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Psychological characteristics and motivation of women seeking labiaplasty

Published online by Cambridge University Press:  10 May 2013

D. Veale*
Affiliation:
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London, London, UK
E. Eshkevari
Affiliation:
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London, London, UK
N. Ellison
Affiliation:
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London, London, UK
A. Costa
Affiliation:
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London, London, UK
D. Robinson
Affiliation:
Department of Urogynaecology, King's College London, London, UK
A. Kavouni
Affiliation:
Cosmetic Solutions, London, UK
L. Cardozo
Affiliation:
Department of Urogynaecology, King's College London, London, UK
*
*Address for correspondence: D. Veale, Centre for Anxiety Disorders and Trauma, The Maudsley Hospital, 99 Denmark Hill, London SE5 8AZ, UK. (Email: [email protected])

Abstract

Background

Labiaplasty is an increasingly popular surgical intervention but little is known about the characteristics and motivation of women who seek the procedure or the psychosexual outcome.

Method

A total of 55 women seeking labiaplasty were compared with 70 women who did not desire labiaplasty. Various general measures of psychopathology as well as specific measures (Genital Appearance Satisfaction; Cosmetic Procedure Screening for labiaplasty) were used. Labia measurements of the women seeking labiaplasty were also obtained.

Results

Women seeking labiaplasty did not differ from controls on measures of depression or anxiety. They did, however, express increased dissatisfaction towards the appearance of their genitalia, with lower overall sexual satisfaction and a poorer quality of life in terms of body image. Women seeking labiaplasty reported a significantly greater frequency of avoidance behaviours on all the domains assessed, and greater frequency of safety-seeking behaviours for most of the domains. Key motivations reported for labiaplasty were categorized as cosmetic, functional or sexual. Of the 55 women seeking labiaplasty, 10 met diagnostic criteria for body dysmorphic disorder.

Conclusions

This is the first controlled study to describe some of the characteristics and motivations of women seeking labiaplasty. We identified a wide range of avoidance and safety-seeking behaviours, which occurred more frequently in the labiaplasty group than the control group. These could be used clinically as part of a psychological intervention for women seeking labiaplasty.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Bramwell, R (2002). Invisible labia: the representation of female external genitals in women's magazines. Sexual and Relationship Therapy 17, 187190.CrossRefGoogle Scholar
Bramwell, R, Morland, C (2009). Genital appearance satisfaction in women: the development of a questionnaire and exploration of correlates. Journal of Reproductive and Infant Psychology 27, 1527.Google Scholar
Bramwell, R, Morland, C, Garden, AS (2007). Expectations and experience of labial reduction: a qualitative study. British Journal of Obstetrics and Gynaecology 114, 14931499.Google Scholar
Braun, V (2009). Female genital cosmetic surgery: a critical review of current knowledge and contemporary debates. Journal of Women's Health 19, 13931407.CrossRefGoogle Scholar
Cash, TF, Fleming, EC (2002). The impact of body-image experiences: development of the Body Image Quality of Life Inventory. International Journal of Eating Disorders 31, 455460.Google Scholar
Crerand, CE, Menard, W, Phillips, KA (2010). Surgical and minimally invasive cosmetic procedures among persons with body dysmorphic disorder. Annals of Plastic Surgery 65, 1116.CrossRefGoogle ScholarPubMed
Crouch, NS, Deans, R, Michala, L, Liao, LM, Creighton, SM (2011). Clinical characteristics of well women seeking labial reduction surgery: a prospective study. British Journal of Obstetrics and Gynaecology 118, 15071510.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1995). Structured Clinical Interview for DSM-IV Axis I Disorders. Biometric Research Department: New York.Google Scholar
Health and Social Care Information Centre (2012). Hospital Episode Statistics (www.hesonline.nhs.uk). Accessed 4 April 2012.Google Scholar
Hrabosky, JI, Cash, TF, Veale, D, Neziroglu, F, Soll, EA, Garner, DM, Phillips, KA (2009). Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical controls: a multisite study. Body Image 6, 155163.Google Scholar
Lambrou, C, Veale, D, Wilson, G (2012). Appearance concerns comparisons among persons with body dysmorphic disorder and nonclinical controls with and without aesthetic training. Body Image 9, 8692.Google Scholar
Liao, LM, Creighton, SM (2007). Requests for cosmetic genitoplasty: how should healthcare providers respond? British Medical Journal 334, 10901092.Google Scholar
Liao, LM, Michala, L, Creighton, SM (2010). Labial surgery for well women: a review of the literature. British Journal of Obstetrics and Gynaecology 117, 2025.CrossRefGoogle ScholarPubMed
Lloyd, J, Crouch, NS, Minto, CL, Liao, L-M, Creighton, SM (2005). Female genital appearance: ‘normality’ unfolds. British Journal of Obstetrics and Gynaecology 112, 643646.CrossRefGoogle ScholarPubMed
Mundt, JC, Marks, IM, Shear, MK, Greist, JH (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry 180, 461464.CrossRefGoogle Scholar
Neziroglu, F, Khemlani-Patel, S, Veale, D (2008). Social learning theory and cognitive behavioral models of body dysmorphic disorder. Body Image 5, 2838.Google Scholar
Neziroglu, F, Yaryura-Tobias, JA (1993). Body dysmorphic disorder: phenomenology and case descriptions. Behavioural Psychotherapy 21, 2736.Google Scholar
Phillips, KA, Diaz, SF (1997). Gender differences in body dysmorphic disorder. Journal of Nervous and Mental Disease 185, 570577.Google Scholar
Phillips, KA, Grant, JD, Siniscalchi, J, Albertini, RS (2001). Surgical and nonpsychiatric treatment of patients with body dysmorphic disorder. Psychosomatics 42, 504510.Google Scholar
Phillips, KA, Hollander, E, Rasmussen, SA, Aronowitz, BR, Decaria, C, Goodman, WK (1997). A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale–Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin 33, 1722.Google Scholar
Phillips, KA, McElroy, SL, Keck, PE Jr, Pope, HG Jr, Hudson, JI (1993). Body dysmorphic disorder: 30 cases of imagined ugliness. American Journal of Psychiatry 150, 302308.Google ScholarPubMed
Rogers, RG, Kammerer-Doak, D, Villarreal, A, Coates, K, Qualls, C (2001). A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. American Journal of Obstetrics and Gynecology 184, 552558.CrossRefGoogle ScholarPubMed
Salkovskis, PM (1991). The importance of behaviour in the maintenance of anxiety and panic. Behavioural Psychotherapy 19, 619.CrossRefGoogle Scholar
Tignol, J, Biraben-Gotzamanis, L, Martin-Guehl, C, Grabot, D, Aouizerate, B (2007). Body dysmorphic disorder and cosmetic surgery: evolution of 24 subjects with a minimal defect in appearance 5 years after their request for cosmetic surgery. European Psychiatry 22, 520524.Google Scholar
Veale, D, Boocock, A, Gournay, K, Dryden, W, Shah, F, Willson, R, Walburn, J (1996 a). Body dysmorphic disorder. A survey of fifty cases. British Journal of Psychiatry 169, 196201.CrossRefGoogle ScholarPubMed
Veale, D, De Haro, L, Lambrou, C (2003). Cosmetic rhinoplasty in body dysmorphic disorder. British Journal of Plastic Surgery 56, 546551.Google Scholar
Veale, D, Ellison, N, Werner, TG, Dodhia, R, Serafty, M, Clarke, A (2011). Development of a cosmetic procedure screening questionnaire (COPS) for body dysmorphic disorder. Journal of Plastic, Reconstructive and Aesthetic Surgery 65, 530532.CrossRefGoogle ScholarPubMed
Veale, D, Eshkevari, E, Ellison, N, Cardozo, L, Robinson, D, Kavouni, A (2013). Validation of genital appearance satisfaction scale and the cosmetic procedure screening scale for women seeking labiaplasty. Journal of Psychosomatic Obstetrics and Gynecology 34, 4652.Google Scholar
Veale, D, Gournay, K, Dryden, W, Boocock, A, Shah, F, Willson, R, Walburn, J (1996 b). Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behaviour Research and Therapy 34, 717729.Google Scholar
Zigmond, A, Snaith, RP (1983). The Hospital Depression and Anxiety Scale. Acta Psychiatrica Scandinavica 67, 361370.CrossRefGoogle Scholar