In their own words: a qualitative content analysis of women’s and men’s preferences for women’s genitals

Abstract

Research increasingly shows genital attitudes have an impact on sexual well-being and health seeking behaviours. This study explored what women and men like and dislike about women’s genitals. Data are from open-ended items, part of a cross-sectional Internet-based survey anonymously completed by 496 women and 198 men. Overall, both women and men had positive attitudes towards women’s genitals, although there was overlap between likes and dislikes. Some of the most common likes for women related to aesthetics and for men related to tactile and sexual aspects. Men listed more likes than dislikes. The emphasis on both positive and negative messages provides a more complete image of the complex ways people interact with their own and other’s bodies and can help tailor clinical and educational messages.

Introduction

An understanding of attitudes toward genitals, genital perceptions, and genital self-image is increasingly important given the range of ways people interact with or make choices about their own or their partners’ genitals (Herbenick et al. 2011). Previous research shows a relationship between body self-consciousness and decreased sexual pleasure, arousability, sexual functioning, sexual assertiveness, sexual self-esteem, and condom-use self-efficacy, and higher levels of sexual avoidance, ambivalence in sexual decision making, and sexual risk taking (Berman et al. 2003, Bitzer, Giraldi, and Pfaus 2013, Curtin et al. 2011, Schooler et al. 2005, Stewart and Spencer 2002, Yamamiya, Cash, and Thompson 2006). In general, for women, sexual satisfaction is predicted by high body esteem and low frequency of appearance-base distracting thoughts in sexual activity (Pujols, Meston, and Seal 2010, Woertman and van den Brink 2012). Common themes that have arisen in research suggest that women’s sexual behaviours may be influenced by concerns related to their genital appearance, size, vaginal tightness, taste, and smell (Braun and Kitzinger 2001, Braun and Wilkinson 2001, Kerner 2004, Levin 2004, Karasz and Anderson 2003). Although research cites women's feelings and beliefs about their genitals as an important factor in their sexual experiences, the relationship remains under examined.

Regarding women’s sexual health specifically, it has been noted that women may delay gynaecological care due to concerns about having a health care provider view their genitals and may feel more comfortable letting a healthcare provider view their genitals if they have positive genital perceptions (Stewart and Spencer 2002, DeMaria, Hollub, and Herbenick 2011, DeMaria, Hollub, and Herbenick 2012). The recent increase in female genital cosmetic surgery (FGCS), concerning because of varied ethical and medical reasons (Braun 2010), suggests an increase in women’s specific aesthetic concerns about the appearance of their genitals (Malone 2013, Rao and Sharma 2012). Women often state aesthetic concerns, for example, disliking visibility of labia minora, shape, colour, and asymmetry, as reasons for surgery, and these issues are mirrored in advertisements and public discourse on the procedures (Braun 2010). A recent review of FGCS advertisements found aesthetic concerns mentioned on all websites sampled (Liao, Taghinejadi, and Creighton 2012). Partner concerns are specifically mentioned in several FGCS advertisements, as well (Liao, Taghinejadi, and Creighton 2012).

Several studies have measured men’s and women’s feeling and beliefs about their own genitals (Winter 1989, Berman et al. 2003, Morrison et al. 2005, Herbenick 2009, Reinholtz and Muehlenhard 1995, Herbenick and Reece 2010). The majority of this research has been quantitative close-ended responses and oftentimes focused on negative perceptions. Understanding what women dislike about their bodies has value, particularly given potential sexual and health consequences (Berman et al. 2003, Bitzer, Giraldi, and Pfaus 2013, Curtin et al. 2011, Schooler et al. 2005, Stewart and Spencer 2002, Yamamiya, Cash, and Thompson 2006). However, it is also important to understand women's positive perceptions of their bodies, which may not be merely the inverse of negative perceptions. Such information could be used to create health education messaging that further promotes positive body image and genital self-image. Sexual education in school, self-exploration, and experimentation and communication with partners have all been found to be common sites for learning about women’s genitals and forming preferences (Mullinax, Schick, and Herbenick 2014). It is important to understand what preferences are formed through these contexts and how positive interactions can be promoted.

A better understanding of genital likes and dislikes would facilitate further understanding of women's sexual and health behaviours. For example, several studies have reported that women who removed all of their pubic hair tended to score high on the Female Genital Self-Image Scale (FGSIS) and have higher sexual function scores (Herbenick et al. 2013, Herbenick et al. 2011). Women may experience complex feelings about various aspects of their bodies. For example, a woman may remove her pubic hair because she simultaneously dislikes her pubic hair and likes her genitals. Alternatively, she may like her pubic hair groomed in a certain manner and like or dislike aspects of her genitals (e.g., she may like how her genitals feel but not how her labia look; or she may enjoy how her genitals function but have anxieties about their taste). Women may also be responding to cultural or partner pressures and expectations related to public hair. While women rarely list social norms as reasons related to hair removal, a greater proportion of women who are partnered (but not married) tend to engage in hair removal and women who are sexually active with a non-monogamous partner are most likely to remove their hair (Herbenick et al. 2010).

Given that individuals may adopt attitudes toward women’s genitals as a result of cultural-level messages, it is important to understand the dominant cultural messages concerning women’s genitals (Braun and Wilkinson 2001). The purpose of the present study is to document specific likes and dislikes by both women and men about women’s genitals, thereby filling a gap in previous literature that focuses on global perceptions. Specifically, the study aims to increase understanding of positive attitudes towards women’s genitals. The collection of open-ended data about likes and dislikes of both women and men has the potential to provide insight into the ways that genitals are constructed socially and can enrich previous research on the ways in which men and women discuss women’s genitals. This research provides important insight into current gender-based cultural beliefs and messages related to women’s genitals. The open-ended nature of these data provides salient content that might be foreclosed by close-ended questions.

Methods

Participants

Women and men 18 years and older were invited to complete an anonymous internet-based survey about their thoughts, feelings, and beliefs about vulvas and vaginas (female genitals). Age was the only eligibility criteria; however transgender participants (n = 27) were not included in this analysis. A total of 496 women and 198 men completed the survey, including the open-ended items. Approval for this study was obtained by the Institutional Review Board of the first author at Indiana University.

Procedures

Data were collected from January through March 2011 using an online snowball sampling framework. Specifically, emails containing information about the study and a link to the study website were posted on Listservs related to sexuality topics, posted on websites related to sexual health, and on social media outlets, such as Facebook. The study website included a brief description of the study, eligibility requirements, a statement of informed consent, and a link to proceed to the survey. Participants were provided unlimited time to complete the survey, could discontinue their participation at any time, and were not compensated for their participation. The average time of survey completion was anticipated to be about 5–10 minutes.

Measures

The anonymous questionnaire asked about participant background (e.g., age, gender, sexual orientation) and feelings and experiences related to their own (if they identified as cisgender women) and/or others' (if identifying as cisgender men) vulvas and vaginas. Participants were asked a total of 20 questions about their thoughts, feelings, beliefs, and perceptions about women's genitals with instructions to write as much or as little as preferred in response to each question. Women and men were given separate questions with the appropriate wording- men were asked about ‘women’s genitals’ and women were asked about their own genitals, ‘your genitals’. This study reports on the responses to the following questions about vulvas: 1. What do you like about your genitals/women’s genitals? 2. What do you dislike about your genitals/women’s genitals? 3. How do you feel about your/women’s genitals overall? In conjunction with question 1 and 2, men were also asked if there were certain qualities they prefer over others or liked less.

Analysis

Demographic data were analysed using standard statistical frequencies. Due to the mixed-method survey design, post-data collection qualitative analysis procedures were combine with a modified grounded theory approach to analyze the open-ended question responses (Charmaz 2006). Analysis was limited to cisgender men and cisgender women respondents only. Given the exploratory nature of this study, participants were not limited by age or sexual orientation.

Categories and coding

Similar response categories were created based on an iterative process of exploratory content-analysis. Since the survey utilised open-ended questions that were not fully qualitative in nature, counting was used in the analysis. A single list of all responses per question was compiled into Excel. The first author read all responses to generate a basic understanding of patterns emerging from the responses. All statements were read through twice to identify prominent themes before the codebook was created. Codebooks for men and women were created independently, and a count frequency was calculated on commonly used words related to certain themes. Then, codebooks were created based on the most salient content that arose from the responses; coding procedures were designed to identify ten to twenty codes of common responses for each open-ended question. Categories were not mutually exclusive. In the final data analysis process, the first author combined similar codes into themes and identified subthemes within the most frequently mentioned themes.

Inter-rater reliability

Two research assistants were trained to conduct independent content analyses of the open-ended data responses based on the codebook. After initial independent coding, the two coders used Excel to identify any inconsistencies in coding and discussed where needed until 100% consensus was reached for categorizing all responses into the coding themes. The two coders also provided insight on code categories based on their readings and finalised consensus on the codes to be used before coding began. Finally, the two coders and the creator of the codebooks met to discuss results of an initial frequency analysis. To illustrate and exemplify identified meaning, the final codes have been tied back to participant statements and specific wordings. Extracts appear as entered online by participants, without editing, to avoid inadvertently skewing meaning.

Results

Sociodemographic characteristics

Of the total of 496 women and 198 men participating in this study, the women ranged in age from 18 to 84 years with an average age of 30.08 (SD=11.134; median=26.00). Most women identified as heterosexual and had only engaged in sexual activities with men, although some had engaged in sex with men and women (see Table 1: Participant Demographics). Men ranged in age from 18 to 76 years with an average age of 39.65 (SD=13.337; median=38.00). Most men identified as heterosexual and had only engaged in sexual activities with women. No substantial difference in types of themes was found based on age or sexual orientation.

Table 1.

Participant Demographics

	Women (n=496)	Men (n=198)
Age
18–24	37.9% (188)	14.6% (29)
25–29	25.8% (128)	12.1% (24)
30–39	19.6% (97)	25.8% (51)
40–49	7.5% (37)	23.7% (47)
50–59	5.8% (29)	15.7% (31)
60–69	2.8% (14)	5.6% (11)
70–79	0.6% (3)	2.5% (5)
Sexual History
sex with men	52.6% (261)	0.0% (0)
sex with men and women	42.9% (213)	20.7% (41)
sex with women	3.2% (16)	77.8% (154)
Sexual orientation
heterosexual	57.5% (285)	90.4% (179)
bisexual	22.2% (110)	6.1% (12)
queer	11.1% (55)	0.0% (0)
lesbian	4.2% (21)	0.0% (0)
gay	1.0% (5)	1.0% (2)
asexual	0.4% (2)	0.5% (1)

Women’s and men’s dislikes about women’s genitals and less preferred qualities

General

Of the 480 women and 186 men who responded to the question “What do you dislike about your genitals” or “What things do you dislike about women's genitals? Are there certain qualities that you like less than others?”, a large group of men and women used the space to clarify they disliked “nothing” (see Table 2). This was, in fact, the second most common response for dislikes for women and the fourth most common response for men. For instance, this man elaborates, “How can you dislike them? No matter what the individual topology of each female is, there is always beauty and uniqueness.”

Table 2.

Women and Men: likes and dislikes about women's genitals and preferred qualities

		Likes		Dislikes
		Women (n=496)	Men (n=198)	Women (n=480)	Men (n=186)
Characteristics		% (N)	% (N)	% (N)	% (N)
General
	Everything	6.7% (33)	7.6% (15)	- -	- -
	Nothing	3.6% (18)	- -	17.3% (83)	18.3% (34)
	Never thought about it	2.4% (12)	- -	- -	- -
Aesthetics
	Appearance	14.3% (71)	24.2% (48)	14.6% (70)	18.8% (35)
	Size	7.3% (36)	17.7% (35)	- -	14.0% (26)
	Color	10.3% (51)	13.1% (26)	7.3% (35)	- -
	Shape	10.5% (52)	- -	- -	- -
	Beauty	9.9% (49)	- -	- -	- -
	Length	- -	- -	11.3% (54)	- -
	Diversity	2.8% (14)	15.7% (31)
	Asymmetrical	- -	- -	6.9% (33)	- -
Pubic Hair
	Pubic Hair	5.0% (25)	21.7% (43)	22.9% (110)	26.3% (49)
	Grooming/Shaving	- -	- -	13.8% (66)	- -
Tactile
	Texture	10.1% (50)	25.80% (51)	- -	- -
	Softness	7.5% (37)	12.60% (25)	- -	- -
	Warmth	- -	11.60% (23)	- -	- -
Smell		9.1% (45)	31.3% (62)	14.8% (71)	35.5% (66)
Taste		3.0% (15)	30.8% (61)	- -	8.1% (15)
Health
	Normal/healthy	12.1% (60)	- -	- -	- -
	Discharge	- -	- -	6.7% (32)	- -
	Infections	- -	- -	6.3% (30)	- -
	Hygiene	- -	10.1% (20)	- -	16.1% (30)
	Childbirth	10.9% (54)	3.3% (16)
Pain
	Pain	- -	- -	10.8% (52)	- -
	Menstruation	- -	- -	7.1% (34)	10.8% (20)
Childbirth		10.9% (54)	- -	3.3% (16)	- -
Sex
	Pleasure	4.6% (23)	26.8% (53)	6.7% (32)	- -
	Sensitivity	7.3% (36)	- -	5.4% (26)	- -
	Tightness	- -	- -	4.0% (19)	- -
	Lubrication	5.6% (28)	29.3% (58)	- -	- -
	Dryness	- -	- -	4.4% (21)	- -
Partner		10.5% (52)	- -	- -	- -

Pubic Hair

By far, the most common dislikes reported by women and the second most common dislike for men focused on the theme of pubic hair. Women’s grievances mostly were, “too hairy” and one woman expounded:

I feel ashamed of my genitals if I haven't shaved or waxed. I don't like the way my vagina looks and feels with hair. If I don't shave or wax, I find myself having less sex because I don't want my partner to see it.

Most men who mentioned hair said they didn’t like “too much hair” and men often disapprovingly referenced “shaving rash or stubble.” A man commented, “…I think hairy genitals on a woman is gross, it makes her look neglectful of her private area” and another, “…Also, pubic hair is a definite turn-off for me.” In contrast, a very limited number of men stated dislike of hairless genitals: “I dislike when women shave/otherwise remove all or almost all of their pubic hair.” This same man elaborated:

I mean really, when you look at them, there isn't much about the labia that screams sexy. This is made even worse with this shaving fad that is going on today. At least with pubic hair there is some air of mystery or something, but a shaved vagina in a young woman looks like kiddie porn and in an old woman it is... let’s say ‘less attractive.’

Additionally, most women who spoke about pubic hair commented on not liking to shave and disliking razor burn. A few women commented on dislikes related to “hair maintenance”, as this women put it, “I feel sexiest and most clean when I have a Brazilian wax, and so the thing I dislike most is probably my pubic hair and the in-growing hairs that inevitably follow its removal…” and another, “Grooming pubic hair is annoying. I also really don't like to look at my genitals.” A limited number of women mentioned ingrown hairs. A couple of women commented on not liking that their hair spread, for example to their thighs and “close to the opening.” Another sensation woman disliked was itching. Itching was often cited with trimming or shaving, but also listed without qualifiers.

Smell and taste

Smell was the third most referenced dislike for women, and the most common response for men was that they did not like the way women’s genitals smelled. A lot of women who mentioned smell clarified “sometimes” they felt their genitals smelled bad and a couple of women specified disliking the smell “depending on the time in the cycle.” Almost always, men clarified the smell was not always bad, but occurred “at times.” For example, men often answered, “if it smells bad.”

A few of the women who talked about smell were concerned what their partner thought about the smell or said things like, “I am sometimes self-conscious about the smell/taste with a partner.” Overall, in the dislikes section, 16 women used the word “self-conscious”.

Men also frequently linked bad smell to hygiene, as this man explains, “Personal hygiene is very important, even more so than with males. When a woman has poor personal hygiene her vagina can have a bad odour.” Hygiene, in general, was something men often commented on. Many men simply said “bad hygiene” or “unclean genitals.” Stronger words are exemplified below:

Bad hygiene is very off putting. Particularly if she smells like three day old sweat and urine. It’s a major turn off. Really, just the lack of self-awareness. If it seems like she never thinks of herself, or how her body as a sexual entity, then it’s hard for me to.

Several men who commented on disliking the smell also negatively commented on taste. This quote touches on several of these points, “Sometimes they don't smell or taste so good. It varies depending on time of the month, what she's eaten, how turned on she is, and more that I'm unaware of…” A few men commented on not liking menstruation, saying “menstruation can be a bit off putting sometimes” or that they disliked “that they bleed.”

Pain

A lot of women used this space to express the concern about pain issues. Frequently, pain was linked to menstrual pain. In general, a few women commented on an aversion to having their periods and how menstruation was “inconvenient.” Genital fluids in general were disparaged; women spoke of disliking the discharge produced by their genitals.

A few women described pain using words like “weak.” This woman explains what others described in relation to situations of sexual abuse, “I dislike that it is a weak and defenseless part of my body that can also experience pain.” Some women also spoke of “pain during intercourse.”

Aesthetics

Aesthetics was the fourth most common theme in the dislikes data. Several women referred to negative views on the appearance of their genitals. One woman summed up most of the concerns about appearance:

I really don't like the way they look. My inner labia are large. One guy referred to them as butterfly labia. They are uneven. One side has sort of a ridge, maybe from childbirth. I'm not so fond of the colour either. Sometimes my labia are pink but usually a sort of purple or brownish colour. I'm afraid they look old…

Sub-themes related to aesthetics included complaints by women with regards to length and colour of their genitals. Women wrote that their genitals were “dark” or “long.” A couple of women used the phrase “meat curtain,” like one woman who told about a new partner being horrified by her larger inner lips.

Asymmetry was another reoccurring subtheme related to aesthetic dislikes. Women simply stated they did not like “the way they look” or “the shape of my labia.” Various women commented on having one labia longer than the other and feeling self-conscious about this.

Men’s dislikes were also centered on appearance, and this was the second most common dislike response. Almost always, men stated preferences with regards to size. All size references negatively used words like “big,” “flappy/flabby,” “protruding,” or “too long” except for a very limited number of men who said they disliked “too small” genitals. Here is an example from a men who elaborated on smallness, “I dislike thin or small labia minora/majora and large clits and little moisture.”

Sex

No men mentioned a dislike related to sex. Complaints related to sexual intercourse were common; most women who spoke about sex commented on frustrations related to sexual pleasure and to difficulty reaching orgasm. One woman put it, “I dislike that they're painful and don't always cooperate during sex.” Women said things like, “I don't like how narrow the range of sensations that can get me off is” and “how long it takes me to reach orgasm.” Other women commented they were “really sensitive.” Participants also wrote of issues related to being too dry and not having enough lubrication. Multiple women disapprovingly commented on the “size of their clitoris” with most specifying they found the clitoris to be too small for easy stimulation, but a few women said the clitoris was “too big.” Selected women commented on being “too tight,” although a couple stated they did not feel tight enough.

Health

In addition to dislikes related to discharge, women also reported about infections, including sexually transmitted infections. The quote below exemplifies topics other women reinforced:

How much easier it is to get infections because everything is inside, problems with PMS, endometriosis, having to get Pap smears, having to worry about so many things after sex such as UTI, yeast infection, pregnancy - and that's if you're not worried about an STI…

Women’s and men’s likes about women’s genitals and preferred qualities

General

The 496 women who responded to the question about genital likes provided a broader spectrum of responses than did men (see Table 2). Women frequently provided responses in the form of a list of likes. The woman quoted below summarises the combined sentiments of most participants:

I love my clitoris the most, and my labia. I like the whole thing really; its appearance, feel (especially when wet) and smell. I am thankful for good health, to date. Most of all I love their ability to make me feel pleasure, empowerment and fulfillment. I love how intimate the act of sharing my vulva with my current partner is, like a secret only shared with chosen people.

Men named numerous aspects of women’s genitals that they liked (see Table 2). Men listed many more likes than they did dislikes. Of the 198 men who responded to “What do you like about women’s genitals,” most men respondents provided a long listed of adjectives similar to this man, “Smell. Taste. Wetness. Aroma. Scent. Shape. Sensitivity. Smoothness. Flexibility. Shaved. Tight...” Providing a list was similar to how women responded to questions. Selected men stated they liked “everything.”

A few women described liking “pretty much everything” about their genitals, while a limited number of women described being “…ambivalent about them: neither liking nor disliking” or liking “nothing.” A very small percentage of women said they had never thought about what they liked about their genitals, “When I think about my genitals, I typically don't even think about the things I like…”

Aesthetics

The most frequently occurring ‘like’ theme for women was a preference for the aesthetics of their genitals. For example, women commonly referred to the way their genitals looked, specifically the shape, colour, and size of their genitals. Some women described their genitals as “beautiful” or “pretty.” Almost all women that commented on the size, a common aesthetic subtheme, referred to liking that their genitals were “small” and “compact.” However, some women specifically identified liking their “large labia” or how their labia were asymmetrical or folded over one another.

A lot of men commented on liking the appearance of women’s genitals. Commonly, men described liking diverse genitals. This man simply says, “I love the variety of shapes and sizes of the labia and clitoris…” Repeatedly, men commented on the size of women’s labia, although preferences ranged from small to large. This man said:

I like long, smooth, symmetrical lips – something voluptuous, that captures the gaze and imagination. I like large clits, but I don't get as excited over them as I do over lips and hoods. I like a vulva to be big, lips unfurled, and deep in its cleft.

In contrast, another man reported, “I don't like the lips to be too big.”

Men also used words like “plump” and “swollen” when describing genital likes. Some men commented on liking the colour and only a few men documented preferences for symmetry.

Pubic hair

Women affirmatively commented on pubic hair (although a limited number of women used this space to comment on preferring being shaved). While most who commented on hair simply reported they liked or loved their hair, a few women elaborated more:

I LOVE all my hair. Whenever I had a sexual partner I would always shave automatically, and when I wasn't with anyone, I wouldn't. Recently, my partner asked me to stop shaving (we've been together over two years). This is the first time in two years I haven't shaved, and the hair is so sexy and feels so good…

Men also described likes related to hair preference. Most men preferred some degree of hair removal, commonly using the word “shaved,” but a few men stated they preferred hair, often using the words “natural” (n = 4) and “trim” (n = 10).

Smell and taste

The most commonly mentioned like for men was both smell and taste. This short quote exemplifies most respondents descriptions, “I like the way they look. I like the way they smell. I like the way they taste.” Several men mentioned issues related to hygiene and a woman’s genitals being clean, mostly as a clarifier with regard to taste as in this example, “taste when clean,” while others simply expressed valuing cleanliness.

Taste and scent were also reoccurring themes for women’s likes. One woman explains, “…I like the smell/taste of the wetness I make especially when I'm fertile...” Occasionally women would clarify like this, “…I want it to be healthy (no infections, no ingrown hairs, no pain). I am happy when my vagina smells like its healthy and balanced…”

Tactile

Numerous men commented on liking tactile aspects of women’s genitals. Some men described tactile preferences, for example: “… I love the way it feels, soft and warm to the touch, hot, swollen and slippery when the woman is aroused. I also love the way it smells, musty and sexual when aroused.” Like this man, most respondents used descriptive adjectives like “soft” and “warm” and frequently referred, in positive term, to the wetness of a woman’s genitals. Lubrication was the third most common aspect men enjoyed and the feel of a woman’s genitals was the fifth. A few men also described liking the “tightness” of women’s genitals.

A common theme was women describing their tactile relationship with their genitals, referring to the enjoyment of the touch and feel of their genitals. Oftentimes, the word “soft” was used to describe their genitals. Women also reported on the lubrication, liking the “wetness.” Women liked “tightness”, though tightness often related to a partner’s sexual enjoyment.

Partner and sex

Women commonly reported on their genitals with regards to their partners. Women wrote about “…the pleasure I can bring myself and my partner…” Women also mentioned sometimes, “my partner likes them.” Using stronger sentiment, this woman expressed, “…And they're a pretty important part of my self-identity. I can't be a woman or wife without them (in my straight relationship). I would be devastated if anything ever happened to my genitals.”

Related, sex was a collective theme related to women’s likes and preferred qualities. Oftentimes, women specifically spoke about their clitoris. This women details, “They work well and they give me pleasure. I am a tremendous fan of my clitoris, and I like the way it feels to be wet, as well as the fact that my arousal is not easily visible.” Some women wrote about a predilection for how sensitive their genitals were, “they easily respond to sexual stimulation,” and how their genitals were associated with pleasure and orgasm, “they bring me a great deal of pleasure.” A few women mentioned they had a “body part made only for pleasure” and how nerve rich the area was compared to men’s bodies or other parts of women’s bodies. Women spoke of pleasure both in reference to when the woman was stimulated and also the ability to give pleasure to a partner.

The fourth most common theme for men was talking about sexual pleasure, both giving and receiving. Men described liking how women’s genitals are “responsive” and “excitable.” This man describes:

The best thing about women's genitals is that, by stimulating them, one can bring (most) women to orgasm. This can be enormously pleasurable for both the giver and the receiver of the stimulation. The second best thing about women's genitals is that one can receive great pleasure by putting one's penis inside the vagina…

Related to the overarching theme of sex, men often spoke about pleasure and oral sex.

Normal and healthy

The second most frequent theme for women’s “likes” dealt with their own genital health and normalcy. For example, one woman explained, “They're mine, they're healthy, and I'm familiar with them” and another woman wrote, “They are relatively ‘normal.’” One woman put, “That everything is functioning correctly and that I'm healthy, and that this makes me attractive to my fiancé…”

Childbirth

Women also commented on their genitals in terms of childbirth, the third most universal response to this item, and in general terms of their “functionality.” One woman explained, “Childbirth gave me a sense of accomplishment and pride in what my body can do.” A very few women described their genitals as “powerful.” Such phrasing was repeatedly connected to childbirth. Some women talked about liking the knowledge that they could “procreate” and “that they will one day function in helping to create life.”

Discussion

The current findings add to the literature by explicitly including positive perceptions of vulvas and vaginas into a framework for how men and women perceive women’s genitals. This research provides qualitative data that demonstrates that high frequencies of both men and women who were surveyed like these qualities in their partners’ or their own genitals. Overall, men were very complimentary of women’s genitals and listed many more aspects they like about women’s genitals than qualities they do not like.

Given the high volume of dislikes mentioned by women, one possible explanation for these findings is women are more readily internalising negative messages about their genitals and fixating on criticisms. Women listed a few more dislikes than likes, even though fewer women answered the dislike question. Given the number of women who described a fondness of their “normal” genitals, this research raises the question of how women define “normal.” Women amongst themselves, as well as with sexual partners, may be promoting conceptualisations about the acceptable nature of women’s genitals that affect the social discourse around genital expectations.

In the light of this data, educators and health practitioners are encouraged to explore campaigns and educational curriculums that seek to improve knowledge and acceptance of women’s genitals. Given the reoccurring theme of sexual pleasure as a like by both men and women, these data support sexual pleasure as a focal point to facilitate interest in learning about and acceptance of women’s genitals across genders. No men mentioned a single dislike related to sex. However, this may also be an area that needs specific messaging from educational programmes. Oral sex, in particular, is something that men mentioned enjoying, while women, both heterosexual and homosexual, stated self-conscious attitudes that previous research has shown to affect participation in oral sex (Herbenick and Reece 2010). If women are unwilling to engage in receiving oral sex or have difficulty relaxing during the act, it may result in lower levels of sexual fulfillment, since previous research shows women’s rates of orgasm and enjoyment increase with oral sex and manual stimulation of women’s genitals (Armstrong, England, and Fogarty 2012). Research has shown that women may experience cognitive distractions, taking third-perspective of their bodies during sex and wondering about how their partner is viewing them, thereby affecting their sexual engagement (Weaver and Byers 2013, Dove and Wiederman 2000, Schick et al. 2010).

While previous research has highlighted the complicated ways in which women maintain their genital hair, this research adds new levels to this media-highlighted conversation (Herbenick et al. 2013). Too much hair was the second most common complaint by men and the first for women. Ironically though, most women also objected to their personal grooming practices and related aftereffects. Given the high distaste for hair maintenance, attitudes and pressures that shape women’s desire to continue the practices must be very strong.

Almost all of the dislikes women and men mentioned were in direct contrast to several of the likes by men. This finding can be used to inform educational curriculums and campaigns that encourage body acceptance. Beyond the anecdotal, these data affirm that many women and men prefer diversity and variety. An important message for sexual health educators is to highlight the diverse views and predilections people have about their own and partners’ bodies. That said, an appropriate note of caution would be focus attention to the ways in which stated and implied partialities can negatively impact self-conceptualisations. It is important to note that several of the things women and men said they like were actually in reference to preferences that could be construed negatively if a woman is nonconforming (i.e. does not shave her pubic hair or identify as having small labia). A notable percentage of women mentioned being self-conscious about their genitals and concerned about their partners inclinations.

Only men highlighted an aversion to a women’s lack of hygiene practices. Future research should investigate this finding. Perhaps with a larger sample of women who have sex with women (WSW) similar concerns would have been expressed, a limitation of this study that should be explored in future research. This is especially relevant given the prevalence of hygiene improvement references in FGCS advertisements (Liao, Taghinejadi, and Creighton 2012). This data might inform sexual health educators about a lack of understanding of women’s biological hygiene processes. On the other hand, if it is assumed that women have low genital hygiene, this data may support previous research correlating a lack of genital care with a low self-genital-image (Stewart and Spencer 2002; DeMaria, Hollub, and Herbenick 2011; DeMaria, Hollub, and Herbenick 2012). Overall, these data highlight the need for more educational campaigns around genital health and hygiene. Women responses related to genital health suggest that women are concerned with prevention and treatment of genital issues ranging from yeast infections to STIs. However, these results should also caution educators from promoting fear-based messages that might further alienate women from their own bodies.

This research presents a multifarious picture of women’s attitudes towards their genitals which complicates the picture of how women come to understand bodily expectations. For example, a larger group of men complimented women’s smell and taste than women did their own. Women may not have accurate images of their partners’ expectations or may be internalizing these attitudes from more dominant sources of influence (e.g., media enforcing messages about genital smell). These findings may support previous research which has documented that women’s perception may be based more on cultural stereotypes than their partner’s actual ideals (Miller and Byers 2004). There are several ways that men and women may form perceptions about women’s genitals. As previously mentioned, sexual education in school is a common site for learning about women’s genitals and forming preferences (Mullinax, Schick, and Herbenick 2014) and research, while inconclusive, suggests that adolescents’ sexual attitudes and sexual self-image are influenced by exposure to pornography (Owens et al. 2012).

Future research should investigate how heterosexual men and their female partners come to understand bodily expectations about women’s genitals. About equal percentages of men spoke disparagingly about genital scent compared to men who commented on liking scent. While many men mentioned they disliked women’s menstruations and women themselves spoke about disliking menstruation, the perspectives did not seem aligned, given women spoke to associated physical discomfort. More men liked the appearance of women’s genitals than disliked it, but the proportion of men citing appearance as a ‘like’ was greater than that for women. This study does not attempt to say that men have a significant role in women liking and accepting their bodies, but rather, to add to the dialogue about how the objectification of the female body teaches women to view themselves through the lens of an external observer (Calogero, Tantleff-Dunn, and Thompson 2011).

These data hint at a salient axis of antithetic perceptions of the strength of women’s genitals. An almost equal number of women mentioned the power of their genitals as described their genitals as weak. More research is needed to understand these two overlapping, yet seemingly oppositional themes. The herein pointed to specific experiences, childbirth and abuse, that may inform women’s perceptions related to power/weakness in contradictory directions.

Sexual health educators should encourage an open dialogue between partners that acknowledges both the realities of people’s preferences while also encouraging a discussion of partners’ willingness and ability to adopt alternate perspectives. Part of this dialogue and overall educational approach should include highlighting the likes of both women and men and challenging presumptions of uniformity of opinion and what each gender values. Sexuality education provides an important place for discussion and questioning of normative views of women’s genitals. There are important examples of current vulva positive books and projects that may guide new initiative: The Petals Project; Femalia; Read My Lips; The Large Labia Project; (Karras 2013, Herbenick and Schick 2011, Blank, Corinne, and Posener 1993, Large Labia Project 2013). Results from this study are being used in an outreach campaign composed of posters and notecards with quotes from the women and artistic images that best illustrate our positive findings (Herbenick 2013).

Limitations

This research has several limitations that are important to highlight. For example, given the self-reported open-ended nature of the data, meaning is especially difficult to extrapolate from the data. Participants responding to open-ended questions may rush through responses, although some research suggests the quality of open-ended questions is higher with online data collection than paper (Roller and Blais February 2009). Future research may use this preliminary, diverse, data to refine close-ended questions, which would allow for testing of differences between groups. Selection bias, resulting in a lack of representativeness, is also increased given the research design, but the open-ended nature of the questions may also have reduced suggestion bias (Reja et al. 2003). Research also shows that the most commonly selected or mentioned responses often do not change between open- and close-ended wordings. The open-ended nature of the data and the specific asking of both positive and negative attitudes (versus overall attitudes) limited to ability to compare between groups. While previous research does not show significant difference of FGSIS scores based on age or sexual orientation, reporting a positive view on women’s genitals has been found to be significant different by ethnicity, marital status, and region of the USA (Herbenick et al. 2011). Heterosexual and homosexual women have been found to have significant difference in overall body satisfaction (Herzog et al. 1992) and sexual attitudes (Hurlbert 1993). Therefore, educational campaigns for women and research on genital perceptions may need to be more nuanced than presented here. Given the increase in FGCS and research linking females’ genital image to health outcomes, this research focused on preferences for women’s genitals. Future research should explore attitudes related to men’s genitals and related health outcomes, an equally understudied area.

Conclusions

Men and women have mostly positive perceptions of women’s genitals. More educational campaigns need to use this information to promote self-confidence on the part of women and understanding on the part of men. Yet, the positives must be weighed against a realistic understanding of negative perceptions. Combined, such perceptions begin to unveil the complicated ways people interact with their own and their partners’ bodies.