Struggles for medical legitimacy among women experiencing sexual pain: A qualitative study

ABSTRACT

Given the prominent role of medical institutions in defining what is “healthy” and “normal,” many women turn to medicine when experiencing pain during intercourse (dyspareunia). The medical encounter can become a contest between patients and providers when physicians do not grant legitimacy to patients’ claims of illness. Drawing on interviews conducted from 2007 to 2008 and 2011 to 2012 with 32 women experiencing dyspareunia (ages 18–60 years) and living in New York City and its surrounding areas, this study examined women’s and their physicians’ claims regarding bodily expertise, particularly women’s perceptions of physician invalidation, their understanding of this invalidation as gendered, and the consequences for women’s pursuit of medicalization. Women overwhelmingly sought a medical diagnosis for their dyspareunia, in which they believed that providers would relieve uncertainty about its origin, give treatment alternatives, and permit them to avoid sexual activity. When providers did not give diagnoses, women reported feeling that their bodily self-knowledge was dismissed and their symptoms were attributed to psychosomatic causes. Furthermore, some women linked their perceptions of invalidation to both historical and contemporary forms of gender bias. Exploration of women’s struggles for medical legitimacy may lead to a better understanding of the processes by which medicalization of female sexuality takes place.

KEYWORDS:

• Doctor-patient relationship
• dyspareunia
• medically unexplained symptoms