A woman’s body is nothing to be ashamed of and yet, there is a discomfort, a stigma, in using the correct terminology in discussing women’s sexual health, and encouraging positive female sexual experiences. “Where there is secrecy, there is shame,” says Orlagh Reid, an accredited psychotherapist specialising in clinical sexology and sexual health promotion. “The opposite of shame is empowerment.”
Reid provides therapy online to women experiencing sexual concerns, vaginismus and sexual disorders, and aims to encourage women to feel comfortable in expressing their sexuality. “As a woman, mother and psychosexual therapist, I feel that our generation is responsible for advocating for female sexual health for the next generation so that they have better access to services and any expression of sexuality is no longer a taboo, something to be hidden,” she says.
“I want women to feel so empowered that they are kicking down doors for smear tests, contraception and tampons and not terrified to look at or touch their own bodies. Sadly, women have bought into so many myths about sex, libido and female sexuality that they are disempowered and uninvested in this part of themselves.”
Reid, who writes The Vaginismus Blog Series, recognises the importance of positive sexual experiences which can help women to develop sexual self-esteem and self-confidence, shifting any preconceptions they have about sex and orgasm.
“Too many women have unfulfilling intimacy or painful sex because they are not in touch with their sexual selves, relying only on their partner for arousal rather than the other way around. When women learn the facts about the female sexual response cycle and desire, how to enjoy mindful touch and fully express needs and limitations, sexual intimacy becomes a positive experience.”
Noting that women of all ages have a choice to no longer perpetuate the multigenerational shame we have been conditioned to feel about our bodies and female sexuality, Reid suggests choosing to “change on a deep level what we truly want to feel about ourselves from an informed place, and that is that sexuality, our reproductive organs, pleasure, intimacy and sexual health and wellbeing is not shameful. It is a natural part of being human.”
And yet, shame, taboo and silence is not uncommon in women’s sexual health as women often live with symptoms for years before accessing medical help due to the potential fear, shame or taboo associated with areas such as sex, menstrual health and reproductive health.
“A study that looked at adolescents’ willingness to discuss sexual health with their doctor, suggested that most young people will generally participate if the conversation is initiated by the doctor,” says Lesley Gilchrist, registered midwife and co-founder of My Expert Midwife, “but that they still feel hesitant, for fear of being judged, ridiculed or dismissed, and it is this internalised fear that may continue into adulthood, perpetuating a reluctance to discuss sexual health.
“Another study commented that sexual health is a concern to most adults at some point during their lives and yet the majority don’t seek advice from their doctor unless it becomes a persistent problem. It appears that many people feel their GPs are not suitably trained in sexual health and that they would rather have those conversations with trusted friends and colleagues.”
Similarly, Gilchrist suggests there are barriers to initiating discussions about sexual health between doctors and their patients with research indicating a lack of time during appointments, lack of formal academic training and a lack of confidence in their abilities to deal with the wide variety of topics within sexual health.
“Communication between a doctor and their patient is a two-way process,” she says, “with either the doctor or patient needing to start that conversation. Remember that GPs want to see you about any health concerns, including those that relate to sexual health. Pregnancy, fertility, possible STIs, menopause or concerns over lack of libido and sexual ability can all be discussed openly, honestly and in strict confidence with your GP.”
Women’s sexual health remains yet another understudied aspect of women’s health. “When it comes to medical research and innovation, sexuality, as part of women’s health and wellbeing, remains vastly underrepresented,” says Dr Karen Flood, consultant obstetrician gynaecologist and maternal foetal medicine specialist at the Rotunda Hospital and senior lecturer in RCSI Department of Obstetrics and Gynaecology. “The comparison between the progress and availability of treatments for male sexual health and performance compared with women’s is stark.”
Dr Flood suggests this gap in research has been acknowledged in recent years with research developing further in this area. “For example, in the Rotunda Hospital,” she says, “we are evaluating how female anatomy, specifically the clitoris, is taught in medical school, gynaecology training and midwifery courses to highlight this deficit and to guide future curriculums in these relevant specialities.”
The question of whether women are still subjected to negative moral judgments when it comes to sexual lifestyles is culturally and socially specific, but Dr Flood feels there has been a significant shift in our attitudes to sexual choice and lifestyle as we are “more enlightened, better informed, and with somewhat more gender-neutral perspectives on this subject. The recent changes in legislation and the preceding debate contributed to the empowerment of women to openly discuss their sexuality, bodies and choice.”
The stigma of sex and pleasure for women has been noted to significantly impact a woman’s sexual and reproductive health. Protection from sexually transmitted infections, contraception, mental health support, maternity care and safe abortion care are all important to ensure women can have and maintain a positive wellbeing and sexual life. The taboo and stigma surrounding women’s sexual health can create barriers to women’s sexual health.
Being comfortable in your sexuality is accepting, experiencing and embracing all of your body without fear or shame— Orlagh Reid, accredited psychotherapist specialising in clinical sexology and sexual health promotion
“My main concern here would be that women may be afraid to seek advice or treatment on matters of sexual and reproductive health because of concerns of stigmatisation,” says Dr Flood.
“With better education and our efforts to debunk myths and misconceptions about female and male genitalia, and other matters associated with sex, pleasure and reproductive health, stigma will become less of an issue in the future. Educating young people through outreach initiatives such as Debunking the Myths: The Science behind our Sexual Health, will no doubt reduce the stigma and in turn make them more proactive in seeking reassurance or help if problems arise.”
Reid suggests a number of things women can do to feel more comfortable expressing their sexuality including “choosing to intentionally detach from sexual shame, re-educating themselves about female sexuality, and embracing sex-positive attitudes at every age and life stage. Being comfortable in your sexuality is accepting, experiencing and embracing all of your body without fear or shame.
“The more we talk about sexuality and sexology, the more it becomes normalised in society. Sex education is for every age and stage; our bodies, minds and circumstances constantly change.”