Epistles of dyspareunia: storying Christian women’s experiences of painful sex

Dyspareunia is painful attempted or completed vaginal-penile intercourse, and vaginal pain from other forms of touch. Because there is a persistent underlying message of shame and taboo surrounding female sexual pleasure in some Christian-informed cultural contexts, we sought to examine how self-identified Christian women in the Midsouthern USA conceptualise and experience dyspareunia. Data were collected through initial surveys and semi-structured interviews and analysed using incident-to-incident and in-vivo coding. Creative Analytic Practice was used to create composite character narratives from the data, storying five aspects of participants’ experiences: (1) ignorance and abstinence at home, church, and school; (2) socially-informed expectations of sex and painful realities; (3) making sense of, coping with, and seeking help for painful sex; (4) validation, diagnosis, and treatment; and (5) sex mis-education and desire for a different future. Findings suggest that participants’ understandings of and coping with their sexuality and the accompanying painful sex are shaped by implicit and explicit religious messages they encountered in their family upbringing, schooling, social and religious circles, and interactions with healthcare providers. Health professionals are urged to pre-screen women for symptoms of dyspareunia and include sexual wellness checks as routine procedure, and subsequently refer patients to pelvic health physical therapy when appropriate