Genitals, like the rest of our bodies, come in all kinds of shapes and sizes; there’s a much wider range of “normal” appearances than the media tends to suggest. Still, some people refer to themselves as having an “innie” or an “outie” vagina, as slang to describe the appearance of their labia. 

From porn to urban myths, there’s a lot of misinformation out there about how a woman’s genitals should look. It’s no wonder that terms like “innie” and “outie” have arisen, potentially creating unnecessary feelings of concern or insecurity about genital appearance. So what do these terms mean? And what is “normal”?

Defining “Innie” VS “Outie”

Let’s start with a quick note on terminology: although many women refer to the outer portion of their genitals as their vagina, this is technically the vulva. The vulva includes two sets of lips known as labia: the labia majora (outer lips) and the labia minora (inner lips). The vagina refers to the internal passage going from the vulva to the cervix. Read more here about the difference between vaginas and vulvas.

They aren’t medical terms, but “outie” is used to refer to when the inner lips are visible and stick out beyond the outer lips. Conversely, an “innie” is where the inner lips are shorter than the outer lips and may not be visible. 

Not all vulvas are the same, whether they’re innies or outies. Each woman’s is unique and may be different in terms of:

• Colour
• Shape
• Size
• Length
• Texture

It’s also common and normal for the appearance of a person’s vulva to change over time. Things like weight change, hormone balance, pregnancy, childbirth, and menopause can all affect genital tissue.

Is It Normal to Have an Innie or an Outie Vagina?

Both innie and outie vulvas are totally normal and roughly equally common. One study suggested that 56% of women have an outie vagina and 44% have an innie. The same study assessed whether women were happy with how their labia looked and whether they considered it “normal”. Surprisingly, they found that women with outie vaginas were less likely to consider them “normal”. In fact, 73% of people who considered their labia to be “abnormal” had an outie.

Even so, there is no “normal” or standard labia size. A study of 657 white women aged 15-84 found that the length of the labia minora varied from 5–100 mm, and the labia majora varied from 12–180 mm.

This means that there’s a huge range of “normal” vulval appearances, and it’s completely healthy and natural to have either an innie or an outie vulva.

What Causes You to Have an Innie or an Outie?

We’ve already discussed how vulvas are all unique, but your labia can also change in size and shape throughout your life. Many factors contribute to the appearance of the labia majora and minora and their size relative to one another. Let’s explore them in more detail.

Genetics

The genes you inherit from your parents affect how various body parts develop, including your vulva.

Your genes directly impact the development of your genitals and can determine how your body makes or reacts to hormones. As labia growth is related to sex hormone levels, genes affecting things like oestrogen can also impact the size and shape of your labia.

Hormones and age

During female puberty, there is a rise in oestrogen and progesterone levels. These sex hormones lead to various changes in an adolescent’s developing body, including growth of the labia. 

Oestrogen levels can vary throughout life, so fluctuations during other stages may also affect labia growth and size. Around menopause, oestrogen levels drop, which can lead to a condition known as vulvovaginal atrophy, where the skin on the labia becomes thinner and less elastic. 

Pregnancy

A person’s body undergoes an incredible number of changes during pregnancy. Oestrogen levels rise, blood volume increases by 50%, and pressure on the pelvic floor increases, all of which can increase blood flow to the vulva and lead to tissue swelling and increased size. Childbirth may also cause changes to the vulva.

Although some women notice a long-term difference in their genitals after pregnancy and childbirth, these changes are usually temporary. Studies have found no significant difference in labia size between women who have and haven’t given birth.

BMI

Evidence fromone study found that women with a higher body mass index (BMI) were more likely to have longer labia majora and shorter, narrower labia minora – in other words, they were more likely to have an “innie.” Other studies suggest that overweight or obese women are more likely to have larger labia majora due to increased fat tissue.

Losing weight may also change how your vulva looks. Rapid weight loss may cause the labia majora to become smaller due to fat loss, which may turn an “innie” into an “outie”.

Other factors may affect the size and shape of your labia, but the evidence is mixed. Some studies have shown no relationship between labia size and height, age, or race, while others suggest there may be a link. More research is needed to say for sure.

Is It Better to Have an “Innie Vagina”?

“Better” is a subjective term when it comes to having an innie or an outie vulva; there is no meaningful difference beyond personal preference. There’s no evidence that the shape and size of your vulva affects the quality of sex, the likelihood of sexual challenges, or how likely you are to catch a sexually transmitted infection (STI).

Some medical issues of the vulva can occur, but they aren’t determined by whether a person starts with an innie or an outie. Labial hypertrophy refers to the enlargement of the labia minora, but even then, it’s only a medical problem if it’s causing pain, irritation, or interfering with your sex life.

What if I’m Unhappy With How My Vulva Looks?

Normal and healthy vulvas come in all shapes and sizes, and labia aren’t always symmetrical. Still, for a variety of reasons, some women are unhappy with how their vulvas look.

Asurvey of Australian women aged 18-28 found their idea of the “ideal vulva” was a hairless “innie” vulva – something that’s commonly seen in pornography. Unfortunately, porn’s stylised, extreme performances and body depictions have been linked to a range of issues relative to unrealistic expectations, body image, and sexual self-esteem. 

Vulva Surgery

A plastic surgery called a labiaplasty is sometimes performed for people who are extremely dissatisfied with the appearance of their vulva, but it isn’t usually available on the NHS unless it’s to remove a cancerous growth or to repair damage (e.g., from childbirth). Labiaplasty also comes with risks, and there’s no guarantee that having surgery will make you happy with your vulva.

If you’re worried about the shape of your vulva, speak to your GP. They can advise you on any symptoms you’re experiencing and refer you for counselling, if need be, to talk about the impact your vulva is having on your body image and self-esteem.