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The Relationship Between Female Genital Aesthetic Perceptions and Gynecological Care

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The Relationship Between Female Genital Aesthetic Perceptions and Gynecological Care Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care By Vanessa R. Schick B.A. May 2004, University of Massachusetts, Amherst A Dissertation Submitted to The Faculty of Columbian College of Arts and Sciences of The George Washington University in Partial Satisfaction of the Requirements for the Degree of Doctor of Philosophy January 31, 2010 Dissertation directed by Alyssa N. Zucker Associate Professor of Psychology and Women’s Studies The Columbian College of Arts and Sciences of The George Washington University certifies that Vanessa R. Schick has passed the Final Examination for the degree of Doctor of Philosophy as of August 19, 2009. This is the final and approved form of the dissertation. Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care Vanessa R. Schick Dissertation Research Committee: Alyssa N. Zucker, Associate Professor of Psychology & Women's Studies, Dissertation Director Laina Bay-Cheng, Assistant Professor of Social Work, University at Buffalo, Committee Member Maria-Cecilia Zea, Professor of Psychology, Committee Member ii © Copyright 2009 by Vanessa R. Schick All rights reserved iii Acknowledgments The past five years have changed me and my research path in ways that I could have never imagined. I feel incredibly fortunate for my mentors, colleagues, friends and family who have supported me throughout this journey. First, I would like to start by expressing my sincere appreciation to my phenomenal dissertation committee and all those who made this dissertation possible: Without Alyssa Zucker, my advisor, my journey would have been an entirely different one. Few advisors would allow their students to forge their own research path. However, she let me follow my passion, even when it led me into unchartered waters. I would not be where I am today without her support and guidance. I am forever thankful to her for taking a chance on me. I feel incredibly fortunate to have had the opportunity to work with Laina Bay-Cheng over the past five years. Her thoughtful revisions never ceased to amaze me. She continuously challenged me to think about things in ways that I would have never considered. I am a better researcher because of her. I never realized how influential a single course could be before I took one with Maria- Cecilia Zea. The space that she created for openness and acceptance allowed me and my research to flourish in ways that I had not thought possible. Her faith in me gave me the confidence to take the risks that have had made my research possible. I am incredibly thankful to my outside dissertation committee members. I cannot thank Rolf Peterson and Florence Haseltine enough for offering to be on my committee despite their busy schedules and my condensed timeline. It was truly an honor to have such iv distinguished members on my committee. Their unique input on my dissertation was invaluable. I would be remiss not to thank all of all of the RA’s who have helped me over the years. In particular, I would like to send a special thank you to Katie Armstrong. I feel incredibly fortunate to have had her as both a student and an RA. I am deeply appreciative for her enthusiastic and careful work. Finally, I would like to thank everyone at the Center for Sexual Health Promotion for providing me with a motive to finish my dissertation. I could not have imagined a more perfect opportunity. Most importantly, this dissertation would not have been possible without the women that took the time to share their personal thoughts and feelings with me. I am thankful to each and every one of them. I would like to thank all of the mentors, colleagues and friends who helped me to grow both personally and academically over the years: First, I would like to thank everyone that I worked with at the Society for Women’s Health Research including Florence Haseltine, Stephanie Pincus, and Suzanne Stone. The skills that I learned while there will likely apply in my future in ways that I can only imagine. I would not have gotten through the past five years without the support of colleagues and friends. Annette Kaufman, I will be forever grateful that I came into this program with someone as supportive and thoughtful as you. Laura Landry and Andrea Mercurio, thank v you for taking me under your wing. Brandi Rima, I feel fortunate to have had the opportunity to work with you over the past several years. I cherish you as both a co- worker and a friend. Thaddeus Russell Sullivan, I cannot thank you enough for your unwavering support over the past several months. Tini Town, although we have had some ups and downs over the past several years, your consistent use of the litter box over the past few months has helped me to maintain my sanity in ways that you cannot even imagine. Above all, I would like to express my gratitude to Sarah Calabrese. Words cannot express how meaningful she has been to me over the past five years. She is undeniably one of the most remarkable people I have ever known personally or professionally. I do not know what I am going to without my better half. I would like to thank the family members who influenced the person that I am today: Grandma and Aunt Bobbie, you showed me that one can be both elegant and refined without being either passive or submissive. I have always admired your seemingly smooth social graces. Frank, you made me recognize that I was stronger than I realized. Thank you to Jordan, Max, Jenna, Jason and the many other family members who have touched my life in various ways. At risk of writing an acknowledgment section that surpasses the length of my dissertation, I would like to thank all of my brothers and sisters individually. Maleese, thank you for always wearing such big shoes. I have had to run in circles trying to fill them. Jared, you have always been wise beyond your years. I envy your tenacity. Ezra, the good in you is absolutely undeniable. Rosalind, your pure kindness is an inspiration. Sophie, I hope to be as versatile as you when I grow-up. Sam, my munchkin, I knew how vi special you would be to me before you could even speak. You are truly my Okapi. Thank you all for helping me keep it all in perspective. Finally, I would like to thank my parents whose love and support made this possible. Dad, many people have told me that I work harder than anyone they have ever met. I often respond by telling them that they have never met my father. I am in awe of your ability to manage a business and raise a family. Your strength and resilience inspires me everyday. I would also like to thank my mother, who has always encouraged me to take the road less traveled. She has never suppressed my creativity, even when it meant letting me walk out of the house in a jacket made of bubble wrap and pants sewn together with Astroturf. I have never had to question her faith in me. Lastly, I would like to dedicate the dissertation to my stepmother Ellen. She was an incredibly humble person who, if alive today, would find this gesture uncomfortable and embarrassing. However, her role in this dissertation was undeniable. Her battle with gynecological cancer was at the root of the topic of the dissertation. Additionally, although Ellen never had the opportunity to finish her dissertation, I was recently surprised to find out that her topic (speaking about the unspeakable) parallels my own research (exposing taboos/ opening closed discourses), illustrating her enduring influence on me. Although she never got to see where my graduate path ended, I can only hope that the direction was one that made her proud. She was truly one of the most wonderful people that I have ever had the opportunity to know. Oddly, she always told me that she envisioned me being the happiest in Bloomington, IN. I sure hope that she was right. vii Abstract of Dissertation Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care Despite the known benefits of gynecological exams, women’s concerns about displaying their genitalia may function as a deterrent to care. While little is known about women’s genital perceptions, the current rise of female genital cosmetic surgeries suggests that women may be dissatisfied with the deviation of their vulva from a uniform appearance ideal. Thus, the current study investigated the construction of this ideal and the relationship to gynecological care. Specifically, the current study tested a path through which exposure to either a constrained or varied vulva picture set would differentially activate a concatenation of cognitions and emotions that would, in turn, predict gynecological care perceptions and intentions. Young, undergraduate women (N=485) completed the on-line survey at a computer of their choosing. Contrary to the hypothesis, picture set exposure was unrelated to vulva perceptions. However, as predicted, young women’s genital perceptions were significantly related to their gynecological care perceptions and intentions. viii Table of Contents Acknowledgments ii Abstract vi List of Figures……………………………………………………………….............. xii List of Tables ……………………………………………………………………….. xiii Chapter I. INTRODUCTION……………………………………………………………. 1 Examining Female Genitalia: A Critical Analysis ……………………... 3 Genital Discontent and Pap Smear Intentions…………………………... 8 Rational-Emotive Behavior Therapy Model………………………… 9 An ABC Path from Genital Discontent to Pap smear Intentions……. 11 Activating Genital Perceptions via Female Genital Images…………. 11 Genital Perceptions as an Antecedent to Generalized Genital Concerns……………………………………………………………... 13 The Relationship between Genital Dissatisfaction and Exam Embarrassment....................................................................................
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