Pelvic pain: You’re not alone, broken or wrong

I lost my virginity relatively late in life, aged 24. It was excruciatingly painful, but because I was expecting it to hurt – that’s what it’s like for women, right? – I didn’t acknowledge it as such and tried not to think about it.

The few sexual partners I had never asked what I liked, or what felt good. They did their business and I laid back and thought of England. When I carefully mentioned the pain to a doctor some years ago, she sent me for a smear test with the resident GP nurse, who could find nothing wrong, and told me it was “all in my head.”

There you go, Jemima. Just fix your head. Just think differently and it will all be OK.

I would love for this article to be a love-letter to the NHS, but unfortunately, it is not. I recently requested a copy of my medical records from my old doctor’s surgery in North London. In my apartment in New York City, I opened the package and flipped through page after page of notes, going back years, and felt the rage roiling and flickering out from my stomach until it flooded to my fingertips, to the ends of my toes.

I had done my part: I had gone to the doctor, I had explained and wept and begged… and they had done nothing to help me. In fact, they had made my problem worse.

Meeting a man who was actually concerned about my enjoyment of sex and horrified at my casual admission that I had always experienced pain during intercourse, changed everything. I finally admitted it did actually hurt quite a lot and as such, I was kind of ‘meh’ about sex in general.

Suddenly that pain I’d always explained away, the pain I had lain back and ignored, was blaring like a siren in my head. Sex became a terrifying prospect, coinciding perfectly with finally being with a man I actually wanted to have sex with. It was a perfect vaginal storm.

Have you ever spoken honestly to another woman about sex? We rarely get past the bravado or the drunken horror stories that we still, somehow, present as freewheeling uninhibited sexcapades.

The day I opened up about my experiencing pain during sex was the day women started opening up to me; started to approach me with their own stories.

And the things they told me broke my heart, because they were all things that I have experienced and thought – and despite everything, in my darker hours sometimes still think: sex is everywhere, sex sells everything, and everyone is having it 24 hours a day. If you aren’t then you must be frigid. You must be broken. Wrong.

I have felt less: less of a woman, less of a person. I have thought about the children I want to have one day and wondered how that could possibly happen. Even if I could have sex – if I wanted it, if it didn’t feel like razor wire inside and out – I begin to feel as though my body would fail.

After all, isn’t it failing at even the most basic of requirements, right now? Surely becoming pregnant and carrying a healthy child to term would be beyond its capabilities.

I don’t trust my body. I don’t trust my mind either, because I am told over and over again that there is nothing physically wrong with me. (If it isn’t immediately obvious, this is really a shitty place to be.)

In London I begged my GP to send me to an actual gynaecologist, which took months of asking and even more months on waiting lists. I came away with the official diagnosis that I “just needed to be more confident, really!”

I was too shocked to respond to my gently smiling doctor. I wanted to get out of there, I wanted to run, I wanted to punch her. I walked out with a quiet, heavy devastation settled firmly about my shoulders.

A few months later I moved to America, to travel around the country for more than 16 months with my now fiancé, who is a touring musician.

Take a girl with anxiety, a broken vagina and a plummeting libido and put her thousands of miles away from her friends, family and job, and see how she does. I fell apart in exaggerated slow-motion, but there was no one around to see it but my long-suffering partner.

Before I moved to America we hadn’t spent more than two weeks in a row together, and I was still trying desperately to hide the extent of my craziness from him, which is hard when you’re living in an apartment in Bumfuck, Illinois that’s barely bigger than the suitcase you’re never in one place long enough to unpack.

But in America, finally, I found the help I needed. I didn’t pay through the nose for it; I would describe it more as ‘opening my veins and being drained dry’.

Paying for healthcare still feels like a slap in the face for me, but quite honestly it was worth every penny. When you pay for something you are allowed to leave a review, which kind of compels the person you’re paying to do a good job.

I saw a therapist specialising in sexual issues, who referred me to a gynaecologist who actually wrote the book – Healing Painful Sex – on my problem.

In October 2016, I went for my first appointment. I dressed in my witchiest black for confidence. Of course I cried the whole way through the appointment (Weeping Witch is totally my go-to look), but after a trauma-free physical examination (who knew that was possible?) I was diagnosed with primary provoked vestibulodynia, a condition in which the skin around the entrance to the vagina (called the vestibule, as if it’s a cloakroom or a hallway with a welcome mat and a place to wipe your feet) is inflamed and sore.

This can be due to nerve, skin or muscle problems. It’s a fairly common condition, and my winding road to diagnosis is shockingly common too. When I read my gynaecologist’s book I discovered most women see an average of six doctors before they find one willing to take their pain seriously.

In Healing Painful Sex, there is an entire chapter covering How to Deal with Difficult Doctors, about gynaecologists who make a patient worse by essentially gaslighting them into thinking that they’re imagining the whole thing.

The blanket term ‘pelvic pain’, which is a much more dinner party-friendly way to describe your hurty vagina should you wish to bring it up at a dinner party, covers a mind-bogglingly wide array of conditions.

I learned some women experience pain so bad in their clitoris that they can’t sit down without a bag of ice between their legs. There is another startling chapter on suicide, and suicidal feelings. This is some serious shit, and I felt wonderful reading it. I cried, because that’s kind of my schtick if you haven’t noticed by now, and because there is a glimmer of hope – faint and flickering, but something to walk towards.

I now have a doctor, a therapist, and a physical therapist that I see once a week, a team of kick-arse ladies who are on my side. They let me sit in their offices for hours at time if I need to, and let me cry without judgment, and correct me gently when I tell them what a failure of a woman I feel.

They have never once told me, as more than one British doctor has, that I should “just drink a bottle of wine before sex”. I don’t know what I’d do without them. I don’t know what I’d do if I was still in the UK, asking the NHS for help.

It’s easy as a Brit to underestimate or completely ignore the emotional and psychological sides of chronic illness. I have been warned that if I continue on my path of anxiety with no way to release the stress and the tension, no amount of medication and physical therapy will help me.

I have to reprogram my brain to want sex, my muscles to ease, my nerves to not send ‘pain pain PAIN!’ signals every time I am touched.

It seems like a mammoth task, and sometimes I’m not certain I can do it. I have had to come to terms with the thought that while there are plenty of options to try (including some pretty scary-sounding surgery) I may never be completely pain-free. It’s about managing it.

Here in America the idea of something being ‘all in your head’ is not the end of a conversation but the beginning. You cannot just think yourself better. The psychological side is not insignificant, and something that begins in your head can have physiological impact on your body with very real pain. But without help of structure of guidance, just thinking happy thoughts will get you nowhere.

Yes, my pain is not helped by anxiety or stress, but that in itself is nothing to be ashamed of, and I now have a regime that includes yoga, stretching, mindfulness, therapy, and medication with doctor’s appointments.

There is woefully little research when it comes to female anatomy, because the very words ‘female orgasm’ or ‘female pleasure’ in research proposals or papers has, for years been enough to immediately disqualify it from any funding.

It is not seen as important by the either the medical community or the wider world. After all, a female orgasm is not vital to reproductive sex.

As women we’re supposed to want sex, but enjoying it is another matter. It never occurred to me that I should be disappointed, sad or angry when a man I was having sex with didn’t bother asking what I liked, or if what he was doing felt good, or was even OK with me.

Which brings me back to the talking thing. Women need to talk to each other, confide, honestly, about this stuff. There are more than 200,000 documented cases of vulvar pain each year in the USA alone. Many women will be fobbed off by doctors, or will be too ashamed to go and see one.

So, so many women will experience some kind of pelvic pain at some point in their life. It can arrive with little warning and disappear as quickly, or remain for years. Sometimes it will have little obvious cause. For instance, did you know that women who have Caesarean sections will often experience pain during sex afterwards, despite the fact they didn’t have a vaginal birth?

Do you really know what is going on down there in your hoo-hah? Do you know what all the bits and bobs are? The ones you can’t see without a hand mirror and a stretch? Do you know that what we call a vagina is actually just one bit of your vulva?

It’s not easy writing this. I really hope that my dad never reads it. But this is something that feels more important to me than my personal privacy or pride.

I don’t want any woman to feel the way I have felt – unheard, ignored, defective. There is nothing so wonderful in this world as feeling understood. God knows there are enough articles in trashy women’s magazines about How To Give The Perfect Blowjob! Why aren’t we talking about women’s sexual health and pleasure in an honest way, from our very first sex education lesson in school?

The more I open up about this, the more I talk about it, the more “Me too!”s I hear in return.

Living through something like this can be incredibly depressing and isolating, and yet, out there are a million other women walking around under that same awful, shameful raincloud.

So, I encourage you ladies to speak to your friends about sex in an honest way. And if you’re experiencing anything like that which I’ve talked about here, please, please, please: keep going. Keep fighting for the attention, diagnosis and treatment options that you deserve. You are not alone, broken, or wrong, and I, for one, hear you.

Originally published in Standard Issue - link

Illustration by me.

Lazarus

(Originally written for the "Me & The Starman" anthology)

There was a hand, gently, on my shoulder. “Jemima,” a voice said softly. “Wake up, baby.” I opened bleary eyes. Without my glasses and I could only just make out my fiance’s face as he leaned over me. “Good morning,” he said, with such tenderness, “David Bowie died.”

It’s a recurring pattern which says a lot about both just how crap 2016 has been and the fact that I am routinely exhausted enough to sleep well past Ben waking up next me and reading the New York Times on his laptop. The death of Alan Rickman, Brexit, terrorist attacks - all have been my tender, whispered wake-up call this year. I’ve started to refer to him as Bad News Ben. He even has a Newsnight-esque theme tune now.

    But it started with Bowie, when the year was still new and pink and raw as our faces in the frigid New York air. We were sleeping on an inflatable bed in our yet to be renovated apartment. The rooms echoed with their emptiness, but after a year spent traveling around the US we were in love with the bare bones of our home and the idea of being in one place for a stretch of time.

    Only a day earlier we had managed to get tickets for the pretty much sold-out run of Lazarus at the New York Theatre Workshop, for a performance a week later - so it turned out that we went to see this bonkers, baffling show just days after its creator’s death, when the world had learned at last that this musical was in fact a complicated, secret goodbye note from a man staring into his own oblivion.

    Supposedly Lazarus was a follow-up to The Man Who Fell To Earth, but for the life of me I couldn’t work out what was going on throughout. It was thrilling, and visceral, and made great use of multimedia with a set projected onto the blank white box of the stage. At one point, as two characters chatted, a scene in which they screamed and raged and threw things at each other played behind them, a surreal and oddly jarring technique that suggested the audience shouldn’t trust a thing that was being told or shown to them. A geisha ran out from behind a screen and chased someone around the stage for a full four minutes, before disappearing off stage without a word. There was balloons and milk and rocket-ships drawn in white tape on the floor, and I haven’t a clue what any of that was about, either.

    It was hard to separate the context from the show. Everyone in the audience that night was there for Bowie, a room of people full to the brim with this odd, androgynous, glitter-bomb of a man. Bowie, down to our flesh and blood and bone. So in the end, the fact that Lazarus made very little sense and, produced by anyone else would have come across only as pretentious, became an honour to witness, as weird and baffling as exciting to watch as the man himself.

    And I was filled up with a tremulous feeling of loss and love, wanting only to speed across the Atlantic and hug the characters that have been there throughout my childhood into my thirties. Like I did with Bowie, I am beginning to suspect that I may have taken a lot of people in my life for granted.

Lying there on that rapidly deflating blow-up-bed, when I heard the news of his death I wondered if I was possibly still asleep, as if this moment might be a hazy, weird dream. Because that’s what David Bowie felt like, in the end: a collective fever-dream, as if the whole world had been tripping since the late sixties and conjured up this wavering, ever-changing trickster god of music.

    But that wasn’t really Bowie. Bowie was glitter and heels and a blasted wide pupil so loud and weird and vivid he couldn’t have been anything but human. From another reality, most certainly - one that had built itself in the skewed future fairground-mirror image of Britain - but real nonetheless, flesh and blood and bone.

I cannot lie and say now that I was an avid David Bowie fan, but as a child of the 1980s he was a constant for me, on the radio, on my parents stereo, dancing with puppets and babies on my tv screen. He was the weird uncle of my generation that we sometimes confused for an aunt. We took him for granted. Bowie couldn’t die. Bowie was too...Bowie to die. To be stricken with something as human and indifferent as cancer? Didn’t cancer know that this was no ordinary man? Didn’t it know that it was taking on Ziggy, and Aladdin Sane, and the Thin White Duke too? No, Bowie couldn’t die.

But he did. And I was in New York, struck suddenly with an overwhelming high-tide creep of homesickness. Bowie was dead. One day the Queen will die, and Terry Wogan (he did, not long after), and Stephen Fry and Hawkins, David Attenborough, Joanna Lumley. The peculiarly British icons, our National Treasures. Do other countries have them? Not like us. These people will die, and I will be in America, where few people will know who it is that I am grieving for.

And one day the people I love will die, and I might be here, in America. I knew that the next time I saw my family I would hug them just a little tighter.

So here I am, far from home. And here is Bowie - alive in art and fashion and music - always far from home too. Here is Bowie travelling, and changing, a man of perpetual movement, striving and pushing at the boundaries of art and reality and everything in between.

I cannot imagine what Bowie must have been thinking when creating Lazarus, when he knew that he might not be around to see it up on stage. The balloons and the Geisha and the milk-like blood still make no sense to me, months later. Even Wikipedia seems unable to decipher Lazarus, (yes, I did just google “what was David Bowie’s Lazarus musical about?”) with notes on production and critical reception but no mention of plot.

Bowie can no longer tell us what to make of Lazarus, and who knows, maybe even he couldn’t make sense of this strange and amorphous creature he’d brought forth. And maybe Lazarus is like life: without plot or tidy narrative arc, strange and beautiful and confusing and sometimes you get chased by a geisha (metaphorical or otherwise).

Bowie taught the world a lot of things in the end, just by being himself - or the mad and multitudinous versions of himself. He taught a generation to express themselves in their life, because life can be art. He taught us to work hard and prolifically at our creativity, that we can be exactly who we want to be and change that person as often as we feel the need. Ultimately, David Bowie taught us that death is inevitable, but life can be weird, and surprising, and breathtakingly beautiful.

BBC's "Merlin", and the Magic of Place

(Originally published in the "You & Who Else" anthology)

How can a television programme come to mean so much to a person? How can a television programme –one that that is, to all intents and purposes, a little bit naff -- come to mean so much to a person?

For the past seven years I have lived in London, but the entirety of my childhood was spent rampaging around the hillsides, forests and lakes on a Welsh farm, and to paraphrase Dylan Thomas, treading bejumpered through the sheepy fields. So a Saturday night with Merlin gave me a little window that I could peer through into the lush bluebell forests and fern-fronded streams that made up the filming locations, and were familiar enough to spark a sharp ache of hiraeth that sat like a stone behind my sternum, hard and burning and wonderful.

Hiraeth is an untranslatable Welsh word: half homesickness, half longing for a past that probably only ever existed in a rose-tint of nostalgia. The landscape in Merlin took me away from the concrete and the fumes of London, back to green and growing things, back to the hills where you can watch the rain or the snow come in like a wall of hazy white from the coast. It took me back to a place where red kites wheel in broad circles overhead, back to the heavy, sucked-up silence of moss and forest floor, packed tight with the sweetness of pine needles and darkly composted soil. These are the places of my youth, the places I go back to when I close my eyes at night.

Merlin was unique in its ability to place itself firmly in a time and location - even if that time was quasi-mythical-medieval - by using the landscape as a definite character, instead of merely somewhere nice looking to shoot. Okay, admittedly most of the action took place in one of four locations recycled for each episode (some caves in South Wales that I have definitely been to on a school trip, a moss-blanketed gully, a quarry borrowed from 70s era Doctor Who episodes and a corridor or two from a castle in France) but the weather was real, and so were the places. The very few sets built for the series were pretty obvious in comparison, but the rest of it was so lovely it didn’t seem to matter.

Merlin will never win any prizes as a quality piece of television, and it certainly doesn’t stand up to the behemoth historical/fantasy series that have come along since, like HBO’s Game of Thrones and The History Channel’s Vikings. But Merlin was the Little Show That Could. It had such heart that you forgave Richard Wilson’s increasingly terrible wig, or the fact that the character of Morgana wasn’t really played by an actress but a costume assistant who was too beautiful to stay behind the camera. When Arthur became king his crown looked like one borrowed from a nearby Burger King. The bromance-o-meter consistently hit the upper levels, and while the budget seemed to stretch to a nice new dress for Gwen once she became queen, it apparently didn’t go so far as to cover the arms of Sir Perceval, whose biceps were so huge they could not be contained by the simple warp and weft of mortal fabric. The humour was slapstick and seemed to mainly involve Arthur’s trousers accidentally falling down or Merlin using magic to make a bandit run into a tree branch. But it was proper, family, Saturday night television in a way that only the BBC can do.

Merlin was broadcast each year as summer was ending, just as the days were shortening towards the end of the year and the air began to take on the fresh pinch of Autumn. It was a show perfectly made for darkening evenings with the rain pattering against the window, while you sat cosy inside with your family and good old Aunty Beeb.

I am writing this piece in an apartment in small-town Massachusetts, America. In the drawer of the desk upon which my computer sits is a passport stamped with a two-year US visa. I have given away clothes and bikes and books, musical instruments and, actually, three box-sets of Merlin DVDs. America, for all its similarities, is not really like Britain. One day I hope it will be home, but for now it is other in a way that makes me crave the familiarity of the BBC, and shows like Merlin.

Britain’s history is ancient and twisted as a gnarled oak; British identities, our histories and mythologies are intrinsically linked with the landscape because it was an important and undeniably present factor in our ancestors lives. Arthur’s seat, Arthur’s Stone, Carmarthen (the Welsh translation of Merlin’s Fortress) - the echoes of the Arthurian legends are in the names of places scattered from Scotland to Cornwall. Our land, our stories, are a part of our national psyche, and are more important to us than we realise. Across this planet, fairytales and myths are dictated by the landscape and its vegetation. How would Hansel and Gretel’s story have gone had it taken place in the Arabian deserts of Scheherazade’s One Thousands And One Nights? And would the goddess Artemis have caused so much woe to mortals who accidentally witnessed her naked in the streams of ancient Greece if the climate was a little closer to that of the Norse sagas, which didn’t really lend itself to prolonged outdoor bathing if you fancied your extremities frostbite-free?

The ancient woodland and mountains of the United Kingdom are the places where things happen in stories, to princesses and lumberjacks and ordinary people alike. Perhaps you’ll meet an old man who offers you magic beans, or come across a trail of breadcrumbs. You could stumble across the tomb of an ancient king, or be proffered a sword from an arm that shimmers forth from the watery depths of a mountain lake. I challenge anyone to walk through a pine forest on a moonless night and not think, even for a tiny moment, of wolves that beguile and consume, and monsters hiding in the dark, patient shadows.

The wild landscapes of Britain still hold a power over us that’s as real as any of Merlin’s sorcery. It is no coincidence that some of the most vivid, well-loved fantasy worlds came forth from the minds of British writers. Just look at how place and landscape and weather feature in the writing of J.K. Rowling, Tolkien, C.S Lewis, to name a few. And while not British himself, George R.R. Martin has explicitly said that his monstrous Wall and the lands that border it on both sides was inspired by a trip to Hadrian's Wall, where standing atop the ruined stones and gazing into the ancient, unknowable north brought forth visions of ice demons and giants, trees with faces and wolves the size of horses.

To belong to a place is odd, because it works both ways: it belongs to you and you to it. It goes bone deep, into the nucleus of every cell, so that leaving it behind - however willingly - is a physical ache. And a place has a history too: the people and the lives lived there, the buildings raised and fallen, the stacking of rock upon rock and the taming of rivers and trees. Merlin helped me rediscover the wonder of place, and gave me back the imagination, lost since childhood, to conjure the spirits and fairies and myths of Britain’s green and pleasant land. It reminded me that there is beauty, and mystery, and magic to be found all around us.

Even if the show itself was a bit naff.