Questions about Vulvanomics

11/17/2011 at 11:45 pm | Posted in Uncategorized | 2 Comments
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This Friday, the New View Campaign will be protesting cosmetic genital surgery clinics and clinics that perform procedures like laser vaginal rejuvenation. In case you’re new here, the New View Campaign is a feminist grassroots organization developed over a decade ago by Dr. Leonore Tiefer, a sexologist and college professor (among other things.) The group’s goals are to present a form of feminist resistance against female sexual dysfunction (their view is largely recognized as THE feminist answer to FSD,) and pharmacological treatments for the conditions that fall under its umbrella; to eradicate cosmetic genital surgeries (or at the very least, to force more research on procesures,) and offer some alternative, non-medical interventions to improve women’s sex lives. The last item means taking a social construction approach to sexuality, a cerebral topic which constitutes another series of blog posts. (Check my archives, I’ve talked about the New View and social construction before.)

This nationwide protest is visible activism as part of their recent Vulvanomics media blitz. The clinics in question have not been publicly named to my knowledge – the group communicates on a listserv instead. I haven’t joined it, due to a clause on the New View website that states joining the listserv means you endorse the group’s philosophy & actions. The New View Campaign does not represent my views and does not speak for me.

It is not the first time the group has publicly protested against vulvar modification. The intentions are good – draw attention to unnecessary asthetic procedures, which target women, are expensive and carry health risks. In spite of this, I wasn’t comfortable with it the first time around. And I remain uneasy, because I fear that their activism has the potetial for some unintended negative consequences.

Full disclosure: I may be a bit biased, seeing as I’m someone who actually knows what it’s like to undergo genital surgery, and as someone who actually has FSD.

As the campaign gets underway, I want to contribute to the hard conversation by raising a few questions about this planned event.

– I understand vulvar and general cosmetic surgeries to be a symptom of a larger problem – body snarking & policing, fatphobia, misogyny and racism – rather than THE problem. Take away cosmetic surgeries, and there will still be these underlying problems remaining. An example of this would be Austrailia’s practice of censoring naturally large labia in softcore pornography.
What steps is this current campaign taking to address the systemic, more intangible problems that may motivate permanent surgical changes in the first place?

– One goal of this round of activism is to get the FDA to monitor cosmetic and laser surgeries and require more rigorous research, to be made available to end users (clients.) That way, women can do better research and make informed decisions about what they do with their bodies.
However, I doubt this type of activism will end there. I got a feeling I can answer my own question above: Even if the New View gets exactly what it wants – which would be beneficial to women – the anti-surgery and anti-medicine activism is likely to move on to new targets. Perhaps then the New View will shift its focus to censorship vs. idealized & unrealistic body representations in pornography, etc. All of which is certainly eligible for a social construction critique.
However, since these systemic problems will still remain, and are likely to be the next area for activism, that means even if you read the material and wanted to go through with surgery, you’ll probably still have your decision questioned. It will never stop and there is no way to do a cosmetic surgery correctly, so you’re just going to have to deal with the stigma and shame of doing it wrong anyway.
So, the question is – are there any conditions in which it is socially acceptable for a woman to undergo cosmetic or sexual surgery on the genitals? If so, what are these conditons?

– One approach to address women’s insecurity about the appearance is to embrace vulvar diversity. But what do we mean by vulva diversity? In galleries of what normal vulvas look like, how often do we see vulvas with visible (if subtle) health problems? Does vulva diversity, a celebration of the wide range of normal, include vulvas like mine which, pretty much everyone including Dr. Tiefer, agrees, is in fact not normal? (Remember, when vulvodynia acts up, a lot of gentle and sexual touches will register to the vulva owner as pain.) And does the movement to celebrate vulvar and body diversify embrace those women who have already undergone modification?

– I notice that this campaign refers to cosmetic genital surgeries as FGCS – it’s not explicitly defined on the petition but I’m pretty sure the acronym translates to “Female genital cutting surgery,” with the intent of invoking FGC, aka FGM – female genital mutilation.
Recall that the film Orgasm, Inc. did not hesitate to use the term FGM, even though it carries a degree of stigma – the implication is that, if you’ve undergone FGM, then you are a mutilated mutant. FGC is more sensitive term.
But how does the New View respond to critics who claim there is a difference between FGC and vulvar cosmetic surgeries? Some critics here, for example, claim there is a difference between damaging girls’ genitals against their will & without their consent, vs. trained surgeons operating on women who seek such procedures out.

– During a recent Feministe shitstorm, (not actually that recent in blog-time but still to soon for me,) (Google “Feministe ‘don’t do this’ just because I’d prefer to avoid trackback trolls for awhile longer,) several commenters deflected questions about medically necessary genital surgeries. The idea seems to be that medically necessary procedures are exempt from critique. That’s different – and I still don’t understand why.
– So how are we defining medically necessary vs. purely asthetic? What criteria is necessary to justify a surgical procedure to a vulva? How do we quantify the amount of discomfort and danger required? How shall we address the intersection of medical, sexual and cosmetic concerns, for example in reconstructive surgery? To that end, were the current surgical facilities subject to the protest screened to ensure that medical patients will not receive unwanted attention?

– Relatedly, some of the New View’s criticisms, and general feminist critique, of cosmetic surgeries include the fact that surgeries hurt, come with health risks, and cost a lot of money. Genital surgeries carry sexual health risks in particular, and the price tag can reach thousands of dollars – just like my medical surgery, which my insurance dicked around about & didn’t reimburse what they were supposed to.
But these concerns – pain, side effects, and cost – are present with medical surgeries as well. So, again, why are medical surgeries, which carry the same risks, not subject to the same critique? (Basically, if cosmetic surgeries are bad because x, y, and z… and I did a surgery that also involved the same x, y, and z… then what makes my situation any more forgivable? Intent? I thought the intent doesn’t matter.)

– During the same recent Feministe shitstorm, I saw a commenter raise concerns about the impact that anti-cosmetic surgery sentiment and activism might have on trans* individuals. Some transsexual women and men undergo top and/or bottom surgery.
Has the New View taken any steps to clarify the difference between GRS and cosmetic surgery? (Of course I suppose transphobes will look for any excuse to be transphobic – and if that means invoking the spectre of cosmetic surgery with all it’s negative implications, – then we’re gonna need a lot more activism to get that to stop.)

In fairness, most of the problematic comments about cosmetic surgery, including genital surgery, is derived from the New View’s work, rather than explicitly stated by representatives of the group. I’ve noticed that in her writing, Dr. Tiefer by and large is very thoughtful about what she puts in print. In contrast on the Feministe post I’m referring to, Jill & co addressed cosmeric surgery as largely an individual provlem, imploring indivduals not to go through with it. Buried in the comments, there was some effort made to address social problems contributing to the spread of this type of surgery… But I had to wade through a whole lot of crap to find it, to the point where I found the thread exhausting. I give up; you win; I disengaged.

The New View has been around for over a decade, stirring up uncomfortable but necessary conversations – and that, in and of itself, isn’t necessarily a bad thing. But its still largely the same organization it was ten years ago, and it really should take some time to examine & reevaluate some areas for improvement, especially with regard to its internalized ableism re: FSD and mental illness.

So, I just hope that on Friday, I don’t run into a protest group outside of an outpatient cosmetic surgery facility just like the one where my medical surgery took place. As much as I’d like to be a punk and counter-protest, (I’d be the one holding the sign that says, “New View doesn’t speak for me / Ask me about my surgically altered vagina”) I know myself well enough to recognize that a group of women protesting vulvar surgeries – by using props of tools like the ones used on me – will probably just set off a massive anxiety attack.

An example of an article about FSD

10/20/2009 at 9:43 pm | Posted in Uncategorized | 5 Comments
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There’s an article about female sexual dysfunction posted at The Nation. Found via Our Bodies Our Blog. [Edit 10/21/09 – I left two comments at OBOS, hopefully will be taken seriously; the second is a little more fleshed out with an explanation of some other problems I have when the media talks about FSD like that.]

I read it. Both of the linked articles.

I don’t get it.

Unfortunately reading the OBOS entry and the article in question has rendered me completely incoherent with rage so I will not be able to do an in-depth competent analysis at this moment in time.

Why am I enraged? I’ll have to use a short list of points list since that’s all I can handle right now. I don’t have the patience to go into great detail tonight. Let’s just briefly touch upon what’s running through my mind right now:

Well, for one thing, I see that dyspareunia, sexual pain, is not mentioned in either article at all. The Nation article places a very strong focus on orgasm in particular, to the exclusion of female pelvic pain. So sexual pain is ignored and erased. Where did it go? Why is it not there? Instead, we have a focus on questions such as,

How else to explain that a reality as old as god–that the vast majority of women do not climax simply through intercourse–has re-emerged as dysfunction? Or that another grab bag of indicators of dissatisfaction and low desire are renamed as symptoms of hypoactive sexual desire disorder, for which a female Viagra or a testosterone patch or cream or nasal spray must be developed?

But I’m not fully comfortable with minimizing a woman’s desire for higher libido and/or climax through intercourse either. I’d like to explore intercourse in general, whether or not my partner or I climax, so I don’t think it would be fair of me to to say that exploring orgasm through intercourse is unimportant to someone who feels it is. I think it’s great to expand the definition of sex and to improve sexual satisfaction & explore other types of sex besides just intercourse. But I want to leave it on the table too. Keep it as one of many options.

One of the first lines over at The Nation article says, “Sex has been missing from the healthcare debate.”

I wrote an article about Healthcare and Vulvodynia last week.
But then, this blog is micro-small, so it’s not likely that many people noticed.

The lines go on,

“A shame, because sexual health, and disputes over its meaning, reveals most nakedly the problem at the core of a medical system that requires profit, huge profit, hence sickness, or people who can come to believe they are sick or deformed or lacking and therefore in need of a pill, a procedure or device. Case in point: female sexual dysfunction (FSD), said to afflict great numbers of women–43 percent according to some, 70 percent according to others, an “epidemic” in the heterosexual bedroom according to Oprah. Ka-ching!”

I’m still not fully understanding the claim that FSD is profitable. If that’s the case, why is it so difficult for me, someone who falls into the pain category, to find a doctor who is equipped to handle me? My experience is that often, my first line of defense doctors get tired of seeing me after I don’t respond to conventional treatments. I think right now my local gyno probably never wants to see me again.

The article goes on to talk about hysteria. For the most part I don’t find this section of the article to be inherently problematic. Except for the part about “pelvic congestion,” being in quotes, since it is mentioned as a real thing in Heal Pelvic Pain (p. 16)

The article goes on,

How to explain that middle-aged women go under the knife for vaginal rejuvenation, basically pussy tightening, and that young women go under the knife for laser labiaplasty, basically genital mutilation, saying they only want to feel pretty, normal, and raise their chances of orgasm through intercourse?

I had vulvovaginal surgery. It was to address the vulvar vestibulitis pain, and not for cosmetic reasons or to tighten things up (Actually, tightness is a real problem for me – I have too much tension in the pelvic floor.) But there was a minor cosmetic change, an incidental one. So, does that count as FGM too? I asked a women’s health class professor, who is also a practicing nurse, if it counted as FGM before scheduling the surgery. And she said “No.” Does surgery for medial reasons also count as condemnable? Or does it get a free pass for some reason?

Things continue forward.

How to explain that a doctor like Stuart Meloy of North Carolina, a throwback to charlatans who tried to shock hysterics into health with electric charges, has even one patient to test his Orgasmatron, an electrode threaded up a woman’s spinal cord and controlled by a hand-held button that the patient can push (assuming the procedure doesn’t paralyze her) to make her clit throb with excitement during intercourse and reach the grail of mutually assured orgasm?

I said to myself when I read those lines, “Huh, that kind of sounds like the TENS therapy I had tonight at my chiropractic & acupuncture appointment.” So I looked into it, and, sure enough, the diabolical device referred to here was originally designed to treat chronic pain. Reading that ABC article though, I’m not sure where the Nation author is getting the sufficiently scandalous softcore erotica quality lines of “Make her clit throb with excitement during intercourse” from, since the ABC article doesn’t actually say that part. I wonder if that line is in the actual study in question. Is that really how it works?

It just keeps on going.

A terrific new documentary, Orgasm Inc., by Liz Canner, addresses those questions in terms of corporate medicine and the creation of need via pseudofeminist incitements to full sexual mastery by Dr. Laura Berman and other shills for the drug industry.

I can’t speak for Dr. Berman, but I suppose now would be a good time to state for the record that I personally have never once received any compensation for writing this blog. If I get something later, I’ll disclose that if/when the time comes.
I did not think that sexual health & FSD was a “Pseudofeminist” concern. Is that to say that I, too, am a false feminist then, for talking openly about it?

And it doesn’t stop.

Female sexual dysfunction, it turns out, was wholly created by drug companies hoping to make even bigger money off women than they have off men with the comparatively smaller market for erectile dysfunction drugs.

Emphasis mine.
I would disagree with that statement. After all, we have evidence that vulvodynia, which falls into the often-overlooked pain category of FSD, existed as far back as about 2,000 years ago. There’s no way for me to know this 100% for certain, but, I have a feeling that I probably would have developed vulvodynia & vaginismus even if Big Pharma did not exist. There’s a lot of variables going on in the history of my pelvis, but a few warning signs stand out to me now. Hindsight still isn’t 20/20 though…
But looking at what’s been written about vulvodynia for years, and seeing women disclose online that they’ve had it for decades, I feel confident saying that Vulvodynia existed long before Viagra. I’m still waiting on the magic pink pill that will take away my sexual pain & get me in the mood. Right now my main pill options are tricyclic antidepressants and anti-seizure medication, to be used off label. There’s also conventional painkillers like Vicodin. I don’t take those kinds of pills though. Actually scratch that, I have an expired prescription for Valium that I’ve taken maybe 10 or 20 of in the last year when my general anxiety got too strong to manage.

Finally, Rachel at Our Bodies Our Blog put the words female sexual dysfunction in quotes, which is another thing I don’t understand. Is that to mean that FSD is not real? I identify as having FSD. It’s very real to me. I do not identify as being distressed by my levels of libido, arousal or orgasm. For me, those three features are a function of the pain, and sexual pain is my main concern. When I’m having a bad pain day, the triad of libido, arousal and orgsam decrease. Sometimes they can hurt too.

So yeah, I’m not in the best mood and mental state right now. That’s all I have to offer right now, as I wasn’t even planning to do anymore vagina blogging at all this week.

I will be your lab rat for the evening

09/30/2009 at 7:05 pm | Posted in Uncategorized | Leave a comment
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My specialist’s office called me the other day. Or rather I should say a researcher from the office, to see if I was willing to participate in a vulvodynia study.

I don’t think I can say what questions were asked or what my responses were, since I don’t want to break confidentiality. But, I answered the questions honestly to the best of my ability. It was pretty simple. I think I see where we’re going with this study. I hope my answers, aggregated with other ones to produce statistics, help someone.

This study is only available to women who have had a vestibulectomy, so, chances are you can’t participate in this one.

Don’t feel left out though. The online support groups are helpful for this kind of thing – finding current research & networking – but the trade-off is that it exposes your identity to your friends…
But there’s some studies posted in there.

On one such group, the maintainer posted a link to this site: Dr. Laura Clark – and that site has links to 3 surveys. One is for women with vulvodynia, one is for women without vulvodynia, and one is for partners of women with vulvodynia. I participated in the first of those studies, and my boyfriend completed the last one. Anybody without vulvodynia reading this can think about doing the second one. I’m not sure where Dr. Clark is going with that second survey.

And I’m not sure yet which journal (if any) these results will be published in.

So yes. I am a statistic.


It was nice to talk freely about having had vulvovaginal surgery without being judged & condemned.

Post articles about vulvodynia

05/27/2009 at 7:31 pm | Posted in Uncategorized, vulvodynia | 3 Comments
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Hey guys, you want to see a recent article on vulvodynia? It’s full text & it’s free!

A practical approach to vestibulitis & vulvodynia

Careful, it’s not work-safe (but then, I suppose few things about vaginas are…) It’s even got pictures.

I don’t want to copy & paste the entire article so instead, let’s have a bulleted point list. Chances are, if you’re reading this blog you may already be familiar with some of what is being rehashed here anyway.

But if you’re not familiar with this topic, then well here’s your chance.

Couple of noteworthy points –

Article breaks out V into 3 kinds: cyclical vaginal infections (recurrent yeast in particular.) Vestibulitis (pain with penetration) and essential Vulvodynia (more generalized pain.)

I still tend to use “Vulvodynia” as a blanket term which includes vestibulitis.
However, technically speaking we’re supposed to start moving away from the “-Itis” suffix in “Vulvar Vestibulitis,” since, that ending implies inflammation. Inflammation was present for me, but it’s not present for every patient. Instead some doctors are moving towards using the phrase “Vulvar Vestibulodynia.” I’m probably going to continue with the -itis though, since I’m more used to that phrase.

This article cites a 16% rate of some type chronic vulvar pain in female patients in Boston. That’s around the same numbers I’ve seen before. That’s not necessarily a 16% rate of diagnosed vulvodynia, just those reporting chronic pain.

I disagree with the headline that says “Medical treatment is ineffective” re: vestibulitis. It’s kind of a weird headline anyway since I always thought that the vestibulectomy was a medical treatment. The only thing I can think of is that the authors consider surgery to be a category of treatment unto itself, separate from “Medical.” Maybe the authors mean “Medical” as in, oral medications?
But then why not mention the oral tricyclic antidepressant approach for vestibulitis? It’s mentioned further down re: treatment of vulvodynia – maybe the authors of this article have concluded that tricyclics work better on vulvodynia rather than vulvar vestibulitis?
Also, the article mentions that steroids don’t usually play out too well as a topical treatment… but why didn’t it mention topical hormones? It’s mentioned as a treatment for older & post-menopausal women, but, I’m a young lady & I used topical estrogen gel for awhile.
I also disagree with this headline because ouch, what a kick in the teeth to women with vestibulitis who would very well benefit from some medical intervention. Surgery or bust just isn’t fair.

The authors note that vulvodynia is more likely to happen among older women, although in practice I’ve seen it among women the same age as I & younger. In practice I’ve also seen resolution take much longer than just a few months for vulvodynia. The authors sound pretty optimistic.

For some reason Physical Therapy is not mentioned as a treatment in this article at all. I find that to be a glaring omission. “Where’s the beef Biofeedback?!”
Dietary changes & avoiding irritants are likewise not mentioned. Alternative treatments like acupuncture & chiropractic is not mentioned.
Sex therapy is missing. Maaaybe this article isn’t really the best place to bring up sex therapy since, the article focuses on typical medical treatments. I don’t think that sex therapy be a good option for myself but the authors could have mentioned it as an option to expand a patient’s sexual horizions. Intercourse does not necessarily have to be the end goal of treatment, which is kind of implied with the patient used as an example at the beginning & end of the text.

The authors do not examine possible causes much.

Some of the sources cited in the footnotes are on the older side. I’m familiar with several studies though; I’ve printed out & read several of these. The Goetsch study in particular comes to mind. I’ve seen statistics in other subsequent studies hover around the same incidence rate numbers that Goetsch came up with so I guess the repeatability makes it a fairly strong research paper. Still, I’d prefer to see a stronger emphasis on more recent work.

So it’s not perfect, it’s missing some things, but it’s still an article on a website so maybe somebody with a medical degree will actually pay attention. Or even a layperson who never heard of such things before.


“Feminine hygiene” and forgetting about FSD

04/18/2009 at 8:38 pm | Posted in Uncategorized | Leave a comment
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Over at Womanist Musings, Renee brought up a new feminine hygene product ripe for feminist critique. She found it via a women’s health forum a few days ago.

I like the title of the webpage the product is on. By “Like it,” I mean I’m being completely sarcastic & I don’t like it at all. The title of the webpage itself  is “Tight Vagina by Vagina Tightening Cream” but the actual product name is “St.Botanica Lady Secret Serum.” I find the difference in names significant. Somehow I can’t imagine the name “TIGHT VAGINA CREAM” going over too well in test marketing with the target audience.

Renee’s right in condemning this product & the geniuses who invented it. There’s a lot we can say about it and especially how it’s being marketed towards women, which seems to be Renee’s focus.

The marketing strategy, as always, can be summed up briefly as, “See a need, fill a need,” with the ultimate goal of making money, even if that means exploitation. But first, how do you get that need to exist to begin with? For the purposes of this product, you create the need by inventing new problems or by re-framing normal bodily functions into such away as to make a problem exist where really there isn’t one. It’s within the realm of normal for a vagina to have a mild odor, to experience some dryness or some wetness. It’s within the realm of normal for a woman to have shifts in libido in one direction or another, to not orgasm or not have G-Spot orgasms. That’s within the realm of normal, but I recognize that sometimes these things and others (Pain!) really do become extreme to the point where they present genuine problems – and when it reaches that point, I won’t stand in anyone’s way to find relief.

Somehow I doubt that this serum would offer any relief though. Let’s look at the ingredients, since I for one have to be careful about what goes on & in there.

Ingredients: Pueraria Mirifica and tropical herb extracts, Carbopol, Water, Butylene Glycol, Glycerin, Propylene and etc.

Pueraria Mirifica sounds like Ephedra… never heard of it before now, appearantly it’s the answer to all your body needs. It may have a legitimate purpose in some situations but then, so do lots of other alternative remedies. I’m a little wary of the wiki’s edit history as well… I’ll pass for now…
Carbopol sounds just completely awful & like something I don’t want in my vagina… a Thickener, apparently. Is that like gelatin? It may have some use in medicine, but that just makes me even more hesitant to use it over the counter. In my vagina.
Water… is water. It’s in everything so fine whatever… then come some other ingredients that can be potentially irritating but nonetheless are found in typical sexual lubricants already available on the market.
Then “Etc…” …Okay what does “Etc” mean? Something St. Botanica’s doesn’t want to divulge, which means it’s probably something I want to know about. And no I don’t care about the secret formula that’s probably critical to this product’s success as a unique hygiene item. I just want to make sure I’m avoiding as many irritants as possible.

Besides, if you really wanted some of the benefits this serum claims it can give, you’d probably get the similar or better results by 1. Going to a gyno to screen for and treat treat any infection that might be acting up, 2. Talking to that same gyno about prescribing a topical hormonal treatment, if warranted due to a hormonal imbalance, menopause and/or old age, 3. Kegels/pelvic floor exercise 4. Other, cheaper over the counter topicals. I’ve heard tales of other women with vulvodynia who variously use vitamin e oil, olive oil, or emu oil topically to soothe irritation. I’m in the vitamin e oil camp (just don’t use oils with latex condoms or if you know you’re sensitive to them.)

So I’m not too impressed with this product and I don’t believe I’ll ever willingly go within 25 feet of a bottle.

Renee doesn’t sound too happy about it either. She recognizes the potential danger St. Botanica’s could present, and does a good job pointing out how the marketing exploits insecurities women feel about their genitals. Insecurity, exacerbated and often created by the marketers themselves and the culture in which they operate.

She is,

sick and tired of being shamed for being born with a vagina.  It’s an awesome body part.  What else can expand to give life to another human being? What else is capable of producing so much pleasure?  What else is so beautiful and intricately crafted?  It certainly is no penis; it is a wonder unto itself

…So on behalf of all of us problematized,vagina bearing beings….St.Botinca keep your noxious spray away from my goddess perfected, beautifully shaped, vagina.

Well, yes. It is tiring to constantly feel like your body has to live up to whatever arbitrary expectations are put in place by culture, especially when such expectations are unrealistic, unreasonable, time wasting & put in place to support the very same culture. These standards don’t benefit the group most effected by them. And yes, it’s very interesting & amazing that the vagina & cervix are capable of expanding to allow a whole new life to pass through.

I’m still learning how to derive pleasure from my vagina though… the first few years of using one resulted in pain and it’s gona be awhile yet before my body completely un-learns that response… And even then, “Completely” may be out of my reach.

So, yes…
And, no.

Unfortunately, unlike Renee, I am someone who does not have a “Goddess perfected” vagina. Mine is more like a, busted up, sewn-together, patchwork, Six Million Dollar Man vagina…

(I’m probably making it sound much worse than it actually is. It’s really not that bad.)

Of course there IS something wrong with my vagina – I am pretty sure healthy vaginas, vulvas & pelvises do not spend all day itching & burning & sending aching, shooting pain signals all down your (my) leg. That’s not “Common discourse,” it’s just me… I’m used to seeing discussions of these painful, life-disrupting symptoms on my vulvar pain support groups – but discussions like that are a lot less common on general women’s health forums. When such topics do come up, experienced posters often point out, “You may have a problem which genuinely needs treatment.”

That Renee asks What else is capable of producing so much pleasure?” without mentioning the capacity for pain may also be worth pointing out here. Shit, mine’s not working. Does that mean I’ll never be able to experience what you have? What else, indeed.

My point here being, while I agree with Renee’s assessment of this product and the way it is and others just like it are marketed to women, and I frequently agree with or at least appreciate her analysis of other women’s issues,
I’m still left feeling alienated by some of her language, too.
Which I know was never Renee’s intent at all.
Which makes it all the more unfortunate.

My vagina, vulva, what have you, is not perfect. It never was. It is never going to be. I don’t feel that way about mine. Instead, I want be content to live with my flawed, refurb post-vestibulectomy vulva, crafted not by a goddess as though woven from precious silk, but modified by a mere mortal man.
Alas, perhaps this modification in and of itself was enough to take away whatever divine spark my vulva supposedly had when it was still whole… even if being whole meant it was also On Fire.

My vagina really does have issues.  I’m sick of feeling ashamed & left out for actually owning one of those “Pesky,” “problematic” vaginas she’s talking about, complete with symptoms strong enough to interfere with my life. And I’m tired of feeling like I am “Doing it wrong” for wanting to, trying to treat these problems.

(And, on a lighter note, I am going to be so sick of spambots in a few days when I still get spam comments latching onto this post for actually using some of the same words they like to use.)

Book review – I Knew a Woman

03/08/2009 at 5:39 pm | Posted in book review | Leave a comment
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I finished another book on the NVA’s reading list, I Knew a Woman, by Cortney Davis.

Spoilers Warning! I’m talking about the contents here so if you’re inclined to read this one and don’t want to know what happens, go no further.

The best, briefest summary I can think of is: It’s a novelization of The V Book. (Awesome book, btw, every female bodied person & friend of female bodied persons should have a copy. I strongly recommend.)

I Knew a Woman is interesting – it is the first-person account of a female nurse practitioner,  the author Davis herself, as she treats four female patients at a gynecology practice over the course of about a year. She treats other patients at the same time, but we follow only a unique four of them, as they touch base with the doctor every few weeks for follow ups to their initial health concerns. The patients are amalgams of many real ones Davis has actually treated. Real patients, mixed up in a blender & combined into semi-fictitious case studies. The women’s health concerns they face are pretty heavy – cervical cancer, teen pregnancy, drug abuse, and sexual pain & abuse.

For the most part, I Knew a Woman isn’t designed as self-help or a roadmap to female anatomy. The book adds some new information to my pool of women’s health knowledge, but not much. Most of what it does add, is little details of what to expect during a procedure I may have to encounter one day, and what goes on behind the scenes. Don’t get this book if you’re expecting a book that guides you step-by-step through your body & everything that can go wrong with it. Save your cash for something else if that’s the case.

For example, I already knew about the Os (opening of the cervix) and normal variations of tilted uteruses.
New information to me includes, I now know in great detail what to expect when the time comes for me to get my first mammogram.
I now have a better idea about what goes on behind the scenes of gynecolgic practice. The gossip, the social circles that form, the natural quirks that all individuals have & express at their jobs.

Since it takes the POV of a nurse practitioner, it gives patients an inside look at what goes on behind the scenes at the doctor’s office. I never know what happens after I go home from a doctor’s appointment. I know that records & sometimes prescriptions must be filled out & called in or faxed to pharmacies. But other then that, I didn’t know.

I Knew a Woman shows a patient (such as myself) what goes on after she goes home.

Some of it is … disturbing.

The monthly meeting of the, “Tumor Board,” a group of doctors who discuss the best course of action for patients who have been diagnosed with cancer – including our cervical cancer patient. The regimented hiearchy of doctors that make it up, each doctor firmly believing that his speciality has the best answer for newly diagnosed cancer patients.
The lazy clinic receptionist trying very hard to convince patients not to come in that day.
Davis’s thoughts about the patients & the judgments she makes about them. It’s disturbing, and she realizes that she’s not supposed to do it, either. But also humanizing. Nurses are human, too. They are not infallible. They silently pass judgments the same as you or I – even when we try to avoid doing so. Davis herself has known single motherhood & poverty, yet still sometimes she judges her single parent patients’ decisions. One editorial review itself explicitly states, “Some days she feels maternal toward Lila, other days she’d like to clobber her.”
This same editorial also points out that “[Davis is] ‘convinced that the cause of Joanna’s pelvic pain has more to do with a bruise in her soul than with an abnormality in her body.'”
So it may not just be my own self-consciousness acting up when I worry about the doctors talking about me behind my back after I go home from an exam as a pelvic pain patient. Maybe they worry about me. Maybe they pity me. It might really be happening. It’s somewhat reassuring… my paranoia is not completely unfounded.

Of particular interest is the pelvic pain patient, Joanna, who returns to Davis’ practice several times trying to determine the cause of & treatment for her dysparunia.
Once again, as with Let Me Count the Ways, the word “Vulvodynia” is never mentioned – leading me to question “Why is this book on the NVA reading list? It doesn’t talk about Vulvodynia.” The word “Vaginismus” does not appear either. I suppose the answer is because it gives that vital behind the scenes look at a doctor’s office. Makes it easier for pelvic pain patients to see how difficult it is for the doctor, too.

Joanna acts like I do at a gynecologist’s office – tense & straight to business, which seems to disarm doctors. Apparently it’s more unusual for patients to “Assume the position,” so to speak, for a gynecological exam without being instructed to do so, as Joanna and I do (31). Davis isn’t used to that.
Joanna and I wound up not having any “Easy” to treat issue causing pain with sex. No infections, lube didn’t help, nothing on the ultrasound, and repeat visits were fruitless for awhile. Sex just kept on hurting.
Eventually, the rapport between Joanna and Davis grows to the point where Joanna feels comfortable disclosing her history of childhood sexual abuse. It gets pretty graphic here. Suffice it to say, it is after addressing this long-forgotten sexual abuse that Joanna is able to begin sexual healing, with guidance from a therapist. The reader does not learn if she is ever able to fully resolve her problem, but judging from her more relaxed attitude at a subsequent exam, she found the right path for her.

Actually, all four of the female patients wind up being wrapped up with some kind of big red bow at the end. It’s not a “And they all lived happily ever after,” but the characters all see their crises resolved to a level of satisfaction. Lila has a healthy baby & leaves her abusive boyfriend & starts straightening out her life. Joanna seeks therapy for her history & perhaps her pelvic pain. Eleanor’s surgery is successful & she survives. Renee’s baby eventually thrives, she overcomes drug use and gets back some of her children that were taken away by the state.

I was kind of surprised that everything winds up being neatly tied up for the reader’s consumption in the end. In real life, it’s not always like that. Some problems last a lot longer than just one year. Lila’s going to have an armful as her child grows. But then, these patients are fictionalized. Davis must have taken some artistic license to make for a happy ending.

Although the book strongly focused on these four women – and Davis herself – there was one other woman who stood out very strongly.
I believe that there is a fifth woman.
This mysterious fifth woman appears in only one chapter, #21.
Davis’s clinic offered Maria, a domestic violence victim at the hands of her husband, some special services to her after the birth of her son. One nurse, Rita, makes periodic visits to Maria to check up on her, in more ways than one.
Maria left her husband, but he didn’t leave her. She dealt with stalking & harassment at work.
One day during a visit, Rita meets Maria’s husband. He reminds me of my own father – manipulative, abusive, and two-faced. Michael can wear a mask of friendliness & concern when there’s an audience. Strangers and even his own friends don’t know about the real person behind that mask. “Oh he doesn’t seem like such a bad guy.”

My father is like that. Wear the mask of an extroverted friend-in-waiting in public, but once he comes home, he takes it off & shows his true form.
It is a loud, scary, dangerous form.
And no one believes me or my mother when we try to explain this to our friends who know his other mask.
No one believed Maria, either, not even her nurse Rita.
She, too, is tricked into believing that Michael really isn’t that bad of a guy… “‘He sounded polite'” (147.)
Her gullibility leads to a violent situation, putting Maria in danger that only the police are able to resolve. But the violence did not end there.
It ended with Maria’s murder at her ex-husband’s hands.

This flashback takes place in the greater context of Davis showing that patients experience a myriad of problems in their own lives – including “Problems” for which the very word isn’t strong enough to describe.
This chapter just really stood out to me. I can relate to living with Michael… I’ve seen that one before… I wish more people would actually listen to victims of domestic violence & assault & just take them at face value.

Now since I Knew a Woman is on the NVA reading list, you may be asking, “Should I get this one?” If you can get copy in good condition for less than $20, then maybe. Like several of the books on thier list, this one is out of print, too, so you may have to order it used through a dealer. Best copy I could get ahold of still had some wear & tear on it.
But it’s a short book. I was able to burn through it within a few days. Won’t take very long, and you may find some reflections of yourself within. You may also like it if you like prose & poetry, as the writer is also a poet. Mostly I just like seeing another perspective of women’s health, from a nurse’s position.

A few caveats though: The women aren’t super-diverse and there aren’t any transfolk. I feel that some of Davis’ statements were a bit essentialist about women’s bodies & the body’s fate. Some parts may be triggering for women who have dealt with abuse. And again, as I said before, it’s not very useful in terms of actual treatment. If you’re on a book budget, or short on time, I would say, it’s nice, but optional.

The 2nd annual Beaver Day celebration

02/02/2009 at 7:06 pm | Posted in Uncategorized, vulvodynia | Leave a comment
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February is a very special month for me. It is the month of V’s.

Two years ago to the day, I had a vestibulectomy. This is THE surgical approach to treatment of vulvar vestibulitis, a sub-type of vulvodynia. When you hear about surgery for vestibulitis, this is probably what is being referred to. The quick & simple overview is, a surgeon excises a few millimeters of pain-feeling vulvar tissue and replaces it by pulling down healthy vaginal tissue and sewing it in place.
I literally wear part of my vagina on the outside of my body.
For me, the results have been good – a significant, measurable drop in my pain levels. Combined with physical therapy to address the residual, there are times where I feel almost “Normal.” But I’ve seen enough horror stories to know it’s not right for everyone.
Recovery from the surgery was the second hardest thing I’ve ever had to do in my life. (The hardest thing I’ve ever had to do was make it through college.. surgery on my vulva is second only to that.)

It was February 2nd – Groundhog Day in the US. I always thought this coincidence was kind of funny. I was having my “Beaver” worked on, on Groundhog Day. In life, groundhogs & beavers are both members of the rodent family, but after that, they branch off into different families & genuses.

Still. They’re both big brown furry rodents… they both like to chuck wood, so to speak. They’re not the exactly same but eh, “Close enough.” So I decided that henceforth, for me personally, Groundhog Day would be known as Beaver Day.
It’s funnier that way.

Especially considering that my elder sister gave me a stuffed Beanie Baby beaver doll when I was in recovery.
With band-aids on its stomach.
I named it “Buster.”
I think I’ve earned a right to laugh. I think I’ve been through enough.

So there’s one set of V’s, for “Vulva. Vestibulitis. Vulvodynia. Vestibulectomy. Vagina.”

February 2nd falls close to February 14 – Valentines Day in many parts of the world. A holiday dedicated to love, romance, seduction, decorated by hues of passion: Reds, pinks, whites… and shared with candy, flowers, movies, food, sexual activity…
…And marred by commercialization.

Valentine’s Day falling shortly after Beaver Day is especially relevant this year, because for the first time, my partner is going to be here with me on Valentine’s Day. We’ve been doing the long-distance relationship thing for several years now, so it’s hard to match up our schedules with work & finances. This is the first time we’ve been able to pull of an actual Valentine’s Day Event. In fact, he’ll be arriving shortly after midnight – which means the day of his arrival will officially be February 14. About 1:00AM in the morning of February 14, but that counts. We’ll have the entire day to spend together.
What a perfect present for me! Talk about a special delivery…

(And now that the day is fast approaching, I’m thinking to myself, “I have no idea what normal couples do on Valentine’s Day… what do I do??? I’ve never done this before!” I am experiencing some performance anxiety.)

So here we have yet another V – “Valentine.

February 14 does double duty as V-Day, as put forth by Eve Eisner, creator of the Vagina Monologues. In practice, the events of V-Day spill over throughout the month of February, and, really the entire rest of the year. It is a time in which people from around the world organize events with the goal of defending women’s rights, and stopping violence & sexual assault, among other things.

Taken directly from the V-Day site, “The ‘V’ in V-Day stands for Victory, Valentine and Vagina.

How appropriate.

There are various criticisms & praise of the Vagina Monologues. Some of the criticisms, I understand. It’s not perfect. One play in particular, about the teenage girl finding sexual healing with an adult, has been called into question due to its flippant use of the word “Rape.” This piece has since been altered to age up the girl. It may be more appropriately called “The Vulva Monologues,” since some parts of the play deal with the external flesh rather than the birth canal.

But other times, I don’t understand where the criticisms are coming from. I do not believe that VM is out to “Get” all men. In my experience, men would do well to watch a performance live, or even the DVD. I do not believe that it objectifies or reduces women to this one part of their anatomy; rather it is an acknowledgment that this part exists. I do not believe it foolish to think of the vagina having its own voice and trying to channel whatever it is your vagina has on its mind.
In my personal experience, I have to listen to whatever it is my vagina is trying to tell me.
You try ignoring your vagina’s voice when for days & nights at a time it is singing its song of pain.
So personally, I’m a big fan of the VM.

V-Day also seems like a noble alternative – or supplement – to Valentine’s Day. Even if you do not currently have a partner (or even if you do,) or do not enjoy Valentine’s Day for one reason or another, perhaps you would be interested in these events. To participate in something greater than oneself, with the goal of reducing violence & rape around the world.
I can get on board with that.

But the first (second) day of the month is Beaver Day. This marks the beginning of the Month of V.

I like to recognize February 2 specifically as an important date in my life. Two years out, I feel a lot better following the surgery (and some subsequent treatments.) So I consider Beaver Day to be my vagina’s Birthday. I like to give it a little celebration.

Partly, I do this because this is an area where I feel superstitious… part of me fears if I don’t take the time out to recognize it, it will throw a tantrum and my pain will flare up again.

I may modify this Beaver Day Ritual since it’s still new, but for the last two years, I’ve acknowledged this date by performing a little Ritual. One year was marked by re-applying and then removing the band-aids from Buster’s belly, by candlelight. For this February 2nd, I poured libations.

It may be worth noting here that, I am not spiritual, like at all. I haven’t decided which organized religion, if any, is best for me. I’m on the fence with the whole afterlife thing. When bad things happen to good people and vice versa, most of the time I wind up taking more comfort in the cold logic of Statistics rather than God’s great plan.
Still. I want to believe in something greater than myself. Some kind of benevolent life force running around in each & every living cell.
I don’t know. I’ll have to think about it some more.

It may also be worth noting here that, I don’t drink like, ever, so I don’t actually own any wine to pour a libation with. I had to make do with what I do have readily available – Kahlua liquor.

I stepped outside. It was unseasonably warm this year. For some reason, the Pennsylvania Beaver Groundhog determined we still have 6 more weeks of winter left. The year I had surgery, he heralded an early spring.

Outside, I poured one ounce of alcohol into a shot glass and consumed it.
One for me…
To be grateful for how far I’ve come but always aware that I could revert back.
Wow the Kahlua is good. :9

Then I poured one ounce into a decorative porcelain dish, then tipped it over & let it hit the ground.
And one for my Homies…
To acknowledge other women who experience vulvar pain.

Then I said a little silent prayer to whatever spirit may be listening… I like to imagine my prayer going up to the Snatch Gods.
I don’t know who those are.

CREEPY MOMENT: This year as soon as I was done pouring the libations, a strong wind blew up out of nowhere & pushed me forward about a step. My hair blew forward into my face. It’s an otherwise beautiful, sunny day – especially for early February.
Welp I guess something was listening. That was kinda weird. Why did the wind blow at that particular moment… that was an odd coincidence… that was enough to make the hair on the back of my neck stand up. I didn’t think I was that superstitious.

Then I ate a big ol’ cupcake. Buying a whole birthday cake seemed a bit much, since it’s not all of me that’s aged another year. One cupcake is enough, for one part of me.

And now I go forward with my life as best I can, my personal coping mechanism ritual complete…

I don’t like this sex book

01/04/2009 at 4:59 pm | Posted in book review, sex, Uncategorized, vulvodynia | 2 Comments
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I have a confession to make.

Although I’ve been citing Let Me Count the Ways as a source of information on sexual dysfunction, and I intend to take some of its knowledge with me along my FSD journey,

I didn’t actually like it all that much.

Actually, I had quite a lot of problems with it…

I always hate marking up my books with pencils & pens. I feel like I’m defacing the book.
So I came up with a compromise system…


Every sticky note represents one or more of my comments on what the authors were saying. Every time I had a thought on something, I wrote it down. I can peel the notes off when I’m finished using them, and the book remains in tact.
Also makes finding pages of interest much faster 🙂


Obviously I had a lot of thoughts on what the authors were saying. Sometimes, I was in agreement. Other times, I felt highly critical & suspicious.

The book is on the National Vulvodynia Association Reading List. That’s the foremost reason why I got it – the NVA listed it as a book of interest. Having gone through Let Me Count the Ways, I understand why it’s on their reading list – it’s useful for couples experiencing difficulties with intercourse. You don’t necessarily have to have vulvodynia or even be female to find the book helpful.

But on the other hand, I don’t understand why it’s on the NVA reading list, because it never explicitly uses the word “Vulvodynia,” or “Vestibulitis.” So begins my criticisms of Let Me Count the Ways. It refers to pelvic pain several times, including one patient who probably did, in fact, have vestibulitis, as evidenced by the following:

I asked Pam if intercourse was ever painful, and she answered slowly.
…Yes, about half the time.”
…And that was the start of medical treatment for Pam, as well as gradual sexual reconciliation of these nice people. By the time they had been sexual together many times with their hands, mouths, and some sex toys, a minor surgical procedure had eliminated Pam’s vaginal pain, and they could proceed-slowly, with their new sexual and communication skills-to intercourse. And neither Pam nor Pete called Pam uninterested in sex ever again
(Emphasis mine, p. 84-85).

Vulvar vestibulitis is not explicitly mentioned here. It’s possible that Pam still had a strong hymen in place, or something else.
But we’re not talking about her using antifungals or antibiotics, and surgery for vaginismus is… not really there, since it’s a muscular issue.
I speculate that this patient most likely had vulvar vestibulitis – but I have no way of being 100% sure because the authors never talk about it. Pelvic pain is my main concern, but the book is vague on the types of pelvic pain & possible medical causes for it. That’s a real shortcoming. And why, if the authors never talk about vulvodynia directly, is it on a reading list of books relevant to vulvodynia? This would fit more comfortably on a list of general sexual education books.

Instead, for the most part, the authors place a strong emphasis on erectile dysfunction, failure to communicate, and sexual boredom.
None of which applies to me right now.

Despite the authors’ openness to gender play as a sex activity, I felt the patients used as case study examples throughout the text adhered to stereotypical male/female gender roles. Patient Sam is a ruggedly handsome carpenter (20,) John is another carpenter (80). (There’s a joke here somewhere, I just know it.) Vera is a small, attractive psychologist & new mother (48). Pam is a “Tall, graceful teacher” (84). Karen is a petite redhead travel agent (191). It goes on.

The examples may be based on factual cases. They may be reflecting the greater demographic – certain fields are still dominated by one sex. Or maybe the authors embellished actual cases in the interest of humanizing the characters for the readers.

Still, something put me off about not seeing any male grade school teachers, male nurses, or female executives. Why did the authors point out some of the patients jobs & attributes, but not others? What does being a travel agent have to do with anything?

On a positive note, the case studies do deal with people of various ages, young & old. There’s no ageism.

But then on a negative note, the book explicitly mentions one patient of Asian decent, but does not go out of its way to point out patients of other backgrounds.
Why did Klein & Robbins point out this one Asian patient? Why not use case studies with Black or Hispanic patients? Why so few ethnicities?

I wonder why their patient pool lacked more diversity. After all, if a thie Ebony Magazine article is any indication, blacks can deal with sexual dysfunction, too.

For all this talk about sexual diversity the authors go on about, there wasn’t much diversity in their patient examples. That might be a turn-off for nonwhites & non heterosexuals slogging through this text.

There were no homosexual couples. There were no transgendered people. This makes some sense in that the book is all about going beyond the borders of intercourse as defined by one man, one woman – but it doesn’t get into communication & sexual problems that can still pop up in non-heterosexual relationships.

Perhaps this is just a marketing thing. Or perhaps it is reflective of the authors’ own privileged backgrounds – maybe they didn’t even realize they left out minorities.

Another criticism is that, although the book remains on the NVA reading list, it’s dated now. This isn’t the book’s fault but… it is 11 years old. And it is showing its age.

11 years down the road, we can look back at the author’s statements in hindsight and say “What are you talking about?” The book was published before Sex & the City, and well before Web 2.0. Back in 1998, the internet was still fairly new in homes – that’s the same year I finally got a computer, primitive by today’s standards.

Klein & Robbins bring up the internet several times throughout the book and talk about how it was to revolutionize sexuality. And indeed, it’s made things more interesting. There are now social networking sites where you can find partners interested in the same things as you, and for better or worse, porn sites are common. You can buy sex toys online and have them delivered right to your door in nondescript packaging.

The authors make a vague reference to Teledilonics on page 190, but the technology still isn’t there yet. They overshot this one…
This isn’t a major criticism, since it’s not the book’s fault it’s so old & busted.

There’s a couple of other passages I’m not comfortable with.

In talking about expanding the definition of “Sex,” the authors encourage looking at the world from a different perspective – a more erotic perspective. “Once all of you is an erotic being, and all erotic activities are equal, the entire world is a sex toy… You and your partner can walk down the street and speculate about the kind of underwear the other pedestrians are wearing – if any” (140).

I like the idea of expanding the meaning of sex, and I like the idea of taking a different perspective, but… I’m not comfortable getting behind the last of this statement, which I have bolded. This sounds like the authors are encouraging sexual objectification.

I’m not okay with it when guys make snide comments to me on the streets or whoop at me out of their car windows. I really don’t like being sexually objectified. When I’m with my partner or maybe a close friend, I appreciate having the sexual side of me acknowledged & respected… but I can do a lot of different things besides just that one sexual component. I am not just a toy.

I don’t think I would like it if people ogled me & speculated about what underwear I’m wearing – at least, not if I knew it. And sometimes, the objectifier makes it blatantly obvious that he or she is completely sexualizing you, by making some kind of “Tell.” A vocalization, an uninvited pat on the behind, following you around… There’s debate about how much you yourself can actually do about it, too, for risk of a violent backlash if you correct the objectifier.

Dude, I don’t even know you. Let me be. Go eroticize that telephone pole over there instead.

So I’ve not yet come to terms with “Eroticizing everything,” at least, not when “Everything” includes “everyone.”

Then there’s one passage that really bothered me… one that really stood out as strange… this one bothered me the most, I think.

Warning: Possible sexual assault triggers

It goes like this.
“One can observe the clash of competing sexual values within American culture in many contexts: … universities claim to support women’s independence but pass rules to hold men accountable for female students’ drinking…” (emphasis mine, p. 60.)

Wait, what? There’s no elaboration here on what they mean by that. I know the rest of the context is that they are discussing some contradictions in sexual values in the US. Other examples included pre-teen access to contraception but a lack of sexual education & conservative Christians opposing abortion but refusing to prevent it from happening in the first place by providing access to contraceptives to teens (60).
I can’t ask the authors what they mean by the sentance in question about college students drinking, but I have a pretty good idea…

I have a sneaking suspicion that Klein & Robbins are referring to the relationship between alcohol consumption & sexual assault on college campuses. And it sounds to me like they are blaming the female victims when that happens. This line reads to me very much like “Why should guys be punished for what happens to college women when women drink? It’s their own fault.” That is what I am hearing.

Once again I must point out the obvious: It is not the fault of the victim; the onus is on the perpetrator of sexual assault. This is a particularly bad implication to make when you’re writing a book about sexual dysfunction. Are the authors really that short-sighted that they do not see how a sexual assault could in and of itself lead to some sexual struggles later on in life?

Am I reading this wrong? Am I looking too far into this? Do you see where I’m coming from?
Tell me now, does this sound like victim blaming to you? It sounds like victim blaming to me.

It’s possible that the authors are referring to other alcohol-related problems that female students may encounter, such as cutting into study time and dealing with hangovers on school days, but this is the big giant red flag that jumps out at me. There’s no way for me to ignore that.

Triggers end here

I’ve never been really good at “Take it or leave it.” Sometimes, I read things that I really like, and then the author screws something up & I don’t like it as much anymore…
But at the same time, I don’t want to leave behind the good parts. This is another one of those times where I am just going to have to cherry pick what I do like, and criticize the rest. Some parts of this book are flawed, and these parts need to be criticized. Klein & Robbins can not be called THE experts on sexuality because they tarnish their own reputation, for the reasons outlined above. I am not going to sing blind praises for Klein & Robbins.

I would also recommend against further purchases of this book, unless you are one or more of the following:
A collector of sexual education literature
A collector of out-of-print books
A collector of NVA reading list books
Genuinely curious to find out “Oh is it really THAT bad?”
In posession of unlimited time & money – because the book is out of print, you’ll probably have to pay extra to get it, and it takes time to read.

I think there are better, more sensitive books out there than this.
And I think I may have found one of them, which I can review at a later date.

Welp. The authors themselves stated that when creating your own definition of sex & tapping into your own eros, you’re probably going to encounter a lot of ambiguity.

I guess this book is in and of itself, one of those ambiguous situations.

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