Does size matter? Genital self-image, genital size, pornography use and openness towards cosmetic genital surgery in 3662 Swedish men and women

This cross-sectional study investigated the distribution and characteristics of genial self-image in a large sample of males and females, and whether factors such as actual genial size (length of penis or protrusion of labia minora), consumption of sexually explicit material (SEM) or avoidance and safety seeking behaviors were associated with genital self-image. Overall, 3.6% of females and 5.5% of males suffered from a severely low genital self-image and 33.8% of all individuals reported dissatisfaction with the appearance of their genitalia, with 13.7% of females and 11.3% of males being positive towards undergoing cosmetic genital surgery. Mean protrusion of labia minora and stretched flaccid penis length in the population was estimated to 0.76 cm (95% CI 0.63-0.89 cm) and 12.5 cm (95% CI 12.33-12.76 cm), respectively. A better genital self-image was associated with having a larger penis or less protruding labia minora, but not associated with the degree of SEM consumption, although 93.6% of males and 57.5% of females had consumed SEM in the past three months. Avoidance and safety seeking behaviors were strongly correlated with a negative genital self-image. Considering this relationship, more research is warranted in the development of potential psychological interventions in order to alleviate genital dissatisfaction in individuals.