3 Common Sexual Disorders Plaguing the Jewish Community
Do sexual disorders in the Jewish community exist?
Sexual disorders in the Jewish community have always existed. More recently however, addressing these issues in therapy is becoming more commonplace. I just discussed with Dovid Lichtenstein in his Headlines podcast how the Torah offers such rich discussion on the topic of sexuality. In fact, sexuality has such vibrancy and holds such a spectrum in Halacha that it truly honors the age old adage “shivim panim l’torah.”
Today, however, the frum individuals and couples who come to my office for treatment of sexual and/or marital dysfunction have found that frum society has lost its sexual vibrancy. Not to say that it doesn’t exist, because it most certainly does. However, in place of that vibrancy and color my clients find dullness. In place of discussion they find whispered conversation or silence. And, instead of hanaah, enjoyment of the mitzvah, they find chiyuv, obligation.
What causes sexual disorders in the Jewish community?
There is much that can contribute to the development of sexual disorders in the Jewish community: anxiety, depression, trauma, misinformation, unhealthy sexual development due to cultural, religious, familial, and personality factors, and a lack of education, just to name a few.
While I attended sex therapy school at NYU there was a lot of discourse on which sexual disorders are most common in different populations and religious communities. We also explored the possible reasons for these findings. In the Jewish world we found that there is a high prevalence of anxiety. It’s an entirely different discussion as to why that might be the case. However, our tendency towards anxiety heavily affects healthy sexuality especially when compounded with a lack of education.
Sometimes the type of education we receive about sexuality exacerbates this anxiety. For example, if I am told at a young age that I am a bad or dirty person for having curiosity towards my sexuality, it will increase my sense of shame towards this part of my life. So, within the Jewish community there can be particular sexual disorders that surface more frequently due to our tendency towards anxiety as well as other unique characteristics of our community.
I had the privilege to discuss the topic of sexual disorders in the Jewish community with Dr. Bat Sheva Marcus, Clinical Director of Maze Women’s Sexual Health. Out of the nine sexual disorders listed in the DSM 5, we agreed that there are 3 most common sexual issues we treat within the Jewish, and specifically the frum community.
3 common sexual disorders in the Jewish community are:
Combination of Issues
Vaginismus is one of the most common sexual disorders in the Jewish community that both Bat Sheva and I treat. The numbers are staggering when it comes to how many frum women suffer from Vaginismus.
What is Vaginismus?
Vaginismus is a female sexual disorder in which a woman experiences vaginal pain due to involuntary contractions of the pelvic floor muscles. This pain is often experienced as a burning or stinging sensation. Women with this condition report that any penetration, whether from intercourse, a speculum at a gynecologist visit, or a tampon, causes this pain.
Vaginismus is the number one cause of unconsummated or sexless marriages. It can appear at the onset of marriage or years into a marriage. Women often come to me feeling very frustrated at not being able to have intercourse. They feel angry at themselves and their bodies and their self confidence is diminished. They also frequently blame themselves for their troubled sex life.
Vaginismus’s dangerous impact:
When this sexual disorder goes untreated for months or years, women develop extreme anxiety about having intercourse. The mere thought of sex can cause a fear of the pain they will experience and the subsequent feelings of disappointment, frustration, and inadequacy.
Bat Sheva puts it succinctly:
"People hold anxiety in different places. Vaginismus is about holding anxiety in the vagina instead of the back or any other body part."
As a result of this anxiety, women may engage in avoidant behaviors so they don’t have to deal with their physical and emotional pain. These behaviors can include avoiding physical contact with their husbands, pushing off going to mikvah, or prolonging the niddah period by being extra stringent with taharas hamishpacha (laws of family purity). Conversely, some women choose a grin and bare it approach. They avoid telling their husbands about their pain and push through it, thinking sex is an obligation they must fulfill at all costs.
With either response, these women may come to resent their husbands for not fully understanding their painful experience. They may also resent their husband’s sexual needs. On a deeper level, they may feel resentment towards themselves and their bodies. In some cases, women begin to neglect themselves as well.
How to properly treat Vaginismus?
Treatment for Vaginismus is based on the reason it’s present in the first place. These reasons vary from pre-existing anxieties which cause the whole body to be tense, an overly active and tense pelvic floor, past trauma, or anxiety about intercourse. I usually recommend a medical consult with a gynecologist, in addition to a pelvic floor specialist. In this way we can rule out medical issues prior to therapy. Bat Sheva adds that since there is a huge correlation between anxiety and Vaginismus, the best treatment involves addressing both the psychological and physiological aspects of Vaginismus.
2. Desire Issues
Desire issues are the second category of common sexual disorders that we treat in the Jewish community. Desire issues are often about attraction or low levels of libido. These issues affect both men and women. According to Bat Sheva, desire issues “can run a wide gamut between ‘I kind of prefer to not have sex’ to ‘I love my partner and it’s destroying my marriage but I can’t imagine having sex.’” The most severe lack of desire is aversion.
We both find that when clients report having low desire they are usually experiencing a different issue or a combination of other issues. These issues could include, the sex itself is not pleasurable, there are physiological or hormonal imbalances, the client is taking a medication that affects desire, or there is a relationship issue. Oftentimes, lifestyle and life transitions play a role in affecting desire. Menopause, exhaustion from a new baby, or a busy work schedule can heavily affect desire.
How to properly treat desire issues?
Treatment for desire issues ranges broadly. Becoming aware of lifestyle, transitions, and physiological changes to the body is a great place to start. Psychoeducation is also a big part of treatment. With psychoeducation clients learn that they need to carve time out to make sex happen.
As Bat Sheva likes to put it, “sex is like Shabbat dinner, you need to plan it.” She further elaborates, “one of the biggest myths in the orthodox community even more than in general society, is that once you get into the groove of having a sex life that’s all you need to learn.”
We both agree that this idea is simply not true. Life happens, we grow and we change. Whether it is from having young or adolescent children, a death in the family, a hectic life pace, or medical issues, change is part of life.
Bat Sheva shares the following relevant analogy with her clients:
"If we were handed a dress when we got married and told we need to wear it for the rest of our lives no matter what, we would find this notion absurd. However, when it comes to our sex lives, we make the mistake of thinking that the way we start having sex is how we will have sex for the rest of our lives. This is equally as absurd."
As we adjust to the natural transitions of life, our sex lives need to stay agile and flexible. This means that our sex lives look very different while raising children, for example, when compared to our first year of marriage.
3. Combination of Issues
A combination of issues make up the third category of the common sexual disorders in the Jewish community that Bat Sheva and I treat. Naturally, treatment for these issues is tailored to the specific issue.
Some of these other issues include:
Shame regarding intimacy
Interest and/or arousal issues
Generalized pain problems
Issues in the relationship dynamic such as communication gaps
What can we do about sexual disorders in the Jewish community?
Esther Perel, a world famous sex therapist, author, and educator, has been known to say:
When sex is an issue it takes up the majority of a marriage’s resources and energy. When sex is not an issue, it comprises a minority of the marriage. As such, treatment of sexual disorders directly translates to the vitality and energy of a marriage.
Treatment for sexual disorders doesn’t have to start when a sexual issue becomes too much to bear. Bat Sheva and I believe that any person or couple can make improvements so that there are fewer incidences of sexual disorders within the Jewish community. These improvements can be boiled down to education both at home and before marriage.
Sex education: The number one way to reduce sexual disorders in the Jewish community
Most of us agree that children deserve to be educated in many areas of life so they can become healthy adults and contributors to society. These areas of education include academics, finances, socialization, and self-care. Sex education is just as important. There is no question that we need more sex education. It is a parent’s responsibility to provide this for their children so their children can develop a healthy sense of sexuality. If parents are unsure how to go about educating their children in this area, they could consult with a mental health expert or sex educator.
Once our children are grown, Chosson and Kallah classes serve the next most crucial role in preparing our frum couples for marriage. This education particularly covers the halachos and practicalities of sex. Because Chosson and Kallah teachers are often on the front lines with sex education, they need to be trained to speak reliably and comfortably about sex. It is incredibly important that they are adequately knowledgeable in the area of sexuality and are not just speaking from personal experiences and anecdotes.
The bottom line on sexual disorders in the Jewish community:
There is a lot of confusion regarding the interplay of frumkeit (religiosity), sexuality, and dysfunction. The common sexual problems within the frum community oftentimes come from a distortion of how frumkeit and sexuality work together.
Luckily we are living in a time when therapy is more available and less stigmatized. We can feel a bit more free to address sexual issues, and hopefully even prevent some of them.
As Bat Sheva pointed out, we’re coming to a point where sexual problems are not just issues in our heads. Exploring the issues both medically and psychologically is really important.
Across the board, my clients are liberated and comforted to learn that there is a richness and vastness for healthy sexuality in the Torah. This realization often helps them approach their relationship to frumkeit and sexuality in more balanced and healthy manner.
This article was featured on OK Clarity's website. OK Clarity is a platform servicing the Jewish community in offering mental health insight and referrals.