Realizing vulvas : feminism, physiology and culture

Based on thirteen months of ethnographic fieldwork in a large research hospital in the U.S., this dissertation analyzes the experiences of eighty American women seeking relief for chronic genital pain. Through extended interviews with diagnosed women, and participant-observation in a vulvar speciality clinic, I investigate the barriers--linguistic, cultural and corporeal--faced by patients who must engender greater familiarity and comfort with their sexual and genital bodies in order to successfully recover from their symptoms. Written as a cultural analysis of the vulva, the dissertation examines the ambivalent relationships between female external genitalia, U.S. dominant culture, and an autonomous female sexuality. Attentive to the transgression, confusion and disorder evoked by the symptoms of vulvar pain, the dissertation redefines the clinical diagnostic phrase "other causes of genital discomfort" in sociolcultural terms. The concepts of "genital dis-ease" and "unwanted genital experience" are introduced and analyzed as corporeo-cultural phenomena that contribute to a profound sense of alienation between many diagnosed women and their genital bodies. In addition to an extended introduction and a description of both the clinical fieldsite and conditions under investigation, the dissertation uses four progressive chapters--Accumulation, Manifestation, Integration and Generation--to theorize the lived experience of vulvar pain. Through a critical dialogue with current clinical literature, through which vulvar pain is understood in increasingly physiological terms, the dissertation argues that an acknowledgment of collective and cultural genital "discomfort" must be included in the emerging diagnostic and treatment regimens for women with chronic and unexplained genital pain.