Tags: books, communication, disability, media, sex education, TMI
I recently picked up and finished reading the sexual guidebook, The Adventurous Couple’s Guide to Strap-On Sex, by author & blogger Violet Blue. It’s exactly what it sounds like – an in-depth guide to integrating strap-on sex toys and techniques into partnered sex.
Why are we reviewing a book about pegging on a blog about sexual dysfunction? For much the same reason cited last time we read a book by Violet Blue: Personal reasons + it was in the book queue. Besides, I’ve said it before and I’ll say it again: Sometimes when you have sexual dysfunction, you gotta get real creative, real quick.
The short version of the review is…
Well… I liked the Ultimate Guide to Fellatio better…
The Adventurous Couple’s Guide to Strap-On Sex – let’s call it TACG from here on out – the book is short. I was able to burn through the book start to finish within just a few hours. The Kindle edition I read has 1568 locations (sentences, I think,) which translates to about 160 pages in paperback format. There aren’t any pictures in the Kindle version – there’s not even one of those cut-away academic diagrams of male pelvic anatomy. All of the descriptions of anatomy and how-to are written out in paragraph form.
TACG‘s target audience is cis, heterosexual couples interested in pegging – and pegging, by definition, takes place between cis, het partners. But strap-ons are used in LGBTIQA communities too – so to me, it was weird to see so little coverage of strap-on use outside of straight sex. There was a lot of reassuring the reader that an interest in pegging does not necessarily mean you or your partner is gay. Definitely a book aimed at cis, het couples primarily.
The book includes just about everything you will need to know about strap-on sex and maybe some stuff you hadn’t thought about – anatomy, history, myth debunking, what gear to look for, how to go warm your partner up and then go through with pegging, and safe sex. Actually, I would have preferred to see the section on making strap-on sex safer close to the beginning of the book, instead of at the very end, but there is precedent for saving the best for last – Sex Toys 101 did it that way too. Remember that anal penetration is a risky sex act in terms of passing along infectious agents between partners, because the tissue is delicate, and there’s a lot of bacteria behind the anus. Blue includes a table detailing your risk of infection from anal sex, pegging and related activities and describes tools like condoms & dental dams you can use to reduce the risks.
Remember also that if you’re inserting objects anally, they really need to be designed specifically for that. If you just grab whatever’s handy, you or your partner could wind up with a toy lost inside the body and/or a serious injury – either scenario requires a trip to the emergency room. Blue addresses what kind of butt-friendly toys to look for. Shape, size, and materials all matter, so shop smart. Don’t forget the lubricant, since the anus can’t produce its own secretions the way a vagina can.
Where TACG really shines is when Blue talks about the importance of communication. Pegging isn’t something you can just spring on your partner, and a desire to engage in it isn’t something you can just pantomime out using secret code gestures (no matter what Cosmopolitan tells you.) If you’ve been slacking off in the sexual communication department, Blue lists a few suggestions for how to bring strap-on sex up in conversation – most of these suggestions can easily be applied to other various sex acts as well. Blue also reminds the reader to think about their partner’s perspective, since talking about sex can be (but doesn’t have to be) nerve-wracking. Blue suggets a few areas for exploration if one partner or another is reluctant – what are you the most uncomfortable with, the potential for pain? Insecurity with flipping around gender norms? Cleanliness/messiness/poop? You don’t even know where to start or what else there is to do during? There’s ways to address these concerns.
I liked the section about the history of the terminology of strap-on sex and why you may have noticed a glimpse of pegging here and there in mainstream sex shops, films and discussions. I was also pleasantly surprised by the inclusion of a chapter on how to have strap-on sex with a third party. Opening up a relationship is a little too advanced for me but the book is clearly polyamory friendly. There’s a lot of coverage about various reasons couples might want to try strap-ons during sex in the first place – some reasons include (but are not limited to) the potential for prostate stimulation, aesthetics, and/or fantasy fulfillment.
TACG contains a little information about strap-on sex and disability. Author Blue suggests using a double-ended dildo if you have a wrist injury or mobility problems (location 1188,) and she suggests a vendor from which to procure a harness designed for cis men. (Specific item is here; NSFW; similar products may be available elsewhere.) Why would someone who already has a penis want a harness for a dildo when their equipment is already present? The idea is double penetration of a cis female partner, but in my mind I’m imagining something like it might actually come in handy for couples dealing with erectile dysfunction – especially since Blue states that an erection is not required to use a double harness. TACG describes other harnesses as well; there’s one kind that the wearer can strap onto their thigh or even their head.
A couple of considerations for folks with pelvic pain issues who might be interested in harnesses:
Blue writes that “If you worry about [your pubic bone] getting sore from thrusting, you can buy a specially made pad of thin foam to cushion your pubic bone” (location 1159,) though where exactly one might buy such a pad is not explicitly stated. If this type of pad has a specific name, I don’t know it.
One of the double-ended dildos described in TACG is the Feeldoe, a double-dildo with one bulbous end. It’s designed to have the bulbous end inserted vaginally, leaving the phallic part exposed, for your partner’s enjoyment. However I don’t know how accessible this toy is to folks with pelvic floor dysfunction and/or pain – It looks like something I would find uncomfortable, if not outright painful, to the point of impossible to use as intended. Supposedly it can be used with certain harnesses with some adjustments, but it’s designed to be inserted in the wearer’s vagina.
In general, I would recommend some of the other dildos from Tantus, because I own one I’ll vouch for, they’re silicone & many have a flared base suitable for a harness and anal stimulation – including a few smaller models and plugs.
If you’re a pelvic pain patient interested in a harness, I strongly recommend sticking to two-strap harnesses only. Or harnesses that are worn over some other body part, like the thigh. The problem is that single-strap pelvic harnesses have to be worn between your legs like a thong and thus cover up more of the vulvar area. Two-strap harnesses go around your thighs and butt instead, leaving more area exposed. The distinction between single and two-strap harnesses is described in further detail in TCAG.
Also, Blue doesn’t mention this part, but beware of harnesses with a pouch for a vibrator… Harnesses with a bullet vibrator are supposed to make the experience more pleasurable for the wearer, but depending on how the vibe rests against you, it might just feel like a foreign, hard something digging uncomfortably into your pelvis. It’s like something out of the Princess and the Pea. I personally find it more comfortable to use a vibrator separately either before or after wearing the harness.
If you’re worried about causing your partner pain, then remember that anal stimulation doesn’t have to – and if you’re doing it carefully, shouldn’t – hurt. You might be tempted to share your prescription lidocaine or OTC novelty numbing gel with your receptive partner but that’s actually a bad idea: numbing gels dull everything, which makes deriving pleasure more difficult… and if you can’t feel what’s going on, then you won’t know if you’re getting injured. The book will tell you how to adjust your techniques to minimize discomfort & maximize pleasure.
Remember also that you are by no means obligated to peg if you’re thinking about getting a harness. After talking with your partner, you may decide instead to just wear it around for awhile or to engage in some other non-penetrative activities with a dildo equipped, just for show.
Overall, The Adventurous Couple’s Guide to Strap-On Sex is an okay book. It will be most useful for straight folks – especially cis women – just starting to consider strap-on sex, who don’t know what’s involved. Likewise, it will be useful for straight men who want to be on the receiving end, but never tried it before.
TACG becomes less useful if you’ve already had exposure to strap-on sex, either through experience or though some of the free how-to guides available on sexuality websites. The trick is, if you’re thinking about trying strap-on sex, then chances are you’ve already looked at those free how-to guides before picking up the book.
I wouldn’t recommend TACG be your first book purchase by Violet Blue. My overall impression is that IMHO I think she put more effort into some of her other stuff. There’s nothing wrong with the book; It contains good factual information & encouragement! I just liked some of her other sex guides more. Franky I thought that some parts of the book were drawn out longer than necessary – I basically skimmed through the chapter about male anatomy because I’ve seen it all before… And I skimmed over the erotic vignettes. The short stories are fine; I have no problems with the writing, though they are several pages too long. They’re just not my taste. Obviously, YMMV!
In summation: the $10-$15 retail price investment will be best for newcomers, with less bang for buck the more experience & knowledge you already have about strap-on harnesses & how to use them. More experienced readers may find it useful as a reference from time to time.
Disclaimer: As with all products reviewed on Feminists with Female Sexual Dysfunction to date, I had to pay for this book out of pocket with my own money, and I don’t get any compensation for writing this review.
Tags: books, communication, disability, experts, media, oral sex, sex, sex education, sexual dysfunction, Sexuality
Case in point from the recent Shorties II post: Presenting a book review for the purposes of sex education + product evaluation. The book in question at this time is, The Ultimate Guide to Fellatio: How to go down on a man and give him mind-blowing pleasure, by Violet Blue. Now in case you’re wondering, “K, why is there a book review regarding fellatio on a blog about female sexual dysfunction?” The answer is, “I decided to read & review this book now, mostly for personal reasons. Also I need to clear away some stuff in the book backlog before I can justify making any new literature purchases.” I read the Kindle version, second edition, which tops out at about 2,400 locations or 256 pages. Here’s a Google Books preview to get you started if you want to look at it.
The Ultimate Guide to Fellatio covers a lot of ground. It’s not just a book of tips written just for people who perform oral sex; it’s for the recipient of oral sex as well. For both the giver and receiver, there’s a lot to think about – what to do, what’s happening to you and your partner, and ways to make sure both parties feel physically & mentally comfortable during the act.
The book provides a detailed anatomical explanation of the relevant body parts – mouth, tongue, throat, penis, testicles, and yes the anus, prostate and pubes. Body fluids are described in frank terms. Blue does present some bullet point lists of tips, but she also provides detailed, how-to instructions that wouldn’t have fit in a short list. She also addresses the cultural baggage and negative attitudes around fellatio – sexuality, especially men’s sexuality, tends to get oversimplified (“Insert tab A into slot B…”) and fellatio in particular is often associated with dominant & submissive gender roles. It doesn’t have to be that way. On the other hand, for some folks, D/S gender roles are a turn-on, and Blue acknowledges this flipside as well in the discussion of BDSM and fellatio towards the end of the book.
The Ultimate Guide to Fellatio is particularly helpful when it comes to safe sex. There’s a chapter talking about ways to make oral sex safe between partners (the pros and cons of various barrier methods are discussed at length,) and the safe sex chapter even includes charts detailing the probability of contracting STI’s from giving or receiving oral sex. One interesting feature about the charts was the inclusion of the probability of contracting vaginitis (a vaginal infection not necessarily caused by STI pathogens,) from giving or receiving fellatio – the risk, according to the chart is, “N/A,” (location 661) or not applicable. Still I thought that was neat to remember it at all. I guess a chart including the risk of contracting vaginitis would be more relevant in the related Ultimate Guide to Cunnilingus book. Which I should probably also read and review.
Throughout the book, Blue addresses erectile dysfunction and disabilities - not just limited to physical disabilities; she explicitly wrote a paragraph on Attention Deficit Disorder, for example. I appreciated the inclusion of these topics. Blue makes it clear that, even if you or your partner are dealing with erectile dysfunction, chances are that fellatio will probably still feel good. (If you’re not certain, ask – the book emphasizes over and over again that communication is important.) Interestingly, Blue points out that certain disabilities may make sexual stimulation painful, even when there’s a penis involved rather than a vulva – she focused on Multiple Sclerosis in particular as a potential cause of sexual pain. With disabilities, erection, orgasm and/or ejaculation may be impaired, but that does not necessarily mean that the penis is non-responsive and that the owner of it does not feel and react to sexual stimulation. For people with disabilities such as spinal cord injuries, she also mentions “Phantom orgasms,” something I’ve seen talked about elsewhere – orgasm isn’t just a body reaction; the body is a shortcut to the brain. There’s still some parts about disability we can push for improvement on though; for example she uses the term “ADD sufferers” (location 1445) which implies that ADD equates with suffering, and at one point she says “You should never consider a disabled man asexual” (location 1432,) by which she probably means that it isn’t fair to de-sexualize people with disabilities… but then again with this quote, you get the whole asexual erasure thing going on. So it’s probably better to not make assumptions about the sexual orientation of people in the first place.
The last part of the book covers resources for learning more about fellatio, and these resources often coincide with learning more about sexuality in general. For example, the contact information for sex-positive retailers is printed (some of it may be outdated at this point though, because the book was originally printed in the early 2000s – you may have to Google some information to confirm if its still current.) There are some suggestions for pornographic yet educational films and how to enjoy them.
For the most part, I felt the book was written with a cis-gender heterosexual audience in mind. The book does talk about how to give and receive fellatio when performed on a strap-on dildo and how the act of fellatio can be subverted into a means to bend gender roles, but for the most part, penis = man = cis man. Most of the illustrative vignettes sound like they were provided from the point of view of opposite-sex couples, although I did see some gay and lesbian content as well. Speaking of which, there are some illustrative sexual fantasies described between chapters – these erotic short stories did nothing for me, but I am certain that is a personal thing. Your mileage with the written sexual fantasies will vary.
One thing I did not like about the book at all was the drawings. The illustrations are just terrible: The line art is shaky and near the end there’s an illustration of a guy receiving oral sex on the beach and one of his eyes is all like 0.- and it just looks weird. Technically speaking, Amazon isn’t supposed to sell pornography, (enforcement is another issue,) so I think the drawings maybe had to be below optimal in order to get the book past the censors.
So who might be interested in pursuing the pages of The Ultimate Guide to Fellatio? Who would gain the most benefit from reading a how-to on how to give or receive “Mind-blowing pleasure?”
Well for starters I’m actually becoming skeptical & jaded when it comes to any guide that promises such a claim. I know that book sellers gotta be able to move stuff off the shelves, but there’s so much human variation that it’s too hard to guarantee that anything can create that kind of sexual pleasure.
This would be a very good book for people who have not yet had any experience with oral sex, or who have had only limited exposure to it, yet who nonetheless have an interest in being the recipient or provider of such an act in the future. Because it covers such a wide berth of content, from Anatomy to X-rated films, (I couldn’t think of anything that starts with a Z – unzipping pants, maybe?) the book will provide plenty of information with which to brace yourself. I would suggest reading the book start-to-finish if you’re on the newer side. If you do not yet have a partner but expect to find one later, Blue makes some suggestions for practicing fellatio in a solo setting. (You won’t get the body language feedback but you’ll be under no pressure while tweaking your own techniques.)
One potential problem newbies may have with the book though, is that since it’s so detailed, it can seem overwhelming at times. As I was reading through some of the how-to suggestions, I found myself asking at points, “How is anyone supposed to remember all this?!” So if it’s too much to take in all at once, you may have to go back and skim parts of the text again later.
It would be an okay book for people who have some experience with fellatio and expect to continue participating in it, but do not yet consider themselves to be experts. If you are such a reader, then you can probably skip around to whatever parts you’re most interested in.
So for these two kinds of audience members, the book is most worth it.
I think the book would be less useful (and thus less worthwhile) for people who already have a lot of experience with oral sex. So if you think of yourself as “Advanced” in fellatio, (even theoretically!) then The Ultimate Guide might not be worth it. At that point, chances are you’ve already seen & heard most of what Violet Blue talks about. It’s still worth something; because it’s so dedicated to its topic, there may still be a few things you can pick up here and there… However, I think you’ll eventually pick up on those few things that you didn’t know about, by reading sexuality & sex education blogs, for free. Just hang around a few favorite blogs long enough (try some of the ones listed on my blogroll) and you’re bound to see the same subjects pop up, eventually.
For example, since I have read a lot of related sexuality material elsewhere, I found myself anxious to speed through the stuff that I already knew. I felt obligated to read everything for the purposes of this review but there was a lot of stuff I could have just passed over without a look back.
The Ultimate Guide to Fellatio may or may not be of use to people who do not expect to give or receieve fellatio in the near future. This is because if you have decided that it’s an act with no appeal to you, then the book may still provide you with insight into what’s on the minds of folks who do engage in it and why such folks will often defend it. But if you’ve already made up your mind that fellatio is off the table, then chances are no book will be able to change your mind and in some cases it will just be a waste of time. It could be irrelevant to you in this case.
I am not sure if this would be a good bet for sexual abuse survivors, because there is only a very brief mention of fellatio and past abuse.
So if price is a factor, then I think the $10 for the e-book version or ~$15 for the printed copy is worth the investment if you are new-to-medium in fellatio. If you feel that you’re advanced, then I think the $10 for an electronic copy is cost-effecient only if you are already heavily interested in sexuality books. Otherwise, if you know what you’re doing, then save your money and read some blogs instead. And if you know that fellatio isn’t going to happen then whether you would benefit from the book depends on your political or philosophical inclinations.
Tags: academia, experts, kink, media, news, psychology, sex education, sexology, Sexuality
A recent controversy in sex education involves one Prof. John Micheal Bailey, from Northwestern University. Professor Bailey teaches a Human Sexuality class to some 600 college students. He is a controversial figure, as described on the wiki page linked to – previous work includes his theories about homosexuality (he believes it is largely an inherited orientation,) and a book about transsexuality, which has been heavily criticized by trans activists for racism & transphobia (Plus Bailey engaged in unethical conduct while making the book.)
Bailey’s sexuality class includes optional events with guest speakers who talk frankly about sex & sexuality. The controversial event in question was titled, “Networking for Kinky People,” and the guest speaker was Ken Melvoin-Berg, associated with the Weird Chicago Tours group. Melvoin-Berg brought his partner and a kinky, engaged, exhibitionist couple with him to the event. (The couple has been named by some sources while others are keeping them anonymous; I’ll stick to the anonymity route here since outed kinky folk face safety risks.)
According to this Salon.com article, during the day’s lecture, Bailey presented a lesson on the G-spot. The Chicago Tribune says that the lecture included an educational video about the G-spot. Melvoin-Berg, his partner & the kinky couple arrived early, so they happened to be there for Bailey’s lecture and video. Melvoin-Berg’s group members were all unimpressed. So just before their speaking part was about to begin (after the lecture was officially over,) Melvoin-Berg asked Bailey for permission to demonstrate to the class what a g-spot orgasm looks like, in person, with a fucksaw. (Exactly what it sounds like: This is basically a modified power-tool with a dildo on the working end.) Bailey hesitated but decided that the demonstration would fall within the bounds of the scheduled speaking event, since such a demonstration is undeniably kinky.
So that’s what happened. The couple Melvoin-Berg brought with him, did exactly that – after giving an hour & half speaking lecture with a Q&A session first, according to Rabbit Write (the same Rabbit Write who organized Lady Porn Week.) When Melvoin-Berg’s crew finished the speaking portion of their presentation, the boyfriend used the fucksaw on his girlfriend and she had several g-spot orgasms in front of about 100 or so present students.
After that, the student newspaper reported on the event. From there, a lot of mainstream news sites picked up on the story. Reports about sex are easily sensationalized & they sell well or generate page views, whatever. So now there’s a lot of backlash & controversy going around now.
I can’t decide whether I’m in favor of this event or not. At first I was all for it – I thought, “That sounds useful,” and I understand that sometimes, written instructions, diagrams and educational videos fall short because they do not provide experience. I needed help learning how to find and then use my own pelvic floor muscles. Although I had anatomy diagrams and written instructions on how to dilate, I eventually hit a wall with my at-home dilator kit and needed to get physical therapy to progress with treating my vaginismus. (It was an incredibly clinical, non-sexual and useful experience – not really all that much different from rehabilitating any other muscle group, except for all the cultural baggage and weight assigned to people’s genitals.) But that was something I initiated, and since it took place behind closed doors, there was no risk of making anybody else know what was going on.
But then the more I read about Professor Bailey and the Northwestern University event, the more I started to change my mind & think to myself, “Hmmm… maybe this wasn’t such a good idea…”
Even Bailey himself has issued a formal apology, of sorts, for drawing such negative media attention to NU. If he could do it over again, he wouldn’t.
However, demonstrations like this have taken place before – just not on campus. Let’s all turn to Page 13 of Sex Toys 101: A Playfully Uninhibited Guide by Rachel Venning and Claire Cavanah. Some of the relevant parts are available on pages 13 & 14 from Google Books. Unfortunately not everything got scanned in – it looks like all the pictures are missing, and page 14′s relevant text is blocked out (It should be on the left side of the page.)
To summarize the relevant passages, the book says that a couple of years ago, sex educators affiliated with Babeland (then still known as Toys in Babeland,) took their G-spot program to a “Carnival-style book release party of a friend of Babeland…” (The next page says this event took place at a bar.) The sex educators set up a tent and one of them called out to passers-by, asking patrons to go in. People who went into the tent (up to 10 at a time) received a lesson in human female anatomy, complete with some suggestions for ways to find the g-spot. But the lesson didn’t end there, “Once they were inside, we gave them more than just a lecture.”
One of the sex educators took safe sex precautions (a glove and lubricant in this case,) and said, “Okay, who wants to experience it [a g-spot orgasm]?” So one lady and her boyfriend stepped up and the lady sat down in the hot seat. The description on page 14 says that this volunteer took off her underwear & used a vibrator on herself, so onlookers would have her masturbating. Then the sex educator with the lubricated glove on inserted two fingers into the volunteer’s vagina & found the g-spot. It’s not clear from the text on this page whether the volunteer had an orgasm on site. The text makes it sound like this scene was repeated throughout the evening.
So one reason I don’t fully understand exactly what the problem with the February 2011 demonstration is that there’s precedent for g-spot demonstrations just like the one at Northwestern University. This already happens. The show-and-tell described in the Sex Toys 101 book didn’t use a video, puppet or a piece of fruit as a stand-in.
On the other hand, this article from GoodVibes says that events which GV hosts do use stand-ins or clothed volunteers. So okay, sex educators can go either way when it comes to live demonstrations.
At first I thought the reason the school program caused so much controversy is that it must have been paid for with school funds, because that’s what was going on when feminist pornographer Tristan Taomino was initially un-invited from speaking at Oregon University. The student newspaper says that NU has events sponsored by Weinberg College of Arts and Sciences, and this Chicago Tribune article says that NU provides funding to Bailey & his speakers (including Melvoin-Berg but not the kinky couple) via this organization. But according to this statement from Bailey, he arranges the class events at “Considerable investment of my time, for which I receive no compensation from Northwestern University,” which makes it sound like he pays for the class’s extra-curricular speaking events out of his own pocket. So now I can’t follow the money trail because there’s like 3 different things going on there. (Maybe the school doesn’t pay him for the time it takes to arrange speakers but it does cover their fees? Like, no overtime pay for whatever networking is required to set everything up?)
So far what I’ve read about the event says that, participants who stayed for the demonstration aren’t the ones who are upset about it – as of 3/6/11, Bailey says that all the feedback received from attending students was positive. It is people who were not present for the show and found out about it afterwards that are registering complaints. They’re upset that it took place at all. I’m seeing similar complaints in comment sections of articles summarizing the event, and the negative comments usually contain some variation of “Immoral,” “distasteful,” “exploitative,” or “sick.” Something to that effect, which focuses on the content of the demonstration. Since kink is widely misunderstood & berated, I’m thinking that such comments would inevitably be made of such a demonstration or sex act regardless of the setting.
Every once in awhile a commenter will bring up the viewers’ ability to fully consent, which I think is a stronger argument against the demonstration, since it was spur-of-the-moment. An event like this should have required time to plan it out and better distribute information about the content. There wasn’t time to include this on the syllabus, basically (though being an optional event, it wouldn’t have been required either.) But even then, the articles say that Bailey & Melovin-Berg took steps with the limited time they had to make sure that the students understood what the content of the demonstration was going to have & that they had the option to leave without penalty, which some students did exercise. Yet, one student Bailey’s class explicitly told the media, “Then, just out of nowhere, the girl just takes her pants off, takes her shirt off, takes her underwear off.” That the student used the phrase “Just out of nowhere” suggests to me that adequate preparation for the students was nonetheless lacking. It should have come from somewhere. This student, though, also acknowledges that students were given adequate opportunity to leave.
So with regards to what the real problem is with this NU event, I keep getting different answers – including the “Nothing wrong” answer. I can’t pinpoint it down. But having done just a cursory background check on Bailey himself, even I am now resistant against throwing all my support behind him too. Will NU administrators be more translucent with their investigative findings now than they were when claims of impropriety were previously leveled against Bailey?
P.S. Good god almighty can I just express my own frustration with this entry – this was hard to research; every source I checked had different pieces & I couldn’t get a comprehensive tell-all! And then before I knew it I had 1600 words and okay fine, up it goes.
Tags: blogging, lady porn day, media, pornography, sex, sex education, Sexuality, TMI
I’ve gone from having writer’s block to not being able to stop writing. Whereas today’s earlier Lady Porn Day post presented an overview of experts in conflict over pornography’s place in sexuality, this one will be more in keeping with the theme of LPD: To talk about my own experiences with porn. While this post probably squeaks by as SFW, it’s still TMI ahead, it goes behind a WordPress cut. Everything should still appear in your RSS feeder if you’ve subscribed though.
Tags: disability, female sexual dysfunction, Feminism, FSD, guest post, health, intersectionality, media, medicine, pain, sex, sex education, sexual health, vulvar vestibulitis, vulvas, vulvodynia, women of color
This was cross-posted to Womanist Musings.
For the purposes of this post today, I will be focusing on vulvodynia; however keep in mind that there are other causes of chronic pelvic and sexual pain; likewise there are serious sexual problems besides pain which also deserve attention.
Vulvodynia is a syndrome, a collection of symptoms, centered around chronic vulvar pain, lasting longer than 3 to 6 months. Pain (commonly described as burning, stinging, stabbing, rawness and/or irritation,) may occur in the vulvar vestibule, mons, urethral opening, labia, clitoris, or elsewhere in the vulvar area. Not all instances of vulvar pain are vulvodynia, and for some women vulvar pain may resolve on its own.
Vulvodynia does not have one universal cause; some possible causes include injury, sensitivity to vulvar microorganisms (like yeast,) hormonal changes, muscular problems, etc., though for some folks the cause will remain unknown. For some women, vulvar pain is caused by pudendal neuralgia or pudendal nerve entrapment. Everyone is different, so some women experience pain all the time without provocation while others experience pain only when attempting to insert something vaginally. Likewise, for some women, it is still possible to enjoy sexual activity even with vulvodynia, while for others sex will become too painful to engage in. There are a number of treatments available for vulvodynia, but no single cure, so women with vulvar pain may have to burn through multiple doctors and treatments before finding the right one.
Who develops vulvar pain? I have seen several sources which present similar estimates as to how many women experience vulvar pain at some point during their life – at least, in the United States. According to one 1991 study, about 15% of 210 patients attending a gynecology clinic met the criteria for a diagnosis of vulvar vestibulitis. According to a 2002 release from the National Institutes of Health, about 16% of over 3,000 survey respondents reported chronic vulvar pain. (More on this figure in a bit.) The raw numbers seem to vary more; this same NIH release estimates that up to 14 million US women will experience vulvodynia at some point during their lives, whereas media coverage such as the Dr. Oz show estimate that there’s about 6 million US women currently living with vulvodynia. One thing all these studies agree on is that chronic vulvar pain, while not experienced by a majority of women, certainly isn’t rare either.
However, for a long time, I thought that women of color developed vulvar pain like vulvodynia less frequently than white women. I believed this, because I saw such statements in books, I saw it in studies, I saw it in the media and I went along with it. I realize now that I was completely and totally wrong. Vulvar and sexual pain does NOT just effect white women and in fact the rates of pelvic pain in white and nonwhite women is similar. But how many people still don’t know about vulvar pain in women of color? How many doctors and gynecologists are, like I was, under the impression that their nonwhite patients rarely experience nameable vulvar pain conditions which have treatment options available?
Here’s why I was wrong and why you too should care about women of color and chronic pelvic pain:
One of the first resources I picked up when I started looking for treatments was Dr. Howard Glazer’s The Vulvodynia Survival Guide, which is all about vulvodynia. Here’s what Glazer’s book said about vulvar pain and women of color…
“For unknown reasons, African-American women as a group are the least likely to report vulvar dysesthesia, or any other type of vulvodynia” (Glazer, 19). And “Again, Caucasian women have vestibultis [a specific, localized type of vulvar pain -K] more than any other racial group (Marinoff and Turner, 1992).” (Glazer, 23).
It goes on. In the late 1990s, early 2000s, Glazer organized a survey of women with vulvodynia though his website, vulvodynia.com, and in his book he reported that 90% of the survey respondents were Caucasian; “Less than 1 percent were of African origin” (33.) Additionally, it’s worth noting here that according to this same survey, participants’ “Socioeconomic status was higher than average; 62% reported incomes greater than $50,000″ (33,) and the majority also held “professional, managerial occupations,” and “59% had completed college” (33.) Glazer cautions, “The higher levels of socioeconomic, education, and occupation status is consistent with previous studies. Why? Unfortunately, it’s probably because educated women with access to money for medical care are the most likely to pursue the best, most sophisticated medical treatments (or at least to use the Internet” (33.)
But who is also the most likely group to be in the higher socioeconomic class and have a high level of education, and be in a better financial position to use technology and seek medical care? White people, in the US. Because of this, the design of Glazer’s study itself most likely skewed the results to exclude women of color. However, he went on to state,
Caucasian women reported more vulvar pain than any other ethnic group. African-American wome rarely report these conditions. Researchers aren’t sure why this is true, though it has been commonly observed by many of our colleagues in the International Society for the Study of Vulvovaginal Disease, who practice and teach in various medical settings where women of various races and incomes are seen. Other dark-skinned ethnic groups, such as Indians, do report chronic vulvar pain syndromes (33).
Hmmm, Glazer sure spent a lot of time driving home his point that black women don’t report vulvar pain frequently and that white women do.
But wait, there’s more. The results of an oft-cited but highly controversial, hotly contested study of sexual dysfunction in the US, Sexual Dysfunction in the United States, also stated that black and hispanic women were less likely to report dyspareunia,
The association between race and ethnicity and sexual problems is more variable. Black women tend to have higher rates of low sexual desire and experience less pleasure compared with white women, who are more likely to have sexual pain than black women. Hispanic women, in contrast, consistently report lower rates of sexual problems. (Laumann et al, online).
Additionally, media coverage of vulvar pain frequently reinforces the idea that it’s mostly white women who experience vulvar pain. Stock photos and illustrations that accompany books and articles about vulvar and sexual pain overwhelmingly feature white women. (See for examples, here, here and here – I could easily go on!) The erasure of women of color with pelvic pain and dyspareunia happens on television too, with a few exceptions; for example in 2008 the television show Oprah explicitly reached out to women of color in an e-mail requesting participants willing to talk about vulvar pain. Alas, to this day, although filming has been completed, that episode has not aired on tv. Another exception took place in 2010 on the Dr. Oz program, which ran a segment on vulvodynia. The original 8-minute segment included a guest woman of color who briefly commented on life with the pain condition (unfortunately the second half of this segment has been excised from the online video.)
However, the prevalence of vulvar pain among women of color may have been understated. The study which the NIH release above references is, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? The abstract contains this critical line: “Contrary to earlier clinical assessments, white and African American women reported similar lifetime prevalences. However, Hispanic women were 80% more likely to experience chronic vulvar pain than were white and African American women” (Harlow and Stewart). Harlow & Stewart’s survey is no fluke; the WebMD article Vulvar Pain isn’t so Rare refers to a University of Michigan study published in the 2004 Journal of Lower Genital Tract Disease, “Although previous reports show the condition is rare among black women, the responses indicated that this is not the case. Black women had similar rates of vulvar pain as women of other races.” (Reed, online).
And as for Dr. Glazer’s claim that women of African descent rarely report pain outside of US settings? Even that has been challenged! In 2005, a study in the Journal of Reproductive Medicine revealed that 22.8% of women attending a general medical clinic in Ghana reported vulvar pain, which was linked to sexual dissatisfaction.
I am certain that effect of emphasizing white women’s reported rates of vulvar pain over that of women of color is silencing to this day. So what’s being done to address this revision in what caregivers should know about vulvodynia? The NVA’s fact sheet on vulvodynia now reflects that nonwhite women are just as likely as white women to develop vulvodynia. The language explicitly shows a change of perspective, from vulvodynia being thought of as primarily a Caucasian women’s issue to much broader. An NVA newsletter, Faces of Vulvodynia, included identifiable women of color like Karen, Yamalis, Amanda, Michele and Emily, who are willing to be interviewed by the media.
Unfortunately vulvodynia remains difficult to diagnose and it doesn’t help that some doctors remain ignorant of its very existence. Even doctors who do know about vulvar pain conditions may not be up do date with all the research. And doctors who are well-trained to address chronic pelvic and genital pain may be too far out of reach for many patients, both in terms of money and geographical distance. Genital and sexual pain received some media attention in 2010 but it still remains very much a taboo subject, and it is the butt of crude jokes surprisingly often. Society, guided by the long tendrils of patriarchy, pushes women to learn how to please men sexually, and so there is also pressure to perform sexual activity – even if it hurts. It shouldn’t have to be that way. And the quality of sex education is highly variable – I recall my own sex education lacked any mention of pain other than what happens when the hymen is broken.
If you or someone you love is experiencing chronic vulvar and/or sexual pain, some resources available online include the NVA in the US or the ISSVD internationally. A short list of some available treatments is available from the Mayo Clinic’s site.
Tags: blogging, health, interstitial cystitis, media, news, pain, sex, sexual health, television, vaginismus, vulvar vestibulitis, vulvodynia
Last night, December 6, 2010, at 10pm EST, MTV aired the season premiere of the television show, True Life. The episode was titled, “I Can’t Have Sex.” To produce this program, the show crew followed three women around over the course of several months and presented the impact of chronic pelvic pain conditions on their sex lives.
I watched the episode on television and I took notes. There’s a lot of things going on with and around this episode!
First, in case you missed it, MTV.com has the full episode available for viewing, now! This is what you’re looking for! I do not know if it will remain online indefinitely or if it will be removed in the future, but if you missed the episode here is a chance to catch up to it. It’s 42 minutes long. No subtitles available on the online version. Here is a brief summary with a link to the video. MTV has posted this follow up feature: True Life Check-ins. The follow-up article contains links to helpful resources.
Full disclosure: I sort of “Know” two of the women who were featured in this episode, because Tamra and Tali both maintain blogs. I do not know if Tess maintains a blog. Tamra’s blog is Living with Vulvar Vestibulitis. Tali’s blog is The Rambling’s of an IC Patient. I have not met anyone in person (that I know of) who was involved in filming this episode. But still, I feel a little weird posting about the episode at all, since I can apply a name, a face and a blog archive to two of the women who were on TV. It’s also weird because I have some of the conditions which were examined on the show.
Here is some of my notes taken during this episode, fleshed out a bit:
This is the first episode of MTV True Life that I have ever seen, so I went in not knowing what to expect. I rarely watch MTV and I tried to ignore the commercials that aired between segments. I was anxious about how the show would be edited and whether there would be any commentary provided by a third party. I’m still anxious about how the episode was received by a general audience. The sound to my TV was cutting out for a second at a time here & there so I was having a hard time hearing at some points.
The episode features three 20-something year old white women over the course of several months – Tess (self-diagnosed with vaginismus,) Tali (the episode focused on pelvic floor dysfunction but she has overlapping conditions which were not all given screen time,) and Tamra (diagnosed with vulvar vestibulitis and, later, orthopedic issues.) Chronic pelvic pain is an invisible condition. You would probably never guess from a first impression that these three women were dealing with chronic health problems unless they chose to disclose such information to you. Tamra, Tess and Tali are currently in, have previously been involved in, or are interested in heterosexual relationships. They are all unmarried and do not have children. We saw Tess and Tali’s boyfriends (at the time of filming) on this episode and MTV followed Tamra around on a date and to a social event. All three live in the USA. Except for the introduction to the episode, there was no narrator. That means that everything you heard, was spoken by the women or those close to them. Of course I’m sure MTV did some creative cutting and editing of the material collected. Filming wrapped up awhile ago, so there have been updates and changes in the womens’s lives in the interim between filming and the airdate.
Actual, proper terminology was used throughout the show. Chronic pelvic pain conditions were named, but some conditions that overlap were not mentioned at all (interstitial cystitis, for example, was not explored in this episode. This is a shame – interstitial cystitis is another misunderstood condition which would benefit from careful media coverage.) This episode focused on the impact of chronic pelvic pain on the women’s sex lives. And that means that while you could learn a little about life with chronic pelvic pain from this episode, for a clinical discussion and details on specific conditions and available treatments, you’ll need to look elsewhere.
We see some of the treatments that Tess, Tali and Tamra tried. A dilator kit on television, a TENS unit, a visit to a sex toy shop (Babeland) to pick out a comfortable lubricant. Psychological therapy, and pelvic floor and intra-vaginal physical therapy. (Several scenes where Tali received physical therapy with Isa Herrera looked familiar to me and Herrera talked about muscle tightness which was and remains a problem for me. It was just weird seeing someone else in the same position I had to spend so much time in.) Injections of anesthetic to the pelvic area and oral painkillers. Ice packs as needed. But I didn’t see anything about diet modification or alternative therapies like acupuncture.
Although sex and sexuality were the focus of this episode, MTV did show how chronic pain and anxiety can bleed out into other, non-sexual areas of life. Sometimes, like in Tamra’s case, pelvic and vulvovaginal pain is not limited to sexual activity. This was downplayed compared to the sexual aspects of pelvic pain, however. Because this is a blog about sexual dysfunction, I was okay with the sexual aspects of life with chronic pain for the episode – especially since I’ve been on this kick lately where I want to hear women talk about their own experiences with sexual problems. But keep in mind that if you do have chronic pelvic pain, there may be a lot of issues going on at the same time besides sexual problems. Or it may all be connected.
For example, there was one point in the episode where Tamra was speaking with a therapist. It was an emotional scene. But I thought that the therapist was misinterpreting Tamra’s concerns. Maybe it was just the way the editing was put together but during this scene, I thought that Tamra’s concerns included sex, yes… but they also went beyond relationships and sexual pleasure. However that that is what the therapist seemed more interested in. In this scene, I thought the therapist’s priorities did not match Tamra’s.
Tess was in a 5-month relationship with her boyfriend at the time filming began. She had not been able to have intercourse with him and was upfront with him. She picked out a dilator kit that came with an educational booklet and talked to a therapist to help address her anxiety.
Tali experienced the onset of her symptoms at age 17 and has seen 24 doctors. She was in a relationship with a young black man, Boom, at the time of filming (they have since broken up.) Remember, Tali’s blog is titled, “The Rambling’s of an IC patient” – yet this episode did not talk about IC at all.
Tamra was a student and the episode featured her giving a speech about vulvar vestibulitis in front of a whole bunch of people, as part of a women’s & gender studies class. Hmmm. Tamra had been in a sexually active relationship before developing what would be diagnosed as vulvar vestibulitis (her condition has since been re-examined.) She talked openly about how pain was making it hard for her to date and enter relationships – and pain made hard to enjoy other activities, like dance.
Viewers saw some of the relationship tension that Tali and Tess had, at least as far as their sexual problems went. If there were other problems in their relationships beyond sexual problems and anxiety, that was downplayed for this episode. Tess mentioned to her therapist though, that a previous boyfriend had said abusive comments to her. I thought it was interesting how Tess and her therapist involved Tess’s partner, Antonio, in her treatment for anxiety. Tali’s physical therapist also demonstrated some therapeutic techniques to Boom. (I wish I had had this opportunity to do the same with my partner; however we were in a LDR at the time of my physical therapy.)
Tess and Tali showe improvement with their favored treatments. For Tess and Tali the episode ended on an optimistic note. By the end of the episode, the two couples, Tess and her boyfriend, and Tali and Boom, were having sexual intercourse following the therapies they chose. But for Tamra, she was still dealing with a lot of pain in the end, and with a new diagnosis and the possibility of surgery. She had a labral hip tear and this may account for a lot of her pain. (She has been writing about this on her blog for some time now.)
Overall, I liked the episode. I thought it was good and I am shocked with the amount of time that these topics received. A whole hour-long television show, which works out to over 40 minutes?! Here I was scrabbling around for 2 to 7 minute clips! But there’s always room for improvement. This episode could have given much more airtime to Tali’s related conditions. Any airtime, really, for IC and lichens sclerosus. Just name them, even. In the future, a television program or other media outlet could do a whole episode or article about life with chronic pelvic pain and focus on areas besides sexual activity, because there is so much to life with pelvic pain. But there is that sexual aspect too… Was sexual pain sensationalized in this episode? Hmm… No, I don’t think so, I thought it was pretty frank. It was focused on sex, yes, but realistic to me. The editors certainly took the show in a certain direction. But it definitely wasn’t sensationalized like a recent segment on vulvodynia that aired on a local news channel. And pelvic and vulvovaginal pain was not treated like a huge joke (although Tess and her friends did laugh nervously when discussing vaginsimus.) There was no narrator for this episode and it did not feature an interview with say, a gynecologist, so no one was able to go into great detail about what causes pelvic pain and what treatments there are.
Future programs like this could also take steps to be less hetero-centric, and could actively reach out to more nonwhite women. (For example, years ago producers of the television show Oprah reached out to women of color for an episode about pelvic pain – an episode which has never aired.) And I’m surprised that the episode didn’t list some resources or URLs to information about chronic pelvic pain during the follow up with each of the interviewees. Resources such as the National Vulvodynia Association, The Interstitial Cystitis Association, and The Interstitial Cystitis Network.
So so far, in 2010, there have been a few depictions of vulvovaginal, sexual and pelvic pain, and each of these depictions have been different. There have been strengths and weaknesses with almost all of them. And I’d like to see more topics like this covered going into 2011 and beyond.
Tags: female sexual dysfunction, FSD, health, interstitial cystitis, media, news, pain, sex, sexual health, television, vulvodynia
Reminder: Tonight, December 6, 2010, MTV’s True Life series will air the episode titled, I Can’t Have Sex. This episode is meant to address chronic pelvic pain conditions, such as vulvodynia and interstitial cystitis. This will also mark the season premiere of the show. As you can see from the title, it’s expected that the episode will look at how these painful conditions impact patients’ sexuality.
Check your local listings for exact details. I expect it to air at 10pm EST.
TV listings to check for what time it airs: MTV’s schedule
Zap2It.com (TV listing website) (type in your zip code to select the service you’re using)
Don’t know yet if MTV.com or Hulu will be simultaneously streaming the episode online. I’m hoping it’s available online in full after the television premiere because I don’t have my VCR here to record & rewind the episode when I take notes tonight.
If you will be in the Manhattan area, consider stopping by The Back Fence for a premiere party and fundraiser. Funds raised at the party will benefit pelvic pain organizations including The National Vulvodynia Association, The Interstitial Cystitis Association, and The Interstitial Cystitis Network.
MTV, we’re counting on you to do this right. Crossing my fingers…
Tags: books, female sexual dysfunction, FSD, health, language, media, medicine, pain, relationships, sex, sexual dysfunction, sexual health, Sexuality, vaginas, vulvar vestibulitis, vulvas, vulvodynia
[Trigger warning for rape]
The Camera My Mother Gave Me is both one of the easiest and hardest books I have ever read.
Years ago, shortly before I received a tentative diagnosis of vulvodynia by my main gynecologist, I started looking for support and information about what causes vulvar pain. The Camera My Mother Gave Me is one of the earliest books I read about the topic. At the time, it was one of a very few books available that talked about vulvodynia with any amount of detail. Most of my other sources were scientific & peer reviewed medical journal articles or anecdotes from the internet. What sets The Camera My Mother Gave Me (henceforth I shall refer to it as TCMMGM) apart to this day is that unlike informational resources that talk about treatments, it is a memoir. It’s a first-hand personal recollection of author Susanna Kaysen’s life with vulvodynia over about two years.
Yes, you read that right, the author is Susanna Kaysen – this is the same author made famous for her previous memoir, Girl, Interrupted, which was made famous by Hollywood – though I understand the film distorted the facts in the name of artistic license. However, I have not read Girl, Interrupted and will not be talking about that today. Whether Kaysen’s experience with psychiatry in the 1960s has anything to do with her vulvodynia later in life, I cannot say.
So, TCMMGM is both an easy read and a hard read for me. How is this contradiction possible?
It’s easy because it’s short. It’s only about 150 pages with paragraphs double spaced. If you’re interested in reading it, it probably won’t take more than a few hours to finish; maybe a day or two tops. Kaysen uses everyday language instead of heavy academic jargon, so you don’t necessarily need to be a doctor or be familiar with vulvodynia in order to follow along.
But it’s hard because every time I read it, for all the progress I’ve made and improvements I’ve seen over the years, I am instantly transported right back to square one – that daunting, hopeless, barren place where the walls of pain obscure every available path. It’s hard because when I read it, I remember everything… the questions unanswered, the ignorant doctors, the uncertainty …the pain. I’m in my early 20s again and I don’t know what’s going to happen to me.
Another reason this book is so hard for me because no one understands this book unless they have vulvodynia. Perhaps I’m not giving folks enough credit. Perhaps that’s an exaggeration… but not by much. TCMMGM has received mixed reviews, many of them negative. The negative reviews usually contain some variation of gross-out due to TMI or frustration with Kaysen’s lack of progress in treating her pain medically. It’s TMI and gross because vaginas and vulvas are generally considered vulgar and gross – at least outside of feminist circles – sometimes even within feminist circles, because don’t talk about vaginas too much or else you reduce yourself to a big walking vagina – and thus it’s a shock to read such frank language and descriptions about the vagina. Frightening, too, to have to think about an area that’s supposed to be capable pleasure feeling instead only pain. If readers are frustrated with Kaysen’s lack of progress, that may be because Kaysen herself was frustrated and was deliberately trying to convey that feeling – trying treatments she felt comfortable with, avoiding the ones that she didn’t want but that were nonetheless pushed upon her over and over again. When she opened up about her vagina and all its problems, Kaysen also left herself open to invasive personal questions, “Why didn’t she do this, why didn’t she try that.” If the book feels unresolved at the end, that’s probably because vulvodynia is itself a chronic problem, often with no clear resolution. There are still loose ends by the time the book ends, because in Kaysen’s real life the struggle with vulvodynia was ongoing.
So what’s the book about?
The briefest answer is to say that it’s about Kaysen’s vagina. One day, mysteriously, “Something went wrong with it” (3.) Everything else follows over about a two-year period.
A more comprehensive answer is to say it’s about Kaysen’s experiences during a time when she had to re-evaluate her relationship and sexuality as she navigated the gauntlet of modern medicine in search of answers for her debilitating vulvovaginal pain.
Kaysen began experiencing vaginal pain that “Felt as if somebody had put a cheese grater in it and scraped” (3.) The reasons for this pain are never made 100% clear. We learn that Kaysen had a bartholin’s cyst surgically drained some 20 years earlier, and the pain felt intense at the surgical site – but the pain radiated to other areas of her vulva as well. She was approaching the age at which many women enter menopause (though I could not tell what her age was when the pain started.) Her gynecologist initially misdiagnosed Kaysen with a run-of-the-mill infection and prescribed some treatments that probably didn’t do any help. At some points, Kaysen explores the possibility of psychosomatic causes.
This pain interfered with her everyday activities like “Wearing pants” (8), “Taking a bath” and “Too much driving – it hates that” (146.) She maintains a pain diary, measured on a scale of 0-5, with her pain frequently hovering around a 2 and sometimes spiking above 5. She had good days and bad days.
The pain interfered with her sex life, to the point where her sex life and her relationship with her own body fundamentally changed. Very early on, Kaysen tells her gynecolgist,“Listen, I said, everything’s getting worse. I’m really having trouble with sex. My vagina hurts all the time now. If I have sex it hurts more, but it never doesn’t hurt” (9). Unfortunately an expanded definition of “Sex” did not adequately address Kaysen’s problems:
“I tried a lubricant named Astroglide that was more glue than glide. My boyfriend and I tried all sorts of varities of sexual activity: very quickly, so it wouldn’t have time to hurt; without moving, just in there; only fingers in there; nothing at all in there, only outside. Whatever we did, it hurt” (10).
She was not even able to enjoy arousal in and of itself, because “Just getting aroused hurts” (55).
When her pain first manifested, Kaysen visited multiple doctors specializing in different fields. She lived in Boston at the time, which is home to some real-life vulvovaginal specialists. She visited her gynecologist, an alternative medicine practitioner, an internist, a vulvovaginal specialist, and a physical therapist. Some of these doctors pass her off to other doctors – notably, when her primary gynecologist was stumped, Kaysen felt that he was “Washing his hands of me! After twenty years” (9). She was tentatively diagnosed with vulvar vestibulitis and tried multiple treatments – conventional western style and alternative – but none of them were right for her. Kaysen was acutely sensitive to side effects, and in some cases the side effects just made things worse. Even physical therapy, a treatment that I had very good luck with, only set her back farther. (Having a crummy physical therapist who ignored her wishes probably didn’t help.) Other treatments, notably surgery, she did not want to try, though the doctors and her boyfriend pushed and pushed.
The doctors left Kaysen with a lot of unanswered questions about vulvar pain…
With her gynecologist:
So what is it? I asked him.
I don’t know, he said
But what is it? I asked him. What’s wrong with me?
I don’t know, he said. (9).
With the internist:
But why does it hurt all the time? I asked. Why does it hurt when I’m not having sex? When I’m sitting on the sofa?
I don’t know, said Doctor Matthew (21).
With the vulvar specialist:
Why did this happen? I asked him.
Eh, he said. He shrugged.
What is it, anyhow?
Eh, he said. He returned to the stool and resumed his Q-tip (28).
What’s the matter with me?
You have a sore spot, he said (30).
WELL THANK YOU, CAPTAIN OBVIOUS!!! A sore spot! Of course! Why didn’t Kaysen think of that?! That explains everything!!!
It goes on like that in some fashion over the whole book. Just as it continues to go on day after day in real life for still all too many women.
[Trigger warning for rape]
Kaysen’s nameless boyfriend was not sympathetic to her situation or open minded about the kind of sex he wanted. For two years prior to the events described in TCMMGM, Kaysen and her boyfriend had enjoyed a sexual relationship. Her partner had a strong interest in sex - “It was one of the things I had loved most about him” (95), though they never say “I love you” to each other. But when sex hurt, Kaysen began to lose interest in sex. While they stayed together for the first year that she looked for treatment, the boyfriend nagged and coerced Kaysen to have sex with him – even if it meant she was performing against her will. Readers of this blog would probably recognize what Kaysen describes as rape. She didn’t say no, she acquiesced under pressure, but certainly she stopped giving any kind of enthusiastic consent. She spends days after sexual activity coping with the painful after effects. Kaysen herself never uses the word rape to describe what she went through with her boyfriend, even when it caused her to disassociate during the act and left her in physical pain for days afterward. When asked by a biofeedback specialist if she had ever been sexually assaulted, she answers “No,” but when the question is rephrased to “Have you ever had sexual relations against your will,” Kaysen says “Yes” (82). When she recounts the last straw to her friend, Kaysen questions herself, her boyfriend’s actions, her own fear at the time, and what actually happened.
Even after evicting her boyfriend, Kaysen continues to feel pain long-term. It wears her down over an extended period of time. “Low-grade pain is debilitating in a subtle way” (121.) Eventually she loses interest in sex, and this is a painful experience for her, but in a different way. When Kaysen talks about sex and eros, it’s clear to me that prior to these events, she really did enjoy sexuality in her life. For her, it was a source of unpredictability. At one point, after throwing her boyfriend out of the house and struggling to rediscover pleasure from what once felt only plain, she tells a friend, “When eros goes away, life gets dull. It’s as if I’m colorblind. The world is gray” (125.) She eventually decides that the best course of treatment is to stop treatment. Eventually she makes a limited, partial recovery… But by then her relationship with her vagina, vulva and her own sexuality are fundamentally changed. Maybe forever.
Kaysen’s language may be plain and easy to understand, but it’s not without criticism. She uses frequently the word “Vagina” even though a more accurate word is “vulva.” Or maybe it is accurate for her to describe her pain as vaginal, since with vulvodynia the pain can radiate and spread beyond the vulva. In practice, when the pain feels like it’s everywhere, it can be very hard to pinpoint. One social construction argument against female sexual dysfunction as a valid diagnosis is that women with sexual problems may not be educated enough to understand their own anatomy; however Kaysen demonstrates that she is aware of her own anatomical structures and function.
Overall though, I would hope that readers accept Kaysen’s idiosyncrasies and simplified language. She uses other inaccurate terms, most likely as deliberately as she chooses to forgo with quotation marks when recalling conversations. She refers to her doctors as the “Vulvologist” and the “Biofeedbackologist” instead of as “The vulvar specialist” and “the physical therapist.” But when you’re encountering these specialists for the first time, perhaps not knowing such fields even existed before, what else are you supposed to call them??? The title of the book itself is an error. The title is based on Kaysen’s memory of a scene in a movie, with some artistic license exercised. (According to this interview with Kaysen about TCMMGM, technically the title of the book should be The Camera My Father Gave Me.) She receives materials from the “National Vulvodynia and Vestibulitis Association” instead of National Vulvodynia Association. And so on…
But this is her story in her words. I hope we can forgive her for taking liberties with some of the language – though it does have some disableist moments that are questionable and perhaps not so flexible.
I don’t know if Kaysen ever found relief for her pain in the years since TCMMGM came out, though it seems unlikely. Around 2003, the following was written about her on Salon.com:
Though she lives in the Boston area, the doctor capital of the world, Kaysen never found a workable medical treatment. Today, Kaysen hasn’t so much lost or won her battle; rather, she’s signed a treaty, with massive concessions. “Celibacy is a great cure!” she said wryly in a recent phone conversation. “I wasn’t interested in having sex again. The only thing I was interested in was not having pain. Pain eclipses desire.”
So who might be interested in reading TCMMGM? Who might benefit from exposure to such a taboo subject and who should approach the book with caution?
If the reviews online are any indication, many readers will be disappointed and frustrated with the book, but a few will strongly emphasize with what Kaysen went through. I am one of those people, and would like to see more people read and attempt to understand Kaysen’s situation. The frustration that so many reviewers are left with may be exactly what readers most need to feel, to better understand the frustration that still too many patients with vulvodynia have to deal with when running the gauntlet of modern medicine in search of adequate treatment.
The book is a memoir of one woman’s experiences with what is probably vulvodynia, and therefore it should not be taken as an advice or how-to book. This is all stuff that happened to Kaysen. It’s not necessarily going to happen to you. Some readers with a history of vulvar pain may find the book depressing because at so many points, things appear hopeless. Others take comfort knowing that they are not alone. It’s been a few years since the TCMMGM came out too, so there have been some advances in treatment since Kaysen conducted her own research and treatments. Your mileage may vary.
TCMMGM is short and small, but it’s not light fare. Although it has moments of dark self-deprecating humor, it’s not something to read if you want to feel good (except perhaps through schadenfreude.) It’s kind of a downer, to be honest. Because Kaysen describes a rape and post-rape scene with frank language, the book may be triggering to those with a history of sexual assault.
TCMMGM is available online from several retailers and it is available in E-Book format for Kindle. If you’re still interested after reading all this, then may I suggest that you make a purchase through the NVA’s book list, since they have a referral program set up for financial support.
As with all reviews conducted at Feminists with Female Sexual Dysfunction so far, I had to pay for TCMMGM with my own money, and I receive no compensation for posting a review of it.