Corpi che gridano in silenzio. Vulvodinia, cronicità e narrazioni oltre i confini della biomedicina.

This dissertation investigates vulvodynia in the Italian context, framing it as an emblematic case of a contested chronic illness. Vulvodynia is a form of chronic pelvic pain that disproportionately affects AFAB (Assigned Female at Birth) individuals and those socialized as women. It is characterized by the absence of observable organic markers and by fragmented or uncertain medical and institutional recognition. Despite an estimated prevalence of 10–16%, vulvodynia is not officially recognized by the Italian National Health Service as a chronic and disabling condition, nor is it included in the Essential Levels of Care. Adopting a situated feminist perspective the dissertation critically examines the epistemological foundations of the Western biomedical paradigm, highlighting its structural limitations in addressing chronic pain conditions lacking objective biological evidence. The first part reconstructs the historical and epistemological genealogy of Western medicine, focusing on the role of gendered power relations and the persistence of biomedical reductionism. It then introduces alternative theoretical frameworks—namely the embodiment paradigm, ecosocial theory, and contributions from materialist and post-structuralist feminism—to reframe the relationship between body, gender, and illness. The second part of the dissertation is based on a qualitative study conducted through in-depth discursive interviews with sixteen women living with vulvodynia. The analysis of illness narratives reveals how the lack of medical recognition produces forms of clinical, epistemic, and institutional exclusion, deeply affecting patients’ biographies, identities, and social relationships. At the same time, the narratives highlight practices of resistance, the production of experiential knowledge, and the emergence of counter-narratives through activism, peer support, and digital spaces. These processes challenge the epistemic hierarchies of biomedical knowledge and point toward the need to rethink care relationships and clinical practices in the management of chronic illness.