Tag Archives: marriage

#TherapistDiaries: Understanding genophobia, the fear of physical intimacy

#TherapistDiaries: Understanding genophobia, the fear of physical intimacy

2019-09-19

By Zaofishan Qureshi Published: June 23, 2019

Almost a decade ago, I heard a story about a villager that stuck with me for quite a while. I was in my sophomore year of my psychology degree back then, and my novice brain was quite struck by the story of a teenage villager who screamed at the top of her lungs every time her husband tried to touch her. She had been married for four months, but due to her reactions, no physical intimacy had been initiated.

Initially, the mother-in-law and the women of the house laughed it off, terming it as mere shyness, even though the girl’s entire body would shake and tremble for hours and it looked like she had endured a disaster. After a few attempts at physical intimacy, the husband did not use any kind of force to coerce her into the act.

Assuming the girl screamed because she didn’t like her husband, she would be questioned about why she had agreed to the marriage in the first place. She claimed that she loved her husband and enjoyed spending time with him, but not the physical intimacy. She claimed that no one had neither explained nor prepared her for this and hence she was clueless about this aspect of a marriage.

According to her:

“I thought that marriage was what I saw in the Star Plus soaps; wearing cool clothes, dining out, doing shopping and such things. My first night was the most terrorising experience of my life and I hate how nobody informed me about this.”

Our professors assessed her and concluded that there was no form of asexuality or intellectual disability present; she was simply not prepared.

Marriage holds a lot of importance in a patriarchal society like ours, more than it should. Our entire lives and career choices revolve around marriage. A lot of people, particularly women, are forced to give up their identity, life goals and dreams, just to be married by a particular age. Considering all this then, it is quite ironic how sex education is not provided to people before getting married, neither is there any demand for pre-marriage counselling in the country.

In my clinical practice, I have come across the dire consequences of lack of awareness and sex education. Fear of physical intimacy, or genophobia, is a commonly occurring phenomenon that I have observed during my practice. There are a lot of women who have this phobia in such extreme forms that it inhibits them from consummating any or most form of physical intimacy through the entirety of their marriage.

A senior of mine once narrated a genophobia case to me. Dr Niazi* was an established medical doctor who had been working in the field for a very long time. She had been married for over a decade and disclosed to my colleague the reason for her frequent absences from work and distress. She was on the verge of getting divorced and quite contrary to everyone’s belief, not having any children was not the root cause of it.

“Would you believe me if I tell you that an accomplished female doctor like me, a mature woman in her late 30s, has never been physically intimate with her husband? Because I’m so afraid?”

She further added that despite of every possible cooperation on part of her husband, she was unable to let go of this fear.

Similarly, Miss Sheikh, a girl in her mid-20s, encountered the fear even before getting married. She had three different surgical procedures done in her life for various illnesses and yet she believed that physical intimacy would be more horrific than that. In this case too, the husband was extremely supportive.

However, there are many cases in which the spouse is unable to understand the situation and marital rape becomes a norm as we are neither culturally sensitive to consent nor very aware of this phobia. There are a lot of instances when patients have a hard time coming to terms with being diagnosed with such a condition, or that such a condition even exists.

Even when the husbands are understanding and not forceful, they do fail to identify this as what it is: a form of anxiety disorder. Couples believe there is no solution for a condition such as this and the best they can do is visit a urologist and ask for tips to improve their foreplay or approach to physical intimacy. Whereas, the actual treatment is counselling.

The very reason for genophobia in our society can be seen through a cultural lens. Though it is true that the reasons for this phobia are rooted in a form of sexual abuse, particularly sexual abuse as a child, but most of the women I have come across have genophobia without an adverse life experience.

Furthermore, the practice of arranged marriages makes it more difficult since there are expectations of consummating the marriage on the wedding night. How could it not scare an already fearful, anxious woman? Genophobia is only a natural reaction in such a scenario.

The treatment of genophobia has a fair prognosis. If an adverse sexual experience is involved, it is treated as a product of trauma. In cases where no adverse experience is involved, we work with systematic desensitisation and cognitive behavior therapy as a treatment plan. Considering the cultural inconsideration surrounding sex education, the patient is also educated about their own anatomy in relation to this. Therapies such as Sensate-focus are also used with couples to improve and overcome the situation together.

Shame and shyness are so inclusive in our culture that they breed a care-avoiding attitude in our women regarding their most intimate issues. We shouldn’t be shaming women about these issues and instead encourage them to seek help.

(*Names have been changed to protect identities and doctor-patient confidentiality.)

https://blogs.tribune.com.pk/story/84621/therapistdiaries-understanding-genophobia-the-fear-of-physical-intimacy/

What is so ‘filthy’ and ‘unnatural’ about reproductive sex, Pakistan?

What is so ‘filthy’ and ‘unnatural’ about reproductive sex, Pakistan?

By Dureen Anwer Published: September 9, 2016

A close friend of mine recently had an STI (sexually transmitted infection) scare. Despite being in excruciating pain, she was scared to ask her husband how she got the infection. After a few days of discomfort and suffering, she consulted a doctor who put her mind to rest by confirming that she had a yeast infection because of diabetes. But during this whole episode, I was surprised to find out how ignorant she was about sexual health.

First, she was adamant that she couldn’t get an STI from her husband because he was absolutely fine, which is irrelevant and factually incorrect because some STIs are asymptomatic – meaning the person who has the infection don’t show any symptoms. Second, after ruling out her husband, she suspected getting the infection from a toilet since it was shared between her and a relative. This wasn’t the first time I had heard an absurdly naive theory about how people get STIs in Pakistan. I remember the days when I was working for a trade association and was told by a colleague that people get HIV, STIs and even diabetes by using public toilets! Yes, someone said that and that someone wasn’t illiterate. That person was an accomplished professional and an independent woman.

Several years later, now that I am working for the healthcare sector in the UK, I observe how young people are educated about these potentially serious and deadly diseases. Let me clarify a few things particularly for the crowd that proudly claims: Pakistani kids do not have sex before marriage so they don’t need sex education.

What they teach here in the UK isn’t just about sex; they call it relationships and sex education for a reason. Secondly, young people in Pakistan do exhibit some risky behaviour before marriage – be it in a serious relationship or with a random stranger. I don’t think I need to elaborate on how young boys are often dared to experiment with transvestite street performers. Even if we were to believe that the Pakistani youth does not indulge in sex before marriage, they do get married and trust me the advice given by elders (for marital bliss and expression of physical desires when someone is getting married) is often not the best advice.

Boys are not told that some girls are born without a hymen and girls are not given the courage to say no to their husbands during intimacy when they are being disrespectful. Expressing your carnal needs is looked down upon if done by a woman and deemed natural if done at the most inappropriate hour by a man. I have known people who accidentally lost their virginity because no one told them when to stop physical advances by someone they weren’t in a serious relationship with. And the cherry on top is that we always assume that it’s only women who can be physically abused.

In Pakistan, we are embarrassed to talk about sex because we think of it as filthy and unnatural. But the truth is that the experience could contribute positively to one’s mental health if done respectfully and with the right person. The ‘no sex talk’ policy only results in ignorance which is often confused with innocence and purity. In today’s world, you don’t want your children to be ignorant about sex because people will (and they do) take advantage of that. They will hurt your children physically, mentally and emotionally.

Imagine a scenario where a spouse tells their better half that they don’t like certain things about their partner’s physical appearance. Surely we change, adapt and improve for the people we love but some things are beyond human control, such as a physical feature. Wouldn’t you all agree that such conversations could be detrimental to not only one’s confidence but to the relationship as well? So how can we stop marriages from falling apart without blaming women liberation and western influence? We must educate our youth about respecting their partners and it being okay to expect the same in return.

Also, protecting one’s health (including sexual health) is a basic human right. Why is it generally acceptable in Pakistan for men to have sexual encounters outside their marriage and bring several diseases home? Why aren’t they taught how to be safe and also protect their partners? Why can’t their wives be assertive about their own marital rights?

Case in point: The friend who was too scared to talk to her husband about her STI scare because she didn’t want to upset him.

I think we, as a nation, are pretentious and have double standards when it comes to intimacy. Why do we cringe while watching a condom advertisement on television but are perfectly okay to watch vulgar dances in movies? Why do we have these stigmas, fears, misconceptions and misinformation about sex and sexual health? Surely, our religion is practical and in no way oppressive or unreasonable.

Our double standards about sex and sexual health are evident when we look at the statistics. According to UNAIDS, 100,000 people were living with HIV in Pakistan during 2015. In 2014, an 11% increase was reported in mortality rates from HIV/AIDs in Pakistan and if you want to learn further about STIs/STDs then read this article published in Express Tribune.

I am a mother and I do plan to teach my children how to love themselves and their bodies. Anyone telling them that they are inadequate or ugly doesn’t deserve to be a part of their lives. I will teach my children their rights about fertility, safety and pleasure. I will tell them that they have to prioritise their own health and well-being in all circumstances that no relationship is worth compromising your own mental or physical health. I will give them the confidence to say no and to be okay with their feelings.

But for those mothers who are not in a position to do all of this, why can’t a trained professional deliver lectures to youth in colleges and universities? If it is so shameful, perhaps have separate lessons for different genders and sexual orientations. What is so taboo about healthy relationships and physical health? Would you rather have your child learn about sex at the right time by the right person or would you let them go out and discover things on their own (which might result in life-altering damages)?

https://blogs.tribune.com.pk/story/39986/what-is-so-filthy-and-unnatural-about-reproductive-sex-pakistan/

Many marriages in Pakistan are troubled by sexual incompatibility but no one talks about it

Many marriages in Pakistan are troubled by sexual incompatibility but no one talks about it

2019-04-26

Lack of sex education and sexual intimacy has adverse effects on couples’ married lives

BY KAUKAB TAHIR 

KARACHI: Rarely ever taken to experts, sexual incompatibility is dismissed as a non-issue. Sarah Aziz*, a 32-year-old divorcee – 28 at the time of marriage – says the root cause of the failure of her marriage was her partner’s sexual orientation. For the longest time, the couple struggled as her husband insisted that the lack of sexual intimacy between them was due to erectile dysfunction. But the truth was that he was gay.

“Even lying naked in his arms wasn’t enough to arouse him, and not once did he have an erection that lasted longer than five minutes … enough for him to be able to penetrate.”

Just so his orientation remained closeted, he even took Viagra but nothing made the situation better. She says, “I had to live in agony for over two years until one day I caught him doing a Skype session with a man.”

As a set norm in Pakistan, married couples are expected to deal with sexual incompatibility behind closed doors and drawn curtains. In this silent struggle, many red flags go unnoticed until it is too late. Kinza Raza*, who is 23 years old (21 at the time of marriage), spoke to Cutacut about her traumatic, four-month-long relationship with her impotent partner. Crushed under society’s many taboos on the subject, Raza suffered from sexual discontentment silently. She kept quiet out of fear of judgement and blame, thinking that talking about problems in her sex life and sharing what she was going through would worsen things for her.

“Even lying naked in his arms wasn’t enough to arouse him”

“Since my husband was impotent, we could never have sex,” says Raza. But instead of working with her on the problem, her husband would beat her up, threatening her to never speak about it. Raza continued to suffer alone, in silence, until one day she fought back and beat up her husband with a wiper.

These stories are far too common in  Pakistani society. A number of young people, especially women, have heartbreaking accounts surrounding sexual dissatisfaction in wedlock.

Misinformation about sex

But the issue doesn’t only extend to women; men, too, struggle to discern head from tail. Couples aren’t aware of the basic dos and don’ts of having sex. They are yet to inform themselves on what may result in a pregnancy.

“I had a love marriage and despite being extremely fond of my wife, I was scared to penetrate thinking she might get pregnant,” said Mubeen Ahmed*, a 30-year-old working professional. Ahmed said even until the end of their honeymoon, the couple hadn’t had intercourse. Only after coming back from the trip, when his partner sought medical help and was prescribed contraceptives, they felt comfortable enough to consummate the marriage.

Speaking of misconceptions, Dr Kishwar Lucas, a general practitioner and sonologist at Karachi’s Good Samaritan Hospital, shared a harrowing experience where she examined a patient who complained that she was unable to conceive.

After a thorough checkup, it turned out that her hymen was still intact and that she was having anal sex with her husband that whole time.

“Men misuse girls and misbehave with them,” said Dr Lucas. Plenty of similar cases are reported to hospitals on the daily.

Sexual health and emotional well-being

Sometimes, the cause of sexual discomfort between couples is also linked to a person’s previous sexual experience. If diagnosed in a timely manner, it can be treated through cognitive therapy.

Problems around not being able to perform sexually generally stem from psychological ups and downs. Many times, the psychological hangups manifest into adverse effects on a person’s physiological health. So it makes matters worse when treatments such as counseling therapy are shunned by our society when, in fact, they should be readily available.

Neither children nor adults are provided the adequate knowledge. The information should come through a reliable source within their reach instead of porn or gossip, said Dr Humair Yusuf, a psychotherapist and private practitioner based in Karachi.

Read: Does watching too much porn affect your sex life?

“It is about time that torrents are excluded from the list of sources that teenagers (and adults) learn about sex from.”

Learning about sex from unreliable sources 

Curiosity around sex and asking questions about it is discouraged. When compared, this censorship is especially strong among teenage girls as sexual empowerment for women remains a taboo subject in our society.

People can only be prepared on what to expect if they are taught about sex from a young age, preferably their teens. Radio silence about these matters leads teenagers, especially girls, into believing that sex is an unspeakable crime or sexual activity makes them untouchable.

Read: We answer sex questions guys are too afraid to ask

“The problem in our society is that sex has been extremely romanticised, and not educating 17 or 18-year-olds — who are dating and are suffering from peer pressure — often lands them into trouble because they are not aware,” says Amna Imran, a lecturer and a mother of an 11-year-old. “I am open and honest with my daughter. She already knows that babies aren’t sent into this world through angels but in fact come out of the mother’s womb.”

How do we fix this endemic?

It is a norm in Pakistan for people to be exposed to sexual activity only after they are married. Prior to that, most are sexually inactive. They discover their sexuality and learn about their sexual health once they enter wedlock, which makes things a lot more complicated.

Ideally, the government should take up the responsibility to educate masses about healthy sexual habits, added Dr Yusuf.

In the age of the Internet, where people, including teenagers, regularly indulge in pornography, it is crucial that they learn about healthy sexual relations from a young age.

“People aren’t able to flag issues because they don’t have the slightest idea. It is important we conduct timely counseling so couples know when to escalate the problem,” stressed Dr Lucas.

Men are still able to identify the signs but it takes women a long time to figure out what’s going on. By the time they learn, their relationship and sexual chemistry has already worsened irreparably, she adds.

*Names have been changed to protect identity