This study explored how cisgender women in Belgium experience and navigate genital self-image. Drawing on seven focus group discussions with cisgender women from the general population (n = 34) and six in-depth interviews with cisgender women who had undergone labiaplasty, the research situates surgical decisions within a broader continuum of responses to genital insecurity. Across both groups, participants described such insecurity as widespread. While many found reassurance over time—through sexual experience, peer conversations, or exposure to representations of vulval diversity—others sought to reshape their relationship with their bodies through body-positive art projects or surgery. Most interviewees described medical encounters in which clinicians validated their concerns and presented surgery as a means of correction, though one woman recounted a contrasting experience involving reassurance, information, and a mandatory reflection period. Although all interviewees expressed satisfaction with the outcome, many also reflected critically on the cultural and emotional pressures that informed their decisions. The findings underscore the need for comprehensive sex education, cultural interventions that affirm genital diversity, and improved clinical training to support informed, confident, and autonomous decision-making.
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