A Therapy Center for Autistic Girls & Women
She Rocks the Spectrum
Pelvic Pain / GPPPD Conversation Guide
Pelvic pain (vaginismus, GPPPD, vulvodynia, dyspareunia, post-childbirth pain, post-surgical pain, trauma-related pain) is common, treatable, and very rarely talked about. This worksheet is a structured conversation guide for the partner experiencing pain and the partner who is not — together.
Safety note: This worksheet is for consensual relationships where both partners can say yes, no, wait, or stop without punishment. Do not use this worksheet to pressure sexual activity. If there is fear, coercion, retaliation, active abuse, trauma flooding, pain, shutdown, or dissociation, pause and use this with a qualified therapist.
Penetration is optional: The goal of this work is not to force intercourse. The goal is safety, comfort, choice, and pleasure. If pain is new, persistent, or worsening, please coordinate with a medical provider and a pelvic-floor physical therapist alongside this conversation.
Name
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Date
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1 — Naming the pain
(Partner experiencing pain fills this section.)
What does the pain feel like? (sharp / burning / pressure / tightening / other)
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When does it happen? (anticipation / penetration attempt / specific positions / after / never goes away)
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What I've already tried and what helped or didn't
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2 — The fear loop
Pain creates anticipation; anticipation creates muscle tension; tension creates more pain. Mapping the loop is the first step out of it.
The thought that loops in my head before/during sex
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What my body does when that thought arrives
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What I wish my partner understood
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3 — What the other partner needs to know
(Partner not in pain fills this section.)
What I've been feeling watching my partner go through this
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What I want to ask but haven't
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Where I've been getting it wrong (be honest with yourself)
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4 — What gets to come off the menu
Together, agree on what is on the menu, off the menu for now, and worth exploring slowly. Sex without penetration is sex.
Off the menu for now
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On the menu / worth exploring
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5 — Care team & next steps
Medical provider we'll consult (date / next appointment)
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Pelvic-floor physical therapist (referral / appointment)
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Therapist or sex-therapist support
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Trauma-informed care if relevant
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One small commitment — one small thing you'll both do this week to support the partner experiencing pain — without it being a sex agenda (a non-sexual touch ritual, attending the PT appointment together, a daily check-in, agreeing to not initiate penetration this week)
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Pain is information, not a verdict: Pelvic pain is common, treatable, and never a sign that something is wrong with you as a partner. A pelvic-health specialist is a reasonable next call.
Go deeper
Ready for more? These lessons pick up where this worksheet leaves off.
- Sex and Intimacy, from The Neurodiverse Couples Repair Program. The intimacy session for a neurodiverse couple: what gets in the way, how to invite and say no, a touch card, and when to see a specialist.
- Sex and Intimacy, from The Neurodiverse Couple. Intimacy in a neurodiverse couple — spontaneous vs responsive desire, the sensory side of sex, why pressure backfires, and how to design it together.
- Sex and Intimacy, from The Neurodivergent Brain. Sex and intimacy for neurodivergent bodies: sensory load, masking, direct communication, and consent.