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


  • Jemma Tosh University of British Columbia
  • Krista Carson Fanshawe College


sanism, rape, discourse analysis, penetration disorder, dyspareunia


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.

Author Biographies

Jemma Tosh, University of British Columbia

Jemma Tosh is a critical psychologist who researches gender and sexual diversity. She is a Research Manager at the Faculty of Health Sciences at Simon Fraser University, and a Postdoctoral Research Fellow at the Institute for Gender, Race, Sexuality and Social Justice at the University of British Columbia. Jemma is  the author of Perverse Psychology: The Pathologization of Sexual Violence and Transgenderism (Routledge, 2015).

Krista Carson, Fanshawe College

Krista Carson is a professor with an interest in historical perspectives on gender and sexuality. She teaches in the School of Language and Liberal Studies at Fanshawe College, Ontario.