well-being. An increased awareness of correct practices will empower women to be the advocates of their own intimate health.

Cosmetic gynaecology

Key content Female genital cosmetic surgery (FGCS) includes several procedures involving the labia minora, labia majora, clitoris, vagina, mons pubis and genital area; procedures may involve, for example, reduction or augmentation and be surgical or energy based. Indications for FGCS can be broadly divided into cosmetic and functional reasons. Counselling on the risks and cosmetic outcomes, as well as sexual and functional results, should be provided, and the woman's expectations discussed. Learning objectives To develop a holistic view when discussing cosmetic gynaecology concerns, including psychosexual assessment. To understand the procedures that are currently available, the evidence‐base behind these procedures, and their risks and benefits. To understand the implications of genital cosmetic surgery on patients, including their psychosexual wellbeing, and the legality of these procedures with reference to female genital mutilation (FGM). Ethical issues The ‘postcode lottery’ in commissioning cosmetic gynaecological procedures in the UK leads to the question: should they be available on the NHS? Who should be performing cosmetic gynaecological procedures: the plastic surgeons who do little vaginal surgery, or the gynaecologists? There is currently no formal training in this area for gynaecologists.

A comprehensive interventional program based on the needs and concerns related to female genital cosmetic surgeries: protocol for a multistage mixed methods study

BackgroundDissatisfaction with one's body and the subsequent rise in the cosmetic surgery trend pose significant public health concerns today. One unusual cosmetic surgical procedure involves enhancing the genital area. Numerous healthy women and girls have recently sought Genital Cosmetic Surgery (GCS) for beauty or improved sexual performance. There is a concern that this phenomenon may be linked to developing a new standard for vulvovaginal appearance. This stringent standard could potentially adversely affect women's mental health in the future, growing feelings of insecurity and possibly leading teenagers to consider plastic surgery.Implementing empowering and awareness-raising programs for women and girls is crucial, especially in light of the constantly evolving gender norms and the medicalization of sexuality and beauty as social constructs. It is essential that such training is integrated into comprehensive sexual education programs for adolescents. These efforts align perfectly with the SDG, recognizing that education in sexual and reproductive health, ensuring access to health, and empowering women are fundamental rights for women and girls. To accomplish these objectives, we will conduct this study to elucidate the needs and concerns related to the increasing trend of GCS. By doing so, we can concentrate on the factors motivating women to undergo GCS. This approach will enable us to develop effective interventions to empower women and girls considering GCS, thus enhancing their sexual and reproductive health.Methods and objectivesThe objectives of this multistage exploratory sequential mixed-method study will be structured into three phases:First phase: qualitative study.In-depth interviews will be conducted to elucidate the needs and concerns associated with GCS with women with a history of GCS, spouses of willing participants, and women actively seeking these procedures.A literature review in parallel with the qualitative phase will be conducted to gain insights into the needs and concerns of women worldwide considering GCS.Second phase: program design.To formulate an intervention grounded in the primary priorities identified during the qualitative stage and informed by the literature review.To prioritize the needs and concerns of women seeking GCS and to validate and endorse the intervention through input from an expert panel.Third phase: quantitative study.To assess and determine the effectiveness of the intervention designed to address the needs and concerns of women applying for GCS procedures.DiscussionThis study marks the first attempt to design and assess an intervention addressing the needs and concerns of cosmetic surgeries performed on the female genital and reproductive system. The hope is that this study's compilation and implementation will yield substantial evidence and documentation regarding the impact of educational interventions on women's and girls' sexual and reproductive empowerment. Given the rising prevalence of GCS among unmarried teenagers, this approach is of utmost significance. It underscores the necessity for gynecological and midwifery service providers to have comprehensive guidance on GCS. Such guidance can be an essential resource for healthcare providers in this field.

"Normal vulva" based on the first national Labiagram design in adult Iranian women not seeking female genital cosmetic surgery: a pilot study.

Several studies have been published to present normal values of female genitalia in different age and racial groups. The primary objective of our study was to measure the parameters of the external genitalia in adult Iranian women, record the data using the Labiagram system (the first national Labiagram design in Iran), and establish a preliminary database. A descriptive study was conducted from March 2022 to December 2022, involving 220 nonpregnant adult women who presented to the gynecology clinic. Women who met the inclusion criteria for the study underwent a comprehensive examination of the external genitalia. The data collected during the examinations were recorded in electronic files and the Labiagram system. The data showed the diversity of external genital parameters of nonpregnant adult Iranian women. In this descriptive study, the mean ± SD age of the participants was 51.5 ± 13.44years, ranging from 15 to 84years. A total of 192 women (87.3%) had a history of vaginal delivery. There was no statistically significant difference observed in the average measurements of the vulva among the 4 age groups (P < .05). The Pearson correlation coefficient test indicated a statistically weak correlation between body mass index and perineum length (r = 0.174, P = .010). Additionally, a weak correlation was found between body mass index and the width of the labia minora at the left-lower point (r = 0.143, P = .030) and the right-middle point (r = 0.146, P = .031). Furthermore, the results demonstrated that women with a history of vaginal delivery had a significantly longer introitus (49.3 vs 44.3mm, P = .037), longer labia majora (91.3 vs 87.3mm, P = .046), and longer labia minora (56.8 vs 50.9mm, P = .008) when compared with women without prior labor experience. The data will be used as a basis for future studies. The use of simple tools for the measuring, data recording, and digital drawing of female external genital anatomy, along with privacy protection, is one of the strengths of this research. The weakness is the small sample size, which is the reason for piloting the Labiagram chart for more extensive studies. Increasing age and the number of births had no statistically significant effect on the size of external genital parameters among Iranian women. Despite the considerable diversity in these parameters, it has not resulted in a significant demand among Iranian women for female cosmetic surgery.

Women's Knowledge, Attitudes, and Practice About Female Genital Cosmetic Surgery: A Cross-Sectional Study in Saudi Arabia.

Introduction Vulvoplasty, or female genital cosmetic surgery (FGCS), refers to any surgical alteration of the vaginal or labial anatomy for aesthetic or medical reasons. It aims to restore or enhance the female genitals and can involve multiple procedures such as labiaplasty, clitoral unhooding, monsplasty, vaginoplasty, hymenoplasty, G-spot augmentation, frenuloplasty, perineoplasty, fat injections, or a combination of these. Labiaplasty is currently the most popular procedure among patients. Since the public is exploring FGCS benefits in the media, it can be foreseen that it will soon gain popularityamong the population of Saudi Arabia. As a result, the purpose of this study is to assesswomen'sattitudes and knowledge towards genital cosmetic surgeries in Saudi Arabia. Methods This correlational cross-sectional survey was conducted in Saudi Arabia among women aged 18 years and above, using an online self-structured questionnaire distributed from April 2023 to October 2023. The sample size of 594 respondents was determined based on a minimum requirement of 500 participants, with a confidence level of 95% and a study power of 95%. A convenient sampling method was employed to select participants, and data collection was carried out through a self-administered online questionnaire distributed via various social media platforms. The survey was self-structured, andCronbach's alpha values for all sections were greater than 0.7. These sections includedemographic characteristics, sexual life and obstetric history, and women's knowledge, practices, and attitudes toward FGCS. Descriptive analysis, chi-square test, and t-test were used for data analysis using SPSS software. Results A total of 589 eligible women were included in the study;284 (48.2%) were from the central region, and ages ranged from 18 to 65 years, with a mean age of 33.5 years. A total of 401 (68.1%) were married, 366 (62.1%) had a bachelor degree. Two hundred and ninety-one(49.4%) participants heard about FGCS, 165 (28%) knew that it involves surgical procedures to change the appearance of the female genitalia, 144 (24.4%) said it is also known as vaginal rejuvenation or designer vagina surgery and 200 (34%) knew it can involve procedures such as labiaplasty, clitoral hood reduction, or vaginal tightening, while 190 (32.3%) reported it is sometimes done for aesthetic reasons but may also be done for medical reasons. Only 45 (7.6%) had undergone FGCS, but 112 (19%) confirmed they consider undergoing FGCS for themselves. Four hundred and ninety-eight (84.6%) participants thought that it's important to have access to support services, such as counseling or peer support, 471 (80%) expressed that it's important that healthcare providers in Saudi Arabia are knowledgeable about FGCS, 425 (72.2%) were concerned about the potential risks and complications of FGCS. Conclusion In conclusion, the current study revealed that nearly one out of five women were knowledgeable about FGCS, mainly about the nature and types of the procedure. Higher knowledge levels about FGCS were associated with younger age, higher educational levels, and women who were more likely to consider undergoing FGCS in the future.

Health professionals’ and beauty therapists’ perspectives on female genital cosmetic surgery: an interview study

BackgroundFemale genital cosmetic surgery (FGCS) changes the structure and appearance of healthy external genitalia. We aimed to identify discourses that help explain and rationalise FGCS and to derive from them possibilities for informing clinical education.MethodsWe interviewed 16 health professionals and 5 non-health professionals who deal with women’s bodies using a study-specific semi-structured interview guide. We analysed transcripts using a three-step iterative process: identifying themes relevant to indications for FGCS, identifying the discourses within which they were positioned, and categorising and theorising discourses.ResultsWe identified discourses that we categorised within four themes: Diversity and the Normal Vulva (diversity was both acknowledged and rejected); Indications for FGCS (Functional, Psychological, Appearance); Ethical Perspectives; and Reasons Women Seek FGCS (Pubic Depilation, Media Representation, Pornography, Advertising Regulations, Social Pressure, Genital Unfamiliarity).ConclusionsVulvar aesthetics constitute a social construct to which medical practice and opinion contribute and by which they are influenced; education and reform need to occur on all fronts. Resources that not only establish genital diversity but also challenge limited vulvar aesthetics could be developed in consultation with women, healthcare practitioners, mental health specialists, and others with knowledge of social constructs of women’s bodies.

Beyond the tip of the iceberg: A meta-analysis of the anatomy of the clitoris.

An understanding of ranges in clitoral anatomy is important for clinicians caring for patients including those who have had female genital mutilation, women seeking genital cosmetic surgery, or trans women seeking reconstructive surgery. The aim of this meta-analysis is to investigate the ranges in clitoral measurements within the literature. A meta-analysis was performed on Ovid Medline and Embase databases following the PRISMA protocol. Measurements of clitoral structures from magnetic imaging resonance, ultrasound, cadaveric, and living women were extracted and analyzed. Twenty-one studies met the inclusion criteria. The range in addition to the average length and width of the glans (6.40 mm; 5.14 mm), body (25.46 mm; 9.00 mm), crura (52.41 mm; 8.71 mm), bulb (52.00 mm; 10.33 mm), and prepuce (23.19 mm) was calculated. Furthermore, the range and average distance from the clitoris to the external urethral meatus (22.27 mm), vagina (43.14 mm), and anus (76.30 mm) was documented. All erectile and non-erectile structures of the clitoris present with substantial range. It is imperative to expand the literature on clitoral measurements and disseminate the new results to healthcare professionals and the public to reduce the sense of inadequacy and the chances of iatrogenic damage during surgery.