I have not been in many relationships and am still a technical virgin at 25. In the past that was mostly due to a desire to wait until marriage (inspired by a Catholic upbringing and severe OCD), but more recently a busy grad school/work schedule and a plethora of painful “female problems” have made a healthy, happy sexual relationship an impossibility. Despite the physical issues, the biggest impediment to physical intimacy is my mind; I allow myself to be on the receiving end, but find myself unable to reciprocate. I want to be physical and uninhibited, but I find myself frozen and cannot get past it to take an active role in pleasing a man; though my OCD is better it isn’t gone, and I can’t let myself lose control. I want to be a giving, honest lover, but something in my head just stops me and I feel indifference, if not aversion. I have a therapist, but I need any advice you can give; chronic pain and no physical intimacy makes you feel dead.
When one is trying to deal with a problem, and I mean any problem, it helps to be able to clearly see what you’re working with. If you were trying to repair something or get your tax papers in order, you’d be wise to clear off the table before putting your work there; extraneous clutter gets in the way of seeing whatever it is you’re trying to focus on, and might even result in some important part or paper being lost among things that have nothing to do with the problem at hand. Personal problems aren’t any different; trying to focus on one while there are a number of others in the way can make it difficult or even impossible to deal with the main issue. Unfortunately, clearing away mental and emotional clutter is vastly more difficult than transferring a bunch of junk from the table to the sideboard and wiping the surface down; furthermore, it’s not always possible to tell which bits and pieces are pertinent and which extraneous. However, it’s vital that you at least make the attempt. Any one of the issues you have listed could present a barrier to intimacy, and you have several; the first step in solving your main problem is therefore dealing with as many of the underlying ones as possible.
First, you speak of your OCD in the past tense; I’m guessing that most of that is due to therapy, but if you’re taking medication for it please be aware that psychoactive drugs often have sexual side effects. I am not advising you to go off any meds; what I’m saying is that you need to be aware of the way in which they may help or hinder your quest for intimacy. Since your issues are “better but not gone”, it goes without saying that you need to keep doing whatever you’ve been doing, so as to continue toward they day when they are largely behind you.
Next, there’s the issue of your schedule. I understand better than most people that economic realities supersede considerations of what we “want” or what might be convenient, but at the same time you need to realize that work- and school-related stress can be huge barriers to emotional intimacy, even for people without your other problems. I suggest examining your schedule and trying to find ways in which it can be made less busy so that you have more time for you. Perhaps you need to take fewer hours; perhaps you need to pace your course work out more; perhaps you need to find an alternative source of income so as to lessen your need to work (obviously, in your case sex work would not be a good idea). Failing everything else, perhaps you may need to take a sabbatical from relationships until you finish school: I was largely celibate from early 1995 to late 1997, and avoided sexual relationships until the end of 2000, and it really helped me to discard a lot of the heavy emotional baggage I had been carrying around for the better part of two decades. Only you can determine which of these approaches is right for you, but I’m sure your therapist and/or trusted friends can help you to think it through.
Then there are the female problems; as I’m sure you’re already aware, two of the three you listed are often (if not usually) of psychosomatic origin, and therefore may not truly be separate from the psychological and emotional issues, especially considering that those issues are related to your aversion to premarital sex. Though Christian anti-sex propaganda teaches that sex is better for those who wait, this is rarely true and is often a blatant lie: women who have been afraid of sex and avoided it for their entire adult lives don’t suddenly open up and lose their fear merely because Church and State give them a signed permission slip. More often, they are unable to relax until days, weeks or even months after the wedding, and as an escort I saw many clients whose wives were still highly sex-averse after decades. What this means to you is getting a competent gynecologist to determine whether your physical problems are somatic or psychosomatic, and to proceed with whatever therapeutic regimen is indicated for each one.
Finally, there’s the passivity issue. This is actually less unusual than you might think; every escort has heard things like “my wife gives me sex, but she won’t give head”. Many women, especially those from Christian backgrounds, view sex as a thing to endure rather than to participate in; since sex is “sinful” they’re “bad girls” if they initiate any sexual act, but “good girls” if they passively submit to a husband’s desires without actively doing anything themselves. This is one of the reasons rape and bondage fantasies are so popular: they allow women with this kind of programming to subconsciously say, “this isn’t my fault; he made me do it”. It may be that you will need to explore that side of your sexuality; embracing submissive fantasies may let you short-circuit the guilt that comes from active participation, and that can (paradoxically) open the door to full acceptance of yourself as a sexual being. Think of it as a mental judo move: rather than trying to take on your inner nun directly, you’re using her own attack against her. The very impulse to avoid responsibility for sex could be the back door into enjoyment of it.
I used the word “finally” above, but there’s nothing “final” about this discussion; as you begin to sort through the problems, you may find others waiting underneath to jump on your hands. Don’t let that discourage you; it’s part of the process, like having to pay an overdue bill that you discover while clearing off the table. It’s going to take you some time, so you must be patient; however, you’re still young so that is to your advantage. I was 28 before I even began to deal with my issues, so you’ve got a three-year head start on me. And as you make progress with separating the important issues from the incidental ones and the easily-cured ones from those that will take a lot of work, remember that any advice I can give you is yours for the asking.