Speaking the Unspeakable

When it comes to anxiety, fear and shame, the body takes center stage

—how it looks, how it functions, how it feels, how it has been cared for or violated, how it is changing, how long it will keep on keeping on. Jewish women in therapy tend to talk more open about most body issues and sexuality than other ethnic and religious groups—with one exception. One part of the female body is the location of so much anxiety and shame that it is universally deleted from the conversation.

Nope, not the vagina.

It’s the vulva.

What, you say?

Yes, the vulva, the external female genitalia that includes the labia, and the clitoris. The vulva is standard female equipment. It’s everything we see when we look. So why can’t we name it?

Raising Vulva Consciousness

Vulva—what’s that? When my friend Nancy was diagnosed with vestibular adenitis, an uncommon disease of the unspeakable parts, she called the National Institutes of Health to gather more information. She presented the facts to the woman in charge of directing her call. “Vulva?” the woman repeated querulously. “Vulva? Is that heart and lungs?”

My first serious attempt to raise vulva consciousness was directed toward my professional colleagues. After joining the staff of the Menninger Clinic, I published a paper called Parental Mislabeling of Female Genitals as a Determinant of Penis Envy and Learning Inhibitions in Women.” A case example illustrated how the failure to label accurately a girl’s external genitalia contributes to shame and confusion about sexuality, as well as to inhibitions about looking and learning. The article appeared in 1974 in a prestigious psychoanalytic journal and was met with a dignified fraternal silence.

I was undaunted. I have continued over the decades to encourage parents to say vagina when they mean that and vulva when they mean that. When I ask parents why they don’t tell their daughters that they have a vulva which includes the clitoris, I hear an imaginative array of excuses:

Telling my daughter about her vulva and clitoris is like telling her to go masturbate.

Vulva is a medical term. It’s sort of technical. I don’t want to burden her with words that her friends don’t know. (This one from Jewish parents who taught their small daughter about ovaries and Fallopian tubes.)

The vagina is her sex organ. It’s related to intercourse and reproduction. That s all she needs to know about.

It is true that Americans do not surgically remove the clitoris and labia, as is the case with millions of girls and women in other cultures. Instead we do the job linguistically— a psychological genital mutilation, if you will. Language can be as powerful and swift as the surgeon’s knife. What is not named does not exist.

The Whatchamacallit Problem

“My husband doesn’t like my vagina,” Louise tells me, eyes down. “He says it’s messy and complicated. It’s like he needs a road map to find his way around. And I hate feeling like a traffic cop. I feel like there’s something wrong or different about me that he can’t find his way around.”

I try to picture a messy and complicated vagina, but to no avail. My client is a professor and a scholar. She knows her vagina from her vulva. She is too uncomfortable to use the correct word, so I invite her to do so, by asking simply, “A complicated vagina?”

She turns red and says, almost angrily, “I’m talking about —you know—that outside stuff!’

“You mean your vulva?” I ask.

“Yes, yes, of course,” she says.

That outside stuff? Why such confused, undifferentiated, self-depreciating language for the vulva? Like most of us, Louise was raised on some variation of “boys have a penis and girls have a vagina.” To quote from a popular book of the day: “A girl has two ovaries, a uterus, and a vagina which are her sex organs. A boy’s sex organs are a penis and testicles. One of the first changes (at puberty) will be the growth of hair around the vaginal opening of the girl.” (italics mine.)

Why do we use such confused, undifferentiated language for our body parts?

Such partial and inaccurate labeling of female genitalia might inspire any pubescent girl to sit on the bathroom floor with a mirror and conclude that she is a freak. Louise had had just such a terrible youthful experience herself, as have countless other women.

Over the long course of therapy, Louise and I had had many conversations about anatomy and sexuality. When she was little, she had looked at her brother’s penis with some envy because it was so neat and simple. “It was easy to figure out. No confusing and hidden parts. It was all on the outside and open to inspection.” When I made the point that what she had “on the outside” was also open to inspection, but was never named, she responded with immediate recognition. “Yes, everyone knows that men have a penis and everyone can say the word. But the only word that people will say to describe what women have is “vagina.”

The shame and anxious confusion Louise felt about her vulva persisted into adulthood. She wouldn’t get undressed in a locker room if other women were present, She hated the fact that her inner labia “peeked out like a turkey wattle.” Of course, heterosexual women almost never have the opportunity to get accurate visual information (that is, from comparison with other women) that allows us to appreciate our anatomical variability. As to the “what’s normal?” question, vulvas differ widely in style, color, size and proportion and many include “turkey wattles.”

A sexual trauma also fueled Louise’s shameful feeling of being different. When she was in middle school, her father came into her room at night over a period of several days when her mother was away caring for her own dying mother. During this time her father tickled her legs and her vulva “to help her relax.” She was in therapy at the time and had tried to circle around her own traumatic incident by mentioning that she had a friend whose dad may have touched her between her legs. “Are you trying to say that her dad touched her vagina?” the therapist asked. Louise clutched and said her friend was probably making it up. She changed the subject.

Louise went home and looked up the word “vagina” in the dictionary. She felt dizzy with shame and confusion. Her father hadn’t touched her there. Was she making a big deal out of nothing? She knew the word labia, which had been defined for her as “the lips that protect the vagina.” So, did

Unless we speak clearly we can’t think clearly.

this mean that her dad had merely touched the place protecting the place he shouldn’t touch? Her reality, first shaken by the sexual violation, was further mystified by the absence of a shared and comfortable vocabulary to facilitate clear thinking and clear conversation.

When we feel prohibited from speaking clearly, we also can’t think clearly. Having accurate language to distinguish the vulva from the vagina is crucial for every girl, even when there has been no history of boundary violations. The persistent misuse of the word “vagina” impairs a girl’s capacity to develop an accurate and differentiated “map” of her internal and external genitals. The fact that a girl’s own exploration of her genitals is not corroborated by information from her environment also creates body shame and anxiety about sexuality. And if sexual violations occur in childhood, inaccurate labeling increases shame and complicates healing.

The Vagina Monologues?

I’ve been doggedly raising “vulva consciousness” since the late 1960’s, publishing and lecturing on the importance of accurate labeling of the vulva, which includes the labia and clitoris. I had reason to believe I was making progress. But when I saw The Vagina Monologues I felt I had fallen down the rabbit hole in Alice and Wonderland. Here was a play whose purpose was purportedly to restore pride in female genitals—including pride in naming—and it could not have been more obfuscating of genital reality.

Playwright Eve Ensler has made enormous contributions to women. It’s not Ensler, but rather her audience I want to focus on, the tens of thousands of women and men who watched the play, or listened to the conversation surrounding it, and pretended that nothing was amiss—or worse, didn’t know that anything was amiss.

How can this little two-syllable word, vulva, be surrounded by such fear and confusion? Freud himself recognized the anxiety that the vulva seemed to inspire, and recalled a passage from Rabelais in which the exhibition of a woman’s vulva put the devil himself in flight. Psychoanalytic theorists believe that male castration anxiety is one source of the fear, noting it’s the “hairy maternal vulva,” and not the vagina (which is invisible to inspection) that may give the impression of a “wound” and may arouse in little boys fear that his penis may be lost.

Freud’s theories aside, one might posit that the vulva is so threatening because it is the primary source of female sexual pleasure, the girl’s first site of masturbation and sexual self-discovery, separate from intercourse or reproduction. Many parents are quite anxious about acknowledging that their young daughter is a sexual individual who has curiosity about and pleasure with her genitals, and the general societal dread and denial of female sexuality has been well documented.

Some years back I started the V-Club with some wonderful women associated with The Women’s Therapy Center in New York City. As president of the club, I invite all of you to become members. The criterion for membership is simply to use the words “vulva” and “vagina” correctly, and to encourage others do the same. Sorry, there are no membership cards, T-shirts or buttons. But if you meet the criterion for membership you’ll be a shame-buster, giving more power to women—which is also a gift to men.

Remember, to be larger than fear and shame we need to choose language, clarity and self-definition over silence and mystification. We owe it to ourselves, and to girls and women of all ages, to use the right word. If you can see it, it’s a vulva. Say it out loud. 

Harriet Lerner, Ph. D., is the author of The Dance of Anger and many other best-selling books. This piece is adopted from her latest book, Fear and Other Uninvited Guests (forthcoming in paperback as The Dance of Fear).