Tag Archives: Labia minora elongation*

Elongation of inner labia minora by constant pulling or stretching.

Introduction of culturally sensitive HIV prevention in the context of female initiation rites: an applied anthropological approach in Mozambique

LMEJ Afr AIDS Res. 2009;8(4):491-502.

Introduction of culturally sensitive HIV prevention in the context of female initiation rites: an applied anthropological approach in Mozambique

Kotanyi S, Krings-Ney B


In Mozambique, initiation rites represent the most appropriate socio-cultural context for dealing with sexuality for a large part of the population. As the group most vulnerable to HIV exposure, HIV-prevention counselling could be ideally introduced to young women during initiation rites. This article demonstrates how interventions can take advantage of the positive aspects of this tradition. We discuss local notions of social ‘contamination’ versus biological ‘contamination,’ and we present a culturally sensitive communication strategy to bridge the divergent paradigms around AIDS-similar symptoms. Because of the emotional importance of the initiation rites, the suggested approach goes far beyond cognitive knowledge. After training, the godmothers in initiation rites became highly motivated to teach novice girls about HIV prevention and they trained other elderly women as well. Thus, the initiation rites turned into a process of empowerment for women in their own communities. A central agenda of the female initiation rites in Mozambique is to inculcate respect towards ancestors, elders, authorities and others; however, this respectful attitude between genders and between generations is disappearing due to factors like warfare and the cash economy. HIV-prevention counselling may be successfully introduced into initiation rites because of the unconscious, emotional impact of the process on the initiates’ behaviour. Other studies have shown that cognitive knowledge is not enough to lead to behavioural changes. Without changing the traditional initiation rites for females, which in Mozambique includes no genital cutting, a complementary approach introduces HIV-prevention counselling during ritual counselling moments, thereby motivating godmothers and novice girls and young women to be more aware and take precautions to prevent HIV infection.

This article can be accessed in this LINK

Determinants of Elongation of the Labia Minora in Tete Province, Central Mozambique Findings of a Household Survey

African Journal of Reproductive Health. 2016; 20(2): 111-121.LMEFREE

Determinants of elongation of the labia minora in Tete Province, Central Mozambique: Findings of a household survey

Martínez Pérez G, Bagnol B, Chersich M, Mariano E, Mbofana F, Hull T, Martin Hilber A


A WHO-supported provincial-level population-based survey was conducted in 2007 to understand the determinants and implications forhealth of vaginal practices. A total of 919 women aged 18-60 were selected randomly for enrolment. This is the first population-based study of females in Tete Province, Mozambique. At some time over their lives, 98.8% of women had practiced elongation of their labia minora and a quarter (24.0%) had done so in the past month. Currently practicing women were more likely to have engaged in sex recently, and used contraceptives and condoms at last sex than women who had stopped labial elongation. Younger age, residence in rural areas and having two or more male partners were also determinants of current practice. Women commonly reported they practiced for no specific reason (62.8%). Discomforting itchiness and lower abdominal pain were more frequent in women who had stopped labial elongation than in women who were currently practicing. Although women may not report current vaginal ill health, it is possible that prospective cohort studies could uncover alterations in genital vaginal flora or other indicators of impact on women’s health. The findings of this study do not suggest that labial elongation is linked with high-risk behaviors for HIV transmission. .

This article can be accessed in this LINK

Grounded Theory A Methodology Choice to Investigating Labia Minora Elongation Among Zambians in South Africa

FREEInt J Qual Methods.

LMEGrounded Theory. A Methodology Choice to Investigating Labia Minora Elongation Among Zambians in South Africa

Martínez Pérez G, Mubanga M, Tomás Aznar C, Bagnol B


A study on how Zambian migrants living in Cape Town perceive and experience the implications of labial elongation on women’s health was conducted. Labia minora elongation (LME) is a genital modification that some women in east and southern Africa practice. This tradition is not common in Western Cape province (southwestern part of South Africa). The aim of this article is to discuss the methodological choices made in the design and conduct of this study, in which a White European male interviewed the female study participants on the health implications of a practice that is considered a woman’s private issue. Constructivist grounded theory informed by a feminist perspective was chosen as the most suitable methodological approach to enable cogeneration of knowledge with the female participants. The methods and tools used by the lead investigator facilitated access to the participants’ emic views. Grounded theory methodology holds the potential to be an appropriate methodological approach for researchers who seek to erode the power imbalances influencing research processes that aim to explore the associated meanings and health implications of female genital modifications, such as LME, as narrated by the women who practice them.

This article is available in this LINK

Zambian Women in South Africa: Insights Into Health Experiences of Labia Elongation

Journal of Sex Research (iFirst). 10.1080/00224499.2014.1003027LME

Zambian Women in South Africa: Insights Into Health Experiences of Labia Elongation

G Martinez Perez, M Mubanga, C Tomás Aznar, B Bagnol


Labia minora elongation consists in the manual stretching of the inner lips of the external genitalia. This practice is documented in east and southern Africa. The experiences of African women in the diaspora practicing elongation are not thoroughly understood. The purpose of this qualitative study was to explore the health harms and benefits associated with this practice of Zambian women who have migrated to Cape Town, South Africa. Twenty women and seventeen men participated in this study. Between December 2013 and May 2014, in-depth interviews and natural group discussions were conducted with the participants. The focus of this article is to report on the emic of the women related to notions of health, hygiene, and well-being. Labial elongation is perceived as a practice involving minor, short-term adverse effects that can be prevented by following some basic hygiene. Overall, personal and social value is placed on this practice because of its reported benefits for the sexual health of men and women, and for women’s femininity and self-image. Further research is necessary on how female genital modifications influence Zambians’ sexual preferences to inform the development of culturally appropriate health promotion interventions.

This article can be accessed in this LINK

Autoerotism, homoerotism, and foreplay in African women who practice labia minora elongation: a review


International Journal of Sexual Health.2014, 26(4): 314-328.LME

Autoerotism, homoerotism, and foreplay in African women who practice labia minora elongation: a review

Martínez Pérez G, Bagnol B, Tomás Aznar C


Labia minora elongation is a female genital modification that some women in certain linguistic groups from Africa engage in. One of the purposes is to enhance sexual pleasure for their male partners. The literature has been reviewed to describe how it serves for women to increase their sexual pleasure, both as an autoerotic method and in the context of homoerotic and heterosexual relationships. This aspect deserves to be investigated, as there are narratives from some women practitioners of labial elongation that this practice might contribute to improve the sexual health of some of the women who engage in it.

This article can be accessed in this LINK

The Practice of Puxa-Puxa among Mozambican Women: A Systematic Inventory of Motives.

J Sex Res. 2013 Aug 7. [Epub ahead of print] LME

The Practice of Puxa-Puxa among Mozambican Women: A Systematic Inventory of Motives.

Vera Cruz G, Mullet E.

Department of Psychology, Eduardo Mondlane University.


Puxa-puxa is the elongation of the labia minora of the genital organs. It is one of the most widespread genital practices among women in Mozambique, and the practice seems to be specific to this country. The motives underlying this practice and its abandonment were examined in a theory-driven way. A total of 616 women currently living in the provinces of Maputo, Zambezia, and Nampula, aged 18 to 62, were presented with one of two questionnaires that contained items about possible motives for practicing puxa-puxa or possible motives for not practicing it. Seven separable motives for practicing puxa-puxa were found, and the most highly rated were “Having a satisfying sexual life”; “Satisfying my sexual partner”; and “Gaining self-control.” Five separable motives for not practicing puxa-puxa were found, and the most highly rated were “Disliking a painful practice”; “Affirming one’s value as a person”; and “Avoiding contamination.” The main findings of the study are that the practice of puxa-puxa is associated with deep psychological motives common to most women in most cultures, namely having a satisfying sexual life with a reliable partner, creating the conditions for having children, and being able to care for them. The abandonment of this practice is largely the result of personal decisions, which are not taken under constraint and which are not exclusively taken from fear of illness.

This article can be accessed in this LINK

Labia Minora Elongation and its implications on the health of women: A Systematic Review

Int J Sex Health. 2013. DOI:10.1080/19317611.2013.851139LME

Labia Minora Elongation and its implications on the health of women: A Systematic Review

Martínez Pérez G, Tomás Aznar C, Bagnol B


Labia Minora Elongation is a female genital modification practice categorized among the types included in the fourth group of female genital mutilation. In this paper we display the results of a systematic review of the evidence-based knowledge published on the health risks and benefits of Labia Minora Elongation as informed by African female respondents who are insiders of the practice. No other systematic review on this specific topic has been published before. A methodological bibliographic search was done in scientific databases, by manual referencing and by contacting experts on this area of knowledge. Seventeen papers turned out eligible for this review, which correspond to nine different studies. Eight of these studies were conducted in Eastern and Southern African countries and one was carried out in Italy. This review concludes that pain at the beginning of the practice, nuisances related to the use of caustic herbs, and stigmatization in failing to comply with the practice are the principal health risks associated to labia minora elongation. At the same time, there is evidence that labial elongation may benefit the sexual health and well being of women. More research of a quantitative nature is necessary to determine its prevalence across the practicing cultures and to precise its implications on the sexual and reproductive health for the women who engage in this female genital modification.

This article can be accessed in this LINK

On MeSH: Have Female Genitalia Fallen into Oblivion?

J Sex Med. 2013 Oct;10(10):2605-6. doi: 10.1111/jsm.12264.LME

On MeSH: Have Female Genitalia Fallen into Oblivion?

Martinez Pérez G, Shah S

Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.


…We could write to the MeSH section staff and propose a defi- nition. However, if we scrutinize each one of the ethnic groups in the world, we will come to different conclusions on what “clitoris” means. One can attempt to name a few. The clitoris is that part of the female genitalia that Rwandese men call rugongo and have to strike with the glans of the erect penis during sexual foreplay [3]. In KwaZulu-Natal, South Africa, the clitoris is that part of the body where women perform cuttings and rub “love medicines” on the scars, aiming to increase desirability [4]. Since Mosotho women in Lesotho are aware of the importance of the clitoris in sexual pleasure, some girls consider the clitoris to be a part of their body they would prefer to elongate—instead of attempting to elongate their labia minora [5]. The clitoris is also what Somali girls have excised because it is thought of as the male part of the female body, which needs to be removed in order to humanize a woman [6]. This belief should not be foreign to Westerners; in 1561, the Italian botanist Gabrielo Fallopio established an analogy between the penis and the clitoris, and it was not until 1987 that somebody—the psychologist Josephine Lowndes Sevely—argued that these organs were not similar at all [2]!…

This article can be accessed in this LINK

Labia minora elongation as understood by Baganda male and female adolescents in Uganda.

Cult Health Sex. 2013 Aug 1. [Epub ahead of print]LME

Labia minora elongation as understood by Baganda male and female adolescents in Uganda.

Martínez Pérez G, Namulondo H, Tomás Aznar C


Labia minora elongation is a common traditional female genital modification practice among the members of the Baganda ethnic group in Uganda. In 2002, a study carried out by the Padua Working Group on Female Genital Mutilation analysed how Baganda girls residing in Wakiso District graphically represented their experiences of labia minora elongation. In the present study, using the same methodology and in the same geographic setting 10 years later, we asked young men and women to prepare graphical representations of this rite. The purpose was to learn about how the practice is perceived and represented, describing the differences found in their testimonies, and comparing the findings with the former study. A total of 36 respondents (21 male and 15 female), aged between 9 and 15 years old participated in the study. The drawings were analysed using a three-themes analysis frame with a focus on setting, subject and operator. Differences were detected between how young women and men represented this practice. Educational interventions may be helpful to address the doubts, concerns, anxieties and misconceptions that Baganda youth may have concerning traditional genital practices.

This article can be accessed in this LINK

Elongation of labia minora – Zambia

manena20.blogspot.com webpage. Sunday, December 07, 2008LME

Elongation of labia minora – Zambia

By Manena (author of the blog where this post is hosted)


I was browsing the web today and just now found out that elongation of labia minora is classified as Genital Mutilation type IV (where have I been?). So of course after my initial shock of “oh my God! I am mutilated!!!” abated… I had a few minutes to think and I have come to a conclusion on the subject. The researchers have erred.

History and Commentary: Let me start by saying that the information contained herein will most likely upset/disconcert a lot of Zambians because we have trouble talking about our sexuality or sex in public places. Ritual/ traditional sexual matters are discussed in private among friends or at gender restricted traditional ceremonies. The reason I feel strongly to speak on this subject is that as Zambian, we sometimes have a tendency to accept western standards as the norm, shunning our own cultures without much investigation other than the fact that it seems primitive. We often forget that when anthropologists come in from other countries to “study” us, they are not highly familiar with the language for a start, and the local people are not comfortable explaining everything or have trouble translating things to English. The evidence is clear in ChisunguA girl’s initiation ceremony among the Bemba of Zambiaby Audrey Richards. Yes there are a lot of inconsistencies and traditional teaching that has been done the same way for ages that we have no idea why it’s done that way other than– it was passed on by our forefathers that way. You could say the same for many religious practices too. Unfortunately, unlike religion, our history is not written, but passes on through fables or partially true stories, through dance and song or a village elders romantic view of the past…

This post can be accessed in this LINK