Clinical characteristics of adolescents and young adults requesting labiaplasty - A Finnish cross-sectional study

Women request labiaplasty due to both physical symptoms and aesthetic concerns. Adolescent labiaplasty may carry higher complication risks than in adults; however, data are scarce. The primary aim of this study was to describe characteristics and comorbidities of adolescents and young adults requesting labiaplasty. The secondary aim was to examine labial dimensions in relation to reported physical and nonphysical symptoms.

This cross-sectional study was conducted at the Pediatric and Adolescent Gynecology Outpatient Clinic at Helsinki University Hospital, Finland. The study population includes all young women <25 years of age seeking labiaplasty between January 1, 2021, and December 31, 2023. The participants were followed up to August 30, 2024. Data on several subjective physical and psychological symptoms, as well as objective measurements of labia, were collected from patient records. The proportion of young women referred to a plastic surgeon's assessment was recorded.

Altogether 65 young women were included. The median age was 20.2 years (range 11.9-25.4), and 22 (33.8%) of the patients were minors. The median body mass index of the participants was 19.7 kg/m² (range 14.9-34.6 kg/m²), and 18 (27.7%) of the patients were underweight. Twenty-six (40.0%) had at least one psychiatric or neuropsychiatric diagnostic code registered. Fourteen (21.5%) had a current psychotropic medication, and 14 (21.5%) had either a current or previous self-reported eating disorder or disordered eating behavior. Labia minora widths were ≤5 cm in 36 (55.4%) of the patients. There were no significant differences in physical symptoms between those with labia minora ≤5 cm and >5 cm. Of self-reported nonphysical symptoms, anxiety was reported more often among those with labia width >5 cm (p < 0.005). In all, 37 (56.9%) were further referred to a plastic surgeon's assessment.

Psychiatric morbidity was common among young women seeking labiaplasty, underlining the importance of exploring mental health issues among these patients. Most women lacked obvious labial hypertrophy. Reported physical symptoms did not correlate with labia size. We suggest that all young women requesting labiaplasty should be met by a specialist team for appropriate patient counseling and evaluation.