Table 1 Summary of reviewed papers

Ashong & Batta 2012 [34]

To explore the content of Western female genital cosmetic surgery provider websites.

Qualitative. Textual analysis, methods not described in detail.

11 international FGCS provider websites (6 USA , 2 UK, 1 Canada, 1 Belgium, 1 Brazil). Does not specify which pages from each site were analysed.

Limited (8/20): lack of rigorous data analysis or theoretical connection.

Nigeria

Howarth, Sommer & Jordan 2010 [31]

To determine if visual depictions of female genitalia differ across 3 sources (online pornography, anatomy textbooks, and feminist publications: online, print).

Quantitative. Comparison of measurements of vulval features from screen and book photos or illustrations.

253 images (98 from 3 free online pornography websites, 29 from <92 human anatomy textbooks, 126 from feminist publications: 2 books, 1 website).

Strong (18/22): limited by unclear sampling strategy and failure to differentiate sources of individual images.

United Kingdom, The Netherlands

Liao,Taghinejadi & Creighton 2012 [32]

To investigate the clinical information on female genital cosmetic surgery provider websites.

Quantitative. Content analysis.

10 international FGCS provider websites (5 UK, 5 USA).

Strong (18/18).

United Kingdom

Moran & Lee 2013 [33]

To examine how the textual and visual content of the Australian labiaplasty provider websites normalises the practice of FGCS.

Qualitative. Multimodal critical discourse analysis.

4 Australian FGCS provider websites: all textual and visual content on home pages, (cosmetic surgery in general), and content related to labiaplasty from entire site.

Strong (18/20): limited by only partial use of verification procedures and reflexivity.

Australia

Zwier 2014 [30]

To compare motivations for considering labiaplasty expressed by women on online communities with those indicated on the websites of an international sample of surgery providers.

Quantitative. Content analysis.

40 international English- or Dutch-language FGCS provider websites (Australia, Canada, Ireland, the Netherlands, New Zealand, South Africa, UK, USA). 78 posts in which women (28 Dutch, 25 US, 25 UK) wrote about their reasons for labiaplasty, drawn from 4 online communities with recent threads about labiaplasty (1 Netherlands, 2 USA, 1 UK). Ages disclosed by posters ranged from 12 to 61 years.

Strong (21/22): limited by inconsistency of sample. A selection of Dutch, US and UK websites would have enabled more accurate comparison between content of online communities and websites.

The Netherlands