Alyssa pushed through the pain each time she had sex with her husband. It was sharp. It stung and it burned. He had no idea. She endured it because she was a good wife.
“Men need to be sexually satisfied, minimally once every 72 hours; after that they start to get sexually frustrated.” That academic tidbit came from Alyssa’s college class “Psychology of Marriage and Family” at Liberty University, where she learned to be a satisfactory wife and mother with evangelical values. She’d learned this same lesson through her upbringing in a Southern Baptist household in Virginia that also dipped its toe into more fundamentalist teachings. What she wasn’t taught was that burning during sex could be the result of vaginal tearing—tearing that would swell then heal thicker into a bump that would be retraumatized each time she had sex with her husband. Every 72 hours, give or take.
Alyssa, who requested to go by her first name only, wasn’t taught how to understand her own body, only how to preserve its purity before she married. As she explained it to me, “Just keep your tatas covered and your legs closed, lest you be a complete slut.”
Purity culture became a fully fledged youth movement in the ‘90s—although the belief system existed long before—with successful books like Joshua Harris’ I Kissed Dating Goodbye. The movement emphasized virginity as an active pursuit rather than just a denial of the flesh, pulling from Bible verses about remaining celibate before marriage while also making sure you did marry, because “it is better to marry than to burn with passion” (1 Corinthians 7:9). At purity balls, teen girls wore white ruffled gowns and were escorted by their fathers. T-shirts with “Love Can Wait” and “Virginity Rocks” written across them sold out. Teens across the country slipped on silver promise rings, just like the 2000s crop of Disney stars (the Jonas Brothers, Selena Gomez, Miley Cyrus, and Demi Lovato).
Purity culture also led to ignorance and shame: an ignorance of our own bodies and a feeling of shame that precluded seeking medical help. Instead, many Christian women—and anyone else who fell across purity culture’s path—developed the mindset that reproductive system-related pain was a result we must endure, because Eve gave Adam that apple. “I will greatly multiply your sorrow and your conception; in pain you shall bring forth children,” the Bible reads (Genesis 3:16). The message was bear the vaginal tears, push through the excruciating menstrual pain, be plagued by yeast infections, suffer from other undiagnosed maladies. Now, in this post-Roe era, politicians are doubling down on purity culture talking points and attempting to correct those who betrayed purity culture values by forcing them to endure the physical dangers of pregnancy.
Endure in ignorance is exactly what Alyssa, who experienced burning, stinging pain during sex, did.
The physical tolls of purity culture on women’s health
Before the year 2000, 70 percent of American adults attended church; a vast majority were Christians. Most of us had our asses dragged there by parents. Some of us stayed. Many left. But the unforgiving “rules” of purity culture undoubtedly impacted many of us.
“I’ve seen so many patients who thought sex should just hurt, so they never sought care or thought they could talk to their doctors about it and suffered silently. All because we’ve been told women who want sex to feel good are whores,” Dr. Jennifer Lincoln, an OBGYN in Portland, Oregon, and author of Let’s Talk About Down There, told me. Lincoln herself grew up in purity culture. “I went to college uninformed and filled with judgement of those who chose to have sex and get ‘what they deserved’ if they ended up with an STI or pregnant,” she said. “It took seeing the actual consequences and getting the other side of the story to see I had been told half-truths and was basically shamed into not asking questions.”
Rebecca, who also asked to go by her first name only, was 13 when she started feeling excruciating pain in her sides during one of her first periods. “I couldn’t hold down food for a few days. I’d have serious exhaustion and sometimes couldn’t actually sit still I was in so much pain,” she told me. But she grew up in south Mississippi, one of six children, to devout evangelical parents. Although contraception pills only helped a little with the pain when she finally went on them, her parents didn’t allow her to take the pills until she was about to get married; putting their daughter on birth control would have sent the message they condoned her having sex, and devout parents don’t want to encourage activity that could lead their children away from God. “It was debilitating and yet I had to go on,” Rebecca said. She turned 30 before she was diagnosed with endometriosis.
“When I finally had the procedure for them to look inside at my organs, the doctor told me out of a scale of four, my adhesions were a three or four,” she said. Her sister had it so bad that her bleeding put her in a life-threatening situation, and her mother and aunt were eventually diagnosed as well after experiencing extreme period pain. Rebecca also learned later than necessary that she had polycystic ovarian syndrome. It couldn’t have been cured with early detection, when Rebecca first started writhing in pain, but proper treatment with oral contraceptives could have slowed down the damage, and possibly prevented her pain from increasing. She will eventually need a hysterectomy.
“Suppression, the years of holding themselves in and down, eventually affects them physically,” Linda Kay Klein, who wrote Pure: Inside the Evangelical Movement That Shamed a Generation of Young Women and How I Broke Free, told me. She previously told Jezebel, “I hear from so many women who are experiencing vaginismus.” Klein coaches people as they attempt to deconstruct the effects of purity culture on their lives, and says some of her clients have reported stress-related physical challenges—like IBS, back pain, and eczema—alongside issues with their reproductive health. “These health challenges are then exacerbated by their sexual experiences, which trigger the sexual shame and anxiety they’ve internalized,” she said.
Much of that internalizing happened in the church. Church youth groups instilled the image of the dirty, damaged non-virgin by playing lighthearted games in which kids drank water from a cup, swished it around and spat it back, then handed the cup to the next person until it held a cloud of backwash. That swill was supposed to represent sexually active, “ruined” women. Other times youth groups compared non-virgin young women to a chewed piece of gum nobody wanted.
Even curiously exploring our genitals, and unintentionally triggering arousal, was seen as sinful. Boys who “stumbled” and jerked off at least knew their own dicks. They knew how they reacted, the coloring, what looked normal, every groove and bump. Women have to make an effort to see their anatomy, and female masturbation was seen as—shocker—worse. The urge was kiboshed, the muscles tightened in shame. Women I’ve spoken to later in life reported yeast infections that went untreated.
“When we hint at shame when it comes to our vaginas or sex or periods, we send the message that we are inherently dirty and shameful,” said Lincoln. And once you’ve been told, “Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own” (1 Corinthians 6:19), it’s an easy step for young women to delegate their urges and bodies and health to an unseen God and his patriarchal followers, one of whom could become their husband. Coercive control is ordained in the second half of Eve’s curse from God: “Your desire will be for your husband, and he will rule over you” (Genesis 3:16).
Adrienne, who grew up in a more liberal evangelical Presbyterian church outside of Detroit, experienced heavy bleeding and pain since she was 15 but didn’t go to the gynecologist until years later. “I was 22 when I decided to seek help, and the first time I ever even heard about HPV, pap smears, or cervical cancer. I looked at [my doctor] blankly, so embarrassed that I had never even heard those terms before,” Adrienne, who I am identifying by first name only, said. “I started tearing up and shakily had to tell her that I had grown up in a religious environment… That was enough for the doctor to know what was going on. She arranged for me to catch up on the procedures I had missed out on, sent me home with lots of pamphlets, and prescribed me the pill.” The pill helped immensely and immediately with the periods, while the pamphlets educated Adrienne on how HPV could lead to cervical cancer and infertility.
Where I’m from, the buckle of the Bible Belt, a gynecologist’s suggestion that parents vaccinate their kids against HPV might be refused, because parents see it as condoning pre-marital sex. We know kids have sex regardless, but this mindset does not take into account that their daughter’s first time may not be consensual. In general, purity culture doesn’t account for abuse.
“The worst cases of harm from purity culture come from people who as children didn’t have the words to describe sexual assault or abuse, or who were shamed into not saying anything because they were told no one would love them anymore because of what they did,” Lincoln said. “Therefore they grow up victims and internalize their abuse as being their own fault.”
Alyssa had a sexual partner before she met her husband. Because purity culture can promote the concept that sexual intimacy binds you spiritually with a partner, and you need to end up marrying them, she felt she had to stay in the relationship despite experiencing emotional and physical abuse. “There were so many things I should have been taught—that sexual abuse is more than rape, what the definition of consent is, what sexual coercion is, what abuse looks like in relationships, etc. But nope, none of that,” she said. “Since we had done the deed, I wanted desperately to make it work and eventually get married. I didn’t want to be even more sinful.”
When abuse is recognized, coming forward would still label you as ruined. Elizabeth Smart, who was raped as a child by her kidnapper, remembered the chewed-gum image during her traumatizing ordeal. “For me, I thought, ‘Oh my gosh. I’m that chewed up piece of gum,’” she recounted years later. “And that’s how easy it is to feel like you no longer have worth, you no longer have value. Why would it even be worth screaming out? Why would it even make a difference if you are rescued, if your life still has no value?”
Abortion bans come from purity culture
In the heyday of purity culture, scare tactics about sex outside of marriage were coming from church communities. Now that fewer and fewer Americans are attending church, the message that sex has dangerous consequences is stemming from abortion bans and abstinence-only sex education in public schools.
In my home state of Tennessee, teachers can be fined up to $500 for discussing “gateway sexual activity” in the classroom. Tennessee lands on the list of top ten states for teen pregnancy, alongside other states that support abstinence-only education. Lawmakers in most of these states have also succeeded in negating a woman’s bodily autonomy through cruel bans on abortion. Senator Lindsey Graham (R-SC), a reported Baptist, just introduced a bill for a national 15-week abortion ban. When Governor Greg Abbott, a Catholic, first signed into law Texas’ six-week abortion ban, he used words familiar to all of us who grew up in purity culture: “Our creator endowed us with the right to life and yet millions of children lose their right to life every year because of abortion.” Purity culture teaches that children are a blessing, and blessings are for monogamous, married Christians. If someone wants or needs an abortion, it’s because they strayed from “the creator’s” plan.
Now, with full abortion bans in my state of Tennessee, along with 13 other states (not to mention the states with extremely limiting near-bans), the lawmakers who kept women from accurate and helpful sex education—including information about birth control and where to access it—will be penalizing women by forcing them to give birth if they become pregnant. Among them will be teens, rape victims, and married, monogamous Christians. With these bans, additional tens of thousands of American women will be forced to deal with pregnancy complications like preeclampsia, gestational diabetes, cardiomyopathy, and sepsis. Some of the women who will be forced to give birth will die. It is a cruel way to learn about your body, if you were raised to know nothing about it.
A year after the pain started, Alyssa went to a vulva specialist’s office, where she had a panic attack when they attempted to take a biopsy. Biopsy abandoned, the doctor asked her questions about her sex life and landed on a diagnosis of vaginismus, an automatic reaction in her body to sexual activity. “She explained that over time, me pushing through the painful sexual experiences caused me to develop a tightening reaction, much like if you stick a finger near your eye, you automatically blink,” Alyssa said. She had tried not to say no to her husband, and she had had sex when she didn’t want to. “[My husband] thought the idea of duty sex or obligation sex was disgusting once I explained to him what all I had been taught,” she said. Her doctor suggested she work with dilators, use numbing cream, or drink wine before sex to help relax. She and her husband took things slowly. “I would say it’s honestly taken the last three years to really work through it and not experience the pain like I used to,” she said. Except for a flare-up every now and again, things are much better.
Despite Rebecca’s two diagnoses of endometriosis and polycystic ovarian syndrome, she considers herself fortunate. “I finally am free of the guilt and shame, and while I still have issues with my health, a lingering side effect, my body continues to amaze me with its ability to recover,” she said.
But by and large, women are afraid to speak about the mental cruelty of purity culture, much less the physical harm done to their bodies. They’re still, I’m still, we are all still reconciling the belief system that adorned girls with white ball gowns and promises of perfect marriages, perfect children, and amazing sex. What we got was a set of rules for our bodies made by men—men of the Bible, men now in power.
Purity culture is in our schools. It’s in our government. It’s in our bodies. The true irony of it is we’ve been fucked the whole time.
Karen Alea is based in the Bible Belt, where she’s writing a book about American Evangelicalism. You can follow her at @KarenAlea.