The Vulva Speaks: Vaginismus, Authenticity and the Body’s Refusal to Pretend

In 1998, Kleinplatz invited clinicians to rethink so-called “sexual dysfunction” as communication rather than defect. Daniel Watter’s writing on the existential importance of the penis further highlighted how erotic anatomy often carries meaning long before it carries physiology. If we take that spirit seriously, a parallel question emerges:

If the vulva could speak, would she scream or whisper. Either way, she would speak.

She might say: You ask me to open yet I do not feel safe. You want welcome yet I have rarely felt wanted. You treat me as a passage when I am in fact a threshold.

As a licensed sex therapist practicing existential sex therapy, I sit with women and vulva-owners who describe their bodies as refusing to cooperate. The diagnosis is often vaginismus. The muscles of the pelvic floor contract involuntarily during penetration. Pain and fear follow. Shame fills the space that language has not yet reached.

The conventional view focuses on mechanics. Muscles. Dilators. Desensitization. These are useful tools at times, but when applied in isolation they risk treating the symptom while bypassing the meaning. In existential sex therapy, the body is not a malfunctioning machine. It is a narrator. It speaks when we cannot.

When a client says, My body will not let him in, I do not correct. I ask what part of her is saying no. I ask what part of herself she has had to silence to stay connected. The vagina is not empty space. It is boundary and barometer. Its closure is sometimes less dysfunction and more discernment.

For many clients, the sexual history is not about pleasure. It is about compliance. Saying yes when the body says no. Performing arousal to avoid conflict. Enduring penetration out of duty or fear. Over time, the psyche learns to leave the body. The body then speaks for the psyche. Pelvic floor tension becomes refusal in muscular form. The body remembers what the self could not afford to register: the first freeze, the practiced self-abandonment, the pressure to be alluring yet not desirous.

Vaginismus can serve as a kind of existential protest. A refusal to participate in sex that excludes the self. It raises questions that lie beneath technique. Freedom: Do I have the right to choose, to refuse, to change my mind. Responsibility: What choices have I made to be accepted and at what cost. Authenticity: What is true for me, not what I have been told should be true. Isolation: Can anyone understand what it is like to live in a body that closes when I wish it would open.

Treating vaginismus solely as a physical impediment can reinforce the very silence that sustains it. Existential sex therapy invites a different starting point. We do not rush the body. We do not treat penetration as the measure of success. We ask what safety actually feels like. We notice where the client has been split from her own experience. We explore what it would mean to include the self in sex.

Healing sometimes begins not with opening but with listening. The closure may be protecting something vital. When that protection is respected, rather than overridden, the body often begins to reorganize. Agency returns. Sensation becomes information rather than threat. Pleasure becomes possible not because the muscles relax but because the self is present.

Vaginismus is not failure. It is not evidence of a broken body. It may be the first time the body is telling the truth and refusing to perform. That truth deserves to be heard without shame and without urgency.

If you are living with vaginismus or sexual disconnection, sex therapy can offer a space to slow down, to listen and to repair. The work is not about forcing the body to comply. It is about helping the self to return so that sexuality can become an expression of being rather than an act of endurance.