070 Painful Sex Among White and Black Women in the United States: Results from a Nationally Representative Study

'My partner will think I'm weak or overthinking my pain': how being superwoman inhibits Black women's sexual pain disclosure to their partners

Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women's open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner's feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women's perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women's sexual health and relationship outcomes are discussed.

Racialized differences across experiences and measurements of pain in genitopelvic pain/penetration disorder

BACKGROUND

Despite a growing body of research on genitopelvic pain/penetration disorder (GPPPD), few studies have examined racial and ethnic differences.

AIM

The goal of this study was to examine differences across racial groups pertaining to GPPPD with sexual vaginal intercourse in young college women at 2 public US universities.

METHODS

Data were collected from 1197 students from 2 public US universities. We limited our sample to 667 sexually active participants aged ≥18 years (mean, 19.21). Participants responded to survey items on their sexual history, wellness, and practices and to the Female Sexual Function Index. Data were analyzed through standard bivariate and regression analyses.

OUTCOMES

Participants were asked, "In general, do you feel pain with sexual intercourse?" and categorized into 1 of 3 pain groups: occasional (10%-25% of the time), frequent (≥50%), and no pain (<10%).

RESULTS

GPPPD was prevalent among young college women, with 162 (24.3%) reporting pain occasionally, 119 (17.8%) frequently, and 386 (57.9%) never or very seldom. While there were no differences in pain between Latina and non-Latina participants, our analysis indicated that pain was significantly higher among all other minoritized racial groups as compared with White women but particularly high in Black women, who had 2.15-higher odds of reporting pain than White women. Differences persisted when adjusting for socioeconomic status. Specific descriptors for pain sensation were more aligned with traditional descriptors of GPPPD (eg, burning, stinging, cramping, and pinching) in the White sample than among participants of color. Pain intensity did not differ among racial groups. We also found that a significant number of participants, particularly Black women, reported experiencing painful sex occasionally. No differences were noted across racial groups when assessing sexual function with the Female Sexual Function Index.

CLINICAL IMPLICATIONS

Existing surveys and physician intake forms should be critically examined for usability with patients of color. As evidenced, Black women's GPPPD seems to go underdetected/undetected by current measures.

STRENGTHS AND LIMITATIONS

This study is the first to explicitly compare racial differences among adolescents/young adults. The most notable limitation is the reliance on participant self-report and the absence of gynecologic examination to determine pain-contributing etiologies.

CONCLUSION

Painful intercourse affects young Black women at a higher rate than White women. Further research is needed into categories and metrics that capture their experiences of pain.

"Anger, embarrassment, less than a woman": the emotional impact of Black women's sexual pain

Limited research has examined the emotions Black women report when thinking about sexual pain. To fill this gap in the literature, we explored the types of emotions that emerged when N = 126 premenopausal Black women thought about pain during sex. Open-ended responses to the following research question were analyzed: "What feelings emerge when you think about sexual pain?" Structural tabular thematic analysis was used to find commonalities in participants' responses. Findings indicated five families, or categories, of emotions: self-judgment, anger/disgust, sadness, anxiety, and emotions felt somatically. Additionally, women's reports were predominantly within the feeling state and cognitive appraisal components of emotion. Implications for health providers and therapists are discussed.

Pursuing Pleasure Despite Pain: A Mixed-Methods Investigation of Black Women's Responses to Sexual Pain and Coping

The current mixed-methods study is the first to explore Black women's (N = 153) cognitive (e.g., worry about being perceived as sexually unresponsive) and emotional (e.g., sadness) responses to sexual pain based on age and relationship status, and coping strategies. Findings indicated significant differences in younger and single Black women's cognitive and emotional responses to sexual pain compared to older and coupled Black women. Qualitative responses revealed Black women engage in several proactive coping strategies to mitigate their sexual pain, including non-penetrative activities, foreplay, tools for increasing arousal, making physical adjustments, and intimacy and sexual communication. Implications for sexual health providers are discussed.