Sexuality is a fundamental aspect of human well-being. Evidence suggests that a negative perception of body image is linked to an increased risk of sexual dysfunctions. However, there is a lack of studies investigating the relationship between genital self-image and sexual function in young adults.

To investigate the associations between genital self-image and sexual function in men and women aged 18 to 40 years.

Cross-sectional, prospective cohort study. Recruited participants through social media. A web-based survey was conducted, including assessments of sexual function (Female or Male Sexual Function Index) and genital self-image (Female or Male Genital Self-Image Scale).

124 women and 101 men participated in the study. Participants of both sexes with a more positive genital self-image exhibited better sexual function, considering total score, as well as improved performance in the domains of satisfaction, arousal, and lubrication/erection, along with higher self-esteem. In males, there was also a positive correlation between genital self-image and the sexual desire subdomain, whereas no such correlation was observed in women.

Both men and women with a more positive genital self-image demonstrated better outcomes in the domains of satisfaction, arousal, and lubrication/erection. Additionally, in men, a positive genital self-image was associated with sexual desire, a relationship not observed in women.

In men, insecurity regarding genital appearance may increase anxiety in sexual situations, potentially impairing erectile function and ejaculatory control. Similarly, in women, genital self-image directly influences sexual satisfaction and function. Negative perceptions of genital appearance are associated with orgasm difficulties and reduced sexual desire, which may be exacerbated by sociocultural factors, such as beauty standards, myths and taboos about female sexuality, ultimately impacting women's sexual health.