Date of Award

Spring 5-2024

Document Type


Degree Name

Doctor of Philosophy



First Advisor

Michelle Miller-Day, Ph.D.

Second Advisor

Jennifer Bevan, Ph.D.

Third Advisor

Vikki Katz, Ph.D.

Fourth Advisor

Elizabeth Hintz, Ph.D.


Women who internalize evangelical purity messages face heightened risk for persistent pain or difficulty with penile-vaginal intercourse. Drawing on research in communication, psychology, and sexual medicine, the aim of this multilevel qualitative study is to increase understanding of how evangelical couples communicatively cope with painful intercourse and the memorable messages they believe contribute to their experiences of coping. This study involved conducting qualitative interviews with 20 evangelical married couples (40 total spouses) who currently or recently experienced a wife’s persistent pain during (attempted) penile-vaginal intercourse and 16 female clinicians (pelvic floor physical therapists and mental health professionals) who regularly work with women or couples affected by painful intercourse. Interview data were abductively analyzed at the individual level, couple-level, and across data points using the flexible coding method and assisted by thematic analysis. Guided by the Theory of Memorable Messages, the findings of this study illuminate how sexual socializing messages received in and outside of religious contexts may set the stage for delayed support and subsequent emotional and communicative challenges, whereas other messages may intervene in the trajectory, facilitating couples’ ability to work as a team, seek support, and reframe their individual and shared experiences. This study supports and extends extant interdisciplinary literature by revealing the social context of female sexual pain, utilizing multiple data points to provide in-depth insight into the phenomenon of coping with painful intercourse, and illuminating timing and co-occurrence of memorable messages as important aspects of their function and memorability. Practically, the findings offer couples, practitioners, and evangelical Christian leaders possible points of communicative intervention that may empower couples and facilitate the coping process.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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