BJOG Exchange
A report from #BlueJC: Does exposure to images of modified genitalia change our perceptions of normal genitalia? Paper discussed: Moran C and Lee C. What’s normal? Influencing women’s perceptions of normal genitalia: an experiment
involving exposure to modified and non-modified images. BJOG. 2014; 121:761–6. Location: Twitter and Facebook Start date of journal club: 29 January 2014 Paper summary Participants Intervention Comparison Outcomes Study design Findings
Number of participants: 22 Number of tweets: 107
Women aged 18–30 in Australia (1) Viewing of a series of images of surgically modified vulvas (2) Viewing of a series of images of non-modified vulvas (3) Did not view any images of vulvas Rating of normality and ‘society’s ideal’ (on a 4-point Likert scale) on a series of images of non-modified and surgically modified vulvas viewed Randomised controlled trial (RCT) All three groups rated modified target vulvas as more like society’s ideal. Women who had first viewed the modified images also rated the modified vulvas as more normal.
Clarifications on the methodology of the study Miss Moran (the corresponding author) clarified that participants were randomly assigned to one of the three arms by the computer programme used after they had logged in using a generic password. This confirmed appropriate randomisation and adequate concealment.
Controversies Was it a research question worth investigating? Some suggested that this study might have encouraged an excessive interest in sexual matters. However, this study has generated immense public interest both on social media and via different news outlets. The discrepancy between public and academic interests is apparent.
Reporting of this RCT Although we acknowledge that this RCT did not aim to evaluate the effects on health outcomes, prospective registration on a clinical trial database would have been desirable. The reporting of this RCT should have followed the CONSORT statement (www.consort-statement.org/).
Proposed future research questions The authors have acknowledged the weaknesses of the current study, e.g. the representativeness of the participants. Moreover, the study has not explored the baseline characteristics of the participants, which made assessing generalisability and applicability difficult. Some have suggested investigating the impact of exposure to images of modified vulvas on older women and the implications of labiaplasty on childbirth.
Take home messages All young women in this study perceived modified vulvas to be closer to society’s ideal. Moreover, those who had first viewed images of modified vulvas perceived these vulvas as more normal and even closer to society’s ideal. The external validity and reasons behind these observations were unclear. This #BlueJC also illustrated its contribution to the post-publication appraisal of this RCT.
Acknowledgements We are grateful for all contributions to this journal club. Storify summary and a list of contributors can be viewed at http://bit.ly/ 1hdiZ5s. The Altmetric summary of the discussed paper can be viewed at http://bit.ly/1frhXzp. EYL Leung Women’s Health Research Unit, Queen Mary, University of London, London, UK About #BlueJC: Regular #BlueJC starts on the last Wednesday of each month (except December). For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Further information is available on www.BJOG.org. Follow @BlueJCHost to receive updates for the next #BlueJC and BJOG news. Queries should be sent to [email protected] or @BlueJCHost.
ª 2014 Royal College of Obstetricians and Gynaecologists
913
A report from #BlueJC: Does exposure to images of modified genitalia change our perceptions of normal genitalia? Paper discussed: Moran C and Lee C. What’s normal? Influencing women’s perceptions of normal genitalia: an experiment
involving exposure to modified and non-modified images. BJOG. 2014; 121:761–6. Location: Twitter and Facebook Start date of journal club: 29 January 2014 Paper summary Participants Intervention Comparison Outcomes Study design Findings
Number of participants: 22 Number of tweets: 107
Women aged 18–30 in Australia (1) Viewing of a series of images of surgically modified vulvas (2) Viewing of a series of images of non-modified vulvas (3) Did not view any images of vulvas Rating of normality and ‘society’s ideal’ (on a 4-point Likert scale) on a series of images of non-modified and surgically modified vulvas viewed Randomised controlled trial (RCT) All three groups rated modified target vulvas as more like society’s ideal. Women who had first viewed the modified images also rated the modified vulvas as more normal.
Clarifications on the methodology of the study Miss Moran (the corresponding author) clarified that participants were randomly assigned to one of the three arms by the computer programme used after they had logged in using a generic password. This confirmed appropriate randomisation and adequate concealment.
Controversies Was it a research question worth investigating? Some suggested that this study might have encouraged an excessive interest in sexual matters. However, this study has generated immense public interest both on social media and via different news outlets. The discrepancy between public and academic interests is apparent.
Reporting of this RCT Although we acknowledge that this RCT did not aim to evaluate the effects on health outcomes, prospective registration on a clinical trial database would have been desirable. The reporting of this RCT should have followed the CONSORT statement (www.consort-statement.org/).
Proposed future research questions The authors have acknowledged the weaknesses of the current study, e.g. the representativeness of the participants. Moreover, the study has not explored the baseline characteristics of the participants, which made assessing generalisability and applicability difficult. Some have suggested investigating the impact of exposure to images of modified vulvas on older women and the implications of labiaplasty on childbirth.
Take home messages All young women in this study perceived modified vulvas to be closer to society’s ideal. Moreover, those who had first viewed images of modified vulvas perceived these vulvas as more normal and even closer to society’s ideal. The external validity and reasons behind these observations were unclear. This #BlueJC also illustrated its contribution to the post-publication appraisal of this RCT.
Acknowledgements We are grateful for all contributions to this journal club. Storify summary and a list of contributors can be viewed at http://bit.ly/ 1hdiZ5s. The Altmetric summary of the discussed paper can be viewed at http://bit.ly/1frhXzp. EYL Leung Women’s Health Research Unit, Queen Mary, University of London, London, UK About #BlueJC: Regular #BlueJC starts on the last Wednesday of each month (except December). For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Further information is available on www.BJOG.org. Follow @BlueJCHost to receive updates for the next #BlueJC and BJOG news. Queries should be sent to [email protected] or @BlueJCHost.
ª 2014 Royal College of Obstetricians and Gynaecologists
913
