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Labia minora elongation is one of the vaginal practices that some Zimbabwean women engage in during the pre-menarche age. This practice has not been thoroughly investigated in Zimbabwe. The objective of this study is to learn about the knowledge, attitudes and perceptions of urban Zimbabwean men towards labia minora elongation. A qualitative study was conducted in Chitungwiza, Harare, in Thirty-one adult men were interviewed.

Foram entrevistados 31 homens adultos. The motivations to engage in vaginal practices are diverse and range from beautifying the genitals, improving hygiene and personal grooming, medicinal practices and health, and preparing for sexual intercourse. One of the vaginal practices that women engage in is labia minora elongation hereafter LME. Traditionally, young girls start elongating their labia before they reach menarche.

Their paternal aunts, grandmothers or their female peers instruct them. The risks and benefits for the health of women who practice LME are, however, still under-explored. To our knowledge, this study from Tete is the only quantitative study conducted up to date that investigates the prevalence, frequency and associated health risks of LME.

Williams and Gelfand a, b and documented some case reports of LME among female members of the Shona linguistic group. Aschwenden described LME as prevalent among the Karanga. These documents described the procedure and its cultural ificance as one of the many components of the rites of passage to womanhood. As Williams explained almost half a century ago, after examining female Shona presenting at the antenatal clinic with enlarged labia:. Labial elongation should serve normally to augment sexual compatibility and to promote marital stability, ever so precarious for humans.

Undoubtedly it has also been exercised as an aid to fertility… Flaccid enlarged lips also increase the love large labia control over intercourse for the defenseless woman. If she wishes to protect herself against intromission, the rolling up of the loose labia into the vagina effectively closes the os Williams,p. In this report, LME is included as a harmful traditional practice along with rape, lobola bridewealthdenial of access to education, forced early marriage, wife inheritance, and prostitution.

As in many other contexts where LME is practiced, this procedure is just one component of certain initiation rites which may contribute to how young girls construct their body image. LME is part of a sexual socialization process that takes place from love large labia Mariano, Some of the herbs and substances employed by Zimbabwean women may serve to irritate and alter the integrity of the cervical and vaginal epithelium, leading to inflammation of the mucosa and disruption of the normal flora, thus eliminating the lactobacilli that form a barrier against colonization of STI pathogens and transmission of HIV Van de Wijgert et al.

There is no evidence on men refusing to use male condoms related to their expectations on their female partners having practiced LME. Table 1: Interview guide used during the study. The inclusion criteria for the respondents were being male, having ever engaged in heterosexual relationships, being above 18 years old, and, born and raised in Zimbabwe regardless of linguistic group.

All respondents that did not comply with these criteria were excluded from the study. The study was conducted between November and March Initially, local authorities were approached to receive permission for the interviews to be conducted, and the study protocol was reviewed and approved by the ethical review board Clinical Research Ethical Committee IRB CEIC. The purpose of the love large labia was explained to the respondents and they gave informed consent to participate in the study. No personal identifiers were requested from them. The respondents were aware they could withdraw from the study at any time and the data would then be destroyed ad hoc.

Interviews were recorded. Once the interviews were transcribed and stored in a computer password-access protected, the recordings were erased. Grounded theory requires purposeful sampling of individual cases from which data is then collected and analyzed from the beginning to recognize findings and simultaneously conceptualize those findings until saturation of data is reached Sandoval Casilimas, ; Thabethe, ; Martin Hilber, Per grounded theory, the themes were identified out of the data itself, with no pre-existing hypothesis or expectations.

The were validated by triangulation with the information from the literature on LME in Zimbabwe Williams, ; Gelfand, a, b, ; Aschwenden, ; Kanchense, ; Thabethe, ; Marsh et al. All respondents were inhabitants of Chitungwiza and complied with the inclusion criteria. An overview of the demographics of the respondents are displayed in Table 2. Table 2: Demographics of the male respondents: age, education and marriage status. Twenty-one and one men were married to one and two women respectively.

Nine were single in a relationship with at least one woman.

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With regards to their linguistic affiliation, twenty-eight had Shona as their mother tongue. Two and one respondents had Ndebele and Karanga as their mother tongue respectively. Fourteen respondents had fathered daughters. Twenty-eight respondents answered in English and three answered in Shona. Young girls engage in LME before puberty or before the onset of the first menstruation.

Women might start elongating at a later age if their male partners required it. It is a tradition that is passed from generation to generation. It is part of the couching to the girls. Since there are other sensitivities involved, the girls do not shy away, they can disclose whatever they want to their aunts Mike 142 y. Girls practice LME indoors or in a private space such as their bedrooms. A few respondents said that girls might also practice in an outdoor space; such as kushinyamariwhich is the special hut built for the celebration of the chinamwari or puberty initiation rites.

LME is not a one-day process but requires ificant investment of time. After the instructions, the girls continue practicing alone. Two men said that some girls might stretch in pairs, with other female peers assisting each other with the pulling. One respondent mentioned the use of pliers to hold the vaginal lips and pull them out.

The procedure love large labia preparing the oils to aid the pulling was described by one respondent as follows:. They use some powder from a tree; pfuta. They start by roasting the seeds. Then they crash the seeds and get some powder and mix with Vaseline.

The belief is that there is more sexual pleasure. For the pleasure of women I am not sure Mike, 42 y. Matinji is not a derogatory term. On the contrary, the elongated labia or matinji are an appreciated physical feature. LME is considered to be useful in reducing pain during childbirth. A few respondents explained how some Zimbabwean women elongate their labia minora in order to persuade their partners to be faithful:.

Just a belief, a myth, a belief which is that if you enlarge your labia, the men tend to like you more Alex, 42 y. Because for those labia elongated outside maybe they feel they have something tangible as well. Like the men have. That is the meaning of penis envy. She wants love large labia have a penis. Penis envy, because if you ask the reason why they elongate it, most girls do not have a tangible reason Daniel, 26 y. Only six men responded that women do not see their sexual pleasure enhanced with LME. To the majority, therefore, LME helps women to become sexually aroused during foreplay and to achieve orgasm during sexual intercourse:.

They do enjoy it because the Shona women are sexually emotive. Women equally enjoy it as much as we men do and same as when we are fondling their breasts. Women get excited? Dhodho, 27 y.

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The vaginal practices other than LME that were mentioned by a few respondents were virginity tests, insertion of substances, herbs and wankie 3 to cause tightening of the vaginal canal, oral consumption of aphrodisiacs, and masuwo lit. After losing virginity, women use medicines, black stones that they call wankie. They believe that after losing virginity the wankie can retain the virginity. This risk was explained by one respondent as follows:. If a woman does not yet have those large labia minora ones, she feels discomfort, even to bathe with women who have big ones.

They extend for men to enjoy, to feel proud, because they consider that she is a true woman if she has extended those labia minora Chris, 43 y. A few respondents mentioned injuries, discomfort and cancer as a result of the use of the herbs. One respondent added that the women need to wear special pants to overcome the discomfort LME causes. Two respondents believed that girls are at risk of acquiring bacterial infections love large labia using public toilets:.

If they go to a loo, sit in that seat, labia can come into contact with what; bacteria, infection. Then, someone with elongated labia has greater risk for taking infection than someone who is plain Daniel, 26 y. One man explained that LME makes introduction of the penis difficult and that men have to be assisted by the women. Risk for the man because he love large labia think they are virgins but they are not, they might be naughty. Those with long labia have many boyfriends.

They are more promiscuous Bill, 27 y. Four respondents explained that men prefer to feel and experience the elongated labia, hence refusing to wear a condom. It must be discouraged because it can attract to unprotected sex… Normally when you think of sex you are more focused on the sexual pleasure. But if someone is looking at the genital physical aspect, that person is more focused on unprotected sex. Because there is the belief that it can hold the men better and longer. They focus more on unprotected sex Mike, 42 y. One other respondent said transmission might be the consequence of the use of pliers to assist with the stretching process.

Another respondent explained that the risk of transmission is associated with the fact that women with elongated labia tend to lubricate more during sexual intercourse. According to this respondent, these men feel sexually unsatisfied and have to seek out other women with elongated labia with whom to have sex. Two respondents explained how they would not feel satisfied if their wives had not had elongated labia, and they seek sex with other women. However, to most respondents, men deciding to have extramarital affairs is not related to whether or not their wives had engaged in LME:.

My wife did not do it. It is not important to me. I personally do myself go with other women, you want to try that one and that other one… Eddi, 39 y. A third of the respondents, ten men, stated that they would not want their daughters to practice it. Four respondents clarified that they would prefer their daughters to decide to start LME once they were older and can make informed decisions to protect themselves:. I would not want my daughter to do it. I want it to be her choice so when she grows up a bit she can talk about it to her mother, and see if she decides it is good for her James, 33 y.

They are more mature then. Rather than when they are in their teens, in the school, being adolescents they maybe end up doing sex John, 33 y. The majority of the respondents, love large labia, said that they could talk openly to their wives about LME. Seven of these said that they would talk to their wives to ensure that their daughters do not undergo the practice.

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On the contrary, three said that they would talk to their wives to ensure that their daughters are elongating, since that is what men expect. One man said that he would talk to his partner if he were aware of any risks associated to labial elongation. As for talking with their daughters directly, it was clear that fathers never talk to their daughters or even get to know if they are in the process of learning LME.

One man said that he could not discuss it with his partner, but he could discuss with her aunt to ensure that the daughter is being instructed in LME. According to seventeen of the respondents who had ever engaged in sexual intercourse with women who had complied with LME, there is no difference between having sex with women with or without elongated labia.

To nine men, the sexual experience is more pleasurable with woman with elongated labia. However, only three respondents said that they love large labia sex with a woman who did not practice LME. Some respondents argued that the preference for women with LME might be psychological.

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In their own words: a qualitative content analysis of women’s and men’s preferences for women’s genitals