Vulva Owners
A video tool for mental health
A video for vulva owners and also their partners, with Australian Sexologists, Alana Shapiro, and Daniel Di Pietro, hosted by Safe Place Therapy Co-Founder, Stuart Cheverton.
Video Transcript
Introducing our guest, Sexologist, Alana Shapiro
Stuart Cheverton: Welcome, everyone and welcome to the SafePlace Therapy YouTube and podcast channel. My name is Stuart Cheverton and I’m a mental health social worker and one of the owners of Safe Place Therapy. And we also have a special guest with us and the first time ever speaking to someone outside of Safe Place Therapy. So, first off, let’s welcome our special guest, Alana Shapiro. Thanks for joining us.
Alana Shapiro: Thank you so much for having me. Hi, everyone.
Stuart Cheverton: Yeah, and we also have a returning guest, Daniel Di Pietro, who works with Safe Place.
Daniel Di Pietro: Hi, everyone.
Stuart Cheverton: Yeah, and Alana, do you want to just share a little bit about your business, where you hail from, that kind of thing?
Alana Shapiro: Yeah, sure. I own a private practice called Bare Intimacy. I’m based over in Perth, north of the river. And … I guess the modalities that I like to work with are quite a few, but it depends on the client who comes in. I usually work with either a gestalt base or Gottman base, depending on whether it’s individuals or people who are coming in for relationship work.
And I’m also getting trained in a couple of weeks in something called ART – Accelerated Resolution Therapy – which is similar to EMDR but it’s supposed to be a more potent intervention and actually has a gestalt base. So I’m really looking forward to kind of adding that into the mix and then kind of stack everything else on top. I have training in yoga. I have training in being an Ayurvedic practitioner.
I also have a Master of Sexology from Curtin University.
And, yeah, just a bunch of other things, but I won’t list all of that for now.
I am really passionate about relationship work, whether it’s with monogamous couples, open relationships, E and M, whatever it might be, however it shows up, I am really, really, really passionate about that work. But I also love that being a psychosexual therapist allows me to be really diverse in the work that I do. So I also work with intimate pain, sexual functioning difficulties. That’s kind of anything with orgasm or, you know, physical functioning, anything like that.
I also work with gender identity, sexuality, kink, the list goes on and on, especially neurodivergence, as well, in that context, because I just feel like that’s something that not everybody really well rounds their practice with so that it can cater to a wider group of people. And I pride myself on being a culturally responsive practice.
Introduction
Stuart Cheverton: Great, thank you for that. And to kind of really narrow down, if you’ve clicked on this link, you would have seen the title Vulva Owners. Right. So that’s what we’re talking about today. We’ve recently had an episode related to Penis Owners.
So now it’s kind of episode two related to kind of. Yeah, sexual intimacy. People who own a vulva and what that’s like … from that kind of perspective.
But before we kind of kick into questions and really opening up that really fascinating, juicy topic, I’d like to acknowledge the traditional owners [of the land] on which we’re meeting today. And we’re actually meeting in two places.
So the first nation that we’d like to acknowledge, is the Kulin Nation here in Footscray, where we’re meeting Daniel. And also from where Alana’s speaking, we would like to acknowledge the wurundjuk noongar people and the first nations there and pay our respects to elders past, present and future.
Now, as we kind of kicking into this, I’m actually going to hand this over to Daniel and Alana. I think it’s really important for all clinicians who actually don’t know anything to kind of raise their hand and say, hey, I actually don’t really know much about this, and I’m definitely one of them when it comes to vulvas and that experience and the different issues. Yes, I’ve worked with vulva owners specifically, of course, but I don’t claim knowing everything about it.
So, it’s really important to hand this kind of work over to people who know about it, who understand that and can really get into the nitty gritty of the specific issues that people with vulvas bring to counseling in a counseling setting or kind of sexology spot.
So I’m now going to hand it over to Daniel and yeah, I guess maybe to throw it to the two of you – what is it like engaging with people – with vulva owners? I wonder, what are some common things that you both are made aware of, or that’s like common presentations that come up?
Common presentations for vulva owners
Alana Shapiro: Thanks, Stu.
I think that… I think that it varies and what comes up in individual work can sometimes vary from how those same issues might arise in relationship work. I see a lot of vulva owners who will come in, especially *cis women who will come in and they’ll sit on my couch and they will say to me that they feel like they’re going through something that’s their own problem. And that they need help with it. And they have to fix it. And that their partner has basically… is fine with them going to therapy, and fine with them working on the issue. But it’s their issue.
Right. And so I always feel a bit disheartened when I hear something like that, because that means this person is going through something alone. They’re feeling isolated. It increases risk for trauma. And, you know, I think when that does happen, the thing that I will always say is, is your partner willing to come in with you? Because outcome, partnership outcomes drastically, drastically affect positive outcomes with any issue, especially when it comes to sexual functioning.
So there’s a wide array of issues. But I think, you know, when there is a libido issue or there is an intimate pain issue, or there is even a relationship issue.
And I see this. I see this with penis owners as well. But I do see it more prevalently with vulva owners who come in and feel like they’re alone, in what they’re going through, regardless of what it is.
* A cis female (short for cisgender female) is a woman whose gender identity aligns with the sex she was assigned at birth. For example, if a doctor declared you a girl when you were born, and you continue to identify and live as a woman, you are a cis female.
The prefix “cis-” originates from Latin, meaning “on the same side as,” whereas “trans-” means “on the opposite side”. The term cisgender does not imply any particular sexual orientation or gender expression; a cis female can be straight, gay, bisexual, etc., and express her femininity in any way she chooses.
Differences between individual and partnership therapy
Daniel Di Pietro: Yeah. And much of what Alana’s just talked about is what I experience as well, in terms of it being, if it’s in within a relationship, a partner difficulty, and always naming that, inviting that so that the person’s not alone in that experience.
So, Alana, you know, I’m really glad that you’re here on the podcast because you’re such a wealth of knowledge when it comes to this area and, you know, leads me up to the first question as to, you know, what kind of differences you see in the individual work when it comes to vulva owners compared to the partnership work, and perhaps how may you work with that on different levels.
And I know that’s quite broad and. And again, it’s so many different ways of working, but what are some of the common things that you may see?
Alana Shapiro: I think that’s a really great, great question. So I’m going to answer it using, like, a more specific example, just to kind of help everybody follow along a little bit better. So let’s say somebody is coming in, and the vulva owner is a CIS female.
She’s coming in and she’s saying, you know, I’m worried that my libido is low. Something’s changed. Whether it’s, I’ve just had a baby, I’m going through perimenopause or menopause where nothing has changed.
I want to know a little bit more about what’s going on. So the first question I’m going to ask is, have you been to a GP? Because I need to know what physiological and medical stuff might be, you know, floating around that we need to take into account. Just to have, like, all of our elements in a row, I guess, so to speak.
So, you know, usually I’ll send them out to do that as we’re doing our work. But that’s the first thing I ask because I want to get as much information as possible.
Then what I ask. I always screen for intimate pain, no matter what. It is a consistent part of my practice. Just like I screen for DV or FDV, IPV, you know, and just to stretch those words out, who hasn’t heard.
Daniel Di Pietro: I was just going to say, can you, can you broaden that a little bit for some of our listeners?
Alana Shapiro: Domestic violence, family domestic violence, and intimate partner violence. So, I screen for these things automatically because those things are a factor in everything you do. It’s going to impact your nervous system. It’s going to impact your relationship. It’s going to impact your relationships with yourself.
It impacts all aspects of our lives. We can’t just ignore it. And it’s also important to know that your client is able to find safety, right? Beyond anything else. And I’ll explain why this is specifically connected in with this issue in a second.
So, I ask about all that stuff and let’s say I screen this client and I ask them about pain. Most people would just prefer you to ask them, right? Are you experiencing any pain, discomfort, numbness, tingling, anything that feels uncomfortable? Right. Because it might not be a 10, but it might be discomfort and they’re discounting it.
So I want them to tell me exactly where they’re feeling it, what they’re feeling, and how intense it is. So better idea because they may be experiencing more of a situation where it’s pain just during intercourse or they’re having pain even if they touch their vulva area, which is the outer part of the genitals.
I need to know what that is, so I know how to move forward. Let’s say they’re experiencing it during intercourse.
So, now I have a really good amount of information and I want to know what is your relationship like with your partner at home?
You know, regardless of whether it’s a, you know, a gay relationship, queer relationship, a straight relationship, I want to know what that relationship dynamic is and what’s going on. I want to know what conflict is like in that relationship. I want to know if you feel emotionally safe in that relationship. That doesn’t mean experiencing abuse or violence, but is there a sense of emotional safety that you can go to your partner, and you feel safe to talk to them about anything, and it’s received well. Because without that emotional safety, one of the largest causes of pain is actually feeling unsafe with your partner.
It doesn’t matter that this issue has happened with partners in the past. I go through entire relationship history. I want to know everybody you’ve ever had sex with, or been in a relationship with to see if there’s a pattern. If that pattern is, that you engage in, you end up in coercively controlled relationships. You’ve never felt safe, and that’s why you’ve experienced it from the get go. So, it’s not just a you problem. This is a relationship problem that’s going on. And while they’re getting all of those other tests, we kind of chat about that. So that’s where I start things.
Then I ask about whether their partner is willing to come into session. And that’s where things kind of branch off into, I think, three different options, really.
If the partner is willing to come in and they’re willing to do the work together, and they can.
I just asked them to come in. I’m like, I’ll charge it as an individual. Just bring them in. So we can have no obligation, right? Because then they feel less pressured, like they have to start something. They come in and I do my little spiel.
I explain why I feel this is important and how relationship dynamics can cause us to have to work at an uphill battle to work through this issue.
Basically, you’re pushing the boulder down and we’re really trying to get up to the top of this hill. But if something’s going on with the relationship, nothing I do is going to be enough. It’s not that we can’t do anything, but we’re limited. Because it’s a relationship issue. So, most of the time, partners will get on board with that. And we can then proceed into relationship work. Start from square one – communication. You need emotional intimacy for sexual intimacy. Right. Start from there.
If a partner is not willing to come in for relationship work, but is willing to come in for their partner, I do what’s called, you know, basically individual work for couples issues.
Daniel Di Pietro: Yes.
What questions does a therapist ask?
Alana Shapiro: The training I did – Daniel, you are also there as well… So, I have the other partner come in and I ask them questions about how this is impacting them, what they perceived issues are. I want another perspective. I’m not just an echo chamber for my client. I want a full… as full of a picture as I can get.
And it lets me, you know, meeting their partner also gives me an idea of some things that might be going on as well, that both of them might not realise consciously. So it gives me more information. And then we might go the individual route. If the partner’s not willing to come in, they’re not willing to work on it, and they’re not willing to do the individual session at all.
Then we have to, like, deal with the cards we’ve been giving and given. And I do everything I can to work with the issue. It’s very honest with my client about the limitations to that.
But I do let them know, like, that doesn’t mean that you’re at a stalemate here. There are things we can do and, you know, it’s just easier to do it as a relationship issue, first ,and see what’s left so that we know that that’s not pushing down on us while we’re trying to get through the ceiling.
Yeah, yeah, that was very long.
Daniel Di Pietro: No, no, but I mean, so many wonderful points there. And I really liked what you talked into, as us as sexologists. You know, we are quite systemic in terms of the way we work and very holistic. I think what you’re talking into there is more so about the sexual history intake.
Right. And can you tell me a little bit about that process in terms of why it’s so important to find out where to start as a sexologist yourself?
Daniel Di Pietro: No, no, but I mean, so many wonderful points there. And I really liked what you talked into, as us as sexologists. You know, we are quite systemic in terms of the way we work and very holistic. I think what you’re talking into there is more so about the sexual history intake.
Right. And can you tell me a little bit about that process in terms of why it’s so important to find out where to start as a sexologist yourself?
Alana Shapiro: Well, the way I describe it to clients is that I want to have… I can never step inside of your experience because I’ve not lived your life. Right. And so the best way that I can go about this and because I work from a humanistic point of view, I want to get a window into your experience. I want to have a little peek into what you’ve been through and what, like what’s happened in your life, so that I can help support you as best I can.
The more information I have, the better I can support you. And I basically set it all out in session one. I set clear expectations and I let them know that next session, I would really love to get a family tree. To not only assess for attachment, but I can see how things started so I can figure out where to go now. I can understand what things that maybe you’re not consciously considering might be connected.
How you were raised, and the environment you grew up in, and whether you felt loved, and if you had trauma. All of these things really do matter. Even if you think you haven’t experienced anything, I still want to take it into account. Because I’d rather be more in line with your experience, and maybe get there in one or two steps, versus three or four.
Because I can support you, like more directly.
Daniel Di Pietro: Yes, yes. So. So it sounds like. It sounds like really exploring, I guess, the biological aspects, to how they impede the psychological aspects, to how they may influence the social aspects in terms of interpersonal connections. And how they form those. And that informs the way our bodies react and our sexual function.
Alana Shapiro: I want to know what the baseline for your nervous system is so I know how best to help you learn to regulate, figure out what the triggers are, and help you understand yourself better so that you are building the tools you need to help yourself. And I want you to not need me anymore. That’s my goal. But we can only do that by getting to the root of the issue rather than treating symptoms. So that’s first.
I ask very specific questions about a family tree in order to assess for things like attachment.
The second part of it is a sexual history intake, where I ask about your sex education, because that matters. What messaging have you had around sex? Not just from school, but family, peers, friends.
I also want to know… I started asking this question first just of like, of all men, you know, penis owners, what masculinity means to you. But now I’ve started asking the same thing of vulva owners.
I now ask the question, what does being a woman mean to you? What does femininity mean to you. And do you feel like you fit into that definition you just gave me?
Cultural trauma
Daniel Di Pietro: Yeah. So, you know… in my work, I also ask a very similar question. I’m wondering, you know, how… What have you been able to uncover as you’ve been asking this question about femininity and womanhood and what it means for your clients?
Alana Shapiro: Yeah, I think, like, if I were to encompass it in two words, cultural trauma.
You know, we live in this… it, you know, everywhere around the world, we live in kind of this patriarchal system. I mean, there are obviously a few societies that have a matriarchal system, but that’s not the norm, right. And so within this system, even… vulva owners are upholding the system in certain ways because there’s so much conditioning and, like, things that are embedded within us that we don’t even realise.
Guilty for saying no to sex, for one. You know, that’s because of a patriarchal system. That’s because, you know, penis owners, you know, can’t control themselves, “boys must be boys”, things like that. And it makes us the ones who are responsible for that. And so there’s a guilt for saying no, or having to be nice to a stranger on the street because you’re worried about violence.
You know, these are… all ways in which we hold up these systems, but also have to in certain ways in order to protect our safety. And so I think that there’s a lot of that that’s wrapped up in that. And so, when I ask vulva owners about what does it mean to be a woman to you? What is femininity – caring, nurturing, mothering – even if they don’t, you know what I mean? And they end up mothering other people in their life, their partners, their friends, their friends kids, you know.
But what I think is interesting is masculinity can also be those things. And about masculinity, strength, you know, being strength, being loud, you know, being, you know, having this charisma… Why is that not a feminine thing? So I just like to dismantle that by, I guess, holding up a mirror to what people are saying about these things and how see themselves. Because it’s a part of all of it.
Daniel Di Pietro: Yeah. And you know, you, you’ve really touched on something that I’d like to get into in terms of sexpectations. And I like calling it a little bit of sexpectations.
How people may feel in terms of engaging in certain parts of sexual intimacy or even being approached and feeling like that there’s a sexpectation for them. You know, I see it a lot in my work, but I’m wondering, can you tell me about your experiences of, of working with clients in terms of what sexpectations do you feel like you’ve seen and how vulva owners perhaps live with that?
Statistics
Alana Shapiro: So let me start with the statistic.
Daniel Di Pietro: Yeah.
Alana Shapiro: Latrobe University did this research, I think in 2021, of all of their sexually active students, 39.5% had unwanted sexual experiences.
- And umm… cis men, 21%,
- 45% cis female and
- 55% for trans and gender diverse individuals.
So everybody can experience unwanted sexual experiences. So, I feel, I feel the need to point that out. But unfortunately it is, it is a lot more common for vulva owners, which is… it’s really disheartening to be aware that that is…
Like I, you know, I don’t think I know any woman, whether a client or personally in my life who hasn’t experienced unwanted sexual advances.
Daniel Di Pietro: Yeah.
Alana Shapiro: And the reasons that, for this research, that the common reasons for the unwanted sex was due to:
- verbal pressure from their partner, which was 65% – so it’s not just strangers, as I say, it’s someone you know,
- worried about negative outcomes of not having sex, 41%,
- physically forced, 32%, and
- too drunk or high to consent, which is 28%.
And the thing is, is all of these things are underreported. So let’s just take that in for a second.
Daniel Di Pietro: Yeah.
Alana Shapiro: […] those percentages are so, you know, I think, again, trigger warning for anybody who’s listening to this – rape culture –that’s what it is.
And everybody’s upholding it. Anytime you see your guy friends out there and they’re objectifying women, or making comments about sex that are quite crude, or about body, what they’ve done with them, if you don’t stand up and say anything, you’re upholding that structure.
And for women, it’s about that guilt of saying no. So being in a partnership and feeling like it’s your duty to say that.
And I know that that’s the case for a lot of cis women.
I can’t speak for all vulva owners in that.
Daniel Di Pietro: No.
Alana Shapiro: I think it’s more prevalent for cis women to experience that. But I wouldn’t discount.
Daniel Di Pietro: Yeah. And such horrific statistics. Right. And as you said, you know, well underreported. And you know, if we speak about vulva owners in terms of inclusivity, you touched on, I guess, trans folk. And can you tell me a little bit about working with trans folk or vulva owners, as well, in terms of, you know, what are some of the difficulties that you see them experience in your work?
Alana Shapiro: I think that it’s very similar. I think it’s all around similar in the sense of objectification, seen as a body and not a person. For all vulva owners.
And to the degree in which that is approached, there are, it’s not mutually exclusive, you know what I mean?
But you know, I’ve had a lot of experiences with trans women and gender diverse folk who have vulvas who talk about, you know, being groped, or in situations where they thought they were safe, someone took advantage of them and you know, assaulted or coercion, which is something that all vulva owners experience. So, I don’t think that the experience is that far off, but I think the motivation for it is what separates those experiences, sometimes.
Finding a sense of pleasure
Daniel Di Pietro: Yeah. And you know, I’m wondering if you could also talk into, I guess, if someone was to come and see you to, I guess, start figuring out their bodies and find their sense of pleasure, here. I’m wondering what are some of the things you feel like that you incorporate in your practices, perhaps some of the first steps that a client could do that.
Alana Shapiro: Well, you can’t feel empowered if you don’t feel safe.
So that’s number one. And that’s a lot of the work.
Because there’s… even if it’s not in your current relationship, right. It’s, it’s all of these past experiences – that built up that wall of like, am I safe?
It’s that sense that this could go south. And you’re bringing all of that with you. And that doesn’t mean somebody is broken and unworthy of having a relationship. That means absolutely nothing. What it is, is that that person needs to do the work, and they need to have a partner who’s going to be able to understand as much as they can. They need to have compassion – empathy, even if they can’t understand it on a personal level – for what this person is going through. Not pushing it. Having patience. Not being… not throwing a tantrum if your partner says no. Understanding why.
The thing that I recommend for everybody is whether it’s pain or something else, if you do not want to be having any sexual activity, and that includes intercourse, in that moment, and you do it anyway because you feel obligated to, somebody wouldn’t take no for an answer, or whatever it is, your brain is going to form neural pathways that associate sex with negative experiences. You’re more likely to develop sexual functioning issues. Your libido is going to go in the toilet, if you had one to begin with. And you’re… not going to feel like you can trust because there’s no safety. Number one. You can’t. There’s no pleasure, really.
The causes of intimate pain
Daniel Di Pietro: Yeah.
And what you’re really talking into there, it’s kind of tying up from what you said about the statistics, and cultural trauma, and societal pressures. Building that sense of safety back in the body. And that’s such amazing work that you do there on that. And, you know, I’m also very curious in terms of intimate pain, now you raised this at the beginning. Is that something that you enjoy working with?
This may be a bit of a twofold question, but when it comes to intimate pain, now tell me a little bit about what that’s like working with it. And also how important is the pelvis and the pelvic floor when it comes to working through intimate pain and perhaps, outsourcing as a sexologist?
Alana Shapiro: Yeah. So, there’s so many reasons for… potentially, for intimate pain. I even, like before we came on here, made a list because it’s… there’s so many factors, here. And I wanted to make sure that I didn’t miss anything.
So bowels. You wouldn’t think that, right? But constipation, diarrhoea, urgency. That has something to do with pelvic pain because there’s this discomfort happening in your system and everything’s connected. And if there’s inflammation, it’s going to set off potentially the rest of the body.
You’ve got bladder. So urine frequency, urgency, UTIs. UTIs, people don’t realise this, but can contribute to intimate pain.
Daniel Di Pietro: Yeah.
Alana Shapiro: So you definitely, if you’re, if you frequently get UTIs, definitely go and have that… if you’re starting to experience pain, go get checked. You know, that can be a contributor. So, I wouldn’t recommend having sex while having a UTI, anyways. But if you needed a better reason, there it is.
So the uterus, the cervix and the vagina. So endometriosis, which we know is like so understudied and affects so many, so many people.
Dysmenorrhea, which are painful periods. Menorrhagia, which is heavy periods. Vaginal discharge. Thrush. BV. STIs. Vaginal atrophy, especially with menopausal changes.
Those are all things that can contribute to pain. And then we’ve got, for the vulva, lichen sclerosis, which is a condition, dermatitis, vulvodynia.
When it comes to musculoskeletal, we’ve got back pain and hip pain. So there are so many things that can contribute.
This is just physiological.
Daniel Di Pietro: We haven’t even touched psychological.
Alana Shapiro: I know! None of it.
So, I’m like, that’s why I want you to go to the GP. I want you to have your hormones tested. I want you to have somebody do a pap smear. If you’ve given birth or had a traumatic birth, I want them to check for scar tissues internally, externally, to see if that’s a factor. I want you to go to the dermatologist, I want you to get checked out there. Because that’s the thing a lot of people miss, like Candida and things like that can contribute, as well. Like, I want you to do a full checkup.
Daniel Di Pietro: Yeah.
Other factors
Alana Shapiro: But if I see a history that says relationship factors and safety are like flashing lights at me, that’s where we’re starting. Because all of that other stuff is outside of my scope. I want to know what’s going on, if that stuff is relevant at all for you, so that I can take it into account and we can adjust to it. But that relationship dynamic, how you feel about it. Are you anticipating pain? Are you now avoiding sex because you’re anticipating pain? Because you’ve built that negative correlation already in your head because you’ve been pushing through for so long. Has there been any changes recently in your relationship that have worsened the issue? I want to know everything. Are you still experiencing this with masturbation? If you’re using anything internally, like, we gotta get into it before I think about how we’re gonna move forward with it. Because I leave anything out, the dominoes fall.
So, yeah, need to look at this holistically so that we can take that approach. And that can take a little bit of time. But I’m here to support. And I’m here to talk about it with. And I’m here to work on, like… Do it with your relationship. If you’re coming in as like a… in a relationship form, like, and still do those things while you’re getting those other things checked. And we can add in the elements as they come.
Daniel Di Pietro: Yeah.
Stuart Cheverton: I just want to… as I’ve been hearing both of you talk, I guess the real diligence of really digging into those details, the sexual history, I’m guessing the… one of the biggest kind of clinical logics there, is a lot of vulva owners, women, there’s this kind of idea that maybe sex equals pain. Like, they just go in thinking that… they just go in assuming that right, off we go, there’s pain coming included in sex. But it doesn’t have to be that way. Right?
Alana Shapiro: Yeah, I think, look, I see that more often with a primary presentation because it’s always been that way. And they probably… a lot of times they’ll tell me, you know, before they had sex their first time, they were told that it was going to hurt a little bit. They thought it would go away, and it didn’t, so they just started to associate it.
But people who have experienced sex in a […], I should say, without pain, know that it doesn’t have to be that way, even though it is. But at some point they just relinquish themselves to it because they feel like they cannot say no. And it’s not necessarily because their partner is telling them they can’t, which – awful when that happens. But it’s not, it’s not even that. It’s pressure they’re putting on themselves because they feel it’s a duty.
Daniel Di Pietro: So, this kind of cultural appropriation or, kind of, this gender appropriation, or sexual appropriation.
Alana Shapiro: Yeah, it’s all cultural trauma that we just don’t realise. And everybody just thinks this is the norm. Just because it’s the majority does not make it normal.
Tools and time
Daniel Di Pietro: Yeah. And so, I’m really hearing the sense of building safety is really core and finding out if this can be done within a partnership space, or if this can be done within an individual space, and bringing that to the clients that you work with. And so important about going at a pace that feels right for them, which it sounds like is what you do, is that you really methodically take your time to see which one of the dominoes need to fall first for you to kind of get the results that they’re hoping for and needing here.
And I’m wondering as well, Alana do you have any tools that you show in sessions? Whether it be, you know, I use something by the Pelvic People. It’s called the Ohnut and it’s a depth… You’ve got one there as well!
Alana Shapiro: I have one!
Daniel Di Pietro: Look at us nerd out, here.
Alana Shapiro: I do also have the Ohnut.
I remember ordering it when it first came out. And I think it’s a really, really great tool. But I do not introduce it until that person is psychologically ready to say, yeah.
While the partner might be excited about it, there’s a lot of work we need to do before sex is even on the table. Like, I’m sorry to say that, like. And I don’t give a specific amount of time when it comes.
Daniel Di Pietro: Yeah.
Alana Shapiro: How long? I’m not going to be like, yeah, six months, or like a year, and…
Daniel Di Pietro: Yeah. And give this arbitrary time frame.
Alana Shapiro: Yeah. I think it depends on the couple. And I’m like, you two get to decide.
Daniel Di Pietro: Yeah.
Alana Shapiro: Gather as a team. When you’re ready for this, you need to be a hundred percent ready. It can’t be like, I really want to do this… Or like, to give in to that feeling of guilt. Because it’s going to take us backwards.
Taking back control
Alana Shapiro: There’s a lot of work we need to do. We need to have you see – I didn’t mention – a pelvic physio. Yes, we do need. You mentioned that earlier. Pelvic physio is really important for finding out where that pain is. Learning how to relax the pelvic floor. Because oftentimes it’s not about strengthening it, it’s about relaxing it.
Daniel Di Pietro: Yeah.
Alana Shapiro: They can teach you those points internally. They can do it for you so that you feel that.
If you have… If you have a trauma history at all and having someone else have control over that feels too daunting for you, please talk to the pelvic physio that you are seeing. I know, I refer to someone who specifically asks about that, for my clients, so that they can have an alternative for you.
You don’t need to be like, if you go to the gynaecologist and you’re getting a pap smear, you don’t have to be like subjecting yourself to re-traumatisation.
There are things they can do. They can have you put in the speculum. You do it yourself so that you feel like you’re in control. Or they can give you some anaesthesia so that you don’t have to like, be awake for the process. Or if that, like, there are other… there are options is my point. And finding something that works for you is really important. So, anybody who’s daunted by that, please find somebody who’s going to listen and respect that and find an intervention for you.
Daniel Di Pietro: Yeah, 100%. And, you know, I really resonate with what you said, and what I bring to my clients, that the journey of healing isn’t linear.
Right. This is something that it will have its ups, it will have its downs. But how do you kind of navigate that together within a partnership? Or how do we work with that in our space together if it’s at an individual setting?
Alana Shapiro: Absolutely. And it doesn’t mean that I can’t give you things to take home for your partnerships, so that you can show up as a partner. But it means that what I can’t do is I can’t offer anything to your partner because they’re not sitting in front of me. I cannot speak for your partner because they’re not sitting in front of me. And I feel like that… I feel really disheartened when I hear that that’s been the experience of somebody in individual work who needed some relationship help.
It doesn’t help the situation. It actually creates more pain and suffering at the end of the day. I’m not here to speak for your partner. I might say this is a possibility of what might be going on, but I don’t know. I’m okay to say I don’t know. And what I can do is say: “This is what you can do if you were to face that situation again. This is how you can conduct yourself. So you are showing up as your best self in that moment, because that’s what matters. We’re here to work on you.”
The pleasure aspect
Daniel Di Pietro: Yeah. And you know, Alana, I wish we could have you on for hours talking about this, but there’s a final question that I wanted to ask and kind of to end this on. In terms of pleasure for vulva owners, can we talk into that? In terms of perhaps if someone is having partnered intimacy, what is the sufficient time for self-lubrication to start taking place, or for the pelvic floor to drop a little bit for penetrative sex? Can you talk into a little bit about the pleasure aspect here for vulva owners?
Alana Shapiro: Yeah, so, look, uh… Let me start by answering your question and then I’m going to say something else I think is important.
Daniel Di Pietro: Please, please.
Alana Shapiro: So, with genital arousal, we have, you know, vasocongestion. So we’ve got the increased blood flow to the clitoris, labia, vaginal walls, and it causes the engorgement and increased sensitivity that we’re looking for. Then we have increased vaginal lubrication. We’ve got that facilitated by the engorgement of the vaginal walls and surrounding tissues. We’ve got aversion and engorgement of the labia minora.
So the inner labia… I actually don’t think that these have any, but…
Daniel Di Pietro: And hopefully we don’t get censored there. But you know.
Alana Shapiro: So they’re normally tucked away and protrude to become more prominent. But everybody has a different sized labia so you know, it might not be tucked away for you. Everybody’s labia looks different. They’re like a snowflake. Clitoral tumescence – so the clitoris becomes larger, more sensitive, increased blood flow. All of those things have to happen with arousal before anything happens.
Daniel Di Pietro: Yes.
Alana Shapiro: But with lubrication, it’s important to note something that Emily Nagoski, hopefully I’m pronouncing your name right, mentions in her book, Come As You Are. And it’s a very important thing to recognise is, arousal non concordance.
It’s a well established phenomenon that you know, is backed by research and empirical evidence. It’s basically how turned on you are – so subjective arousal…
Daniel Di Pietro: Yes.
Alana Shapiro: … different from the physiological things that are happening to you because the context is sex.
Daniel Di Pietro: Yes.
Alana Shapiro: And she gives this great analogy that says, if I told you my mouth watered when I bit into an apple that was wormy and rotten, would you think, well, if her mouth watered, she must really enjoy eating a wormy rotten apple, right?
Of course not.
Daniel Di Pietro: No!
Alana Shapiro: So just because. And I think people use this as a standard, mostly penis owners, use this as a standard for readiness.
Daniel Di Pietro: Uh huh.
Alana Shapiro: This happens when the context is sex.
So somebody with a vulva could be watching two monkeys have sex on the animal channel and lubricate.
Does that mean they are into bestiality? No.
Daniel Di Pietro: No.
Foreplay
Alana Shapiro: It’s a… It’s subjective. So, my best advice is, on average, not for everybody. And we… I don’t like giving averages out because I think for people who don’t fit within that average, it makes them feel like something is wrong with them. Nothing is wrong with you if you take more or less time to do this. I think the average is around 20 to 22 minutes to be ready for penetration. But that is after that amount of time doing foreplay.
What foreplay, you ask?
The foreplay that you ask your partner if they enjoy. You don’t just do what you think works for everybody. Everyone’s body is different, everybody’s nerves are different. Everybody gets pleasure from different things, has different preferences.
It means we have to talk about it and you need to ask your partner:
“Do you like it when I do this?”
“What would you like instead?”
“Is there anything that you don’t like that I’m doing?”
And you need to have very real conversations about – it both ways. Because we can’t just plaster the same routine on everybody’s body and expect this… expect this result.
Daniel Di Pietro: And not everyone fits into a cookie cutter mould.
Alana Shapiro: No. And the thing I think is worth mentioning is that if anybody has had like, potentially with traumatic birth, changes in the body, like perimenopause or menopause, if anybody has had gender affirming surgery for their genitals, the nerve endings can change where they are. And what you have responded to in the past might not feel good now. So that means in any of those scenarios and more, your body has changed in union. You now need to figure out what your body will respond to and what it likes. And your partner needs to understand that that’s an exploration space. And it’s exciting.
Like, we get to… I get to, like, explore the world all over again. And it’s your world, and we’re doing this together. And it’s… it’s not a daunting thing, it’s an exciting thing, but it is a change. And so we need to make room for different bodies and different responses.
In Conclusion
Daniel Di Pietro: Yeah. And, you know, Alana, you know, it’s been so wonderful having you on, and I think a lot of the messages, a lot of openness, a lot of safety, a lot of communication, particularly when it comes to partnerships and your approach of that, not everyone fits the same presentation, because although multiple people can be experiencing something similar, it’s still different in many ways, which is why talking about this at a holistic perspective is so important for us as sexologists. And, you know, I think your work is amazing, as you know, and, you know, you’re a dear friend and colleague of mine, so thank you so much for coming on here. And I’ll hand it over to Stuart, here.
Alana Shapiro: Thank you both for asking.
Stuart Cheverton: Yeah, thank you for coming on board. I’m really seeing the interplay of… sex and intimacy and closeness with your partner and feeling psychologically and emotionally safe. And it just goes so naturally together.
And that’s why I think lots of psych clinics, you know, more broadly, need to start at least thinking about sex, thinking about safety, thinking about how people think about, you know, their connection with others and really opening that up, even if they’re not at an expert level, starting to ask those questions. So… thank you both for that.
And if you enjoyed today’s podcast, or YouTube episode, please like, please subscribe, please comment. I know that that would be a really brave, courageous thing to do about, about this topic.
Or reach out for help. You might, you might have never really explored this for yourself. But if you own a vulva, start asking questions. Is it actually okay to talk to friends about this? If you’ve never gone there, why not?
And if you have it, how about you give it a go with someone that you trust?
So please reach out for help.
We’ve got two websites that you can explore more. So Safe Place Therapy is where Daniel and I work with, and Bare Intimacy is where Alana is from. So please reach out for help and take care for now.
Alana Shapiro: Thank you so much.
Safe Place Therapy are dedicated to providing you with a safe place to explore your thoughts and feelings and work towards a positive change.