<p>Baseline characteristics of participants.</p>

Background Female genital cosmetic surgery (FGCS) has experienced increasing popularity over the past decades. This procedure includes surgical and non-surgical intervention to alter genital appearance, often without medical indications. As many women are unfamiliar with normal genital anatomy, healthcare providers play a critical role in guiding patients. Therefore, evaluating their attitudes and knowledge for identifying gaps in training and ethical issues could be valuable. Materials and methods This cross-sectional study was conducted from 17 January 2023 to August 2024 among 320 healthcare providers in Iran. Participants included obstetricians and gynecologists, plastic surgeons, midwives, gynecology residents, urologists, and general practitioners. Data were collected using a validated web-based questionnaire about participants’ demographics, clinical experience, knowledge of FGCS, risk awareness, ethical considerations, and attitudes toward FGCS. SPSS version 27 was used for statistical analysis. Results The majority of participants (57.6%) were obstetricians and gynecologists. Most respondents reported being approached by patients seeking FGCS, with body image dissatisfaction (65.4%) and partner requests (62.2%) being the primary complaints. Awareness of short-term risks varied significantly across specialties (p < 0.001), with obstetricians and gynecologists being the most informed. Confidence in performing procedures was highest among plastic surgeons, while ethical considerations were more recognized among obstetricians and gynecologists. Although most participants in all groups (68.6% of OB/GYN, 90.0% of plastic surgeons and 75.2% of others) reported formal training, long-term risk awareness and procedural confidence gaps persisted. Only a minority endorsed FGCS for purely aesthetic reasons (8.6% of obstetricians and gynecologists, and 1.6% of others). More than half of respondents (56.8% of obstetricians and gynecologists, 60% of plastic surgeons, and 55.6% of others) agreed that all women should undergo consultation before FGCS. Conclusion Healthcare providers demonstrated diverse levels of knowledge and confidence in FGCS, which is influenced by specialty and training. Attitudes towards performing procedures solely for aesthetic purposes, including for those under 18, were generally positive, although pre-procedure counseling was also emphasized. While ethical considerations were widely acknowledged, a targeted training program is needed to address gaps in risk awareness and improve providers’ confidence.背景 女性生殖器整形手术（Female Genital Cosmetic Surgery, FGCS）在过去数十年间愈发流行。该类手术包含外科与非外科干预手段，旨在改变生殖器外观，且常无明确医学指征。由于诸多女性对正常生殖器解剖结构不甚了解，医疗服务提供者在引导患者过程中发挥着关键作用。因此，评估医疗从业者的态度与认知水平，以识别培训及伦理层面的现存不足，具备重要研究价值。 材料与方法 本横断面研究于2023年1月17日至2024年8月期间，在伊朗的320名医疗服务提供者中开展。参与者涵盖妇产科医师、整形外科医师、助产士、妇产科住院医师、泌尿科医师以及全科医生。研究采用经过验证的网络问卷收集数据，内容涉及参与者的人口统计学特征、临床经验、对FGCS的认知、风险认知、伦理考量以及对FGCS的态度。本研究采用SPSS 27版本进行统计分析。 结果 大部分参与者（57.6%）为妇产科医师。多数受访者表示曾接诊寻求FGCS的患者，其中以身体形象不满（65.4%）与伴侣要求（62.2%）为主要就诊原因。短期风险认知在不同专科间存在显著差异（p < 0.001），妇产科医师的认知程度最高。整形外科医师对FGCS操作的信心最强，而妇产科医师则更重视相关伦理考量。尽管所有组别中的多数参与者（妇产科医师68.6%、整形外科医师90.0%及其他群体75.2%）表示接受过正规培训，但长期风险认知与操作信心的不足依然存在。仅少数受访者认可仅出于美学目的开展FGCS（妇产科医师占8.6%，其他群体占1.6%）。超过一半的受访者（妇产科医师56.8%、整形外科医师60%及其他群体55.6%）认为，所有女性在接受FGCS前都应进行术前咨询。 结论 医疗服务提供者对FGCS的认知与操作信心存在显著差异，且受专科类型与培训情况的影响。尽管研究强调术前咨询的必要性，但针对仅出于美学目的（包括18岁以下人群）开展FGCS的态度整体偏向积极。虽然伦理考量已得到广泛认可，但仍需制定针对性培训计划，以弥补风险认知方面的不足，并提升从业者的操作信心。