Content warning: sexual abuse, trauma

I have had urinary tract infections for nine months, almost at a rate of once per month.

When a urinary tract infection (also known as a UTI) occurs, there is bloating, gas, urgency to urinate, frequent trips to the bathroom, and severe pain around my lower midsection. Organs and tissues are inflamed, from deep in my center outward. My skin is too tender to touch. I’m not able to stand up straight or walk very far, and I spend hours sitting on the toilet because it’s more comfortable, until my back and legs ache.

Usually the symptoms occur in the evening or the middle of the night, and the next morning I call my doctor and must be seen. I take time off work if needed and spend the necessary time and energy required for an antibiotic. I am so practiced at this that I arrive at my doctor’s office, check in, pee in a cup, and they have it tested before I get my vitals taken.

It has gotten to the point where, to physically mend this condition, I will have to take an antibiotic every day for the rest of my life.

Unseen Shame

About four months in, my doctor started testing in order to eliminate the possible causes of my UTIs. I had blood and urine tested. I was poked, prodded, and swabbed. We tried tinctures and natural remedies and supplements and medications and basically everything short of casting spells. Still, every month or so, I would be sitting on her exam table in severe pain.

I have known my doctor for about four years. She’s seen me through one of the toughest times of my life, from my antidepressant medications bottoming out and the resulting breakdown to my divorce and the rebuilding of my life. She knows about my past with trauma and abuse and my present healing journey from PTSD. She’s a holistic doctor, a naturopath MD, and as she is from Brooklyn, she does not mince words.

“We’ve eliminated most of what could physically cause your urinary tract infections,” she said. “I’m wondering if your UTIs have a deeper reason. A deeper cause. Maybe they have to do with shame around sex.”

“What?” I said. “But I love sex. I could have sex every single day. In fact, I could have sex right now.”

I paused while a look of surprise flitted across her face.

“I mean, not with you,” I continued, and we both laughed.

“You didn’t have UTIs before your divorce, correct?” she asked.

“Correct,” I answered.

“And when did you start dating?”

“Eight months ago.”

And when did the UTIs start?”

“Eight months ago.”

She stared at me for one second, then two. The proverbial lightbulb over my head went off. “Ooooooohhhhhh.” I took a deep breath.

And still, I didn’t know if I believed her, really believed that shame could be the center of this condition, and what to even do about that. But we have quite literally tried everything physically possible to find a physical explanation for this condition.

Getting to the Heart of It

For the last month, I have reviewed this conversation over and over again, like replaying a voice message from a lover or reading the dog-eared pages of a favorite paperback.

Almost exactly a month after this conversation with my doctor, I ended up back in the doctor’s office, on the exam table, in severe pain. Except this wasn’t my doctor, or even my city. I was at an urgent care, three thousand miles from home. I got a prescription for the antibiotic I needed to get rid of the bacteria.

The next day, I stared blankly out of the train window, traveling from one city to another in this place far from home. Emotionally numb, physically tired, pain still throbbing in my core. I was so tired of trying to deal with this condition, of trying to find the answer, of feeling sick so often. Since sex seemed to be the cause, there was only one obvious answer.

I had to stop having sex.

Rocked by the train’s rhythm, I felt hopelessness bloom like a flame. Instead of putting out that flame or simply observing it, I fed it with what seemed like a very real and undeniable set of truths:

• UTIs were from having sex
• I had to stop having sex. Forever.
• Nobody would want to be with me without having sex.
• Result: alone forever.

I already felt alone. I had felt alone for most of my life. I was fairly certain I could handle it.

A Wound That Is Seen

It took hours for me to talk to my partner about what was going on in my head and heart and urinary tract.

I cried and yelled. I felt confused and frustrated. I heard myself say, “Nobody will want me without having sex.”

Something clicked.

The sentiment wasn’t simply a textbook response to childhood sexual abuse. This was real. A foundational belief. A certainty cultivated over a lifetime.

Shame.

“Nobody will want me if I can’t have sex.”

The words changed slightly as they coursed through my mind, over and over again, like red dotted letters on a reader board, relentlessly streaming.

I heard myself say these words once, twice, more. Tears first leaked, building to a steady stream, dripping down off my chin and onto my chest.

Those words were true to the young girl I was, the one who has few memories of her life, blocked out by the brain’s response to trauma. They were true to the 10-year-old, victimized in her room at the hands of her father. They were true to the 14-year-old, bleeding from her center after he was done and had left. True to the 15-year-old, who gave herself to an older boy not because she loved him, but because she wanted to be loved and worthy. True to the religious 20-year-old, married young to have sex inside of marriage but was too traumatized to participate. True to the 30-something woman, lush and ripe with desire and met with rejection.

“Nobody will want me if I don’t have sex.”

I saw the girls and women I once was in my mind’s eye, lined up and staring back at me. Not accusing me. Wanting to be seen, to be witnessed.

See me, they said.

I saw the girls and women I used to be – I still am – in a row, wanting, needing, desperate to be loved, to believe she is lovable at her core. Without using her body, without giving herself away and getting little to nothing back, without being taken or stolen. I looked each one in the eye, while tears flowed freely and my body shuddered with sobs and I could not take a full breath.

I saw all that had been stolen from the girl and the young lady and the woman – all of me – and I wept. Innocence and joy and laughter. Love and worth and life.

I see her – myself – and I weep for how she was not protected as a girl and then how I did not protect her as a woman. And I also understand – at the very same time – that I was not equipped to protect her. I could not save her, I could not love her, I could not see her as she needed. And this is not my fault, this wound that knifes to the core of who I am.

A wound through the very center of my being. A throbbing pain in my middle that begs to be healed.

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