Volume 25, Issue 1 , Pages 12-14, February 2012
The Incidence, Attitudes and Practices of the Removal of Pubic Hair as a Body Modification
Article Outline
Abstract
Objective
To evaluate the incidence, attitudes, and practices of the removal of pubic hair as a body modification.
Design
A voluntary, anonymous survey was conducted among adolescents and young women 12-20 years of age seen in gynecology clinics in Houston, Texas.
Results
There were a total of 171 adolescent participants surveyed, of whom 70.4% of reported routinely shaving or waxing their pubic hair. More traditional body modification methods were evaluated, and 3.5% reported tattoos and 57.1% reported piercings. Sexually active participants were more likely to remove pubic hair routinely. The areas of the body where the participants felt there was “too much” hair included the genital area, upper lip, and abdomen. Of total respondents, 14.7% reported feeling “pressure” from friends or family to participate in body modification such as tattooing, piercing, or removal of pubic hair. The decision to participate in body modification was mostly influenced by friends and family.
Conclusion
Based on this study, removal of pubic hair as a body modification is common. The results of this study demonstrated that removal of pubic hair was more common in sexually active participants compared to non-sexually active participants. Therefore, providers should additionally be aware that removal of pubic hair may be a warning sign of sexual behaviors or impending sexual activity.
Key Words: Body modification (nontherapeutic), Body piercing, Tattooing
Introduction
Body modification involves any change to a previously unaltered part of the body. Body modification among adolescents has traditionally focused on behaviors such as tattooing and body piercing. Recent studies demonstrate that 4%-26 % of adolescents/young adults have tattoos and 10-51% of adolescents/young adults have body piercings excluding the ear lobes.1, 2, 3, 4, 5, 6, 7, 8 Although tattooing and body piercing are the 2 behaviors most commonly studied under the category of body modification, removal of pubic hair either by shaving or waxing may also be considered a type of body modification.3 There are no published studies specifically addressing the removal of pubic hair in adolescent females or young adult women. This study was designed to describe the incidence of body modification (including tattooing, skin piercing, and removal of pubic hair) in adolescent girls and young women at 1 institution and to describe the practices and attitudes involved in this behavior.
Methods
A voluntary anonymous 26-question survey was conducted among adolescents and young women 12-20 years of age seen in pediatric and adolescent gynecology clinics in Houston, TX. Approval for the study was obtained from the Institutional Review Board for Clinical Research Studies at Baylor College of Medicine. Survey questions inquired about pubertal development, sexual history, presence of acne, presence of body hair, and different body modifications such as body piercings, tattoos, and removal of pubic hair. Data was analyzed by SAS, SAS OnlineDoc 9.2, SAS Institute, Cary, NC, USA, 2007.
Results
A total of 181 adolescents and young women were approached to participate in this anonymous survey study. Of those approached, 171 chose to participate. Our study population was diverse; 50% identifyed as Caucasian, 27% Hispanic, 20% African American, and 2% Indian. The mean age of participants was 15.6 (± 1.9) years (Table 1). Body mass index (BMI) ranged from 16-53 kg/m2 in our study group. The mean age of menarche was 11.7 (± 2.1) years. Among total participants, 46.2% were sexually active. Within the sexually active group, 2.9% of participants reported a history of pregnancy, 12.8% reported previous history of sexually transmitted infections, 47.7% reported use of birth control, and 62.3% reported regular condom use. The age of first sexual intercourse was less than 13 years in 12.5%, 14-16 years in 14.3%, 17 years in 15.3%, and 18 years in 16.5% (Fig 1). The majority of sexually active participants (65%) reported 1 or 2 sexual partners (Fig 2). In addition, the majority of total participants reported attraction to males (91.9%) versus attraction to females (1.7%) or both sexes (6.3%). Although 60.6% of total participants reported having acne, only 46.8% of the sexually active participants reported acne compared to 73.0% of the non-sexually active participants. Sexually active participants were more likely to report tampon use (74.7%) compared to non-sexually active participants (45.6%).
Table 1. Patient Demographics
| Demographics | Mean/SD of total participants (N = 171) | Mean in sexually active subset (n = 79) | Mean in non-sexually active subset (n = 92) | P |
|---|---|---|---|---|
| Age (y) | 15.6 (± 1.9) | 16.6 | 14.7 | <.001 |
| Menarche (y) | 11.7 (± 2.1) | 11.9 | 11.4 | NS |
| Thelarche (y) | 10.8 (± 1.8) | 11.1 | 10.6 | NS |
| Adrenarche (y) | 10.8 (± 2.3) | 11.5 | 10.2 | <.001 |
| BMI (kg/m2) | 25.4 (± 6.7) | 26.1 | 24.9 | NS |
Fig. 1
Age (y) of first sexual encounter (N = 79)
Fig. 2
Sexual partners and percentage reporting 1 versus multiple sexual partners
Approximately one-third of participants felt they had “too much” hair, although 70.4% of adolescents surveyed reported routinely shaving or waxing their pubic hair. Whereas 89.7% of the sexually active adolescents reported shaving or waxing their pubic hair, only 53.9% of the non-sexually active adolescents reported similar behaviors (P< .001). The areas of the body where the participants felt there was “too much” hair included the genital area, upper lip, and abdomen (Fig 3). More traditional body modifications were also assessed, that is, tattooing (3.5%), piercing (57.1%), and both tattooing/piercing (5.9%). Among the sexually active participants, 5.2% reported tattoos compared to 2.3 % of non-sexually active participants (P<.001). Of total respondents, 14.7% reported feeling “pressure” from friends or family to participate in body modification such as tattooing, piercing, or removal of pubic hair. The decision to participate in body modification was influenced by friends (73.1%), family (43.0%), magazines (9.6%), Internet (5.3%), and television (16.3%). Among total participants, 28.2% reported having older sisters who participated in body modification behaviors as addressed in the survey.
Fig. 3
Percentage of participants reporting “too much” hair in respect to body location
Discussion
The 2 most common and traditionally studied body modifications are tattooing and piercing. The rate of tattooing in our study was 3.5%, slightly lower than previously reported rates.4, 5, 6 The rate of piercing in this study was high (57.1%), but it may be difficult to compare to other studies since ear piercing was not excluded. Overall, removal of pubic hair was significant in our cohort (70.4%) and was the most common method of body modification reported among participants. These data are consistent with the fact that removal of pubic hair is the easiest, cheapest, and most reversible method of body modification available to the adolescent or young woman.2 Body piercings in the United States can range from $25-$85 per piercing, whereas tattoos can range from $75 to several thousand dollars per tattoo. In comparison, a razor is easily accessible at a grocery store and costs less than $10, and waxing is easily accessible at most salons at a cost from $30-$100 per session. It is interesting to note that whereas 70.4% of participants in this study actively removed pubic hair, only 28.3% of participants felt they had “too much” hair. However, 64.3% of this subset believed the extra hair was in the genital area. In addition, our data do not suggest that the participants felt pressured to remove pubic hair, as only 14.7% of participants reported feeling “pressured” from friends and family to participate in body modifications such as removal of pubic hair. Nonetheless, adolescents and young women attribute decisions to proceed with body modifications such as tattooing, piercing, or removal of pubic hair based on influence from friends and family members.
The incidence of body modification behaviors in this study is consistent with previous studies.1, 2, 3, 4, 5, 6, 8, 9 In our study, sexual activity rates and ages at initiation were similar to those reported in the 2007 Youth Risk Behavior Survey (YRBS).10 In addition, 6.5% of our participants were sexually active under the age of 13 years, similar to previously reported rates.1, 2, 3, 4, 5, 6, 8, 9 This finding further emphasizes the importance of questioning all adolescents about sexual activity. Birth control use was 47.6% among all participants, although the rate of pregnancy was low (2.9%). In contrast, the rate of history of sexually transmitted infections was higher (12.8%). Not all adolescent and young adult females reported having male partners in our study, however, associations between sex preference and body modification behaviors could not be assessed because of lower numbers. Finally, it is interesting to note that there was a lower rate of sexual activity in participants who reported having more acne. Although it may be postulated that lower self-esteem may secondarily decrease interest in sexual activity, the association noted with acne rates and sexual activity is unclear.
Previous research on body modification demonstrates a link to other high-risk behaviors such as sexual activity, alcohol and drug use, gambling, gang affiliation, rave attendance, school truancy, and suicide attempts.1, 3, 7, 9 Therefore, it has been suggested that tattooing and piercing should be used as “red flags” for health providers to screen for other high-risk behaviors. Although the results of this study demonstrated that removal of pubic hair was more common in sexually active participants compared to non-sexually active participants, over half of non-sexually active adolescent girls were engaging in this behavior.
The present study has generated information in an area that has not previously been examined and in which data are scarce, though more data are needed to better understand the behaviors and motivations behind body modifications in adolescent girls and young adult women. There were some limitations to this survey study. The survey was completed by patients in gynecology clinics located in 1 metropolitan medical center. In addition to the small potential for recall bias among participants in answering questions, there is no validated survey tool yet available to investigate this issue. Despite these limitations, this study emphasizes the importance of recognizing associations between these body modification behaviors and other high-risk activities. Follow-up surveys will be necessary to validate this survey instrument as a potential screening tool.
References
- . Contemporary college students and body piercing. J Adolesc Health. 2004;35:58
- Body piercing in England: a survey of piercing at sites other than the earlobe. BMJ. 2008;336:1426
- . Body modification and substance use in adolescents: is there a link. J Adolesc Health. 2003;32:44
- Tattoos and body piercing as indicators of adolescent risk-taking behaviors. Pediatrics. 2002;109:1021
- . Body art (body piercing and tattooing) among undergraduate university students: then and now. J Adolesc Health. 2008;42:201
- . Tattooing and high-risk behavior in adolescents. Pediatrics. 2002;110:1058
- . Body piercing and high-risk behavior in adolescents. J Adolesc Health. 2004;34:224
- Body piercing, personality, and sexual behavior. Arch Sex Behav. 2007;36:47
- . Are tattooing and body piercing indicators of risk taking behaviors among high school students. J Adolesc. 2006;29:379
- Center for Disease Control: YRBSS: Youth Risk Behavior Surveillance System. National Center for Chronic Disease Prevention and Health Promotion 2007; http://www.cdc.gov/HealthyYouth/yrbs/index.htm: website accessed on 6/28/2011.
There was no source of financial support for this study and there are no disclaimers.
PII: S1083-3188(11)00292-0
doi:10.1016/j.jpag.2011.06.015
© 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Volume 25, Issue 1 , Pages 12-14, February 2012
