Sexual performance anxiety is a phrase often associated with men, conjuring images of ailing erections. But it’s a struggle common to many.

For me, as a chronically single people-pleaser with anxiety, sex with virtual strangers is the only way I get to have it. But this makes it even harder for me to say what I really want. This hit home recently when I found myself having terrible sex on an uninspiring mattress without a bed frame, with someone I’d met through a dating app, too anxious to say that this really wasn’t working for me.

The causes of sexual performance anxiety are wide-ranging, from a lack of confidence to disability and chronic pain. I spoke to several people who struggle, to see how it affects their sex lives.

‘Partners ask: “Are you almost done?”’

Vannesa, 23, struggles to get “out of her head” when she’s having sex, particularly with a new partner. In the past, she would worry about what she looked like naked. Now more secure in her body, it’s performance that worries her. “I will almost rehearse what to do beforehand in my head. I also worry a lot that I won’t orgasm. This can also make me feel anxious during sex – partners asking: “Are you almost done? Are you going to orgasm?”

I was absolutely terrified the first time I slept with another woman, because I was afraid I’d be awful

Recently she started dating women, which brought with it new anxieties. “I was absolutely terrified the first time I slept with a girl, because I was afraid I’d be awful.”

Being open with friends has given her a more realistic understanding of sex. “Discussing my horror stories with friends, who had usually all had similar experiences, has definitely helped.”

Talking and learning about realistic sex would help ease the pressure to perform for everyone. This includes widening our understanding of what sex is. “The socialisation that glorifies penetrative penis sex is ridiculous, as so many people do not find that to be the most pleasurable option, yet it’s still seen as what ‘real sex’ is,” says Fydo, who identifies as non-binary. If their partners typically have sex with cis-men, this can be a cause of anxiety.

“Some disabled men have evolved a more progressive understanding of sex precisely because they have acquired an impairment,” says Penny Pepper, who writes about sex and disability. Kev, who has a physical impairment, agrees. “I developed skills in non-penetrative sexual practices, which were more comfortable than intercourse and would be more likely to lead to orgasm.”

‘Sex can be excruciatingly painful’

If a health condition makes sex physically painful, this can take an emotional as well as physical toll. Elise Mai, 21, suffers from vaginismus – the involuntary tightening of muscles around the vagina – as a result of chronic pelvic pain condition. “Sometimes when I have sex it’s excruciating, as my muscles clamp up.”

She has experienced pain for years. “When I was younger I was so embarrassed about it,” she tells me. “I remember pulling my underwear down to go to the toilet and crying because the movement of the fabric was that painful.”

She didn’t go to the doctor until she was 18, but once she did she was taken seriously by a female GP who referred her to a pain-management consultant and pelvic-pain specialist. “I’m very accepting of my issues now and feel fine talking to partners about it. If things aren’t working right, I’ll just take a few breaths (because I get frustrated sometimes) and try again.”

Kat, who also has vaginismus, started the Vaginismus Network. “Having the condition is a very isolating and shameful experience,” she says. “We offer email support to women, as well as connecting people with others in their area.”

‘I thought pleasure meant I’d go to hell’

Strict upbringings can have a lasting impact on people’s relationship with their bodies, or willingness to talk. “As a disabled man, at my boarding school any expression of sexuality was often frowned upon – if not actively discouraged. This resulted in anxiety around sex,” says Kev.

Tamara, 32, grew up in the Haitian Pentecostal church and then a more evangelical one. After a stint in a long-term relationship, her beliefs about sex slowly began to change.

“Everyone was doing it but no one was miserable or going to hell,” she says. “I woke up one day, and I was horny and I thought – I can’t continue like this. I was no longer going to deny myself the things that I deserved.” But the shame that she associated with sex lingers. “I couldn’t reconcile the enjoyment with the issues I once had.” Therapy has helped her understand her past and present beliefs.

Sammy Rei, 27, who grew up in a very conservative, religious household where sex was cast in a negative light and homosexuality was called an abomination, struggled to separate pleasure and her bisexuality from shame.

“I developed low self-esteem and anxiety about sex,” she says. “If like me you’ve struggled with decades of shame, it won’t be an overnight fix, but the more you exercise your sexuality and confidence, the more your body will learn that it’s safe to be yourself.”

Some names have been changed