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BAD SEX IS EVERYWHERE on television. But painful sex isn’t. Vaginal pain—despite affecting around a quarter of people with vaginas—still seems to be taboo enough that TV screens have rarely reflected this common experience. There are a few, often misinformed, exceptions. Devout Sex and the City fans might remember a couple of minutes in Season 4 when a gynecologist diagnoses Charlotte with vulvodynia—a vulvar pain condition—which quickly turns into a joke about her “depressed vagina.” (The National Vulvodynia Association strongly condemned the episode.) More recently, the Netflix comedy Sex Education featured a high-school girl who experiences pain during penetration; the show was lauded for increasing representation of the condition, but also criticized for implying the character’s uptight personality might have caused the pain. 

Joining this short list is Unorthodox, the Netflix miniseries about a young woman who flees her Satmar Hasidic community in New York, loosely based on Deborah Feldman’s memoir of the same name. Central to the story is 17-year-old Esther “Esty” Schwartz’s struggle to consummate her marriage with Jacob “Yanky” Schwartz and her eventual diagnosis of vaginismus, a condition that causes extreme pain with vaginal penetration. Esty’s challenges with “proper” penis-in-vagina sex create serious conflict with her community, where bearing children is a religious imperative weighted by the memory of genocide. That tension propels her to flee Satmar Brooklyn for a new life in Berlin. Critics writing about the show have mostly elided or fumbled through its presentation of sexual pain, but in fact Unorthodox provides a rare, attentive look at a condition often shrouded in shame and confusion in both religious and secular contexts. 

In her book, Feldman portrays her failure to achieve vaginal penetration during sex as a manifestation of her psychic rebellion against the community. The show could have taken the same track—representing Esty’s sexual “troubles” as a symptom of repressive Hasidic culture and freeing her from them upon her escape. Instead, Unorthodox trains an unflinching gaze on the physicality of Esty’s experience of vaginal pain and examines how people with disabilities navigate the experience of occupying a body deemed non-normative or dysfunctional, a narrative that resounds beyond the Satmar context. Unorthodox is a meditation on disability’s radicalizing potential: Esty, unable to physically fulfill her community’s expectations, rejects a life structured by pain and must forge new ways of being, belonging, and living. 

“VAGINISMUS,” THE DIAGNOSIS Esty—played by Shira Haas—receives, is one outdated name for a variety of conditions that involve vaginal pain. Although millions suffer from these conditions, the misogynist leanings of the medical industry mean that conditions gendered as female are under-researched, underfunded, and underdiagnosed. Contemporary studies note that a large percentage of people who suffer from vaginal pain continue to have intercourse despite the pain. Fifty percent do not seek treatment, and—among those who do—one-third attend more than 15 doctor’s appointments before receiving an accurate diagnosis. 

Vaginismus was “discovered” and coined in 1861 by James Marion Sims, the infamous father of American gynecology known for his early experiments on enslaved women without anesthesia. Sims described vaginismus as an involuntary vaginal muscle spasm that caused extreme pain, rendering sexual intercourse impossible. For a century and a half after Sims’ coinage, various treatments came and went, but the condition’s name and definition remained roughly the same, despite the discovery that the muscle spasms characteristic of vaginismus were only present in a small number of cases. “It is hard to find another diagnosis with such longevity,” two sex therapists wrote in the Psychiatric Times in 2016. “We suspect that this diagnostic longevity was not a testament to its validity but rather the result of the lack of critical attention.” In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) gave the condition a new name: “genito-pelvic pain/penetration disorder,” or GPPD. 

The fact that vaginismus—now GPPD—is even in the DSM reflects a longstanding tradition in which healthcare workers frame vaginal pain as a psychosexual problem rather than a medical one, even as contemporary studies on whether pain with sex is more prominent among those with histories of sexual trauma or sex-negative upbringings are inconclusive. When Esty meets with her Orthodox marriage instructor to address her struggles with sex, the teacher does not perform any physical exam and instead focuses on Esty’s psychological state, assessing Esty’s anxiety level with a biofeedback machine despite her protests that she is not anxious. Psychological factors are not necessarily irrelevant: Emotional distress is associated with inflammatory responses or muscle tightness—both of which can cause painful sex—and experiencing painful penetration can make women more anxious about sex in the future. Yet this complex mind-body connection often serves as an excuse for professionals to dismiss women’s complaints by encouraging them to “just relax” or “have a glass of wine” before penetration. 

The little medical attention vaginal pain receives belies its actual impact on people with the condition. As it affects a primary sex characteristic that labels bodies female, vaginal pain is a deeply gendering illness that profoundly troubles social expectations for women and women’s work, which demand that female bodies function to produce children through heterosexual sex. That function is especially crucial in Satmar Williamsburg, where marriage and children form the bedrock of acceptable female identity. 

Esty initially hopes marriage might provide a path to belonging after an upbringing marred by scandalous parenthood. But her body makes that future impossible, separating her from her Williamsburg milieu even after marriage. “My brothers’ wives had no trouble!” Yanky says to her, in frustration, after another failed penetrative sex attempt: “They all had babies nine months later, didn’t they?” In multiple scenes, Esty hustles past fellow Satmar women, all congregating around their baby carriages; she is positioned on the fringes. 

Instead of resigning herself to these judgments, Esty pushes back. Although there is nothing inherently redemptive, interesting, or useful about having a body in pain, the series explores the possibility that disability can be radicalizing—it requires us to tear out our assumptions about ourselves and our communities at the root. Feminist disability scholar Rosmarie Garland-Thomson asks: “What kinds of knowledge might be produced by having a body radically marked by its own particularity, a body that materializes at the ends of the curve of human variation?” Despite Esty’s original intentions, having vaginal pain pushes her to speak up, to stand up for herself, and to make difficult choices.

The show begins this radicalizing arc for Esty in part by zeroing in on the physical experience of pain that she seeks to escape, a point of departure from Feldman’s book. Feldman writes frequently about failed attempts at sex with her husband but avoids detailed description and mentions pain only in a muted and hurried fashion. Of her first “successful” consummation attempt, she writes, “it hurts a lot, stings and burns up, but it’s nice that it’s over fast, that he can make it quick.” By contrast, the show foregrounds pain in the jarring moment when Esty reluctantly allows Yanky to penetrate her despite the agony. He orgasms, and their bodies fall parallel to one another, writhing: Yanky with the shock of new pleasure; Esty with the jolt of burning pain. 

Treatments for vaginal pain are notoriously painful, involved, and confusing. An unregulated field of possible “cures”—which often privilege successful penetration over the absence of pain or presence of pleasure—includes physical therapy, lidocaine and botox injections, pharmaceuticals, capsaicin, talk therapy, biofeedback, progressive dilation, vulvar surgery, and hypnosis. As Garland-Thomson and the historian Paul Longmore put it, the “ideology of the cure” insists that “cure rather than adjustment or accommodation is the overdetermined cultural response to disability.” Disability, in other words, is constructed as an undesirable condition located in the body, rather than in the cultural and social construction of non-normativity.

In Esty’s case, the notion of what “cure” looks like is based on the sexual norms of her community. “Is there a cure for it?” she asks, concerned, after a Hasidic marriage instructor announces her diagnosis. “Well . . . kind of,” responds the instructor, then looks at the floor as she announces, “We’ll have you pregnant in no time.” To help Esty achieve penetration—with no mention of potential pleasure or even freedom from pain—the marriage instructor suggests breathing exercises and work with vaginal dilators. “They hurt. They hardly make the idea of the real thing appealing,” Esty tells Yanky about the grueling work of using vaginal dilators. In one respect, the instructor turns out to be right: Esty’s sole fraught, successful consummation does ultimately lead to pregnancy. At this point, though, she has already begun to chafe against the ways her husband, and her community, have devalued her and her body. She begins plotting her escape to Berlin. 

When Unorthodox moves to Europe and to the secular world, it explores whether simply leaving the restrictive Hasidic community behind is a “cure” for sexual pain. Esty dances with the improbably handsome Robert in a Berlin club and then follows him to his dorm room at the music school. She turns and kisses him intensely, a far cry from the passive role she played in the Brooklyn bedroom. She backs off at first as he unbuttons her shirt, but then steadies herself; he caresses her face, signifying that their sex will include the “foreplay” missing from life with Yanky. They kiss again. What happens next? We don’t know. The episode ends. 

The next episode, however, offers a teasing suggestion, when we return to the Berlin bedroom in the morning. Esty wakes up still in her bra and long skirt, suggesting one potential explanation: that she and Robert engaged in some sort of sexual activity without penetration, perhaps with the opportunity for her to assert her needs and desires and have them heard. One rarely invoked “cure” for vaginal pain, after all, is to simply remove the penis-in-vagina component from the sexual equation and engage in other types of sex. Considering that heterosexual penetrative sex is often unsatisfying for most cisgender women, rejecting the “coital imperative”—a term scholars use to describe the Western idea that penis-in-vagina intercourse is the only option for “real sex”—looks less like sacrifice and more like freedom. 

Vaginal pain, when taken seriously by doctors and partners, requires heterosexual couples to seek out new models of sex that might better produce mutual pleasure. Unorthodox does not directly present this option, but nor does the series foreclose it. It’s hard not to want more, particularly since the show is otherwise careful to avoid depictions of Williamsburg as uncomplicated hell or Berlin as simple deliverance. Why not open up the Berlin bedroom and consider how someone with vaginal pain might navigate sex in an also-unforgiving secular world? Esty’s pursuit of pleasure deserves the same courageous attention given to the scenes of pain in Williamsburg. 

Mari Cohen is an assistant editor at Jewish Currents

Hannah Srajer is a graduate student and poet based in New Haven. She is a founding member of Tight Lipped, a podcast and organizing project for people with chronic vulvo-vaginal pain conditions.