In this study I wanted to examine the experiences of heterosexual women who
suffer pain during intercourse, a phenomenon known as Vistibulitis. In my research I
was able to map the conditions that enable or prevent women with Vistibulitis from
having sexual relations that do not center around intercourse.
Much of the literature about Vistibulitis examines the phenomenon from a
medical and/or psychological perspective, but few studies have explored the subjective
experiences of women with Vistibulitis, or from a feminist theoretical perspective,
which is the main purpose of my research. This study links critical theories on
heterosexuality as an institution, the different meanings of pain and gender, and
resistance to heteronormativity. The connection between these three themes is
essential to the experience of women with Vistibulitis.
In the study, I conducted semi-structured interviews with 14 women aged 20-32,
diagnosed with Vistibulitis. The women in the study are Jewish, heterosexual, secular,
single or in a relationship, without children, and well educated. They all stated that
they had not experienced sexual assault. I analyzed the data extracted from these
interviews, using theme analysis and critical discourse analysis methods.
Chapter One: Heteronormative Sex
This chapter discusses various discourses about heterosexuality as expressed in
three types of subjective understanding by the women interviewed: The male sex drive
and “the male inside the head”, the coital imperative, and the sexual work women do in
the context of their pain during sexual relations. This analysis shows how the sociallybased,
“biological” concept of men’s insatiable sexual desire serves as the basis for
women’s strong motivation to have sexual intercourse, even when painful.
“The male in the head” validates the concept of the male sex drive, even if the
interviewees’ partner did not express his sex drive in an uncontrollable manner. The
coital imperative and the concept of intercourse as the sole definition of heterosexual
sex remain strong. Small changes are discernable, however, based on different
interviewee circumstances, such as age, changing partners, and casual sexual
encounters as opposed to long-term relationships.
Three sexual work strategies were discovered: Discipline, performance and
avoidance. These strategies corresponded with the male sex drive, “the male in the
head”, and the coital imperative. However, the sexual work shows the various
strategies that women use to ease their pain, even at the cost of silencing it in order to
preserve the relationship. Discipline, performance and avoidance allowed the
interviewees a range of agency and leeway for negotiating with themselves and their
partners on the way to silencing and/or presenting their pain.
The women also expressed their efforts to create a representation of normal
femininity. They enlisted themselves to provide sexual pleasure to their male partners
and to themselves, and endeavored to establish a worthy relationship based on mutual
desire. This enlistment is contrary to the individual expectation of what is good and
right for one’s own body. This chapter shows how political and ideological enlistment
remains stronger than individual expectations.
The social structures that prevent women from voicing their pain during
intercourse are the discourses that comprise heteronormativity. The social process
described here reveals the motivations of these women to undergo intolerable pain:
Intercourse enables women to align themselves with the social imperatives of
heteronormativity, to be responsible for mutual sexual pleasure and conform with
society’s expectations from heterosexual sex.
Chapter Two: The different meanings of pain
Pain in this study was given three main meanings. The first was pain as a
disability. This meaning is offered to the interviewees by the medical discourse,
giving them relief and release on the one hand, but also preserving heteronormative
sexual norms in the context of health and illness. A disability label validated the
women’s physical experience of pain, which until the diagnosis had not been given to
them by multiple health care providers, who told them “it was all in their head”.
The second meaning of pain is that of a defect affecting their sense of selfworth.
The fear of being deprived of their femininity, and the experience of pain as
precluding their sense of worth, separates them from other women in their age group,
and are among the main reasons that women continue to have painful intercourse.
The last meaning of pain was related to the ability to limit or stop sexual
intercourse when it became too painful. While the interviewees were able to unsilence
their pain, they were unable to stop the painful intercourse for several reasons:
Their partners continued, despite being asked to stop, leading to sexual coercion. The
interviewees themselves found it difficult to retreat from their consent to sexual
intercourse, and hoped that eventually pleasure would overcome the pain. In addition,
un-silencing their pain did not lead to pleasurable alternative sex, because they were
expected to bring their partner to sexual release in ways which were not necessarily
pleasurable for them.
Chapter Three: Resistance, subversion and the creation of alternatives
This chapter discusses the different ways in which the interviewees expressed
their resistance to heteronormative sex, where intercourse is considered to be the sole
definition of sexual relations. In some cases, the interviewees exhibited a subversive
stance towards hegemonic femininity and normative heterosexuality, and created
alternative sexual practices that did not include intercourse as part of pleasurable sex.
Un-silencing their pain, redefining normative femininity and rejecting
heteronormative sexuality were enabled by several factors: The first was the maturity
of their sexual experience. The older the interviewee, the more she testified to selfacceptance
and the ability to avoid painful intercourse. The interviewees noted how
their sexual agency and ability to guide sexual situations increased with age. The
second resource was a strengthening of their internal dialog and self-acceptance, which
enabled them to clarify their desires and preferences in both sex and their relationships.
A third resource was the development of sexual negotiating skills, and the un-silencing
of their pain. The dialog with their partners enabled them to seek alternative sexual
practices. Still another resource was the use of feminism and exposure to feminist
content, that enabled them to legitimize the discussion of pain and the possibility of
alternative modes of sexuality. The last resource was the choice of a “considerate and
sensitive man” for whom intercourse was not the focus, and who did not define his
relationships or masculinity in those terms.
The question I wished to investigate in this study was whether there were
conditions under which heterosexual women who suffer from Vistibulitis were able to
maintain sexual relations without intercourse, to un-silence their pain, and to avoid
painful penetration. My findings showed that a number of resources were used to
empower the interviewees to un-silence their pain and avoid painful intercourse in
different stages of their lives and relationships. An analysis of the results showed that
it is difficult to maintain these relationships over time. The study was conducted
through the strategy of breaking the silence: Which conditions enable sex without
intercourse, and which resources are available to the interviewees to un-silence their
pain and protect themselves against it? Breaking the silence provided them with access
to these resources.
The first and most important resource was the interviewees’ perception of their
partner’s masculine identity. The choice of a “considerate and sensitive man” was
seen as key to pain-free sexual relations that did not include intercourse.
A second resource was casual sexual encounters. In casual sex, the interviewee
associated her ability to enjoy sex without intercourse with the fact that she was not
emotionally involved or responsible for maintaining the relationship. The age of the
interviewees and their sexual experience are additional resources for sex without
intercourse. Women who were “sexual novices” tended to hide their pain from their
Sexual negotiations are also important. The interviewees in the study came
from an upper middle class, educated, urban, mostly Ashkenazi background. As such,
their feeling of entitlement to sexual pleasure, sexual autonomy, and the right to live
without pain, were key. As women of privileged social standing, their ability to
perform sexual negotiation was especially high. Even so, access to resources for
managing sexual negotiations was not always available, especially at the beginning of
their sexual activity.
The exposure to feminist critical content of sexual heterosexuality, and their
participation in feminist courses at the university, helped them to conduct internal and
external negotiations, and strengthened their sexual assertiveness vis-a-vis their
This is the first study in Israel to examine the experiences of women with
Vestibulitis from the point of view of the women themselves, outside of the health
professions. Its contribution to research in Israel stems from the fact that Israeli
society is pro-natalist, and female heteronormative identity is central to the feeling of
self-worth and collective belonging. Alongside this discourse, other discourses of
gender equality and women’s liberation are available to upper middle class, educated,
secular women. The intersection between these two discourses enables an in-depth
analysis of the institution of heterosexuality in the Israeli context, which is especially
powerful in light of the emphasis on marriage and parenthood.