Mindful Exploration of the Vulva Through the Mirror Exercise Increases Genital Self-Image in College Students

Abstract Objectives The mirror exercise, an intervention instructing women to mindfully self-observe their vulva, has been shown to improve sexual functioning in clinical populations when couched within larger interventions. The current study examined the efficacy of this exercise in isolation in a non-clinical population (college students), as well as the role of mindfulness in predicting intervention benefits. Method Participants ( n = 415; after exclusion criteria) were undergraduates who self-reported having a vulva. They were randomly assigned to the vulva mirror exercise or a control condition (foot exercise), then divided by whether mindfulness instructions were present vs. absent (four total conditions: two exercise types x two mindfulness instructions). Before and after the intervention, participants completed online questionnaires measuring vulva self-image (VSI) and state mindfulness, the latter consisting of retrospective reports about mindfulness experienced during the exercise. Results Participants in the vulva condition showed larger improvements in vulva self-image than participants in the foot condition ( β = 0.06, p = 0.025), and significant increases in VSI pre- vs. post-intervention ( d = 0.25, p < 0.001). Although there was not a significant effect of mindfulness instructions on vulva self-image at the group level, at the individual level, participants who reported being more mindful during the exercise showed larger benefits from the vulva mirror intervention ( β = 0.11, p = 0.003). Conclusions Our findings provide preliminary efficacy of the vulva mirror exercise on improving vulva self-image among healthy young adults and highlight the importance of cultivating a mindful, non-reactive stance while engaging in this exercise. Preregistration The study design, hypotheses, and analyses were preregistered on the Open Science Framework (OSF): https://osf.io/f948t/ .