Information and advice for health educators
Anxiety around labial appearance is increasingly common among young girls, adolescents, and people with labia in Australia and around the world. This anxiety can have significant impacts on physical and mental health and health seeking behaviours, leading to avoidance of GP visits and demand for genital cosmetic surgery.
Comprehensive and fact-based education regarding labial diversity and the anatomy and function of the vulva and labia is crucial to addressing labial anxiety and combating the shame and stigma associated with these parts of the body. It is also important to help people better understand their bodies and promote positive genital body image and sexual self-concept. Starting sexual health education in younger age groups has been shown to be conducive to the development of healthy sexual behaviours.
Why use the Labia Library?
The Labia Library is a free online health promotion resource that provides accessible and evidence-based health information about labia and contains a photo gallery to demonstrate the significant diversity of labia. It is an initiative of Women’s Health Victoria, a statewide feminist not-for-profit health organisation.
Sharing the Labia Library with students, as well as exploring it for yourself, can support you to have well-informed conversations about labial diversity, health and positive body image. You may use the site to demonstrate genital diversity and address labia shame and stigma in sessions. For institutions that have restrictions on what can be shown in classrooms, or for younger cohorts, it may be useful to share the anatomy page and specific information pages, rather than the full site and gallery. You may also recommend that students review the site at home. If you would like to receive Labia Library postcards to distribute in sessions, let us know via our contact us page.
The Labia Library is included as a recommended resource in the Royal Australian College of General Practitioners (RACGP) Female genital cosmetic surgery: a resource for general practitioners and is listed on the Australian Government’s HealthDirect website.
It is also an extremely popular health literacy tool. As of May 2024, it had been visited by 11 million users from countries around the world.
A wide range of users have benefited from viewing the Labia Library, including older women, adolescent girls, parents, men with female partners, and health practitioners and educators. The site now also provides information for trans and gender diverse people with vulvas, making it an inclusive resource for a wide range of audiences.
Analysis of user feedback shows that users of the Labia Library often experience a significant reduction in anxiety and feel reassured that their genital appearance is ‘normal’.
Teaching labial diversity
The diversity and function of labia
The labia serve many important functions, such as:
- Protecting the urethra and vagina
- Contributing to sexual arousal
- Providing sensation and lubrication during sex
Significant variation exists in the size, symmetry, and shape of labia between individuals. This includes differences in the size of the labia minora: 30–50% of all women have labia minora that are longer than the labia majora.
Labia colour also varies. Sometimes labia are the same colour as a person’s skin, but often they are lighter or darker. Some people have pink labia and others have brown, grey, reddish, or purplish labia.
Due to the significant variation that exists, there is no medical definition of what ‘normal’ labia look like.
The labial appearance of trans and gender diverse people may also be impacted by gender affirming therapies, including vaginoplasty and testosterone therapy. Vaginoplasty is a surgical procedure to create a vulva and vagina, commonly using skin from the penis and scrotum. The genitalia of individuals who have undergone vaginoplasty vary greatly and are often indistinguishable from the vulvas of cis women. Testosterone therapy can cause the clitoris to become enlarged, and the labia and vulva to grow – this is often referred to as ‘bottom growth’. These variations to the appearance of the vulva are typical, and part of regular genital diversity.
Factors that influence concerns about labia appearance
Concerns regarding the appearance of labia and vulva are increasingly common among young girls and adolescents, as is the demand for labiaplasty and other forms of female genital cosmetic surgery.
The way someone feels about their labia may be impacted by several factors, including:
- the limited diversity of genitalia found within mainstream or commercial pornography, published images or other online content
- changes in hair removal practices which expose more of the labia
- limited access to accurate information and education about female genital anatomy and its natural diversity
- societal norms relating to genital appearance
- social pressures, including pressure from intimate partners, body image concerns and negative language regarding female genitalia used in social settings
Concerns about genital appearance can also be impacted by cultural context. Female genitalia have been long thought of in a derogatory matter, being considered ‘dirty’, ‘nasty’ or ‘disgusting’.
All these issues – concerns about not being ‘normal’, comparison to the limited number of labia that are represented, misinformation about what labia can look like – can lead to shame and embarrassment.
Teaching labial diversity can help people to better understand their bodies, combat myths around what ‘normal’ labia look like, and address stigma and shame associated with labia.
Using the Labia Library in health education
Sexual health education that includes information on the diversity of genitals, as well as function, wellbeing and sexual choices and satisfaction, is an effective way to address fears about differences in genital appearance.
The Labia Library can help support this. The site contains photographs of labia across a wide range of ages, skin tones, gender identities and body sizes, and also provides health information regarding the functions of the labia. Moving away from a strictly aesthetic point of view can help people understand that there is much more to labia than how they look.
It is important that education on labial and vulval diversity is provided to people of all genders, including boys and men. Information should also be discussed in a way that is inclusive of trans and gender diverse people. An example of this is to say, ‘women, girls and people with labia’ instead of ‘women’ or ‘girls’. If you share the labia gallery with your audience, or recommend that they view it at home, you can also note that it includes vulvas of trans women and men, and that these are part of the normal genital variation.
Questions you can ask
A good way to start is by asking how much your audience already knows about the subject.
When providing health education regarding labia diversity, a good way to start is by asking how much your audience already knows about the subject. You could pose a question such as:
- ‘How much does everyone know about the vulva, for example the names of the different parts?’
Asking a question like this can show the audience that people generally have a limited understanding of labial anatomy and diversity, and that a lot of people’s knowledge of what is ‘normal’ is based on assumptions rather than facts.
This can then lead to a conversation about the functions of the vulva, and the different roles that each part plays. Further questions could include:
- ‘Does anyone know what the labia do?’
- ‘What are the main functions of the labia?’
It is also important to consider your choice of words. Off-the-cuff remarks can be misinterpreted and can contribute to someone’s concerns about the way that they look. Staying away from judgemental language, such as describing things as ‘abnormal’, ‘weird’ or ‘ugly’ is recommended.
Exploring pressures and influences
Additionally, it can be helpful to explore the different pressures and influences that affect how people feel about their labia, such as pornography, cosmetic surgery advertisements on social media, and social pressures from friends, partners or family members. Open-ended questions can be used to encourage audiences to think about the pressures that affect the way they view labia and why. The influence of pornography, including the general lack of labial diversity represented and depiction of women as sexual objects, will be particularly important to cover. You may also situate this conversation in a broader discussion about how women, girls and people with labia are often treated as though their value lies in their physical desirability.
You could also explore how someone might feel if they do worry about their labia, and the impact this may have on their relationships and lifestyle choices.
The Labia Library provides a list of additional resources, including mental health, body image and sexual health, that can be recommended for anyone needing further support.
Recommended resources
British Society for Paediatric and Adolescent Gynaecology (BritSPAG) (2013) Labial reduction surgery (labiaplasty) on adolescents (Position Statement)
Trans Hub (2021) Trans Hub medical affirmation
Women’s Health Victoria (2013) Women and genital cosmetic surgery (Issues Paper)
Women’s Health Victoria (2018) “I never realised they were so different”: understanding the impact of the Labia Library (Knowledge Paper)