A perceived injustice? Querying the ‘social’ in the biopsychosocial approach to vulvodynia

Vulvodynia is a poorly understood chronic pain condition that has attracted a range of investigations aimed at identifying biological, psychological and social factors potentially contributing to its aetiology and maintenance. Recently, there has been a call by pain science researchers to classify vulvodynia as a central sensitisation syndrome without relevant nociception, warranting a biopsychosocial as opposed to strictly biomedical approach to care. Framed through autoethnographic storytelling, this article troubles the current biopsychosocial approach to vulvodynia in research and practice, particularly the emphasis on psychometric testing, positive affect and makeover logics of personal transformation, as well as the disavowal and pathologisation of patient critique. It does so by drawing upon disability studies research, challenging the neoliberal logics of purportedly biopsychosocial approaches as well as feminist scholarship implicating gendered forms of power in creating challenges for those with vulvodynia, as opposed to maladaptive psychology or poor critical literacy. The article argues for structural competency and a medical humanities component in chronic pain education and advocates for a greater feminist and disability-informed presence in vulvodynia research and activism.