Jennifer's insecurity about her labia began after a comment from a friend.

"My friends and I were always quite open with nudity — I actually didn't notice until one of my friends pointed out to me that my flaps were quite long," says the 33-year-old from Meanjin/Brisbane, who asked we change her name for privacy.

"Ever since it was mentioned to me, it became a hang up of mine."

At 21, Jennifer had labiaplasty to reduce the size of her labia minora — the inner lips.

"I didn't realise you could get that done, so when I read an article about it, I went 'Yes, I want that.'"

Jennifer's never told anyone about the surgery. Not even her partner at the time, or her husband now.

"I was embarrassed. I'd never seen anyone with labia like mine, so I just thought it was abnormal."

Almost one quarter of people aged 18 to 24 feel anxious or embarrassed about the way their vulva looks, and one in 10 have had or considered having labiaplasty, new research from Women's Health Victoria has found.

It's an unsurprising finding to Pav Nanayakkara, a gynaecologist at Jean Hailes for Women's Health, who says patients frequently express embarrassment about their labia.

"Often I go to examine them, and they will almost apologise for it," she says.

The concern is women may avoid medical examinations like cervical screenings, stop certain activities like sport and sex, and experience poor mental health and wellbeing due to shame around their genitals.

Knowing that labia come in "all colours, shapes and sizes", Dr Nanayakkara says, can help combat that.

Getting to know the labia

Labia are the lips or folds of skin that sit either side of the vaginal opening.

The outer lips, which are covered with pubic hair, are the labia majora. The inner lips are the labia minora.

They are part of the vulva, the external part of the female genitals you can see, which also includes the clitoris and other parts.

The vagina is inside the body.

Dr Kate Johnston-Ataata is the manager of policy, health promotion and advocacy at Women's Health Victoria and says labia are a functional and important part of the body.

She says they protect the urethra and vagina and can give you pleasure.

More than half of people with a vulva have labia minora that protrude from the outer labia, Dr Johnston-Ataata says.

"It's very common they may not be symmetrical, and they might vary in colour and texture.

"What we see in mainstream pornography, cosmetic surgery websites, or people wearing tight-fitting or revealing clothing is that more idealised 'tucked away' or 'neat' version, which is only one of many kinds of varieties."

Dr Nanayakkara says labia can change over time, such as after childbirth and with age.

Why labiaplasty is on the rise 

Labiaplasty is one of the fastest growing cosmetic procedures among young people in Australia.

Almost a third of Gen Z people included in the Women's Health Victoria survey were associating their labia with negative words such as weird, disgusting, and ugly.

A key finding was the significant role that porn and social media are having on young people's anxiety and shame around their genitals.

Previous research has also shown that derogatory comments from other people — including sexual partners — can be a motivating factor for women seeking labiaplasty.

Libby Payne is a consent and respectful relationships educator. She says high school students consistently tell her they feel pressure live up to body type stereotypes including "big boobs" and "the Barbie slit".

"Those pressures are coming from social media, influencers, advertising around bikinis," Ms Payne says.

"I'm also hearing they are worried their partner will compare their body to what they've seen in pornography."

Research from Monash University has found women who go looking for information on labiaplasty may feel persuaded by language used on clinic websites advertising the surgery.

They noted many websites used language that "pathologised any appearance other than a Barbie doll", such as labia that are "floppy" or "uneven".

Dr Johnston-Ataata says older women they surveyed, such as those in Gen X, were "pretty unconcerned" about their labia.

"That younger cohort have grown up in this environment where they are overwhelmed with imagery… that is where we saw the strongest feelings of shame."