Ayling Kathryn, Ussher Jane M
Gender, Culture and Health Research Unit: PsyHealth, School of Psychology, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia.
Arch Sex Behav. 2008 Apr;37(2):294-304. doi: 10.1007/s10508-007-9204-1. Epub 2007 Sep 18.
Vulvodynia has recently been recognized as a significant health problem among women, with a considerable proportion experiencing psychological distress and sexual dysfunction for many years. This study used a material-discursive framework and a qualitative methodology to investigate women's subjective experience of vulvodynia within the context of a hetero-sexual relationship, and their negotiation of coitus, commonly associated with vulvar pain. Seven women, who had experienced vulvodynia between 2 and 10 years, took part in in-depth interviews. Thematic decomposition drawing on a Foucauldian framework for interpretation identified that six of the seven women took up subject positions of "inadequate woman" and "inadequate partner," positioning themselves as failures for experiencing pain during coitus, which they interpreted as affecting their ability to satisfy their partners sexually, resulting in feelings of shame, guilt, and a decreased desire for sexual contact. This was interpreted in relation to dominant discourses of femininity and hetero-sexuality, which conflate a woman's sexuality with her need to be romantically attached to a man, position men as having a driven need for sex, and uphold coitus as the organizing feature of hetero-sex. Only one woman positioned herself as an "adequate woman/partner," associated with having renegotiated the coital imperative and the male sex drive discourse within her relationship. These positions, along with women's agentic attempts to resist them, were discussed in relation to their impact on hetero-sexual women's negotiation of vulvodynia. Implications for future research and vulvodynia treatment regimes are also raised.
外阴痛最近被认为是女性中的一个重大健康问题,相当一部分人多年来一直遭受心理困扰和性功能障碍。本研究采用了物质话语框架和定性方法,来调查女性在异性恋关系背景下对外阴痛的主观体验,以及她们对通常与外阴疼痛相关的性交的协商。七名有2至10年外阴痛经历的女性参与了深入访谈。基于福柯式解释框架的主题分解表明,七名女性中有六名占据了“不称职的女性”和“不称职的伴侣”的主体位置,将自己定位为在性交时经历疼痛的失败者,她们认为这影响了她们在性方面满足伴侣的能力,从而产生羞耻、内疚感以及对性接触的欲望降低。这是根据关于女性气质和异性恋的主导话语来解释的,这些话语将女性的性与她对与男性浪漫依恋的需求混为一谈,将男性定位为有强烈的性需求,并将性交视为异性恋的组织特征。只有一名女性将自己定位为“称职的女性/伴侣”,这与她在关系中重新协商性交的必要性和男性性驱力话语有关。这些立场,以及女性抵制它们的能动尝试,都被讨论了它们对异性恋女性外阴痛协商的影响。还提出了对未来研究和外阴痛治疗方案的启示。
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