title: Survey of male perceptions regarding the vulva.
abstract: OBJECTIVE
  The purpose of this study was to characterize male preferences of vulvar appearance, their awareness of labiaplasty, and their knowledge of genital anatomy.
  
  
  METHODS
  Men 18-80 years old were recruited via emails sent by an Internet provider to participate in a 27-question web-based survey. The questionnaire included images and queried demographics, men's familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. Two deployments to >150,000 email addresses were sent. Demographic data were described using frequencies for categoric variables and mean measures of central tendency for continuous variables. Logistic regression models were used to analyze associations between demographics and responses.
  
  
  RESULTS
  Two thousand four hundred three men responded to the survey. After excluding incomplete and ineligible surveys, 1847 surveys were analyzed. The median age of respondents was 55 years. The majority was white (87%), married (68%), employed (69%), and had completed high school or beyond (97%). One-third of the respondents lived in the South, with the other regions nearly equally represented. A significant majority, 95%, reported having been sexually active with women, and 86% felt comfortable labeling the vulvar anatomy. With regard to preferences, more respondents considered smaller labia attractive compared to large labia; yet 36% of the men remained neutral. Men also showed a preference for partially or completely groomed genitals compared to natural hair pattern. Whereas 51% of participants believed the appearance of a woman's labia influenced their desire to engage in sexual activity, 60% denied it affected sexual pleasure. Only 42% of men were familiar with labiaplasty, and 75% of all respondents would not encourage a female partner to change her genital appearance. Multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, as well as familiarity with labiaplasty.
  
  
  CONCLUSIONS
  In this national survey, men demonstrated familiarity with the female anatomy, but many did not feel it impacted sexual desire or pleasure. Moreover, the majority lacked strong preferences for a specific vulvar appearance and would not encourage a female partner to alter her genital appearance surgically.
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, Cincinnati, OH. Electronic address: Donna_Mazloomdoost@trihealth.com.
authors.forename: Donna
authors.initials: D
authors.lastname: Mazloomdoost
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Westermann
authors.affiliation: Hatton Research Institute, TriHealth/Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Janine M
authors.initials: JM
authors.lastname: Benbouajili
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Kleeman
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth/Good Samaritan Hospital, Cincinnati, OH.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D003430:Cross-Sectional Studies; D005260:Female; D005836:Genitalia, Female / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014844:Vulva / Q000033:anatomy & histology; D055815:Young Adult
keywords: cosmetic; genitoplasty; labia; labiaplasty; male perception; vulvar appearance