[Image description: A naked woman kneeling with legs tucked behind her and hands laid on her thighs. Her head is depicted in profile, with eyes closed and head facing slightly upwards. Long black hair connects two heads; one attached to her body and the other dangling by a strand of hair just behind her butt. Behind the figure is a geometric patchwork of earth-toned shapes. The shapes are larger towards the top of the image and smaller towards the bottom.]

—

The pain began to escalate as the winter set in, until one night in January I couldn’t pretend that the hurt was something I could breathe through, something surmountable. I wanted only to be alone, shivered away from him, abruptly
                           and in the cold, I could not even cry, pulling my limbs in tightly, closing closing

I noticed the two white spots before I felt the pain. They line the very edge of my inner labia where the lips meet just below my clitoris. They are small, almost unnoticeable against the pink of my surrounding skin. At first they did not hurt. When they began to, the first pain was sharp and precise, like a grain of glass grinding into me when I touched myself, when I was touched. But the glass was in my body, it was my body.
                I do not actually want to say “touch myself.” “My hands reach out,” the dis-joined I. I reach. I masturbate. My gentle fingers, my own knowing and tender touch.

I tried to talk about the pain I was experiencing with my friends who have vaginas too. I got a lot of sympathy, some bad advice, pity, a line of questioning roughly distilled to “are you sure you’re doing it right?” But no one seemed able to empathize. Statistically, someone is probably lying; about a quarter of people with vaginas experience vaginal pain at some point in their lives. Maybe my friends are all in the lucky three-fourths, but maybe they aren’t, or won’t be. 

(I do not want to be afraid. I tell my mother that if I write this piece about my vagina, I will be able to write anything. She laughs.) 

I never doubted that my pain was pain, as opposed to some misinterpreted sensation, for it is mine and within me. But though I could not deny it, I tried. I blamed every factor but my body: tried lubes of all kinds (water-based and all-natural and silicone-tinged and hot ’n cold and coconut oil);  condoms made with and without carcinogenic chemicals and with and without latex and with and without the smell of latex; different sex positions, new angles; the oft- (and ill-) suggested glass of wine to loosen up. I wanted to believe that the pain was a result of a choice, and therefore its relief in my power.  

Around the same time, I had a terrible tooth ache for days and didn’t call the dentist. M, who never misses an opportunity to ask a medical professional about an ailment, was confused, told me that isn’t the way to handle these kinds of things. Most pain gets worse, won’t abate until faced. The tooth ache faded. 

It took months of increasing pain with touch and during sex for me finally to admit to someone other than myself and M that something was really wrong. Not just that the pain was real, but that it was enough to complain about, that it had passed some personal threshold of disturbance and become worthy of a reaction. Finally, I scheduled an appointment for the next time I’d be home from school, marked my calendar, resolved to take better care of myself. 

At my first appointment for the pain, I told my doctor about the spots and the points of discomfort — my clitoris, when touched sometimes, and my perineal skin, the opening of my vagina, during sex almost always now, and inside my vagina too, a dryness. My doctor, inspecting my vulva before inserting the speculum, said she saw some tearing, adding that that made sense given the pain that I described.

By my third or fourth appointment, I became more specific: It is like no matter how much lubricant we use, I feel dry, like burning, like blockage, like sandpaper, like being ripped apart, unripe.

My doctor said, you’re a smart woman, you’ve probably already looked this up. She was right — I’d done my googling, diagnosed myself weeks before. She broke the news gently anyway. She told me she wouldn’t do a biopsy, because the spots are so small and in such a sensitive place, but I have lichen sclerosus, a rare, chronic condition that whitens and thins the skin of the vulva. She didn’t linger on the details, skipped ahead to a treatment plan, not mentioning that a treatment plan for lichen sclerosus is probably lifelong. Not mentioning that nobody actually really knows. Or that not only is lichen sclerosus rare, but very rare in someone as young as I am. 

Instead, she devised a treatment plan. To heal the whitened skin near my clitoris, she prescribed clobetasol, a very strong steroid, goo thicker than toothpaste, slick and scentless. She drew a diagram of my vulva, highlighting the thin peak where I should apply just a scant amount before bed. Call with any questions, she said, and come back the next time you’re in town. Soon.

—

A few weeks later, sitting together at a bookmill-turned-bookstore in dark Western Massachusetts, after a day spent wandering the Yiddish Book Center, M declared he wouldn’t have sex with me for at least five months, not even if I begged. He said it with humor but also a gentle hand over mine. Relief rose within me, a sudden less-aloneness, an agreement. My pain had brought with it a guilt, a false blame, an apart-ness from him. And now, necessity disguised as choice, but something shared nonetheless. I saw my doctor again, told her things really weren’t getting better, had my IUD removed, tried to remember which days to apply the clobetasol

                Monday, Wednesday, Friday before bed, don’t forget to wash your fingers, don’t let it touch your anus, don’t               worry
                M suggested that I don’t put it on right before bed, that I have a cup of tea between, that I reserve my day’s last act for happier things. So I make time between, the cream becomes habit, simmers enough that sometimes I even forget Monday, Wednesday, Friday

—

Some things that may or may not be true about lichen sclerosus depending on the decade, the doctor, the day: It is not contagious. It might increase the chance of developing vulvar cancer. It might be an autoimmune condition. There may be bruises. There may be pain during sex. It may be caused by trauma, genetics, a previous skin condition, infections, or nothing, they (the doctors) don’t know. It may lead to labial fusion, the closure of the inner labia. Or the fusion of the labia into surrounding skin, a self-swallowing smoothness that leaves only the vaginal hole. It is unlikely that this will happen to me, but I watch for signs of disappearance anyway, and worry that any irritation or opened crack will catalyze this change in my vulva’s structure. The possibility creates a double fear for me — to become only a hole, an embodiment of some reduced male gaze, but also the loss of the lips, to be alienated from the feminist reclamation of a vagina-ed body empowered by its delicate folds, layers. O’Keefe’s flowers, the otherworldly inward bloom of figs. What would it mean to have a vagina so unlike?

The uncertainty has made me feel alone in my healing, somewhat clinical in my attempts to care for myself. Unable to control my body, I try to control other things, give new attention to sequence and effect. M notices this rigidity in our sex life. I feel it elsewhere: distrust in scented and unscented products, concern about the tightness of my pants, the quality and cloth composition of my underwear. I scrutinize myself, but don’t know if my attentiveness will prove fruitful. 

Before my sexual pain and diagnosis with lichen sclerosis, it had been my privilege to expect my body, almost always, to follow my will. I had thought the promise of my body was its capacity to stretch and contract, to accommodate my choices, to rise to them. I was told of the elasticity of my vagina, its self-regulating power, its strength and durability. I know I was not lied to by omission, misunderstanding, malicious intent, nor has my body chosen this, but the betrayal is in my bones. My body, which has never before failed me, is failing. Not to keep me alive but to meet the expectations of my life as I had imagined living it, without pause, without fear, without pain. I am, I think, mourning. 

The scholar and essayist Elaine Scarry writes of the diagnostic language used to describe pain, its capacity to provide “an exterior image of interior events.” Much has been written about the importance of metaphor in understanding, and misunderstanding, illness and pain, including some projects with specific attention to sexual and gynecological conditions. One study of the language used by patients diagnosed with endometriosis, a condition related to uterine tissue growth, attempted to organize the metaphors its interviewees used to describe their pain, dividing them into categories like “physical damage,” “transformative force,” and “animate agent” — the pain as a being unto itself. 

Thinking about vaginas, woundedness became the metaphor. Make my pain a mechanism. If the vagina is already a wound, what am I to do with a wounded wound? A scarred one? What might it mean to heal this wound?

My mother tells a story about a woman in our community, a woman who speaks to herself, who wanders. She gave birth to a dead baby, my mother says, on a cold winter night, alone. She did not cut the umbilical cord, instead she ripped her skirt from the hem, carried the body in her arms through the snow to the hospital, the cord between them pulled through the rent cloth. Finding no seam, she made one, she                carried on.

—

My doctor compares my perineal skin to cigarette rolling paper, asks if the reference is outdated. The description sickens me, the terrible crinkliness of it, the sticking to fingertips, the way that cigarette paper wrinkles and cannot be made smooth again. 

I do not know when my tear began, if it was a slow unzipping or one quick rip. After my doctor mentioned it during my first visit, I went home intrigued, held a two-sided table mirror between my legs, became familiar with myself. The tear has healed into two white scars held close together, a phantom seam like a mild iteration of the kind of split some sustain in childbirth. Like I gave birth to a ghost. The only physical evidence of my penetrative pain, the tear becomes a kind of reassuring proof, a visibilizing validation. An exterior image of interior events. Though I know I shouldn’t need it to believe in my pain. Though I’m tired of “shoulds.” 

The clitoral pain has resolved with treatment, and although the spots remain, they have mostly brightened back to their natural shade. The delta of my perineal skin, thin like cigarette paper, is becoming softer, smoother again, but still darkened around its edges. Through months of steroid treatment, I continue to watch, have found myself mostly unable to determine subtle change, like looking at your face every day in the mirror until one unremarkable day, you realize you have aged. 

Revolving the mirror’s faces, close and closer, perspective. 

The forests are burning and my vagina looks the same
in good-faith inflamed

—

Repetitions of Pain:

1. At sixteen, I dream of a sudden laceration that runs the length of my body’s center meridian, a gash from the cuts of my clavicle down the boned flat of my rib-caged middle, the soft of my stomach, stopping inches above my pubic bone. I move among my friends and family, explaining my injury, presenting my openness with urgency, asking for care. When I awake, relieved, I run my fingers through the crevice of my breasts, finding myself whole, inhale. 
2. The abrupt rip of cloth splitting along no seam. 
3. My mother and I float in the shallows of the lost river and watch the forceful flutterings of a drying ladybug, its attempts to air out the wetness, the repetitious reassembly of wings. I pity her short life, the healing for which there is not enough time. We are patient; time passes. The ladybug lifts off and away. 
4. In and out, in and out. This too, I cannot bear. 

The pain changes, comes in different forms. The moment of penetration, the sexual act, the stinging when it’s over, my tear re-torn. I try to isolate the stages, understand each pain, learn to describe their chorus, name them.

Scarry writes of the artist’s potential to offer languages of pain for those experiencing “the real life crisis of silence.” Last summer, Jewish Currents, for which I work on the lowest rung, published “Unorthodox Bodies,” a review of the Netflix show “Unorthodox,” in which, among many other plot points, the protagonist experiences sexual pain during attempts at penetration by her husband. The review begins with an acknowledgement of the rarity of such a plot point, listing the handful of painful sex scenarios depicted on television. The piece concludes with what at first felt like an uplifting argument: “One rarely invoked ‘cure’ for vaginal pain, after all, is to simply remove the penis-in-vagina component from the sexual equation and engage in other types of sex. Considering that heterosexual penetrative sex is often unsatisfying for most cisgender women, rejecting the coital imperative — a term scholars use to describe the Western idea that penis-in-vagina intercourse is the only option for ‘real sex’ — looks less like sacrifice and more like freedom.” My pain, I was relieved to read, would radicalize me. 

I sent the article around to friends, excited that it existed. Then, the glow of being less alone wore off, and frustration crowded in. I still want to find a way to make penetrative sex not painful again — I do not care about pleasure, which I can give and feel in so many other ways. I care about being denied by my own body something that I desire, being limited from within, being always just a misstep away from pain. Resisting the impulse to pursue a “cure” for my pain, I still am not ready to stop searching for ways to reduce it, especially when lichen sclerosis and so many related conditions remain medically mysterious, when those trained to provide care for bodies with vaginas have been so often uninterested in understanding them. 

And what is so radical about wanting to avoid pain? What desire could be more obvious?

—

I dreamed I was traveling with a couple I did not know. Suddenly, they were naked in my lap, their penetration happening, impossibly, right between my legs, and I was watching, as if I could see through her, as they slid in and out of one another. I awoke with my hand between my legs, wondering whose hands guided mine there (yours?). 

Although my doctor has never said it aloud, it is likely that my sexual pain and lichen sclerosus are linked to one another, or at least related. I am not sure if she assumes that I know this, which I do, or that she really believes them to be in some way separate. She’s trying to help me treat both, checks in, wants to make sure that despite it all, I’m still having “good sex.” I tell her I am, and it’s true. Like many people with vaginas, I have never come from traditional penetrative sex, so my enduring sexual pain has not changed the most acute pleasures of my sex life. It is the present impossibility of entangling with my partner in penetrative sex, more than its mere absence, that has most saddened me. We are a pair with bodies that in the past were able to enter and envelope one another — it is not shameful to hope that someday we will be able to again. 

Sexual pain, exceptionally, is a kind of medicalized pain that implicates, and is aggravated by, another body, the animate agent truly an intimate partner, a lover, a friend, another human being. My dear M. Early in my healing, right before the pandemic struck, I came to a minor crisis. I wanted, I thought, to date someone with a vagina. The thesis was not shocking, I’d wanted that before, but then I wanted it more, imagined myself in a relationship without traditional penetration, or its expectation, a relationship where I wouldn’t feel guilty for my body’s limits. I imagined refuge in my queerness. I still often do. M has offered me only reassurance and love, but I feel guilty nonetheless, worried about some future point when his patience might expire, when accommodating what my body can not tolerate might become intolerable to him. And then guilty for feeling guilty, sorry for doubting his love, his capacity for tenderness. My partner, who cannot feel my pain, who does not doubt it, whose body awakens it. 

But the winter’s agreement held, and we changed. Instead of penetrative, sex has become more externally focused, sliding and rubbing and rocking. Though the inversion of our roles is one obvious alternative, we have mostly shifted more of our partnered sexual energy towards explicit, focused pleasure, a relief from the pressure for each of us to have simultaneous or similar experiences. 

I have discovered a love for blindfolds, for taking away M’s sight. I feel mischievous, wicked, powerful in the illusion, like magic. Sometimes, I try to create a sensational facsimile of what I imagine penetration feels like for him. Sometimes, the objective is more than that, the desire to create new sensations. We take turns. When I cannot see, I do not lose myself in fearful anticipation, do not have the opportunity to feel the wash of fear, to be afraid of touch and pain. Knowing that the painful acts are not among the possibilities, the anticipation of his touch is only the anticipation of pleasure, trust compounded. In the darkness, I listen for his breath above me, beside me. So close, so unknown. I burn. 

—

The poet Yehuda Amichai writes, “The precision of pain and the blurriness of joy,” says he wants to “describe, with a sharp pain’s precision, happiness / and blurry joy.” I have stopped the acts that cause my pain, made my pain imprecise, already a memory, although in truth I am only avoiding it, making my body blurry and no less unsure. Or perhaps I am healing. Or both.

I gave birth to a ghost. It left my body on wings, it flew.