Traditional Jewish attitudes towards sex dictate that within a marriage it is good, and sexual gratification is a perfectly legitimate justification for sex, in its own right, unrelated to the mitzvah of procreation. Sexual gratification is one of a woman's rights in her marriage contract. Purposeful emission of semen outside the vagina however, is forbidden*. When a couple can have sex is mandated however: Not during Nidah, not while drunk or arguing, not if sex is being used as a weapon by one spouse over the othe. Also, if one party is not consenting, sex is forbidden. When the importance of sexual gratification is combined with the importance of procreation, Judaism's attitude towards marital sex is quite positive.
In Orthodox Jewish women, ignorance of their own body due to lack of info on the female anatomy, lack of sexual experience and tampon use or exploration of their own body, purely physical factors related to their hymen or their level of lubrication, fear and anxiety about sex, or some combination thereof, are all factors in the inability to acheive penile penetration after marriage.
The self-inspections of Niddah that a woman takes on before marriage may help her to know her own body, since she must instert a bedika cloth. Often, women who report inability to consumate marriage may have had difficulties with such inspections. Vulvar vestibulitis and vaginal muscular hypertonus, as well as fear, anxiety, and lack of knowledge of one's own anatomy, all contribute to inability to consummate marriage. These symptoms do not uniquely affect Orthodox women, but treatment for such issues shoudl take the clients' cultural sensitivities into account, which in the case of Orthodox women may involve toning down the explicit language and visual aids often used in treatment.
While most Orthodox women are able to consummate marriage, for some, the modesty standards they have been raised with make them feel inhibited, or make them feel immodest and thus transgressive in their attempt at sex, especially since Jewish law expects both partners to be naked, whereas religious culture expects women until marriage to always be very clothed in front of men.
As for men, erectile disfunction and premature ejaculation are the two main factors preventing consummation. The reasons for these symptoms may be purely physical, purely psychological - or, as is most often the case, some mixture of the two. Most men have not had any physical contact with their spouse or even with women in general, especially in Haredi communities - yet at the same time, they are expected to know what to do, to be the man and take control - which leads to performance anxiety. ED or PE on a first try will further increase such anxiety, thus increasing the chance of future ED or PE.**
Jewish prohibitions on "spilling the seed" may play a role in this phenomenon in the following ways:
1. Since even masturbation is not allowed, men are used to viewing the entire concept of sexual arousal and ejaculation as negative, and are not able to suddenly start viewing it as positive the minute they are married, even though halachikly they are entitled to do so.
2. Fear of non-vaginal ejaculation causes the man to insert the penis before he is either emotionally or physically ready (or both). Things then go badly, and the dissapointment and shame means that its a while before the couple tries again.
3. This fear of non-vaginal ejaculation, even if the man inserts at the right time, causes the woman to be nervous as well, so there is a general sense of nervousness surrounding the sex.
Extreme sensisitivity/heightened excitability at the female touch can lead to PE, which can become a pattern.
Major factors in inability to consummate in Orthodox couples include: lack of information about sex/the female anatomy, so the husband does not even know where he is supposed to be penetrating, and the woman might not know or might be too modest to guide him, lack of arousal, lack of knowledge about foreplay/ways to stimulate arousal, and discomfort/awkwardness with one's own body.
When first experiencing inability to consummate, couples may turn to religious, rather than medical sources. These sources may be unable to provide them with accurate scientific information they need. Often religious sources will refer them to medical sources - whether psychological, gynecological, or both. Most couples feel "failure at meeting personal, spousal, and communal expectations". They think something is wrong with them or their partner and are embarrassed.
A therapist must ask her or himself if one or both spouses are expressing reservations about the marriage through "sexual distancing". Therapists should not refer to inability to consummate as a "problem" and should try to make the couple feel as normal as possible, emphasizing that all newlyweds face certain challenges. While one spouse may be more responsible than the other for sexual failure, emphasis should be placed on how sex is a partnership and responsibility for consummation lies with both spouses, and unite the newlyweds in pursuing a common objective ie sex. Religious couples may turn to religious professionals whose "noise" interferese with the therapy. Therapists should help couples evaluate advice from religious sources to see what is and is not applicable and right for them, and should develop working relationships with a couple's rabbi, if necessary. Information abot sex and genitalia must be presented in a very medical manner that can in no way be considered inappropriate. The gender of the therapist, as well as whether the couple will work together or alone, or some combo, and whether or not one spouse would feel ok with a therapist of the opposite gender, must be taken into account.
Each spouse should be included in the treatment as much as possible, even if the treatment is focusing one one spouse who is the primary cause of the issue. For example, with vulvar vestibulitis, the husband should help guide the dilator, while with ED, the wife should manually stimulate the husband. Such steps should only be taken if and when the couple is comfortable with them, however. In the process of encouraging spousal sex, also emphasize that in the eyes of Jewish law, all sex must be consensual, since in the process of pursuing consummation, one spouse might bully the other into sex if the therapist does not do her or his best to prevent the couple from pressuring each other.
A 19 year old, S., and her 20-year old husband, N., were referred after 6 months of marriage. S. barely spoke or made eye conact, and N. "seemed confused and embarrassed". S. had been diagnosed with vaginismus. S. was shown her anatomy using a mirror and started inserting dilators, while B. saw a therapist who corrected some "sexual misinformation" he had regarding male and female anatomy, as well as "paramaters of desire, arousal, and performance". During therapy, S. revealed that her ability to prevent penetration was the one thing she felt she could control in her life, and she resented her community's pressing her into a marriage that involved moving to a new country, and leaving her friends and family. N. revealed guilt about pre-marital - and later, marital, given the lack of sex - masturbation. He fantasized about sex with his wife but didn't know how to communicate his feelings, and wasn't sure whether he considered sex with is wife positive, or simply a biological necessity. S. and N. were encouraged to be more open about their mutual desire with each other and to find a common vocabulary to express their feelings. N. "was advised to consult with a rabbi regarding his perception" about sex and Jewish values. N. was involved in S.'s dilation exercises, done from home, which proved stimulating and enjoyable. After completion of the dilation exercises, the couple succesfully had sex. "Residual issues" regarding their discomfort with physical contact were left unresolved at the time of therapy, since the couple feared to continue therapy due to the social stigma surrounding it.
A clinician treating a couple such as the one above must educate her or himself about the cultural and religious norms of the community they come from and take those norms into account; often much of this education will come from the clients themselves. Sometimes it may be necessary to involve more than one clinician.
This was published in the "Journal of Sex and Marital Therapy" in July 2005.
* Yeah, I don't plan on observing that one.
** See how gender stereotypes affect men? If they weren't expected to take control and know what to do more than their spouse, simply because they are the men and being in charge is masculine, maybe they'd have less performance anxiety and hence an easier time getting laid.
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