[1][4]: 143  The photographs by Corinne and Perry had been taken years before the book's original publication in 1993; those by Posener and Rosen were taken specifically for inclusion in the first edition of Femalia.

[5]: 222 [10]: 36 [12]: 25  By contrast, portrayals of the vulva in pornography and in biomedical science are characterized as stylized and uniform, excluding women whose genitalia do not match their models.

[8]: 13 [13][14]: 69 Librarian Sanford Berman has cited Femalia as an example to illustrate his thesis that libraries engage in inappropriate self-censorship, often motivated by concerns about controversial sexual content, in deciding which books to stock.

[19]: 9  Simonis has further referenced this educational use of Femalia in slide and poster presentations intended to promote better management of the demand for FGCS on the part of healthcare professionals.

[3]: 431 Plemons documents the use of Femalia as a resource to demonstrate the existence of female genital diversity, and to educate both clinicians and patients as to the range of normal vulval appearance.

[3][22] Beginning in the year 2000, surgeon Neal Wilson began showing photographs from Femalia to his prospective patients and asking them to indicate which vulvas they found most aesthetically pleasing, as well as which ones they would choose for themselves.

Wilson attempted to approximate through surgery the appearance of the photographs from Femalia selected by his prospective patients, even though he held that they set "impossible standards" because of the limitations of early 21st-century surgical technique.