A Desire to be ‘Normal’? A Discursive and Intersectional Analysis of ‘Penetration Disorder’

Jemma Tosh, Krista Carson


Psychiatry’s problematic framing of femininity, women’s bodies, and sexuality has attracted much condemnation (Caplan & Cosgrove, 2004; Frith, 2013; Ussher, 2011). The intersection of sanism and sexism is particularly overt in the psy- complex’s (Rose, 1979) response to violence. While psychiatry acknowledges that many of those diagnosed with ‘female sexual dysfunction’ have experienced sexual abuse, addressing the problems of violence against women is starkly absent within psychiatric discourse. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders combined ‘vaginismus’ and ‘dyspareunia’ to produce a new diagnostic classification: ‘genito-pelvic pain/penetration disorder.’ The diagnostic criteria included difficulties, pain, or fear regarding penetrative heterosexual sex (American Psychiatric Association, 2013). Using discourse analysis (Burman, 2004; Parker, 2013) and critical intersectional analysis (Cole, 2009; Crenshaw, 1991; Hill- Collins, 1998, 2003), this paper analyzes psychiatric discourse to illuminate the violence inherent in procedures and treatments that perpetuate sanism and (hetero)sexism within psychiatry. We argue that psychiatry’s positioning of penetrative heterosexual intercourse as ‘normal,’ necessary, and ‘healthy’ pathologizes experiences of sexual violence as well as other forms of sexual identity (e.g., asexuality and homosexuality). Psychiatry needs to promote and accept sexual diversity, including the choice not to have penetrative sex at all.


sanism; rape; discourse analysis; penetration disorder; dyspareunia

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