Attitudes Toward Women’s Genitals Scale

Abstract

The Attitudes Toward Women’s Genitals Scale (ATWGS) is a 10-item psychometric scale developed by Debra Herbenick (2006, 2009) to measure individuals’ perceptions and attitudes toward women’s genitals, encompassing both the vulva and the vagina. The scale specifically focuses on general societal and individual perceptions—such as whether genitals are viewed as clean or dirty, attractive or unattractive, or pleasant-smelling/tasting—rather than an individual’s self-image regarding their own genitals. The development process involved multiple stages, starting with pilot surveys and a review of literature to identify 14 key themes, which informed an initial pool of 101 items. Through an iterative process utilizing reliability analysis, the measure was reduced to its final 10-item format. Initial validation was conducted on a sample of 604 undergraduate and graduate students. The ATWGS is recommended for use in research assessing the impact of educational curricula or interventions designed to shift attitudes toward female sexuality and health.

Keywords

Attitudes Toward Women’s Genitals Scale, ATWGS, sexual health, perceptions of women’s genitals, gender studies, psychometric scale, sexuality, vulva, vagina, body image.

Authors

Debra Herbenick

Purpose

The primary purpose of the ATWGS is to quantify individuals’ general perceptions and feelings about women’s genitals. These attitudes are crucial because they can significantly influence women’s sexual and sexual health behaviors. For instance, negative attitudes (e.g., believing vaginas are inherently “dirty” or “smell bad”) may lead women to avoid important health practices, such as annual pelvic exams, or inhibit sexual activities like cunnilingus. By providing a reliable measure of these attitudes, the scale allows researchers and clinicians to better understand barriers to sexual health engagement and develop targeted interventions.

The scale is particularly useful for assessing attitude change over time, especially following educational programs or therapeutic interventions. Furthermore, it has potential utility in clinical settings involving women who have experienced changes in genital appearance or function due to conditions such as vulvar cancer or lichen sclerosus, where measuring attitudes may provide insights into psychological adjustment.

Construct

The ATWGS measures the psychological construct of Attitudes Toward Women’s Genitals. This construct is defined as the set of affective, cognitive, and behavioral predispositions an individual holds regarding the female external (vulva) and internal (vagina) genitalia. This measure is explicitly designed to assess attitudes toward women’s genitals generally, distinguishing it from “genital self-image,” which pertains specifically to how an individual perceives their own genitals.

The development of the scale was grounded in 14 emergent themes identified through pilot surveys and literature review, including: genital appearance, hygiene, smell, taste, pubic hair, menstruation, wetness, touching, communication, femininity, size in relation to function, vaginal birth, “looking,” and oral sex. The final 10 items capture the core evaluative dimensions of these themes (e.g., beauty, cleanliness, pride, and societal openness).

Validity

The ATWGS demonstrated initial evidence of both convergent validity and predictive validity in the initial validation studies (Herbenick, 2009).

• Convergent Validity: The ATWGS scores exhibited a significant positive correlation with the 5-item Sexual Opinion Survey (Fisher, 1998), with a correlation coefficient of

  r

  = .43 (

  p

  < .001). This finding supports the notion that positive attitudes toward women’s genitals are moderately associated with generally positive sexual opinions.

• Predictive Validity: The scale demonstrated strong predictive capacity regarding sexual and health behaviors. Women who reported having experienced a gynecological exam, received cunnilingus three or more times, examined their own genitals three or more times, or used a vibrator, scored significantly higher on the ATWGS (indicating more positive attitudes) compared to women who had not engaged in these behaviors. Similarly, men who had performed oral sex on a woman three or more times scored significantly higher on the ATWGS than those who had not.

Reliability

The ATWGS exhibits strong internal consistency and excellent temporal stability based on initial testing across genders.

• Internal Consistency: Measured using Cronbach’s alpha, the scale demonstrated high reliability: .85 among women, .82 among men, and .86 for the genders combined. Furthermore, corrected item-to-total correlations exceeded .38 for every item, confirming that each item contributes meaningfully to the overall scale score (Herbenick, 2009).
• Temporal Stability (Test-Retest Reliability): The stability of the ATWGS was assessed over a 2-week period using a small group of 16 participants (women and men). The resulting test-retest reliability coefficient was exceptionally high at .93 (

  p

  < .001), indicating strong consistency of scores over time.

Factor Analysis

While the source content does not explicitly detail a formal Exploratory Factor Analysis (EFA) or Confirmatory Factor Analysis (CFA), the scale was developed through an extensive iterative process of item reduction. The initial pool of 101 items, derived from 14 thematic categories, was reduced to the final 10 items based on detailed reliability analysis conducted on data from 604 students. This process ensured that the final 10 items maximized internal consistency and measured a unified construct of attitudes toward women’s genitals. Further research is recommended to confirm the underlying factor structure (unidimensionality vs. multi-dimensionality) across diverse adult and clinical populations.

Instrument

Test Type: Psychometric Attitude Scale

Format: 10-item self-report measure utilizing a 4-point Likert-type scale.

Language Available: English (Original development language).

Population Group: General adult population (Recommended for use in research and clinical settings).

Age Group: College students (Mean age 20.0) in the original validation; recommended for use with other adult populations.

Population Details: Initial validation sample consisted of 604 undergraduate and graduate students (362 women, 242 men) from a large university setting.

Test Methodology: Multi-stage development including Phase One pilot surveys (370 participants), literature review, expert consultation (gender studies, medicine, public health, psychology, women’s sexuality), writing of 101 items, and final iterative reduction to 10 items based on reliability analysis.

Scoring Details

The ATWGS uses a 4-point Likert scale:

Strongly Disagree

,

Disagree

,

Agree

, or

Strongly Agree

. Scoring is achieved by summing the assigned numerical values for each item.

Scoring Schema:

• For positively worded items (1, 2, 4, 7, 9, 10): 1 =

  Strongly Disagree

  , 2 =

  Disagree

  , 3 =

  Agree

  , 4 =

  Strongly Agree

  .

• For negatively worded items (3, 5, 6, 8): Scores are reverse-coded.

A higher overall summed score indicates more positive attitudes toward women’s genitals. Initial findings showed a significant gender difference, with men scoring higher on average than women (29.77 vs. 26.48,

p

< .001).

Keywords

Attitudes, genital perception, sexual education, psychometrics, Herbenick, Likert scale, sexual health behavior, gender differences, reliability, validity.

Authors

Author ORCID Identifier: Not specified.

Affiliation Email addresses: [email protected]

Correspondence Address: Debra Herbenick, HPER 116, Indiana University, Bloomington, IN 47405

Permissions & Fee and Test Year

Test Year: Initial development 2006 (Dissertation); Published 2009 (Journal).

Permissions and Fees: Information regarding commercial usage fees or formal permissions for non-academic use is not specified in the source material. Researchers should contact the corresponding author, Debra Herbenick, for permission to use the scale.

Reference’s

• Fisher, W. A. (1998). The Sexual Opinion Survey. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.),

  Handbook of Sexuality-Related Measures

  (pp. 218–223). Thousand Oaks, CA: Sage Publications.

• Herbenick, D. (2006). The development and validation of a scale to measure college students’ attitudes toward women’s genitals. Unpublished doctoral dissertation, Indiana University.
• Herbenick, D. (2009). The development and validation of a scale to measure attitudes toward women’s genitals.

  International Journal of Sexual Health, 21,

  153–166.

Items of the Attitudes Toward Women’s Genitals Scale

The following items are about people’s feelings and beliefs related to women’s genitals (both the vulva and the vagina). The word vulva refers to a woman’s external genitals (the parts that one can see from the outside such as the clitoris, pubic mound and vaginal lips). The word vagina refers to the inside part, also called the birth canal.

Please mark an “X” in the box to indicate how strongly you agree or disagree with each statement.