(229) FEMALE GENITAL SELF-IMAGE SCALE-SPANISH (FGSIS-S): PROPOSAL FOR A CUT-OFF SCORE

Abstract Objectives To explore cut-off scores for Female Genital Self-Image Scale-Spanish (FGSIS-S) to discriminate women concerned about their genital appearance and/or considering female genital cosmetic surgery (FGCS), most frequently labiaplasty. Methods FGSIS-S is a Spanish validated, 6-item scale, developed from original FGSIS. It measures women’s genital image self-perception. Total score varies from 6 to 24 and higher scores resemble a more positive attitude towards genital self-image. Answers from 200 women taking part, through an online survey, in the FGSIS-S validation original study were analyzed. Participants were 18-70 years old, native Spanish-speakers, non-pregnant, without vulvar disease, attending general gynecology consults in Hospital 12 de Octubre, from march to may 2021. Questions “Have you ever been concerned about your genital appearance?” and “Have you ever considered undergoing genital cosmetic surgery?” were validated and used for stratification of FGSIS-S scores. Sensitivity and specificity analysis was performed through logistic regression and plot of the area under the ROC curve (AUC). Results Overall FGSIS-S score was able to predict women’s concern with an AUC of 0.80 (95% CI 0.74 – 0.86); and those considering FGCS with AUC 0.78 (95% CI 0.69 – 0.86). A 90% sensitivity cut-off for the detection of women concerned was found at 21 and 17 for 90% specificity. Best trade-off between sensitivity (51.6%) and specificity (91.6%) was found at 17. To detect women considering FGCS, cut-offs were found at 21 (90% sensitivity) and 15 (90% specificity). Best trade-off was found again at 17 (sensitivity 72.0%, specificity 81.1%) Cut-off scores are shown in FIgure 1. Conclusions We consider 17 could be a good cut-off to refer women to specialized counselling as they probably represent the most extreme group of those concerned and considering surgery. Further studies are needed to validate cut-off scores as well as establish the total score increment required to obtain clinical benefit from interventions. Conflicts of Interest The authors report no conflicts of interest.