Female Genital Self-Image Scale (FGSIS): A Full Guide for Researchers and Clinicians
Published
The Female Genital Self-Image Scale (FGSIS) is a 7-item measure of genital self-image in women, scored 7 to 28. Learn its items, scoring and languages.
Introduction
The Female Genital Self-Image Scale (FGSIS) is a 7-item self-report measure of women's perceptions, feelings and beliefs about their own genitals. Debra Herbenick and Michael Reece published it in 2010 in The Journal of Sexual Medicine, and it has received more than 300 citations.
The FGSIS was developed to give a reliable and valid measure of genital self-image and to study its relationship with female sexual function. This guide explains its items, scoring, translations and evidence.
Key Features of the Female Genital Self-Image Scale (FGSIS)
Purpose and Use
The FGSIS measures genital self-image and supports research on its links with sexual function.
Target Population
The FGSIS is intended for adult women aged 18 and older.
Structure
The FGSIS has 7 items forming a single factor. The items cover:
Overall feelings about one's genitalsSatisfaction with genital appearanceComfort with a sexual partner seeing one's genitalsPerceptions of genital odor and functionComfort with examination by a health care providerEmbarrassment about one's genitalsScoring Method
Each item is rated on a 4-point scale: strongly disagree (1), disagree (2), agree (3) and strongly agree (4).
Total score: sum the 7 items, for a range of 7 to 28.Higher scores indicate a more positive genital self-image. The original article reports no cut-off scores or severity categories.
Administration Format
The FGSIS is a brief self-report questionnaire.
Applications of the Female Genital Self-Image Scale (FGSIS)
The FGSIS supports several uses:
Sexual health research: studying the relationship between genital self-image and sexual function.Population research: describing genital self-image in large samples, including a nationally representative US sample.Women's health: exploring comfort with genital examinations and sexual partners.Languages and availability
The FGSIS has been translated and validated in several languages:
Arabic: validity and reliabilitySpanish: translation, adaptation and validationTurkish: cross-cultural adaptation and validationSwedish: translation and validationWhen reporting, record the exact version, language, country, population and reference used.
Reliability and Validity
The original development study showed good internal consistency (Cronbach's alpha = 0.88) and preliminary evidence of construct validity in a large sample of adult women.
Validation studies:
Development and validation of the Female Genital Self-Image Scale (2010): study linkSpanish translation, transcultural adaptation and validation of the FGSIS (2022): study linkCross-cultural adaptation and validation in a Turkish population (2018): study linkValidation of the Swedish FGSIS (2022): study linkLimitations and Considerations
Keep these points in mind:
Convenience sample: the original sample was mostly White, and further validation in diverse populations was recommended.Test–retest reliability: this was not assessed in the original study.Not diagnostic: the FGSIS does not measure anatomy, and a high score does not show normal anatomy or the absence of sexual dysfunction.No cut-offs: no cut-off scores are established.Other Versions And Related Questionnaires
A 4-item version, the FGSIS-4, has been analyzed in an international sample of adults with spina bifida.
These questionnaires are related:
Female Sexual Function Index (FSFI); see the ResRef FSFI guideFemale Sexual Distress Scale (FSDS)Index of Female Genital Image (IFGI)Additional Resources
The original article: linkFGSIS results from a nationally representative probability sample of US women (2011): linkFor inquiries, contact Debra Herbenick, PhD, MPH, Center for Sexual Health Promotion, Indiana University, at debby@indiana.edu.Browse more obstetrics and gynecology questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Female Genital Self-Image Scale measure?The FGSIS measures how women feel about and perceive their own genitals, including appearance, odor and function, comfort with partners and health care providers, and embarrassment.
How is the FGSIS scored?Each of the 7 items is scored from 1 (strongly disagree) to 4 (strongly agree), and the items are summed for a total of 7 to 28. Higher scores mean a more positive genital self-image.
Is the FGSIS a diagnostic tool?No. The FGSIS measures self-image, not anatomy, and a high score does not establish normal anatomy or the absence of sexual dysfunction. It has no cut-off scores.
Is there a shorter version of the FGSIS?Yes. A 4-item version, the FGSIS-4, has been analyzed in an international sample of adults with spina bifida.
A Word from ResRef About the Female Genital Self-Image Scale (FGSIS)
The FGSIS is a brief self-report instrument designed to assess women's perceptions and feelings about their own genitals. The original development study demonstrated good internal consistency (Cronbach's alpha = 0.88) and preliminary evidence of construct validity in a large sample of adult women. However, the study used a convenience sample that was predominantly White, and further validation in diverse populations and assessment of test–retest reliability were recommended. The scale does not have established cut-off scores in the original development article and should not be used as a standalone diagnostic instrument.
References
Herbenick, D., & Reece, M. (2010). Development and Validation of the Female Genital Self-Image Scale. The Journal of Sexual Medicine, 7(5), 1822–1830. https://doi.org/10.1111/j.1743-6109.2010.01728.xMohammed, G. F. A. E., & Hassan, H. (2014). Validity and Reliability of the Arabic Version of the Female Genital Self-Image Scale. The Journal of Sexual Medicine, 11(5), 1193–1200. https://doi.org/10.1111/jsm.12494Bartolomé, A., Villalaín, C., Bermejo, R., Bolívar, A. B., Castillo, L. P., Galindo, A., & Tejerizo, Á. (2022). Spanish Translation, Transcultural Adaptation, Validation and Clinical Applicability of Female Genital-Self Image Scale (FGSIS). Sexual Medicine, 10(5), 100558–100558. https://doi.org/10.1016/j.esxm.2022.100558Ellibes Kaya, A., Yassa, M., Dogan, O., Basbug, A., Pulatoglu, C., & Caliskan, E. (2018). The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population. International Urogynecology Journal, 30(1), 89–99. https://doi.org/10.1007/s00192-018-3688-1Loewinski, T., Östling, F., Alehagen, S., & Grundström, H. (2022). Translation, cross-cultural adaptation, and validation of the Swedish version of the female genital self-image scale. Sexual & Reproductive Healthcare, 33, 100758. https://doi.org/10.1016/j.srhc.2022.100758Herbenick, D., Schick, V., Reece, M., Sanders, S., Dodge, B., & Fortenberry, J. D. (2011). The Female Genital Self-Image Scale (FGSIS): Results from a Nationally Representative Probability Sample of Women in the United States. The Journal of Sexual Medicine, 8(1), 158–166. https://doi.org/10.1111/j.1743-6109.2010.02071.x