Labia

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Outer, labia majora pudendi and inner labia, labia minora pudendi of a depilated woman

The labia ( lat. Labia pudendi , from singular labium “ lip ” and powder “ashamed”) are a part of the external female genital organs that occur in two pairs and are collectively referred to as the vulva .

As an alternative designation, the term Venus lips (after the Roman goddess of love Venus ) can also be found in some treatises and general media. In some contexts it is preferred to the term "labia". In addition, as for all other external genital organs, numerous different slang terms are used.

In humans and other primates, a distinction is made between the large labia, labia majora pudendi, and the small labia, labia minora pudendi . In the other mammals there is only one pair of labiae ( labia pudendi or labia vulvae ), which correspond to the small labia.

general characteristics

The size and shape of the large and small labia can vary significantly from woman to woman. The definition of a normal expression or any characteristics of a pathological deviation are therefore problematic from a biological point of view. However, the shape and characteristics of the labia are subject to strong societal and cultural norms and ideas of beauty, which means that aesthetically motivated changes in the labia are also motivated. (see also: Labia: Operative and cosmetic changes )

The labia minora are sensitive to touch; when sexually aroused they fill with blood , darken and swell. In some women, this exposes the vaginal entrance or opens the pubic cleft slightly.

The skin of the labia as from elsewhere on the body skin appendages accompanied. In addition, the Fordyce glands are found in the area of ​​the labia , which are free sebum glands in the genital area, and free sebum glands are also found in the clitoral hood as Tyson's glands . Naturally, i.e. without the intervention of the human individual (see body modification ), pubic hair develops at the onset of puberty as part of the body hair and thus as a secondary sex characteristic .

In the female newborn , the fact that the small labia are covered by the large labia is a development-specific so-called sign of maturity.

  • Frontal view

  • Less pronounced inner labia

  • More pronounced inner labia

  • Detail view

  • Less pronounced inner labia

  • More pronounced inner labia

The large (outer) labia

External labia

The labia majora (lat. Labia majora pudenda ) extend from the mons pubis (mons pubis) to the dam . They cover the clitoris , urethral opening and vaginal entrance and thus protect them. The labia majora contain cushions of fatty tissue and are covered by pigmented field skin. In the adult woman, in their natural state, they are partially covered with pubic hair . Both large labia form the pubic cleft ( rima pudendi ), their upper junction is called the commissura labiorum anterior , the posterior one is called the commissura labiorum posterior .

In non-primates, in which the labia majora are absent, the upper and lower pubic angle ( commissura labiorum dorsalis and ventralis ) and the pubic cleft are formed by the labia pudendi (syn. Labia vulvae ), which correspond to the small labia of humans.

Directly under the skin is a poorly developed layer of smooth muscle called the tunica dartos labialis , which can contract the skin into fine wrinkles. In the subcutis lies the corpus adiposum labii majories described by Waldeyer , a coherent, connective tissue structured body of fatty tissue that determines the size and shape of the labia majora . In the direction of the subcutaneous fatty tissue, i.e. towards the skin, the fatty tissue is surrounded by an elastic, connective tissue covering which, however, has sieve-like gaps. This was called the superficialis cribriformis fascia by Kehrer and Jaschke (1929) . Because of their gaps, the labial adipose tissue body has a certain relationship to the subcutaneous adipose tissue of the anterior abdominal wall.

The small (inner) labia

Vulva of an upright woman: the inner labia are exposed by pulling the outer lips apart (picture below)

The labia minora pudendi ( labia minora pudendi ), also known as nymphae , laterally limit the vaginal vestibule and meet at the clitoris (clitoris). They are thin, fat-free skin folds made of multi-layered squamous epithelium , which are heavily pigmented on the outside . The insides are not very pigmented, not horny and contain sebum glands . The labia minora diverge in two folds at the front, with the front fold merging with the opposite side to form the clitoral hood ( Praeputium clitoridis ). The rear fold ends as a clitoris reins ( frenulum clitoridis ) directly on the clitoris.

In most mammals, the foreskin of the clitoris is fused with its glans ( glans clitoridis ), in horses and dogs the clitoris is surrounded by a dimple ( fossa clitoridis ) in which the glans of the clitoris is exposed.

Hormonal influences

It play both heriditäre influences that directly affect the morphology can impact a role as well as the hormonal balance influencing factors. Furthermore, the point in time in the life phase or in the reproductive cycle must be taken into account. But generally promote estrogens through their effect on the tissues existing steroid receptors the development and growth of the labia minora , labia minora pudenda , further increasing the vascularization and generally the tumescence of the vulva with a proliferation of covering them epithelium . In addition, the estrogens stimulate the accessory sex glands , such as the Bartholin's gland , glandula vestibularis major , but inhibit the sebum glands . In contrast, the large labia , the clitoris, and the mons pubis are more under the additional influence of androgens . The estrogens promote the keratinization of the keratinocytes in the vulva epidermis , while androgens and progesterone inhibit them.

Expression of the labia minora

In some women in a standing posture, the inner labia minora are completely covered by the outer labia, but often protrude visibly beyond them. There is a certain variance in terms of size and characteristics . In a study by sex researcher Robert L. Dickinson on 2981 women, lengths of up to six centimeters were found, with the majority of women (87.7%) being in the range under two centimeters. The results can be found in the following table:

length Number of women Percentage
0-2 cm 2613 87.7
2 cm 146 4.9
3 cm 170 5.7
4-5 cm 32 1.1
5-6 cm 20th 0.7

In a smaller empirical study of 50 women aged 18 to 50 years, the length of the inner labia ranged between 0.7 and 5 cm. Measurements were taken at the widest point of the lip, perpendicular to the longitudinal axis of the vulva.

The pigmentation of the inner labia is usually darker than that of the surrounding skin. The above-mentioned study found in 41 of 50 women a darker pigmentation of the inner labia in relation to the rest of the skin.

The individual shapes of the human vulva are subject to genetic variability , as is the case with any other body organ :

hypertrophy

As hypertrophy of the labia minora is more pronounced of the labia minora is called. This can be caused either by genetic predisposition or by aging processes. There are no absolute measures from which severity a hypertrophy is given. It is therefore not possible to determine the size of the patient in an objective medical manner as to when what is known as “labial hypertrophy” should be present. Rather, what counts here is the possible subjective impairment of the patient as a measure of whether there is a “disease value”. It should also be considered that the (functional) closure by placing the two labium minus next to one another can be biologically sensible, as this prevents possible infestation or even infection .

Diagnostic criteria

From which degree of severity one can speak of hypertrophy is defined differently. Some authors take a length of four centimeters as a criterion. Others are based on the size in relation to the outer labia: for example, protruding in front of the outer labia is mentioned as a criterion, some authors already speak of "severe hypertrophy" from a length of three centimeters . Plastic surgeons simply divide into a Class I under two centimeters, Class II two to four centimeters and Class III greater than four centimeters.

If there is "hypertrophy", an operation can be considered medically. However, this is only necessary if the woman concerned has personal discomfort and limitations; Otherwise there is no disease value and should be viewed as a standard variant.

Hypertrophy in the historical medical discourse

Inner labia hypertrophy in a Khoisan woman, spread (left) and standing upright (right) Inner labia hypertrophy in a Khoisan woman, spread (left) and standing upright (right)
Inner labia hypertrophy in a Khoisan woman , spread (left) and standing upright (right)

About the women of the Khoi Khoi - formerly called " Hottentots " - it was reported by ethnologists of the 19th century that they had unusually enlarged inner labia that protruded clearly visible from the outer labia. In connection with the reports, the term “Hottentot apron” was coined in the ethnological literature of the first half of the 19th century to denote strikingly large female genitalia. The objectivity of the sources is questionable, since many studies of this time are characterized by racist prejudice and exaggerations and distorted reports of actually available findings cannot be ruled out. It was also quite common in the 19th century to work as a "room ethnologist", that is, to describe peoples and their peculiarities without second or third hand field research .

In African women, hypertrophic inner labia were interpreted as a racial characteristic by some doctors and anthropologists at the time . It was discussed whether the "strange formations" are innate, arise naturally during the developmental years or are acquired through "artificial manipulations" - masturbation or artificial stretching . Regardless of whether the size of the labia was interpreted as a result of masturbation or as a natural variation, it was associated with a racist devaluation: The "Hottentot aprons" were seen as an expression of greater "lasciviousness" and "shamefulness" as well as evidence of a closer connection between Africans and monkeys .

Other doctors understood the "Hottentot apron" as a common variety that could be found in women worldwide. If an enlargement of the clitoris or the labia was observed in European girls and women, this was also called "Hottentot apron". “Hottentots” were considered by European ethnologists to be at the lowest level of the races, and elongated labia were considered in Europe at that time as an indication of the supposedly disease-causing masturbation of those affected. The designation as “Hottentot apron” contributed to the reinterpretation of a possible standard variant of the labia size as a disease requiring treatment. According to the scientists Camille Nurka and Bethany Jones of the Australian National University , this discourse in the sense of a collective, unconscious evaluation continues to shape the attitude towards visibly pronounced labia that is widespread in the western world .

However, it should also be considered that in some cases the "Hottentot apron" described by the observers could have been forms of elephantiasis , more precisely elephantiasis of the vulva.

Ideals of beauty and attitudes of both sexes

In 2018, Erich Kasten , psychologist and professor of neuroscience at the Medical School Hamburg , investigated the question of what attitudes and aesthetic preferences exist with regard to the vulva and whether these differ between women and men. Study participants were asked to state their subjective assessments and evaluations. In addition, the reactions to photographic images of the female genitals were recorded in various forms. The background to the study was the widespread dissatisfaction and insecurity among women with regard to the appearance of their vulva and, as a result, the rapidly increasing demand for cosmetic surgeries in the genital area, in particular labia reduction .

There were clear gender differences with regard to the size of the inner labia. Women showed a strong preference for weak inner labia that do not protrude above the outer labia. In contrast, the preferences of men were less clear: men rated both large and small inner labia as similarly “erotic” and “aesthetic”.

“ In the data presented here, large labia minora were rated significantly better by men than by women. What is striking is the high negative mean value for the women surveyed in contrast to the positive mean value for men. This means that vulva with large inner labia were rated significantly more negatively by the participants than by men [...] These results show that men rate less strictly than women. "

The posture with respect to the outer labia and the clitoris and clitoral hood showed the same gender effect, although less clearly. There was no connection between the assessments with previous sexual experience in men or with personality traits (the open-mindedness dimension of the five-factor model ) in men or women.

Cosmetic and surgical changes

Inner labia piercing

The removal of pubic hair is widespread in many cultures and has been normal for some years, especially among younger women, also in western cultures. Also piercings in the area of the labia recorded a growing popularity.

The social notions of beauty with regard to the severity of the labia, in particular the labia minora, can vary greatly between cultures. In numerous cultures there are therefore surgical-surgical interventions that permanently change the shape and size of the labia.

Labia enlargement

In some African countries, stretching of the inner labia is practiced to this day. From the onset of puberty onwards, the inner labia are continuously enlarged and enlarged. In addition, plant extracts are sometimes used, for example from the coloquin or the Bidens pilosa . Here, too, the aim is to conform to an ideal of beauty. Labia enlargement is usually limited to certain ethnicities in a region. In a questionnaire, men from the Baganda people in Uganda expressed the view that the sexual experience of both partners was improved as a result of their practice of enlarging the labia minora.

As part of cosmetic surgery, padding, that is, an increase in volume, of the outer labia can be performed. This procedure is done for purely aesthetic reasons to counteract age-related slackening of the tissue.

Labia reduction

The reduction of the labia is a form of labioplasty , whereby the labia (mostly the inner, rarely also the outer labia) are surgically reduced. The inner labia, which are sometimes perceived as oversized, mean that some women have this surgical procedure performed. In rare cases, the operation is performed for medical reasons - problems with cycling or horse riding, chafing of clothes or suffering in sexual life - but mostly for aesthetic reasons.

Female genital mutilation

The main area of ​​prevalence for female genital cutting is Africa, but the practice is also documented for some countries in Asia and since the 1970s within migrant populations in Australia, North America and Europe. The external genitalia are circumcised to different degrees; the labia can also be partially or completely removed. In rare cases, the pubic cleft is then closed to prevent penetration of the vagina. There is no medical indication. Tradition is accepted as the most important reason for this practice, religious reasons are also given in Islamic regions, but it has its roots in pre-Islamic times. Problems often arise as a result of the operation, which are caused by the high risk of infection under often unhygienic operating conditions. Under certain circumstances, the procedure can lead to death from infections.

Labia in social discourse

Criticism of the term "labia"

The high German term labia was originally derived from the old German scama or the Anglo-Saxon scamu , "that which is to be covered". Regarding origin and meaning, see the Duden:

Shame originally means shame or shame [...] later it was also used to cover up the genitals.

The prefix "shame" as a designation of the female genitals is therefore partly criticized. Volkmar Sigusch concludes in his essay "Lips of Shame", published in 2005:

Although all the terms that haunt the sexual sphere are problematic, it does not matter which word we use. Because they suggest how something is felt, viewed and classified ideologically and theoretically. Behind every expression there is a story or an intention that has often become so flesh and blood that we can barely recognize it. So I am not saying that it does not matter what expressions we use, it does not matter whether we speak of the labia or of the labia or of the lips of Venus.

In a petition started in 2018 by the journalist Gunda Windmüller, the replacement of the term “labia” with the term “vulval lips” is requested. The aim is to ensure that Vulvalippen is used as an official alternative term in the Duden . The conceptual link to with the language change to emotion of shame be broken: shame should not be lips, what a woman must feel ashamed.

Critique of social ideals

"Love your Labia! (Love your labia!) "- Poster on the London Muff March (2011)
As part of the “Large Labia Project” and Courageous Cunts, women show their labia to counter taboos and distorted ideals of beauty. (see also labia reduction and feminist reactions )

The emergence of an ideal of beauty goes hand in hand with the growing demand for cosmetically motivated, operative labia reductions. While in earlier times this region of the body was hidden from the public eye, the labia are increasingly subject to aesthetic standards. The feminist "labia pride" movement is taking action against this development and its consequences .

Many of pubescent and adolescent girls and women perceive the appearance of their genitals as "abnormal", even though they are within the physiological and anatomical range. Anatomical normality and social norm are not clearly separated. The increasing (one-sided) medicalization of sexuality also seems to have an impact on women's own body perception. Because especially among girls at the beginning of puberty , deviations from these norm expectations can lead to insecurities and self-doubt. One possible prevention is the early transfer of knowledge about the condition of the genitals within the framework of sex education . The professor for health sciences at the University of Hamburg , Ingrid Mühlhauser, said:

"There must be a much stronger public awareness that there is a spectrum of normality and diversity of the human body that should not correspond to a certain norm."

- Ingrid Mühlhauser

This includes, in particular, the presentation of images of non-operated and also non-shaved genitals in order to convey a differentiated picture of the natural variance of the labia. Some media endeavor to counteract these developments, the youth magazine Bravo is an example . In order to convey a more realistic body image or a change in one's own body perception, photographic images will show unretouched genitals in their natural diversity.

"Labia pride" is also an aspect of sex-positive feminism , which expresses the idea that sexual freedom should be a fundamental component of all female aspirations for freedom and equality. Therefore, sex-positive feminists completely reject any social or legal effort to limit consensual sexual activity between adults.

Web links

Commons : Labia  - Collection of images, videos and audio files
Wiktionary: labia  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ a b Claudia Haarmann: "Downstairs ..." - The shame is not over. Innenweltverlag, Cologne 2005, ISBN 3-936360-15-4 .
  2. ↑ a b c Volkmar Sigusch: Sexual worlds - heckling of a sex researcher. Psychosozial-Verlag, Giessen 2005, ISBN 3-89806-482-4 , p. 97.
  3. ↑ Vulva, Scheide, Vagina on loveline.de, the youth portal of the Federal Center for Health Education
  4. ↑ Jillian Lloyd, Naomi S. Crouch, Catherine L. Minto, Lih-Mei Liao, Sarah M. Creighton: Female genital appearance: 'normality' unfolds. In: BJOG - An International Journal of Obstetrics and Gynaecology . Volume 112, Issue 5, 2005, pp. 643–646, PMID 15842291 ( full text as PDF file; 171 kB ( memento of November 2, 2013 in the Internet Archive )).
  5. ↑ Kali Holloway: The search for the perfect vagina: Why labiaplasty is suddenly booming . On: salon.com from February 22, 2015; accessed on February 16, 2016.
  6. ^ Marisa Riley: Laci Green's "Freaky Labia" Video Encourages Us to Accept Our Vaginas and Move On. On: bustle.com on August 21, 2014; accessed on February 16, 2016.
  7. ↑ Eva Berendsen: Intimate Surgery - The standardized sex . On: faz.net ( FAZ ) from March 15, 2014; accessed on February 16, 2016.
  8. ^ Siobhan Norton: Vaginas have become the new talking point, as the labiaplasty and 'vagacials' are on the rise. When did vaginas become such a beauty issue? On: independent.co.uk ( The Independent ) January 21, 2015; accessed on February 16, 2016.
  9. ↑ GH Schuhmacher, G. Aumüller: Topographische Anatomie des Menschen. Urban & Fischer, Munich / Jena 2004, ISBN 3-437-41366-X .
  10. ↑ a b Uwe Gille: urinary and sexual system, apparatus urogenitalis. In: FV. Salomon, H. Geyer, U. Gille (ed.): Anatomy for veterinary medicine. Enke, Stuttgart 2004, ISBN 3-8304-1007-7 .
  11. ↑ Alan H. DeCherney, Ashley S. Roman, Lauren Nathan, Neri Laufer: Current Diagnosis & Treatment Obstetrics & Gynecology . 12th edition, McGraw Hill Professional, 2018, ISBN 978-0-07-183391-2 , p. 23.
  12. ↑ Erwin Kehrer, Rudolf Theodor Edler von Jaschke , W. Stoeckel (Ed.): Handbuch der Gynäkologie. Volume 5, half 1: The vulva and its diseases. Positional and movement anomalies of the female genital apparatus. 3rd, completely revised and expanded edition, Bergmann-Verlag, Munich 1929; Reprint: Springer-Verlag, Berlin / Heidelberg / New York 2013, ISBN 3-642-96015-4 , p. 5.
  13. ^ W. Lierse: Anatomical remarks and functional anatomy for groin pain. In: W. Overbeck, W. Franz (ed.): The athlete's groin pain. Differential Diagnosis and Therapy. Springer, Heidelberg / New York 1995, ISBN 978-3-642-79620-3 , pp. 1-7.
  14. ↑ Gunther Göretzlehner, Christian Lauritzen, Ulf Göretzlehner: Practical hormone therapy in gynecology. de Gruyter, Berlin 2007, ISBN 3-11-019044-3 , p. 16.
  15. ^ Robert L. Dickinson: Human sex anatomy: a topographical hand atlas. 1949; Fascicle 2d edition: RE Krieger, Huntington NY 1971, ISBN 0-88275-014-3 .
  16. ↑ a b Jillian Lloyd u. a .: Female genital appearance: 'normality' unfolds In: BJOG - An International Journal of Obstetrics and Gynaecology . Volume 112, No. 5, pp. 643-646, doi: 10.1111 / j.1471-0528.2004.00517.x
  17. ↑ See Figure 1 in Jillian Lloyd u. a .: Female genital appearance: 'normality' unfolds. In: An International Journal of Obstetrics and Gynecology. (BJOG) Vol. 112, No. 5, pp. 643-646.
  18. ↑ Robert Latou Dickinson: Atlas of Human Sex Anatomy. The Williams & Wilkins Company, 1949.
  19. ↑ Love your vulva! She is you! Take pride in your labia. ( Memento from December 20, 2014 in the Internet Archive ) In: courageouscunts.com .
  20. ↑ M. Krause: Fashion trend: cosmetic surgery in the genital area. In: midwife. Volume 24, No. 4, 2011, p. 214, doi: 10.1055 / s-0031-1299547
  21. ↑ S. Motakef, J. Rodriguez-Feliz, MT Chung, MJ Ingargiola, VW Wong, A. Patel: Vaginal labiaplasty: current practices and a simplified classification system for labial protrusion. In: Plast Reconstr Surg. March 2015, Volume 135, No. 3, pp. 774-788.
  22. ↑ Steven P. Davison: Labiaplasty and Labia Minora Reduction . 2008.
  23. ^ R. Rouzier, C. Louis-Syvestre, BJ Paniel, B. Haddad: Hypertrophy of the labia minora: experience with 163 reductions. In: American Journal of Obstetrics and Gynaecology. (AJOG) Vol. 182, No. 1, 2000, pp. 35-40. (on-line)
  24. ^ A b Marion A. Hulverscheidt: Female genital mutilation. Discussion and practice in medicine during the 19th century in German-speaking countries. Mabuse-Verlag, Frankfurt am Main 2002, ISBN 3-935964-00-5 , p. 82 f.
  25. ↑ See on this Heinrich Schnee (Hrsg.): Hottentottenschürzen In: Deutsches Kolonial-Lexikon . Volume II, Quelle & Meyer, Leipzig 1920, p. 81.
  26. ^ A b C. Nurka, B. Jones: Labiaplasty, Race and the Colonial Imagination. In: Australian Feminist Studies. Volume 28, number 78, 2013, pp. 417-442, doi: 10.1080 / 08164649.2013.868332 .
  27. ↑ Gérard Badou: The black Venus. Diana-Verlag, Munich / Zurich 2001, ISBN 3-8284-5038-5 .
  28. ^ Hermann Heinrich Ploss , Max Bartels: The woman in nature and ethnology - anthropological studies. Leipzig 1884.
  29. ↑ Rachan Chaudhary, Sudhir Rathi, Amit Maheshwari, Shipra Nigam: Vulvar Elephantiasis of Filarial Origin: A Case Report. In: Indian Journal of Clinical Practice. Volume 24, No. 2, July 2013, pp. 160–162 ( full text as PDF file )
  30. ↑ Arun Prasath Palanisamy, Kamalakannan Kutuwa Kanakaram, Sivasubramanian Vadivel, Srivenkateswaran Kothandapany: Vulval elephantiasis. In: Indian Dermatol Online J. September - October 2015, Volume 6, No. 5, p. 371, doi: 10.4103 / 2229-5178.164470 , PMC 4594409 (free full text).
  31. ↑ Satish Kumar Ranjan, Mini Sinha, Nawal K Jha, DK Sinha, Amrisha Sharan: Giant Vulvar Elephantiasis of Filarial Origin: A Rare Case Report. In: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). Volume 14, No. 11, Nov. 2015, pp. 38–40 ( full text as PDF file )
  32. ↑ Tropical dermatoses; juxta-articular nodes; Rat Bite Disease Handbook of Skin and Venereal Diseases. German Dermatological Society, Springer-Verlag, Berlin / Heidelberg / New York 2013, ISBN 3-7091-3057-3 , pp. 514-515
  33. ↑ a b c d e E. Kasten, K. Hoffmann: Female genital esthetics. Comparison of preferences of men and women. In: Journal for Aesthetic Surgery , 2018, pp. 1–9. doi: 10.1007 / s12631-018-0123-x
  34. ↑ M. Koster, LL Price: Rwandan female genital modification: elongation of the Labia minora and the use of local botanical species. In: Culture, health & sexuality. (Cult Health Sex). Volume 10, 2008, PMID 18247211 , pp. 191-204.
  35. ↑ Guillermo Martínez Pérez, Harriet Namulondo: Elongation of labia minora in Uganda: including Baganda men in a risk reduction education program . In: Culture, Health & Sexuality . tape 13 , no. 1 , 2011, p. 45–57 , doi : 10.1080 / 13691058.2010.518772 ( online [PDF]).
  36. ^ Cosmetic Vaginal Surgery. International Society of Cosmetogynecology
  37. ↑ Arasee Renganathan, Rufus Cartwright, Linda Cardozo: Gynecological cosmetic surgery. In: Expert Rev. Obstet. Gynocol. Volume 4, Heft 2, 2009, pp. 101-104, doi: 10.1586 / 17474108.4.2.101 , accessed on December 27, 2013.
  38. ↑ Rudy Leon De Wilde and others: DGGG opinion on intimate surgery. In: DGGG.de. Edited by the German Society for Gynecology and Obstetrics. V., July 13, 2009, accessed December 27, 2013 .
  39. ↑ Female genital organs - don't be ashamed: say vulval lips! - Germany radio
  40. ↑ A petition wants to replace the word "labia" with "vulval lips" - Jetzt.de (Süddeutsche Zeitung)
  41. ^ Large Labia Project
  42. ↑ Christa Stolle : More and more intimate operations on women: The trend is towards “designer madness”. In: TAZ. dated December 18, 2011.
  43. ↑ Josephina Maier, Achim Wüsthof: Beauty below the belt. In: The time. July 15, 2009.
  44. ↑ Juliane Löffler: The corrections, intimate surgery - the female sex is on the operating table. What do tight labia mean for society? In: Friday. 20th July 2012.
  45. ↑ The age associated with the adolescence phase is perceived differently in different cultures. In the USA, adolescence is settled at the onset of puberty: starting between the ages of 13 and 19 (from which the term teenager is derived because of the word endings of the English numerals thirteen to nineteen ). In Central Europe, the adolescence phase - depending on the stage of development - usually means the period between 16 and 24 years.
  46. ↑ Christein Annemarie Hamori: Aesthetic Labia Minora and Clitoral Hood Reduction Using Extended Central Wedge Resection. In: Plastic & Reconstructive Surgery. July 2009, Volume 124, No. 1, p. 337 doi: 10.1097 / PRS.0b013e3181a8394d .
  47. ^ Lih Mei Liao, Sarah M. Creighton: Requests for cosmetic genitoplasty: how should healthcare providers respond? In: BMJ. Volume 334, No. 7603; British Medical Journal. May 26, 2007, pp. 1090-1092, doi: 10.1136 / bmj.39206.422269.BE .
  48. ^ CE Marchitelli, MC Sluga, M. Perrotta, R. Testa: Initial experience in a vulvovaginal aesthetic surgery unit within a general gynecology department. In: Journal of Lower Genital Tract Disease. 2010, Vol. 14, No. 4, pp. 295-300, PMID 20885155 .
  49. ↑ Intimate surgery: risky operation below the belt. - Spiegel Online (accessed March 7, 2013)
  50. ↑ Sandra Brüssow: youth magazines as a counselor for young people the example of the youth magazine Bravo. 2007, ISBN 978-3-638-64547-8 .
  51. ↑ Vulva gallery - look what differences there are! - Bravo (accessed November 24, 2010)
  52. ↑ Sheath and Vulva - Bravo (accessed November 24, 2010)
  53. ↑ Labia - the Dr. Sommer team repeatedly receives e-mails and letters from girls who do not find the appearance of their labia normal or even ugly. That is why we explain here how different vulvae can look. - Bravo (accessed January 8, 2012)
  54. ↑ Labia - What is normal. We explain and show how different the inner and outer labia look. - Bravo (accessed July 29, 2012)