ver the past few decades, depictions of sex onscreen have diversified: They’re no longer all cis, straight, white, and penetrative. In just the last ten years, shows like Sense8, Broad City, Transparent, and, most recently, Normal People have broken down barriers by portraying intercourse in all its messy, silly, awkward glory.
There’s still a hell of long way to go, but TV sex is finally beginning to resemble real life. But as slow as movies and television shows have been to present intercourse as it actually happens, media has been slower still to acknowledge that even consensual, loving sex can be unintentionally painful.
The lack of space to depict this reality enables the pleasure gap and alienates many whose lived experiences of intimacy differ dramatically from what they see onscreen.
According to the National Survey of Sexual Health and Behavior (the largest national sex survey ever), conducted by the Center for Sexual Health Promotion at Indiana University surveying more than 20,000 people over 7 years, “about 30 percent of all women ages 18 to 59 reported some difficulty with pain the last time they had sex,” versus five percent of men.
Reasons for the discomfort ranged from lack of lubrication and/or foreplay, to uncomfortable positions, to anxiety, to chronic pelvic pain conditions like vulvodynia and vaginismus. A 2017 study in BJOG, an international journal of obstetrics and gynecology, found that nearly 10 percent of women regularly experience painful sex, or dyspareunia.
In short? Painful sex is very common.
Yet these statistics aren’t often reflected in the media we consume. Why? Perhaps because reigning sexual ideals heteronormatively center male gratification at the expense of women’s pleasure and wellbeing. Or maybe because sex scenes riddled with sadness and physical pain aren’t sexy. Discussing that sex is often painful for women is unsexy. Much has been written about how even the medical community struggles to adequately address women’s pain — particularly Black women’s pain — and the pain of nonbinary people.
However, recent series like Masters of Sex, Sex Education, and Unorthodox have started to shift the conversation by bringing these experiences to the fore in their depictions of sex. All three shows portray vaginismus onscreen, destigmatizing a common, though not-oft discussed condition.
Vaginismus is the painful, involuntary contraction of the vaginal muscles upon penetration. This can make certain sex acts, pelvic exams, and even inserting tampons or menstrual cups difficult or impossible.
In an interview with HuffPost, pelvic floor physical therapist and American Physical Therapy Association spokesperson Carrie Pagliano notes that the condition and its root causes still aren’t fully understood. “The definition of vaginismus has changed a lot over the years, from the psychological realm to the physical. It now lies somewhere in between.”
While for some, vaginismus can be linked back to past sexual trauma, other medical issues, or anxiety, for others there is no discernible “reason” for the pain. Symptoms can begin the first time a person inserts a tampon or attempts penetrative sex, or develop years after becoming sexually active.
For people with vaginismus, the lack of answers can lead to feelings of shame and isolation. But recent portrayals of the condition onscreen have made clear to those with vulvar pain disorders that they’re not the only ones struggling.
Emma, 29, says that Sex Education is the first show she’s seen represent her experience: “I remember thinking ‘Oh my god! They are going to talk about vaginismus and pain? That’s so cool!’” In season one of the Netflix comedy, high school student Lily (Tanya Reynolds) wants to lose her virginity before graduation, but when she and a male partner attempt to have intercourse, she screams in pain and can’t continue. She describes her vagina as having “lockjaw” and strains to understand why her body is “betraying” her.
Most of the women who contacted me for this article use similar language, describing cycles of desire, panic, and then frustration when trying to have sex, comparing attempting penetration to “hitting a brick wall.”
Megan, 28, has experienced vaginismus for four years and, in an email, tells me she can relate to the portrayal in Sex Education: “It’s hard to reconcile the literal fight your body is putting up against penetrative sex despite mentally and emotionally wanting to partake in it.” Many of the details of Lily’s journey also feel familiar to Megan: the collection of dilators, the frustration, the denial.
However, unlike Lily, Megan had a relatively normal sex life before developing secondary vaginismus as a result of the harsh medication she was given to manage her endometriosis.
“The lack of estrogen in the medication made the skin in my vagina become thin and lose elasticity. It took me far too long to seek medical help because I was convinced that the pain I was experiencing was my own fault or that I could just power through it.”
Many of the women I speak to echo this idea — they thought pain was just part of sex. Emma, who has had the condition since she was 21, states “I assumed that it was normal to feel pain during penetrative sex and didn’t really do a lot of research into it.”
Emily, 21, who has experienced the condition since she became sexually active at nineteen, tells me she had anticipated feelings of discomfort when she began having sex, but the pain never eased. We are often taught that sex is “supposed” to hurt the first time, that there’s a certain amount of “sucking up the pain” to be expected during penetrative sex.
Let’s dispel that myth right now: Outside of consensual pain play, sex should never hurt.
Alaina, 27, recently finished watching Unorthodox, a Netflix miniseries about a young woman, Esther Shapiro (Shira Haas), who flees her Hasidic Jewish community in Brooklyn to begin a secular life in Berlin. The show’s depictions of Esty’s struggle with vaginismus are vivid and devastating — the pressure from her husband and family to have a child, the Kallah teacher diagnosing her with vaginismus and presenting her with dilators, her aunt worrying that she’s “defective,” her feeling that there’s “something wrong with her,” the painful, not-quite-consenual sex she is compelled to endure.
Alaina, who has experienced vaginismus since she became sexually active at 23, says the emphasis Esty’s community places on her husband’s pleasure and conception despite her pain rings true:
“Esty is taught that she is the [one who] is supposed to give pleasure, and the man is supposed to receive it…When I try to have [sex] with no luck, I always feel like I’m disappointing the man.”
Megan remarks, “People, and I think men especially, don’t want to acknowledge the ugliness of how painful this condition can be and that individuals with vaginas sometimes try to force themselves to endure painful intercourse out of a sense of obligation to their sexual partner.”
The women I spoke to all emphasize the impact — good and bad — that their relationships with their partners and their support systems had on their mental health and ability to successfully treat their vaginismus.
Megan, who recently gave birth to her first child with her husband whom she’s been with for eight years, says her partner was a “patient angel during all this. (He even proposed during the Great Sex Drought).” But because of unhealthy ideas about sex she was taught by her mother — “if he isn’t getting it from you, he’ll find somewhere else to get it” — she still grapples with feelings of inadequacy and shame.
Like Megan, Priscilla, 30, originally had a healthy sex life. But two years ago, she began dealing with pelvic pain, for which she still has no discernible underlying cause or diagnosis. She stresses the emotional and mental toll of the pain:
“Sex stops, but feeling like you are disappointing your partner and failing as a woman gets carried around 24/7. Even in situations like mine where I have a loving, understanding, and compassionate partner, I still feel those things.”
Emily’s experience with her ex-boyfriend was less positive. “Because of the vaginismus, my partner and I no longer could have penetrative sex because it scared me so much,” she writes. “I would go as far as to say that it massively impacted our relationship, and it was part of the reason we broke up. It’s something I feel I need to tackle before I get into another relationship.”
he interviewees also report that their treatment by medical professionals had a large role in shaping their vaginismus journeys, an aspect of dealing with pelvic pain often missing from TV portrayals.
Many of the women I spoke to used words like “frustrating” and “defeating” to describe their encounters with doctors. Priscilla says her pain has routinely been “shrugged off,” even though all of the professionals she’s seen have been women. Emily was diagnosed correctly, but can’t access or afford the therapy and treatment she needs — unaffordability is just one of many additional barriers to care.
Emma gave up on visiting medical professionals after an incorrect diagnosis. “I have basically dealt with it on my own since” then, she remarks. She only learned about the term “vaginismus” after a customer at the online sex toy store she worked at asked her to recommend them some products that could help with the condition.
Alaina goes so far as to call her experience with the medical system “traumatizing” — her gynecologist suggested Alaina was exaggerating her pain during a pap smear and recommended using lube. Alaina also self-diagnosed after learning about vaginismus from a friend.
Unlike the other interviewees’, prior to giving birth, Megan’s encounters with doctors had been largely positive. She notes that since being treated by a well-known surgical specialist for her endometriosis at nineteen, gynecologists trust that her self reporting is accurate.
She says, “Any time I have gone to an OBGYN with a problem, they see his name in my records and take everything I have to say seriously. I think I only got the care I did because the right man thought I deserved to be listened to and treated for endometriosis-related pain almost a decade ago.”
Her birthing experience, however, was extremely painful and traumatic — the doctor attending her delivery knew about her vaginismus, but violated her requests and bodily autonomy repeatedly while she was giving birth. This has made Megan and her husband question whether or not they want to have more children in the future.
“We always wanted two children,” she says. “But now I feel like I’m mourning the fact that I may only ever have one because I’m terrified to ever go through delivery again.”
These are the harsher realities often missing from the few onscreen depictions of pelvic pain that exist. It’s also worth noting that most of these representations feature cis, straight, slim, white women.
Tatyannah, 24, developed vaginismus after suffering a small perineal tear three years ago. She says she appreciates Sex Education’s depiction of the condition — “Lily navigating how to take control of her sex life through sex toys and mutual masturbation with her [same-sex] partner.” But she worries that as a Black woman, her pain isn’t seen as legitimate in doctors’ offices or in the media. (A fear that, as I mentioned before, is warranted.)
“The lack of diversity in portrayals of vaginismus and chronic pelvic pain onscreen is further confirmation of the reality that the pain of Black women isn’t taken as seriously. Common stereotypes about Black women being naturally stronger and more self-sacrificing than others also add to the lack of empathy and care we get.”
Emily also identifies sizeism as an issue. “As a plus-size woman with vaginismus…I would love to see bigger bodies onscreen. It’s not just thin people who have sex and experience all of the complications — we do, too!”
Despite the lack of diversity in these series’ portrayals of painful sex, the majority of women who reached out to me agree that any serious representation of vaginismus is good representation.
Emily writes of Sex Education: “I can only imagine the amount of awareness it brought to the condition and how many people it comforted. It felt so nice for a show to recognize every aspect of sex — not just replicating the stuff you see in porn.”
Priscilla tells me she feels seen when shows incorporate scenes of “(consensual, wanted) sex that ends up being painful or impossible.” She asserts, “Even if it doesn’t match my situation exactly, it makes me feel less alone.”
Some of these depictions of painful sex are more accurate and compassionate than others — Remember when Charlotte’s vagina was “depressed” in season four of Sex and the City? (She had vulvodynia.) — and the need for greater diversity is real, but they all succeed in starting an important conversation.
By shining a spotlight on pelvic pain disorders, these shows communicate to viewers with these conditions that they aren’t on their own and educate general audiences on how to be supportive partners.
Painful sex is a reproductive justice issue, and it’s not uncommon. Let’s close the pleasure gap, together.
Note: The names of interviewees who wish to remain anonymous have been changed.