We are in the 16 days of activism against sexual and gender-based violence and this has reminded me of Tracy, a lady I attended at the Sexology Clinic at one point. She walked into the clinic and after settling on her seat went into an uncomfortable silence.
“So are you unwell or you are visiting me for other reasons?” I asked to break the silence.
“I do not know where to start,” she said staring at the horizon, “I am not sure I am normal and I do not know whether you are the right doctor to help me.” I nodded inquisitively in a way to encourage her to say more.
I knew she was about to throw me in the deep end and that I would have to dig all over the place to be able to find my way out and arrive at a diagnosis. She fiddled with her finger nails, dropped her car keys and picked them in a hurry, turned her head across the room as if to confirm that nobody was listening to our conversation then turned her gaze to the floor.
“I feel nothing when having sex, nothing at all, it is like I am numb down there,” she said, “do you treat people with such complaints?” I nodded, well aware that at this point there was no diagnosis to work with.
She was 31 and had been married for four years. She had endured sex for all those years and even got one child. Her husband demanded sex frequently and she pretended that she was fine with it while in real sense she was hurting. Every sexual encounter left her hollow and sad.
“Of late I have been giving excuses to refuse sex,” she said, “I am however worried because tension is building up and I fear my marriage may suffer.”
I dug deeper in to Tracy’s medical, sexual and relationship history. She did not have strong conservative beliefs around sex, a common cause of numbed sexual feelings in many people.
She grew up in a loving family of liberals where sex was discussed quite openly. Her family of origin was not dysfunctional, another cause of problems in later life for children from such families. I could also not put a finger on any medical problems such as hormone abnormalities that could have led to her condition.
“What about rape, incest or defilement; have you faced any of these in your life?” I asked to which Tracy reclined back on her seat and turned her head to look down again. There was an uncomfortable quiet for close to a minute then she blindly fetched a handkerchief from her bag, blew her nose and wiped tears which were fast building up in the corners of her eyes.
“Is it really necessary to discuss that?” She blurted out to which I gently nodded, realising that something painful was eating her up. She then went into an emotional fit and cried for close to a minute. It happens that in her late childhood years a cousin who lived in their house defiled Tracy severally.
Initially he threatened her that she would kill her if she talked about it. Her behaviour changed and performance in school dropped. Her teachers met with her parents and she was put on counselling. She finally opened up. Her cousin was sent packing. The family kept the issue secret and told her never to tell anyone. She never attempted to have sex after that till she got married.
I finally came to my diagnosis: Tracy was facing the consequences of untreated sexual assault. Unless treated, sexual assault is known to have severe effects on a woman’s sexuality. Commonly many women lose desire for sex and find it hard getting aroused.
Poor arousal is associated with sexual pain. Many affected women also do not orgasm. Psychological effects are even worse and sex can be traumatising, leaving one disgusted, hollow and sad. Generally affected women are dissatisfied with sex. Some feel filthy, useless and hopeless after sex.
Treatment of the effects of sexual assault is sex therapy. The survivor is helped to confront the difficult experience, deal with it and relieve herself of the bitterness.
Tracy therefore went through therapy. In addition, she and her husband went through sex coaching to relearn intimacy, given that they had been on different tangents in their sexual lives. Progress was slow but a year later, Tracy visited the clinic and reported that she got her first orgasm, a sign that she had overcome the hurtful experiences of the past.
