ORIGINAL RESEARCH—OUTCOMES ASSESSMENT: Development and Validation of the Female Genital Self-Image Scale

INTRODUCTION: Women's sexual function may be influenced by various factors including medical conditions, trauma or abuse, medications, relationship dynamics, relaxation, mood, and body image. However, few studies have explored the influence of a woman's genital self-image on her sexual function or behaviors. AIMS: The purpose of this study was to establish a reliable and valid measure of female genital self-image, the Female Genital Self-Image Scale (FGSIS), and to assess the relationship between scores on the FGSIS and women's sexual function. METHODS: The FGSIS was developed in two stages. Phase One involved an analysis of cross-sectional paper-based survey data and a review of the literature. Phase Two involved a cross-sectional internet-based administration of the scale items to a total of 1,937 women. MAIN OUTCOME MEASURES: Psychometric properties of the scale were evaluated through the use of reliability analysis, factor analysis, and score differences based on women's experience of orgasm from receiving cunnilingus or from self-masturbation with a vibrator. Correlation analysis was used to explore the relationship between female genital self-image and scores on the Female Sexual Function Index (FSFI). RESULTS: The scale was found to have sufficient reliability (Cronbach's alpha = 0.88) and one factor that explained 59.23% of the variance. Women who had ever experienced orgasm as a result of cunnilingus or self-masturbation with a vibrator and women who reported having had a gynecological exam in the previous 12 months had significantly higher FGSIS scores than those who had not (P < 0.001). Scores on the FGSIS were positively and significantly correlated with scores on all FSFI domains (P < 0.001), including the Total score, with the exception of the Desire domain. CONCLUSION: The FGSIS was initially found to be a reliable and valid measure though further research is needed to understand its properties in diverse populations. In addition, female genital self-image was found to be positively related to women's sexual function.