A: What a humanitarian! I bet you even reduced her fees for your weekly sessions. Of course, it's rationalizing, you devious son of a bitch! You deserve to lose your license and your patient deserves a principled therapist who won't give in to emotional blackmail and keeps it in his pants.
Q: I seriously think I hate my vagina. To me it just seems like more trouble than it is worth, causing PMS and cramps and having periods. It's becoming intolerable and sex is starting to become that way too. I think I am sick of being a receptacle and I have been having some serious penis envy. A penis is just so simple; insert one into a warm, wet place and have orgasms almost every time. My G-spot has become so sensitive that I can't even stand to have it touched. Just the thought of penetration is a big turn-off. I know I am not gay, though I've considered it. I've had my boyfriend for more than 3 years and I have tried to explain how I feel. He gets all worried and thinks it's his fault. Honestly, he has satisfied me. We are very open with communication and close physically as well as mentally. I am almost positive this is psychological and not physical. I don't want to hate sex. It's almost like I've developed a phobia about it. I feel satisfied with just petting and smelling. I don't even think I like kissing any more and it is really freaking me out. I've already hated anal sex for a while, which is a big disappointment to my boyfriend, but he accepts it. I don't want to have to take this away from him too. Please, please help.
A: I'm afraid there's much more here than I can deal with briefly in a column, or even briefly in therapy, if you were consulting me in my office. Much as you may love your boyfriend, the feelings you described, unfortunately shared by a certain percentage of women, are not those of a woman satisfied by her loving boyfriend. Were sex satisfying, all this revulsion, pain and envy would not be associated with it. Of course "it's psychological," and while there may be some physical components, I strongly suggest you get yourself to a reputable therapist (avoid the above letter writer) and start doing some work on your feelings about your body, your gender and, yes, your relationship. Isadora Alman is a board-certified sexologist and a California-licensed marriage-and-family therapist. Contact her via this paper or email@example.com. Her Sexuality Forum is at