Now this could be interesting, I thought to myself. Ron and Pam were on the first night of their honeymoon, and both registered as patients. They looked too healthy to have food poisoning, and the fact that they were holding hands led me to believe they hadn't been arguing. Pam seemed a bit sheepish, but Ron was eager to talk.

Ron: Hi, Doc. We're on our honeymoon, and we're having a marital problem.

Dr. Pezzi: Yes?

Ron: We're not able to consummate our marriage.

Dr. Pezzi: What seems to be the problem?

Ron: I can't get it in her.

Dr. Pezzi: Are you able to get an erection?

Ron: Heck, yeah. It was hard as a rock. I just couldn't get it in—it just didn't want to go.

Dr. Pezzi: (looking at Pam) Have you ever had intercourse?

Pam: No, I'm a virgin.

At this point, the most likely possibility was that she had vaginismus. In that condition, muscles around the vagina go into spasm when intercourse is attempted; such a contraction can make penetration difficult or impossible. Vaginismus is generally rooted in a psychological aversion to coitus. Alternatively, I thought that her hymen might be the source of the problem. I discussed these possibilities with them. As I was about to find out, Ron was a creative thinker.

Ron: I've got an idea, Doc.

Dr. Pezzi: What's that?

Ron: Wouldn't it help if she were unconscious?

Dr. Pezzi: Do you mean asleep?

Ron: No, unconscious.

Dr. Pezzi: Well, yes, it would probably help, but how do you propose to do that? (I wondered if he considered getting her drunk enough to pass out.)

Ron: Can't you put her out? You know, anesthetize her?

Dr. Pezzi: (shocked) What?

Ron: Yeah, anesthetize her, and I'd get it in when she's out.

Dr. Pezzi: I can't do that!

Pam: It's OK with me.

Dr. Pezzi: I still can't do it. It's just not proper.

Pam: But I'd do anything for Ron. I love him.

Dr. Pezzi: I'm sure that you do, but that's not the issue. The logical thing to do now is for me to examine Pam. Let's try to determine the cause of the problem before we consider any solutions, alright?

Ron: Yeah, that makes sense.

As I performed the pelvic examination, it did not take long to realize why Ron was having difficulty entering her, but I didn't want to say anything until Ron was back in the room. A few minutes later, we were all back together.

Dr. Pezzi: Pam, you've never had a period, have you?

Pam: Not yet.

Dr. Pezzi: Did you ever see your doctor about that?

Pam: No.

Dr. Pezzi: Did your Mom's obstetrician ever say anything special to her after you were born?

Pam: I was delivered by old Doc Martin. He died about ten years ago, and I don't think he ever said anything to my parents—at least, nothing they ever told me.

Ron: (emphatically) Why? What's wrong?

Dr. Pezzi: (thinking, oh boy, how do I phrase this?) Well, when I did the exam, Pam's external genitals looked normal, but . . .

Ron: But what?!?

Dr. Pezzi: Her vagina is not normally developed.

Ron: What do you mean by that?

Dr. Pezzi: She doesn't have a vagina . . .

Ron: Holy shit!!!

Pam: (momentarily stunned, then began crying) I don't have one?

Dr. Pezzi: Not a normal vagina. Her vulva opens into a pouch that is at most an inch deep, and there's no uterus.

Pam: (still sobbing) You mean I'm not a woman?

Dr. Pezzi: (thinking that this isn't the time for a lecture on genetics and abnormal androgen receptors) You are a woman . . . .

Ron: Oh, thank goodness! (pause) Then why doesn't she have a vagina?

Pam had the testicular feminization syndrome (TFS). This results when a fetus that is genetically a male lacks a receptor for testosterone, which prevents the body from responding to the testosterone. Since testosterone is responsible for development of male sexual characteristics, absence of its effect blocks the appearance of the male “equipment.” Sans the testosterone effect, the body is programmed to develop more or less as a female—at least externally. In fact, one of my professors said that women with TFS are often unusually attractive, and he claimed that women who are cover models for Cosmopolitan and similar magazines are far more likely to have TFS than a woman with average looks. Sounds like an interesting research project, if nothing else.

Internally, it's another story. Some TFS women have a short, rudimentary vagina, but the other plumbing just isn't there. Hence, they cannot conceive.

Although they were hungry for a thorough explanation, I thought it was best to obscure the fact that Pam was a male, at least genetically. I explained how she could develop a vagina that would allow them to have intercourse, and I emphasized that she was essentially just a woman who would be permanently infertile. She would need some additional treatment, but they could otherwise lead a normal life together.

They seemed relieved. So was I.

In case you haven't satisfied your yearning for edification this week, I'll fill you in on some idle gossip that may never be covered by The National Enquirer and other distinguished journals of medicine. Rumor has it that the actress Jamie Lee Curtis has TFS. This speculation is based upon the fact that she is unusually attractive, has slim hips, and adopted children. Of course, there are plenty of attractive women with adopted children who don't have TFS, so Ms. Curtis may not have that condition. In any event, she and Pam are unquestionably women.

Return to the story list

You are probably thinking, "I don't need to buy his book. I can read about sex for free on thousands of web sites."

Yes, you can, but even if you spent the rest of your life doing that, you still wouldn't know many of the things in my book. No doctor in the world knows more about sexual pleasure than I do. Don't believe me? Then read some books by various experts on sex, check out a thousand sexual web sites, and then read my book. You will be stunned by how much more I know. Here's what one reader said:

Read more about this book

Incidentally, The Science of Sex isn't just about sex. For example, it also discusses topics such as:

• Non-surgical ways to increase your breast size.
• How to maintain your breast shape.
• Ways to ward off wrinkles that you won't learn from your doctor or favorite beauty magazine.
• Secrets for feeling great.

And many other topics that aren't discussed in other books. However, you're probably thinking, "Blah, blah, blah, that's what everyone with a book to sell says." However, I am so confident in the superiority of my book that I offer a 100% money-back guarantee: If you find a book with a more comprehensive and detailed presentation of sexual pleasure, performance, attraction, and desire, tell me about it and I will refund your entire purchase price.  I can confidently make this offer because I've read hundreds of competitive books and have yet to find one that is even remotely comparable.  I've spent years of 100-hour weeks working on this book, while some others in this genre appear to have been thrown together over a long weekend.  No reader has yet been able to suggest a comparable book.  Besides the fact that I cover more subjects in more detail and present information that you cannot obtain elsewhere (unless someone is copying me), I also correct some pervasive sexual fallacies; for examples of some of them, see this page .