It is amazing how much you can do with a female patient under the guise of medical examination and treatment. It isn’t shocking that malpractice insurance rates are so high.

I am a family doctor in an affluent neighbourhood. My greying hair at the temples gives me a slightly older, more sophisticated look. I work out regularly and have a lean muscular body. With that combination, when I am dressed for work, I look older and more experienced than my 45 years. When I step out of the shower, I look considerably younger.

I am very careful in selecting and screening which patients I will abuse. First and foremost, they have to be worth the risk. I’m not going to lose my livelihood over some fat, middle-aged housewife. The woman needs to be beautiful. You might think that the ditzy ones would be good candidates because they are easily fooled. But they invariably run their mouths and someone would find out. Besides, people are always expecting the bimbos to be taken advantage of, so they look out for these “handicapped” women.

The ideal candidate is the highly intelligent woman, who is slightly awkward socially because of her brains. They don’t have to be an introvert, but it helps. They need to be shy, particularly about their bodies and sex. But even when I have an ideal candidate, it has to be approached carefully. I always explain that it will be an intimate and potentially embarrassing process. I always ask if they would be more comfortable with a female doctor, letting them know I can recommend several good ones. I always offer that having a nurse present is their choice; some women are more comfortable with another female present while other prefer not have anyone else see them. I emphasize that whatever they want to be comfortable is all that matters. I repeatedly tell them that if they are ever uncomfortable about any aspect of the treatment to speak up; I let them know that we can stop, change procedures or doctors at any point.

Nearly all of the women prefer not having to explain the situation to another doctor, and the shy ones that I target usually prefer that no other person is present. But when they feel like they have made all those choices and even insisted that they would prefer to be treated by me alone, they now feel both in control of what happens and responsible for what happens. As a result, most of them thank me for being such an understanding and compassionate doctor. My online reviews are through the roof.

Case Study #1 The first patient that I would like to tell you about is Andrea. Andrea is a 23-year old newlywed. I have been her only doctor since she stopped seeing the pediatrician at age 12. “This is really embarrassing. I’ve been afraid to tell anyone. But I guess you ARE a doctor and you have probably heard everything before. I can’t believe how nervous I am even talking about this.”

“It’s OK. Take your time.”

“I’m worried something is wrong with me. I’m never interested in sex. It doesn’t feel good. I’m afraid that if I don’t find out what is wrong, Im going to lose my husband. Is there anything you can do to help me?”.

After covering the preliminary screening issues, I proceed.

“I will have to check for your physical responses to stimuli. This helps me establish the specific physiological functions and either identify or rule out dysfunctions. Some of my actions may seem a little strange, please remember I am trying to evaluate your physical response to each action and compare these against normal ranges.”

Of course there are no established normal ranges for what I am about to do, but there is no reason to tell this to the patient.

I step out of the room so that she can undress and lay back on the table. I don’t want her to wear a robe, but I give her a sheet to cover herself. I raise the stirrups before I go, but don’t instruct her to place her legs in them yet.

“First I am going to test for physical and psychophysical responsive to various stimuli to your breasts. Some tests may tickle, hurt, or elicit another strong response. Don’t worry about how you respond, I’ll be tracking that. As soon as you are ready to start, lower the sheet below your breasts.”

Andrea pulls the sheet down to her stomach exposing two tiny tits. Laying on her back, the small breasts nearly disappear. I begin with a light caress. I switch to an even lighter touch, barely brushing her skin and the tips of her nipples with my fingers. I try a feather. I squeeze vigorously, pinch her nipples and even pull on her breasts. None of these register any response. I try nipple clamps, vibrators, and even ice. The ice makes her nipples harder, but nothing I do elicits any arousal.

“It appears that you have diminished nerve sensation from you breasts. You certainly should have noticed both more pain and more arousal from the different tests I conducted. I will want to do some further testing to identify the causal mechanisms for this diminished nerve function, but it could explain some of your lack of sexual desire. Routine foreplay may not be preparing you for sexual activity. I’ll need to repeat some of these same tests with your genitals in order to determine how widespread the nerve dysfunction may be. This may be a little strange for you because of how intimate some of these tests may seem. Let me know if any test is making you uneasy and we can stop. When you are ready, put your feet in the stirrups and pull the sheet up to your waist.”

Despite Andrea’s light brown hair, her cunt is sparsely covered; she looks more like a blonde given the minimal hair. There are no indications that she ever shaves or waxes, instead there are a number of stray hairs just outside the clustered edges, the kind of outliers that only develop over years. I begin by lightly running my fingers through the hair on her pubis mound. I follow this up by brushing my fingertips along the outside of her labia. She begins to show a response as her lips swell and a slight amount of lubrication is present.

I proceed with my vigorous stimulation, rubbing hard. Her arousal builds. I try pinching and pulling on her lips, that doesn’t diminish her arousal. I move directly to rubbing and pinching her clit. At this point she is quite aroused and appears to be on the verge of an orgasm.

I gently insert one finger into her very wet pussy. She immediately tenses up and complains of pain. I don’t move, neither removing the finger nor pushing further into her. Surprisingly, she doesn’t relax the tension.

“I have been able to determine a great deal with the tests so far,” I explain. “I feared after the breast exam that you might have a complete lack of functioning of any sexual nerve; however, you responded normally to vaginal stimuli, at least until the point of insertion. Something in your body is triggering a muscular response that causes you to involuntarily spasm, rejecting any object, or person, that enters you. I would venture an educated guess that you weren’t completely forthright with me about the sexual response problems you are having.”

“I’m sorry, I truly didn’t realize. My husband has never touched me in the ways that you did. I’ve never quite felt like that ‘down there’ before. Yes, sex is painful when he enters me, but I figured that it was my lack of arousal.”

“That’s OK. It was only a guess on my part. I asked so that you could correct me if I was wrong. It appears that I was. I want to apologize in advance for the next part of this test. I need to evaluate and document the physical limits of your vaginal passage. I will use probes that increase in diameter. This will be uncomfortable given your body’s response, but I wouldn’t do this if it wasn’t necessary. The first probe is ¾” diameter, about the same size around as the end of my finger. The probes increase by ¼” at a time up to 2.5”. Once I can determine the maximum width, I will also measure the maximum depth. Your tissue throughout the vagina is very resilient and stretchy, it has to be in order to deliver a baby. But your muscle reaction is the issue.”

Even though Andrea is plenty wet from the earlier I still apply a liberal amount of KY to the probe-or dildo-before gently inserting it between Andrea’s legs. She tenses her muscles, but has no problem fitting this small object. I proceed to the 1” probe. Again, she struggles to accept it but it does fit within her. She tenses so hard with the 1.25” probe that it hurts.

“I’m not going to try any larger this week. But I still need to test your depth tolerance. I know it is uncomfortable, but you are doing a good job so far. Let me know the deepest you can tolerate the insertion.”

I slide the probe back and forth (sounds like I’m fucking her with the dildo doesn’t it?) I slowly move the probe forward until she tells me to stop; it isn’t quite 4” deep at this point.

“Andrea, what we need to work on is reducing the involuntary muscle response. I could give you strong muscle relaxing drugs, combined with some anxiety medication. Sex would be much more comfortable, but I doubt that you will get more enjoyment from the act. There is an alternative that will take considerably longer; however, I have had good success with this approach in the past, helping women achieve normal sexual functioning. I’ll describe the approach and you can decide.”

Posed in this manner, there is no question which choice every woman is going to make, but outlining the options reduces the chances that they will blame (or sue) me later.

“First, don’t even attempt sex until I tell you that you are ready. This could be several months. I recommend explaining to your spouse that you are undergoing treatment, you don’t have to share the details of that treatment if you don’t wish, and that your doctor has ordered you to refrain from sex until the treatment is complete. Is that going to be a problem?”

“No. I don’t plan to tell him, but it shouldn’t be a problem. He rarely asks anymore, and it will be easy for me to put it off.”

“We are going to help you become accustomed to objects entering you. During the next week I have cream that I want you to apply to your genitals twice per day. You need to spread it around the softer inside areas, where it can be absorbed better. You will need to make sure that you spread it around really well. Once every two hours I want you to work this probe into your vagina as far as you can, spend at least 5 minutes each time with the probe. It is important that you stay as close to 2-hour time block as possible. I’ll have you return in a week.”

The biggest reason for the cream was to have this shy young woman rub herself. I mixed the cream myself and it contains tiny amounts of testosterone-to increase sex drive, a blood vessel dilator-to increase blood flow in the area, along with small amounts of peppermint and nettle oils to provide a “warm” sensation. I emphasized the two hour spacing to be a little humiliating as she would have to excuse herself from work activities and even home/social events in order to stay on the schedule.