Don’t forget to grab your seat for the LIVE taping of Sex Gets Real to celebrate our 200th episode. Enter to join us here.

This week, I am joined by the incredible Bianca Palmisano from Intimate Health Consulting. Bianca specializes in training medical doctors, nurses, and staff to be more inclusive when treating marginalized folks, especially around sexuality and gender.

So, we go there.

We talk about all the ways doctors fail us and the emotional labor we often have to do to train doctors on how to treat us well. We also talk about how Bianca gets into their offices in the first place and how she’s received.

Then we geek out over the medical conferences we’ve both attended because good god, is there a problem with the research being done. Ugh. And of course big pharma spends loads of money at medical conferences attracting doctors. There’s NO MONEY in giving people better communication tools.

We field two listeners questions. One on when to disclose that you have a kidney draining pouch and the other on how to live with yourself after you’ve sexually abused someone.

You’ll also want to check out our bonus chat on Patreon all about the orgasm gap and how much variance there is in our orgasms. Because orgasms are at the top of everyone’s minds when they feel like there’s a problem. Patreon supporters at the $3 level and above get access, so head over and listen now. patreon.com/sgrpodcast

If you want to grab my latest workshops, head to dawnserra.com/courses.

Follow Sex Gets Real on Twitter and Facebook. It’s true. Oh! And Dawn is on Instagram.

In this episode, Bianca and I talk about:

• Bianca’s work training medical doctors, nurses, and staff to be more inclusive towards marginalized identities around sexuality and sexual health.
• Are you poly or trans, have an STI or a similar sexual health issue? We talk about good ways to have a conversation with a doctor or nurse to get their attention and have it be mutually beneficial.
• If a doctor or staff mistreat you or make you do too much emotional labor around your needs, it’s important to let them know why you’re leaving their practice. We dive into why and how.
• ISSWSH, a medical conference I attended last week that left me feeling bizarre. What did I learn from all the doctors, the researchers, and even the vendors? And what was the biggest disconnect that I noticed during my time there?
• Researchers are studying common issues in the field of women’s sexuality: high levels of sexual dissatisfaction, high levels of lack of orgasm, high levels of sexual pain.
• If lesbians are having more orgasms and less pain and higher satisfaction than straight women, maybe we should be queering up straight women’s sex… just an idea.
• Why doctors and medical experts often forget about the critical role social/culture play in our sex lives and why Bianca does NOT want doctors trying to have conversations about sex, pleasure, and how-to’s with patients. But if not doctors, then who?
• Reimagining the way doctor’s offices handle sexual health, who should be included, and who the current system leaves out.
• Most marginalized folks can’t afford a sex coach, a sex therapist, or a sex educator because insurance won’t cover it. We call bullshit
• The kind of money and investment from the industry into the ACOG conference is enormous. They know there are millions of dollars on the line from these health care providers in terms of what they are going to invest in and how they are going to prescribe to their patients. They are willing to put huge amounts of their advertising budgets on the line to capture people’s attention. “There’s no money behind a social approach that says, ‘Maybe we just need to talk to each other a little bit more.’
• We field a question from listener Chet, who is an older bisexual man. Their vulnerable question is when to disclose that they have a kidney draining pouch after childhood surgery. When is it too soon and when is it leading someone on?
• We also field an intense question from listener R.O. who thinks they violated someone’s consent and don’t know how to reconcile that. We talk about consent, drinking, coming to terms with the fact that you caused harm, and how to move on.

About Bianca Palmisano:

Bianca Palmisano is a sex educator, medical consultant, and the owner of Intimate Health Consulting. She specializes in training healthcare providers around issues of sexual health, as well as LGBT, sex worker, and sexual assault survivor competency. Palmisano is the primary author of “Safer Sex for Trans Bodies,” an outreach and education guide for the trans community sponsored by Whitman Walker Health and the Human Rights Campaign. She has been a guest lecturer at George Washington University, Johns Hopkins, and University of Chicago.

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Episode Transcript

Dawn Serra: You’re listening to Sex Gets Real with Dawn Serra, that’s me. This is a place where we explore sex, bodies, and relationships, from a place of curiosity and inclusion. Tying the personal to the cultural where you’re just as likely to hear tender questions about shame and the complexities of love, as you are to hear experts challenging the dominant stories around pleasure, body politics, and liberation. This is about the big and the small, about sex and everything surrounding it we don’t usually name. The funny, the awkward, the imperfect happen here in service to joy, connection, healing, and creating healthier relationships with ourselves and each other. So, welcome to Sex Gets Real. Don’t forget to hit subscribe.

Hey, you. Welcome to this week’s episode of Sex Gets Real. I am your host, Dawn Serra. Joining me this week is Bianca Palmisano, who is this incredible sex educator, who also works to train doctors, nurses, and other medical professionals to be more sex positive, inclusive, to understand better trans issues, and gender issues. Really important work in the world. But before we get to my chat with Bianca, I want to remind you that there are still seats up for grabs for the live taping of Sex Gets Real that we are doing to celebrate episode 200. So if you are available on March 22 at 5pm Pacific – 8pm Eastern and you want to join in the fun, there is going to be a group taping where you can join me. We can talk I’ll answer questions live and it will end up being one of the episodes of Sex Gets Real. So if you want to join in and put your name in the hat for a potential spot, just click on the link in the show notes and/or head to dawnserra.com/ep202. The link is there and I would love to see you. 

Dawn Serra: Speaking of super rad things, don’t forget that I’m also live streaming every single Wednesday at O.school and their URL is O.school. It’s free online sex education streaming every single night. Every single night. And every Wednesday, I do pop culture undressed. We have talked about 50 Shades of Grey, Twilight, John Hughes’ ‘80s films, Magic Mike XXL. It is a total blast. If you have any TV shows, movies, characters, books that you love to geek out on with me, be sure to hit me up on Twitter. I’m @dawn_serra to let me know what you’d like to see on pop culture undressed. 

This week’s episode includes a listener question from someone who got drunk and then sexually violated a partner. I do offer a warning before we read the question and the scenario out loud, it’s towards the end of the episode. Please do care for yourself around that. I also want to let you know that Bianca and I record a really fun Patreon chat so if you support the show at $3 or above, you can get access to all of the weekly bonus content that’s being put out. Bianca and I rage against the orgasm gap, why for women, dissatisfying sex often includes pain and suffering, and dissatisfying sex for men generally includes just not being that into it. We also talk about all the different kinds of orgasms that we experience and how that ties to the medical treatment that we get. It’s a really interesting, dynamic conversation, so be sure to check that out. You can support the show at patreon.com/sgrpodcast. 

Dawn Serra: So, Bianca Palmisano is here this week. Bianca is a sex educator, medical consultant, and the owner of Intimate Health Consulting. She specializes in training healthcare providers around issues of sexual health, as well as LGBT, sex worker, and sexual assault survivor competency. Palmisano is the primary author of “Safer Sex for Trans Bodies,” an outreach and education guide for the trans community sponsored by Whitman Walker Health and the Human Rights Campaign or HRC. 

She has been a guest lecturer at George Washington University, Johns Hopkins, and the University of Chicago. So let’s find out how to advocate for ourselves. Let’s find out how to get better healthcare. Let’s find out what we should do when a doctor mistreats us or makes us do too much labor. And then we’ll roll around in a couple of your questions. So here we are, me and Bianca.

Dawn Serra: Welcome to the show, Bianca. How are you?

Bianca Palmisano: I’m doing great. Thank you so much for having me on here.

Dawn Serra: You’re so welcome. You do some really important work in the world. And, so much of what you do is helping the medical establishment and doctors’ offices, and medical professionals to be a little bit more aware and comfortable talking about sexual health issues. And I’d love to know how you got started doing that because it’s so fucking necessary.

Bianca Palmisano: Oh my gosh, it is. And part of the reason that I got started in it was not necessarily because I felt like I had unique qualifications for the job, but just because I looked around and said, “Why aren’t people doing this? This is a serious unmet need in the community.” But, I started out – my background is a little bit hodgepodge, as I think a lot of sex educators do have that arrangement in their background. My degree is in International Studies and I realized in the midst of that, that I actually really wanted to work stateside and focus on problems systemically, that I understood a little bit better. So, I felt like that degree gave me this interest and this awareness of the way that big systems like health care and education, and government affect the day to day lives of people who might be struggling. Then, I went to work for a couple of years with a homelessness organization. 

So I was doing case management and helping people find employment. And that gave me a better understanding of what some of the health needs were for marginalized communities and the hands on in the trenches experience; of what it means to be poor, be marginalized, be black in a lot of cases in DC and trying to make things work. And while I was doing that, I was also interning at a little organization called The Garden here in DC, which doesn’t really operate anymore. But that gave me the opportunity to connect with a lot of other sex educators and learn more about that field, which is something I’d already been passionate about. 

Bianca Palmisano: So when it came time for me to sort of strike out on my own, I pulled all three of those pieces together. I said, I want to work to support marginalized people. I want to make things better for my community – for LGBT people. I want to make it better for survivors of sexual assault. I want to make it better for people of color and I want to work at a systems-based level, and make sure that people know how to talk about sex and how to support our health care needs that way. So it just brought all of those pieces together under one roof.

Dawn Serra: For listeners who have been listening to the show for a while, you probably remember when I had Zena Sharman on the show who put together the anthology, “The Remedy,” which is all about the barriers and the challenges that trans and queer and non-binary people face when they’re trying to navigate the medical system. And, I’m sure so many people listening have had less than satisfactory to traumatic experiences with doctors for a range of reasons. It’s so interesting to me because, culturally, we have this narrative that doctors are godlike. And this belief that doctors are somehow knowledgeable in all things and above it all, and are somehow superhuman. I think that’s one of the reasons why it can hurt so much more to experience some kind of judgment or shame when you’re sitting in a doctor’s office because we have this cultural belief that they know all the things. So if they’re shaming me or if they’re not seeing me for something, then it must be really bad.

Bianca Palmisano: Yeah, and that doesn’t come from nowhere, either. A lot of health care providers see themselves that way. And it’s really built into how the curriculum is set up – this very strong barrier between professional self and personal self that gives you the feeling that you are above at all. So for people who have that experience and who are disappointed in their health care providers. It’s not just you setting up unrealistic expectations, that is the medical culture to a tee.

Dawn Serra: Yeah. How do medical staff respond, usually, when you work with an office or you offer a training and you’re talking to them about trans issues or queer sex or trauma, what’s the response that you usually find?

Bianca Palmisano: Well, the thing about it is, is by the time I get into an office, that is a group of practitioners that have already decided this is worth paying attention to. This is stuff that I don’t know and I need to know. Whereas, I would say the majority of my time is devoted to doing outreach and cold calls, and trying to connect with practices that mostly show their lack of interest by not picking up the phone. 

So, once I get in the room, people are very excited, and they’re very engaged and they’re laughing, and they’re learning and they’re saying, “Oh, I didn’t think about it that way, but that’s so true.” But, it’s the silence from the people who say, “This isn’t a priority for me,” that I think really hurts the most. 

Dawn Serra: Yeah. And I think something that’s been challenging for me, personally, so my guess is I’m not alone, is there has been feelings I’ve had to navigate around the fact that I know now when I go into a medical situation, that I’m going to have to do a lot of emotional labor to advocate for myself and to set very clear boundaries; and to oftentimes, educate the people that are trying to treat me.

Bianca Palmisano: Oh, my gosh. I’m sorry, you have to deal with that and I’m sorry to all of the listeners who probably have that experience too. It’s freaking exhausting and it’s unfair in a lot of ways.

Dawn Serra: And I’m wondering, what do you think, for people who either have STIs or they’re poly or they’re queer and trans or whatever it is, that they’re going to have to probably advocate for themselves in a little bit more active of a way, than we’d like to. What do you think is a good way to have a conversation with a nurse or a doctor that’ll really get their attention and make it something that can be mutually beneficial rather than completely taxing? What do you think is the best way to approach a situation where you have to advocate for yourself?

Bianca Palmisano: Well, I mean, I think it does vary based on what it is you need to advocate for yourself for. It’s so different for people with bigger bodies trying to advocate like, “Hey, I don’t want to be weighed at the doctor’s office. I don’t need your commentary on my weight and my body size” versus a trans person that specifically needs you to use specific language and pronouns and navigate the differences in documentation that are going on with their insurance and things like that. So, I think it’s very contextual, I don’t feel like there’s a very good script. But the main thing I always remind people of is if you have the power of choice, and you feel like a provider isn’t hearing you, isn’t listening when you correct them or when you try to offer context for what’s going on in your life, then please, Dear God, vote with your feet and vote with your dollars to go somewhere else. Because if nothing else, you should know that you are entitled to something better. So if you can’t fix the problem, at least know that you deserve to go somewhere that you’re respected.

Dawn Serra: And I think it’s important to let doctors know when you leave their practice the reason why. I mean, I know that it can be really difficult, especially if you’ve just maybe had an OBGYN visit and they shamed you for having multiple partners or whatever it was. But, when you make the decision to leave, if you’ve got that option, I think it’s so important for us to let their offices know, “I’m leaving because of this. It’s not acceptable. I’ve found a new practitioner and this is something you really need to address,” because otherwise they don’t know why you left and they’re not going to change.

Bianca Palmisano: Yeah, absolutely. And I mean, I have had situations where on the back end, if I had a bad experience, I would call the office manager and be like, “Hey, this wasn’t appropriate and I waited a long time for this appointment, and I didn’t get the care I deserved.” When I’ve had to do that, they’re like, “Oh my gosh, I’m so sorry. Let us get you in with a different provider. We’ll make sure that we address your needs appropriately.” And I got seen two days later and by a much more sensitive nurse practitioner instead. So sometimes, they do hear you on the back end and do make adjustments accordingly. I would like that culture of humility to pervade medicine much more than I feel like a standard at this point.

Dawn Serra: Okay, so I just attended the International Society for the Study of Women’s Sexual Health Conference.

Bianca Palmisano: Oh, yeah.

Dawn Serra: Yes. And I know that you have a blog post about a medical conference that you attended last year. And, I have shared a couple of thoughts on the show, but I haven’t really dug into it. I would love to kind of geek out with you a little bit about my experience at this conference and also hear about your experience, because it was kind of bizarre and kind of… I don’t know, it was weird.

Bianca Palmisano: It’s like a whole other world, right? I’m Totally down to talk about that.

Dawn Serra: Okay, so the first thing that I noticed when I walked in was the vendors, which were interesting. That it was easily 95% white and maybe one visibly queer person. So it was, I don’t know, it was mostly white, a handful of folks who were visibly Asian. I saw one black woman, and not anybody with visible disabilities, not anybody who was visibly trans or even identifying themselves as trans. So, I thought that was kind of interesting. And then, I don’t know, it was so fascinating to me to sit there and listen to all of these researchers and these doctors talking about the studies that they’re doing. And just over and over and over and over again, I felt like they were either completely leaving out the social and the cultural elements. It was like they’re so hyper-focused on the biology that they’re completely forgetting about all the other aspects that go into sexual health and sexual experiences. 

There was also this interesting thing where it seemed like there was this unspoken agreement that if we can eliminate “dysfunction” and if we can eliminate pain then that is the same as pleasure. Did you find that?

Bianca Palmisano: The conference you went to was was ish-wish, which was specifically focused on “women’s sexual health.” So, for me, it was similar because I went to ACOG, which is the American Congress of Obstetricians and Gynecologists. So the focus wasn’t specifically on sex. There was a pregnancy track. There was a gynecology track, there was a sexuality track. I think the strong focus was definitely on the biological component. But we saw there was a little more variety of voices. I went to a session that was looking specifically at the laws and the evolving legal climate related to abortion care around the U.S. And that was one of the only sessions that was run by a non-MD. It was put on by the people from the National Women’s Law Center, I think. It was half so it was actually really cool. I thought that was a lovely session. 

So there was definitely a dominant trend of we’re talking about the physicality associated with sex, and we’re looking very much at the biomechanics. And there was a huge emphasis on sexual pain and especially related to menopause. That was like, “Oh my gosh, the entire industry had just finally discovered that people go through menopause and that there’s less estrogen in their bodies and sex isn’t great anymore.” Wow, that’s been happening for a really long time for you to just figure this out now.

Dawn Serra: So here’s the biggest disconnect that I noticed and I am being a little bit of a jerk, but there was some lovely people at this conference and everyone that I talked to was super excited that I’m a sex coach and that I have podcast. But it was also really clear that heterosexual, cis white folks studying heterosexual, cis white folks, doesn’t yield the most inclusive findings. The reason that I say that is because I sat in on probably 12 different presentations, where they were talking about heterosexual women – of course the majority are white – but heterosexual cis women and their sexual issues. The high levels of sexual dissatisfaction, the high levels of lack of orgasm, the high levels of sexual pain. And the ways that they’re studying that and trying to find the biology behind it, and testing Addyi for low sexual desire. So there’s all these panels about that. One morning, very early, it was a 7am session – I went to a discussion group called “Women Having Sex with Women.” 

Bianca Palmisano: Know that when it happens at 7am, it’s not a priority because that scheduling is not a mistake.

Dawn Serra: Right. So it was, thankfully, a full room but it was an older heterosexual, cis white psychologist doing her best to lead a discussion. There were definitely some misses. But the room was full of nurse practitioners and OBGYNs, and there were some really fantastic people in the room. In fact, there was this one woman who’s the head of the Kaiser Trans Hormone center in Oakland. But, the vast majority of the room were just speculating, “Oh, I’ve had one client who’s a trans woman.” “I’ve had one client who’s come out as queer to me.” And they’re all guessing about women having sex with women. But what was interesting was the person leading the discussion had all of these studies in front of her, and she kept reading these studies that show, which you and I both know, that lesbians have the highest rates of sexual satisfaction and lesbians have the highest rates of orgasm and lesbians have– All of these things that are the antithesis of the heterosexual and the Bi women’s experiences. But nobody was talking about, “Well, if lesbians are having less pain and more orgasms and higher satisfaction, then straight women,maybe we should talk about queering straight women’s sex.” 

Bianca Palmisano: Maybe it’s not just a biological problem because there’s nothing biologically different about lesbians. We have the same teeth and the same spleens.

Dawn Serra: Exactly. And it was shocking to me that all of the same people that were in the room talking about women having sex with women, weren’t then translating that information into something in the other panels that was for discussion. It was the most bizarre disconnect. And thankfully, I saw one person tweet after the conference that ISSWSH talks about being conference that takes the bio psychosocial approach. And there was lots of biology and there was a handful of psychologists and psychiatrists there. Only one person, the entire conference talked about culture. And, so it just made so clear for me why we have the problems that we have when it comes to sexual health and the medical community, and people feeling so broken. There’s these massive – there’s no one at the conference that’s connecting it to the social and cultural. And I just felt like such a massive mess.

Bianca Palmisano: Yeah, no, absolutely. And there’s this deep siloing of queer health, like we’re a different species or something. And I’m like, “Oh, the rules are just totally, totally different for us.” And they’re not. So much of the the teaching model that I do is looking at this idea that, “Okay, we don’t have to have a different way of talking to queer and trans people.” We needed a different way of talking to all people that’s more inclusive, so that it’s less othering and we are queering sexual health in a way that’s beneficial for everyone.

Dawn Serra: Yeah.

Bianca Palmisano: It’s very frustrating. I’m sorry. 

Dawn Serra: It’s okay. I have to vent about this one other thing that happened. Because, again, I’m going to sound a little bit like I’m picking on them and there were some lovely things that happened. But, for the vast majority, I thought it was a miss. But there was this one panel. It’s the president of some men’s health prostate cancer guy. All of his work is with prostate cancer. And his presentation actually cited the book, “Men are from Mars, Women are from Venus.”

Bianca Palmisano: No!

Dawn Serra: So he puts the book up, and he’s like, “This was one of the best sellers of the entire ‘90s.” And then, the next slide comes up and he’s like, “But isn’t gender a social construct? Isn’t this just ridiculous? And I’m like, “Okay, maybe this is going in a better direction.” Then the slide after that was, “But no, men actually do define their entire beings by their penises.” 

Bianca Palmisano: OH MY GOD.

Dawn Serra: “All of the studies being done about prostate recovery and sexual satisfaction for men is appealing to women and their needs for communication. But men don’t want communication. Men don’t want tenderness and intimacy they want intercourse.” 

Bianca Palmisano: Oh my god. 

Dawn Serra: Yeah. And like it was, it was so interesting to me because there’s this man preaching to a room of mostly women. He’s talking about how study after study after study after study has been done on how post prostate cancer men feel about sex, and that every single one of the studies basically shows no improvement for the men and only improvements for their female partners. Because all of the studies are about teaching better sexual communication and sharing feelings more, and men don’t care about that stuff. They just want a raging hard cock that they can put in holes. And so, basically his takeaway was if we want to do better by prostate cancer survivors, then we need to make women realize that penises and sex are more important and focus less on the talking about it.

Bianca Palmisano: Oh my god, because that isn’t how our entire society already works. It couldn’t possibly be that maybe with these interventions, women are experiencing better sex because they were the ones having shitty sex in the first place. And so, as soon as we deprioritize people with erections, we can suddenly start having an equal playing field. But it looks like a loss to men, because rightly it’s not literally all about you. Oh my god, I want to shake this person.

Dawn Serra: Oh my God, I know. I was like, “I would actually burn this hotel to the ground if I could right now.” The thing that was just so striking to me was all of the interventions that they’ve been testing, because I’m not trying to say prostate cancer isn’t serious. It’s super serious. And they were showing the statistics that prostate cancer rates are one in five and breast cancer rates are one in six. So, prostate cancer is much more common and lots of people with prostates are going to end up with cancer. Of course, it was completely gender essentialist and he was only talking about men getting prostate cancer. That’s a whole different conversation.

Bianca Palmisano: Oh, yeah. Because trans women aren’t real. They don’t have bodies actually.

Dawn Serra: Right. So, I get that prostate cancer is terrifying and scary and difficult, and it does take a toll on your body. And, and I agree that our culture, because of toxic masculinity and sexism and patriarchy, does tell men that their only access to pleasure, masculinity, and worth is through their penis. And that, to me, is the exact point where as a healthcare provider, you can start having conversations around, “Yes, you should mourn and grieve. Yes, things have changed and they might change again, as you get older or as other things happen. Let’s talk about sex toys. Let’s talk about strap-ons. Let’s talk about all the ways you can have super yummy ‘I’m fucking the hell out of my partner’ sex, that maybe don’t rely on whether or not your penis is getting fully erect today.”

Bianca Palmisano: Absolutely. And I mean, this is the place where I have the most trouble with the healthcare industry, not because this is something that doctors should be doing and they’re not. Because, I genuinely believe that that’s not their role. They cannot be all things to all people. There’s so much information in your brain as a healthcare provider, that it’s just absolutely astounding, but we do not have a system set up. And this is the thing that I don’t know how to fix yet, because I don’t understand managed care organizations and health insurance and nonsense like that. But, we don’t have a system set up where people can access through their healthcare providers and through their insurance any kind of specialized advice and support around these issues.

I don’t want a doctor to be like, “Yeah, let’s talk about sex toys and let’s about teasing and denial play and things like that.” No, they should be talking to you like, “Okay, I’m going to write you a referral for Dawn Serra and you’re going to go talk to her,” and that’s going to be a productive conversation. But, we don’t have the resources for that right now. So if somebody has a sexual problem that they don’t want treated with medication, then they have to pay out of pocket for it. And that leaves it so inaccessible and it makes it so that the only people who even get to talk about pleasure and these alternative approaches are white, middle to upper class people who can afford sex coach work and stuff like that. So it’s this vicious cycle. And that was actually where I wanted to bring it back around. 

Bianca Palmisano: You mentioned when you first came in all these vendors. I don’t know if it’s quite on the same scale as ACOG, but can you talk a little bit about what the exhibit hall looked like or what scale we’re talking about with these vendors?

Dawn Serra: Okay, so there weren’t that many, which kind of surprised me. But when you first walked into the hotel, there was maybe six vendors right at the registration desk. And then if you walked around the corner into a bigger hallway, there was maybe another 20. The thing that surprised me was, it was KY. I wanted to be like, “Here is Sarah Miller study on…” So KY had a massive booth there. It was a handful of plastic surgeons/bionic wave face tighters/‘use this chin exerciser and it’ll take years off and wrinkle free’ kind of stuff. And then a couple of smaller dilator and vibrator companies for folks with disperenea. So, it kind of ran the gamut. But I was a little bit surprised by, one, the KY thing and, two, there was a number of booths for a variety of pills around desire or looking younger or getting rid of wrinkles, and I was like, “No.”

Bianca Palmisano: Okay, so let me paint the picture for you of what I saw in the exhibit ACOG, because this is a dramatically different story. And this, I think, illustrates where the deviation between the biology approach and the social approach comes from, because one of them has money behind them and one of them doesn’t. So you walk into the ACOG exhibit hall, which is like… I don’t even know how large. It’s the size of three conference halls – it’s enormous. And, just a brief sweep around the room, I would say there is at least $3 million worth of booths set up in this room, easily. And not even people trying to sell stuff, but upline product development and advisory people. So they’re like, “This is something that we’re working on right now. And so we want people to know about DHEA and we want people to know about dyspareunia,” and things like that. And they’re baking cinnamon buns for you in their own oven at their booth. They’re serving cocktails and ice cream from their booth as a way to say, “Hey, come over and talk to us about this product that we’re developing.” 

Bayer had a waterfall that when it fell down, it would write out words – it showed the Bayer logo. And then it said, “Women’s health,” or something in patterns. So the kind of money and investment in this conference from the industry is enormous. They know that there are millions of dollars on the line from these health care providers in terms of what they’re going to invest in, and how they’re going to prescribe to their patients. And they’re willing to put their huge amounts of their advertising budget on the line to capture people’s attention. There’s no money behind a social approach that says, “Maybe we just need to talk to each other a little bit more.” So I looked into having a booth at ACOG and it would have been absurdly expensive like $2,000 was the minimum of four tiny tables. And then I would have to buy all of the stuff to take with me to just staff it. So, this is not accessible to people who are talking about marginalized populations or people who are trying to look at socio-emotional approaches to gynecological health and sexual health.

Dawn Serra: Yeah, it was pretty clear to me that the people at Ish Wish, even though a lot of it was misguided, are people who are on the fringes. Women’s sexual health is not a moneymaker and it’s not a place where big companies want to have their name associated with it. There were, other than KY, no names that I recognized in the booths, other than one or two small toy companies. And I was talking to my partner afterwards and he was like, “When you think about where universities are putting money for research and funding, it’s not in orgasms and clitorises. It’s brain science and breast cancer and things that have big social value and money behind them.” It was just so weird.

I will say, there were a couple of really rad things that happened. Cindy Meston from Meston Labs, I think at the University of Texas in Austin, gave this fantastic talk that had all of the women in the room clapping so loudly. Because apparently, at last year’s meeting, Ish Wish issued a statement that basically said, “Women’s sexual response is entirely and fundamentally based on whether or not they notice their genitals engorging with blood.” And so, Cindy Meston got really pissed off that this conference was basically saying, “We believe that women’s sexual satisfaction is based on whether or not their brains are connected with the blood that’s engorging in their genitals”. And she was like, “Bullshit.” So, she actually spent the whole last year conducting multiple studies in her lab and then presented the findings at this meeting and said, “I’ve spent the last year proving you wrong. That there are loads of women who have high levels of sexual satisfaction, and in fact, don’t care about their genitals engorging because it’s just not part of what turns them on and gets them off. And they’re not broken. They don’t need to be fixed. And I have all these studies and numbers now to prove it.” So that was super awesome. I think she’s doing really cool work.

Bianca Palmisano: Yeah, I think that was actually in a “Unscrewed,” Jacqueline’s new book has a chapter devoted to that research. And I was like, “This is fascinating, brilliant stuff.”

Dawn Serra: Yeah, yeah. That was really good and a whole bunch of her grad students and research assistants also shared some of their papers. So that was really great. And then they had– It wasn’t packed the way that I hoped it would have been, but it was pretty full. They had a trans symposium, where three people who are leaders in the field of trans health talked about the super basics that doctors and nurses would need to know about hormones and how to code papers. And if a trans woman says, “My employer can’t know. I’m not out. I need you to use male pronouns in my files. Here’s how you do that.” And, they also did this presentation with pictures of bottom surgery, before and after, and talking about hormones and teens. And so, that was fantastic. I hope they have more of that.

Bianca Palmisano: I freakin love that and that was like, I know, obviously culturally, we need to move away from our obsession with trans people’s genitals. But the actual surgical processes associated with affirming gender-based care is one of those things that I’ve gotten super nerdy into lately, as somebody who will never be performing surgery, but just loves – appreciating the different processes that we continue to develop to make these procedures better and more authentic and less painful and have quicker recovery times and things like that.

Dawn Serra: One of them had this study, I’m hoping to get a couple of them on the show at some point, because they just do such fascinating work. But one of them had this statistic up that showed that it was something like 92% of trans people have contemplated suicide or attempted suicide in their lives. But, that number drops to 4% if they come from a family that is fully accepting of their trans status.

Bianca Palmisano: I don’t know if the numbers are that dramatic, but that is definitely accurate. I’ve seen, for adolescents, it halves their risk of depression and anxiety and suicidality and things like that. It’s a huge protective factor.

Dawn Serra: Yeah, yeah. It was wonderful. And I hope more medical conferences start talking about these issues. I also hope that more medical conferences – my number one takeaway was, so much could be changed if medical offices had on-staff, people like sex coaches and sex educators, and people who could offer the social component, the communication component, and the support component. Because you’re right, doctors and nurses can’t know all the things. So, how do we make it more integrated and holistic, so that the tools that we need when we’re talking about, “Oh, my orgasms aren’t feeling how I want them to feel.” “Well, let’s look at the biology. Let’s talk about the psychology and let’s also talk about a whole bunch of other skills that can help you in the meantime, and maybe even shift the way that you’re feeling about it all. And we can do that all here and/or with our network.”

Bianca Palmisano: Gotta find a way to bill for it, man. I know there are providers out there who want this. The folks that are already saying, “This is a problem.” And I do know a number of providers, at least in my network, who are saying, “Hey, we want more resources. We want to be able to do this better,” but there’s just a limitation to what they’re able to offer. So, yeah. But what I’m hearing is also that we probably need to put together a presentation Ish Wish. I don’t know if we’re allowed to present there, because a lot of these conferences make it so that, “Oh, you have to have a specific qualification in order to submit a proposal or an abstract.” But like, I would want to see that happen. 

Dawn Serra: Oh, for sure. I was like, “Okay, I either need to present at this thing or I need to table.” Because the tabling in Ish Wish, I think, is a lot less expensive than at ACOG, because it’s a lot smaller. But I was like, “Maybe I should just have a table and maybe we should just put together a whole bunch of booklets and stuff that give them all kinds of tools for conversations, and to do better,” because we can’t keep having misses like this. Too many people end up harmed and traumatized when the misses are in this space specifically.

Bianca Palmisano: Yeah, absolutely.

Dawn Serra: Okay. So I just want to let everybody know that Patreon supporters, after we wrap up for this, Bianca and I are going to have a conversation about orgasms and the female price of male pleasure, which is an article that came out that we were talking about before we hopped on. So if you’re a Patreon supporter, be sure to head over to patreon.com/sgrpodcast to hear us talking all about orgasms and pleasure, and how it ties in with all this medical stuff. But Bianca, I’d love to know if you’re up for fielding a listener question or two with me?

Bianca Palmisano: Yeah, of course.

Dawn Serra: Okay, so this first question comes from Chet and the subject line is: “When to talk about your body issues.” So the email says, 

“I appreciate all the good advice you give on your show. I’m an older man, bisexual but leaning more towards gay. When I was a kid, I underwent surgery and ever since, I’ve had to wear a pouch on my side to drain my kidneys. For most of my life, I was self-conscious about this and reluctant to get into sexual situations. Recently, I’ve gotten better and feel less self-conscious about this once I’ve told a perspective sexual partner about it, and they’ve accepted it. And a lot of that has to do with listening to you and your show. But my question is, when do I bring it up? I don’t think it’s right to wait until I’m dropping my pants. And sometimes I feel like I’m waiting too long and trying to get them to see the real me may look like I’m leading someone on and hiding something from them. So I’d love to know what you think.”

Bianca Palmisano: That’s so real. Well, thank you for writing in Chet. That’s a very vulnerable thing to share. And I’m glad that you did. So, that’s really valuable. I mean, I see a lot of corollaries there, too, like the conversation that we have in the trans community about when to disclose and things like that – like if you pass really well, “Am I hiding the fact that my genitals aren’t what you’re expecting?” Or is it like, “I’m trying to get you to see who I am inside first before you make all these assumptions based on what I look like with my pants down.”

Dawn Serra: Right, right. Because unfortunately, the current state of affairs is that it can be very dangerous. And it can be very unfortunate to someone to make that discovery in the moment, right? Because culturally speaking, genitals are very meaningful. And if someone were to have a different set of genitals than they thought they were going to get, it could lead to violence and all kinds of terrible things. I think similarly with disabilities and different kinds of bodies that might not be visible at first, we don’t have the social skills to navigate disability well. 

So, people say shitty things in the moment because they don’t know what to do when they’re feeling awkward. So, I think, unfortunately, most of us who have a variety of things going on from transness to disability – surprising someone with it in the moment can end badly because we just culturally aren’t giving ourselves the skills to be able to handle something with curiosity.

Bianca Palmisano: Right, I mean everybody benefits from a little cognitive rehearsal. So, it’s definitely not a bad instinct to be like, “We should mention this ahead of time.” But I also don’t think, Chet, that you’re hiding anything from a person. This bag that drains your kidney or this pouch that drains your kidneys is not who you are. It’s a part of your body and it’s a part of how you live your life. But you’re not keeping some big dark secret from someone. It may fundamentally change a little bit of the mechanics of how someone interacts with you sexually, but it doesn’t change who you are or how your body works, necessarily, in the moment. I don’t ever want you to feel anxious about feeling like you’re leading someone on or you’re keeping something a secret, that I don’t think that even qualifies as a deep dark secret. It’s just a part of your life. But when you want to bring it up… 

So the thing that I’ve realized is whenever I used to be that very dramatic person that was like, “Okay, so I have something to tell you. And, I think it made any disclosure that I had more of a big deal than it ever needed to be.” The thing I learned from doing case management social work is, if you use a tone mirroring, essentially – so if you say it like it’s no big deal, it’s just a part of your life, it happens, whatever, then the other person as no big deal, it’s a part of your life versus, “Oh my gosh, I have this big important disclosure to make with you.” So I don’t think there’s a specific – appropriate time. Like, “Oh, you need to mention this after dinner, but before dessert on the first date.” Whatever. But when you do bring it up, as long as you’re in a place that – it’s like, “Hey, this is just something that you might want to know about.” Even if you want it to be humorous and like, “This is just something funny and cool about me,” can be a cool way to introduce it rather than some big confession that needs to happen.

Dawn Serra: Yeah, I totally agree. If you’re opting to tell someone once you’ve established a little bit of a connection and had some conversations, then I think you’re right. When we come into something, just knowing it’s okay and, “This isn’t a big deal to me. It doesn’t need to be a big deal to you. And now I’m just going to share the thing,” that has a very different feeling because the other person picks up on the confidence. And it’s like, “Oh, well. They know what they’re talking about. So maybe it’s okay if I follow their lead,” versus the, “I’m super scared of being rejected and I don’t know how to say this, and this feels awkward. And now I’m building it up.” And then the other person starts getting nervous like, “Oh, god.What is it going to be?” And it totally shifts. I think that’s true for anything. If we’re going to talk about, “Oh, hey. I want to tell you I’m kinky.” That’s totally different than, “Okay, can we have a talk because I need to tell you something.” Very feeling. Very different.

Bianca Palmisano: And I mean, especially if there’s – and that was a great segue, Dawn, because I was thinking it’s really easy – it’s not easy – but you can have a conversation about kinkiness and desires and things like that that turns into a very sexy conversation; where you’re like, “So one of the things that really gets me going is – I really love bondage,” or whatever. And I’m talking about some of the specifics and how that impacts you in a very positive way. So, I don’t know where you’re at with your pouch – if it’s a thing that you love and appreciate about your body now or if there’s anything erogenous about it or fun or exciting. I know for people who have ostomy bags for their colons, there’s special lingerie and things like that that really helps you embrace what that looks like. So if there’s any touchstone of conversation related to how you interact with that pouch. It’ll be like, “Oh, yeah, I have this super awesome shirt that I feel like really highlights or it goes right around the pouch in a really comfy way.” You’re able to talk about this particular medical issue you have without it being about the medicalization of your body. I don’t know if that was clear.

Dawn Serra: Yeah, that was totally clear. And, I think it just depends for Chet, where you are with it and how it feels. I’m also a fan, too, you get to decide based on the person and the conversation when you want to do the disclosure. You get to feel it out. Is this someone that I feel immediately comfortable with or is this someone who like, “We need to get to know each other a little bit before we start getting vulnerable?” I’m also a fan of the “put-the-thing-you’re-most-afraid-of” in your bio. So I know that Krista Anaranda, one of the first things in her dating bio is, “I have herpes.” And it’s because she was like, “I don’t even have to worry about having the conversation. It’s just in my effing bio. People can self select out.” People say that about being fat or having a variety of disabilities or anxiety. And that might be something, too. If you’re doing online dating, you could decide whether or not you want to fold that into your bio in a really creative way of, “Here’s all these awesome things about me. Hey, guess what? I also had this super impressive surgery when I was young, and now I have this incredible life and I got this cool bag that came with me.” And it’s just part of you and what you’re putting out into the world. Then people can either select in or select out based on that. 

So, I think it just depends on your comfort level, how you’re meeting people, what feels good. I think the main answer, though, is you really can’t do it wrong. You just have to do it your way. And if somebody has shitty feelings about it, then there’s the information you need about that person doesn’t deserve access to your body.

Bianca Palmisano: Right.

Dawn Serra: Yeah. Thank you for helping me field that and thank you to Chet.

Bianca Palmisano: Yeah, thank you, Chet.

Dawn Serra: I love that you’ve you’re feeling less self-conscious about it and that once you’ve told someone, you feel a lot more comfortable. And so, I hope that you continue meeting someone and enjoying your sexuality, and having pleasure and celebrating all the things that your body can do.One of the other things – I pulled this question out for a reason and I’d love to know if you’re open to it. You also talked about consent in your workshops and you wrote this wonderful piece about the Kelly Shibari and Reid Mihalko situation. And the thing that you ended up with was, “I start all of my workshops by talking about consent and also acknowledging all the times that I have violated someone’s consent or hurt someone,” to name that we can hurt people. And, it’s not only monsters that do that and we can violate consent. We need to live with that and do our best moving ahead from it. 

I got a question that’s a little bit long. But it’s about this kind of space of, “I think I violated somebody’s consent, but I don’t know how to reconcile that.” And I’m wondering if you’d be willing to listen to it and then help me field it.

Bianca Palmisano: Yeah, absolutely. That’s really intense and I’m glad to have space to do that.

Dawn Serra: So it’s a little bit long, but I think the story is important. And I also just want to offer to everybody listening, the subject line is: “Am I a rapist?” So, depending on how many spoons you have, as you’re listening to this, this might feel tender for you. And you might want to skip ahead 15 minutes or so. But, I’m going to read the question and then we will explore. So it says, 

“First, I have been binge-listening to your podcast for the last week and I have learned so much. Thank you for all of your emotional labor and the time you put in. I am non-binary, 24, queer, and assigned female at birth. It’s a long one so saddle up. Almost a year ago, I met another non-binary abfab human and it was your typical love at first sight – U-haul scenario. We immediately became very close and intimate. I was absolutely head over heels in love. One evening, they had a party. I was slightly uncomfortable because all of their friends are very queer. And I was just coming into my queerness and discovering my identity. For some reason, I never felt queer enough for them, so I drank too much. Typically, my coping mechanism when I’m feeling very anxious is drinking. At some point in the evening, I blacked out. So the rest of the story is what I was told by my former partner.” 

Dawn Serra: “Basically, we went to their room for something and I decided I was in the mood for some quick playtime. I started trying to seduce them. I put my hand down their pants and they said no. I, then, stuck my fingers inside of them and they said no again and pushed me off. I left the room and went back to the party. Within seconds, forgetting everything that had happened. Fast forward to the next day. I left in the morning for work. They texted me exclaiming that when someone says no, they mean it, and I should respect that. Very confused, I asked them to explain. They told me the story pretty much verbatim of what I just told you. I was mortified. I apologized profusely. I took responsibility for my actions and I explained that I understood if they never wanted to speak with me or see me ever again. They said they just needed time. And I respected that.”

“The next day, they were texting me saying they didn’t want me out of their life, and they still deeply cared for me. I still kept my distance for a while. But when we did eventually meet about a week later, they went out of their way to convince me that they still trusted me with their body. I was reluctant and nervous to touch them, but I was so insanely crazy about them that I did start to sleep with them again. After about another month, our relationship seemed to just fizzle out. I stopped hearing from them and it sucked. But because of the circumstances, I let it go. Another month went by and I received another text from them. This one saying that I raped them. And it took a long time to realize and accept it, and that they couldn’t believe or understand how I could have just moved past it so quickly. This text crushed me, but there was no justifying my actions.”

Dawn Serra: “After that, I ran into their roommate a few times in some openly queer spaces, and their roommate approached me each time and very publicly announced that I was a rapist and not safe in queer spaces – always creating a scene. They told all their friends and it was very scary for me to go to queer places that I knew and loved, because I always felt like everyone that I knew. I finally started dating again and was very transparent with each person about the events. I wanted them to decide for themselves whether they could date a rapist. I eventually left that city feeling ostracized and heartbroken.”

“So here’s the thing, I’m not looking to be a victim. I know what I did was terrible, and it eats me alive that I hurt a person like this. I have since been very adamant about consent. But sometimes, it feels like I have lost my mojo. I’m afraid to make first moves like I used to when I go on dates, and almost all of my dominant tendencies are gone. I used to consider myself a switch, now I’m almost always dominated. I want that side back – the confidence side, and I am lacking so much closure with that person I assaulted. I would like to believe that my intent is known and that they know I would never intentionally hurt them. And that I definitely would never hurt anyone else ever again. But do you have any advice to help me live through this? Do you think I am destined to live with this pain and feel like this disgusting person for the rest of my life? I know this is a lot. Thanks for reading.”

Bianca Palmisano: Oh my gosh. Oh, my heart hurts so much. And there are pieces that are so terrifyingly familiar to me and other pieces that are levels of pain I have never felt before. Oh, that’s hard. So, thank you for the person that wrote in for this. I am deeply grateful for you sharing this pain and this process that you’ve been through. And I want to start by saying, you handled this situation and all of the fallout from it, exceedingly well. A lot of us have done things that we shouldn’t have done while we were drunk. The thing that I talk about in a lot of my consent classes is we want to live in this world where we have perfect consent every time because nobody drinks and then has sex. Nobody does drugs and has sex. Nobody is in the middle of a manic episode and isn’t being accountable to their own actions kind of thing. We want that. But we realize that the world is messy and shit happens and it’s not perfect. 

So I think this person has handled the fallout from – what was not a good behavior, but it was also something that they were not fully in control of, exceedingly well and takes full ownership of it and tries to repair the harm that they’ve done, and really respects the space of the person who’s hurting and all of that stuff. The thing that I hate about our queer community is, the thing that makes it the things that make it small and safe and intimate and family, are the things that also make it toxic and impossible to find peace with sometimes when stuff goes wrong.

Dawn Serra: Yeah, nuance is challenging. 

Bianca Palmisano: Oh my god, it’s so much easier to write somebody off as a horrible person and that we should never talk to them than it is to see the way that the situation is complicated and the accountability actions that are happening behind closed doors. Because that’s also not – and this is what I wrote about with Reid and Kelly is sort of – what the community wants from an accountability statement and an accountability process is not nearly as fucking important as what Kelly wants. The person who has been hurt gets to make the rules. And so, when friends and community members start creating their own – their own litmus tests – that’s just a recipe for everyone’s continued pain and then isolation and confusion. And I’m sorry that it happened to this listener.

Dawn Serra: I think one of the things that’s so tough is whether we’ve cheated on a partner or we’ve lied, or we’ve done something like this person who wrote in whose initials RO, by the way, so RO – it’s we don’t have good systems or modeling for how to live with ourselves and how to hold ourselves accountable, and to feel the feelings, and not treat ourselves horribly at the same time. We’re not very good, culturally, at self-compassion. And we’re also not very good at sitting in really uncomfortable uncertain places, sometimes for long periods of time. And sometimes, that’s just what it takes when we do something, either intentionally or just because of the circumstances. I think being drunk and doing something like this is a terrible set of circumstances for everybody involved. But, to sit in this place – it’s going to suck for a while and we’re going to have complicated feelings about it. We might not like ourselves very much for a while and maybe it does change us for a while, and we have to find ways to care for ourselves and grapple with that and get the support that we need. Whether it’s therapy and counseling or support groups or unity or friends or family. 

We are not culturally very good at the tolerating. We just want to go from point A to point B as quickly as possible and to have the thing fixed, to have things solved, to have the thing cured. And when we can’t have that, then often the solution is what you’re talking about, which is total ostracization, totally cutting someone out of their lives, totally removing someone from the community. And that’s a really, really tough thing for communities, and for the people who have hurt others. I think you’re so right, we need to be always centering the person that was hurt. And I think that was one of my favorite parts of Jacqueline Friedman’s book “Unscrewed,” was when she was talking to that indigenous lawyer. And the indigenous lawyer was talking about how, back in the day this one particular tribe had this law, that if a woman was raped, then the community supported the woman in getting to choose the punishment. And, I think that’s kind of another version of what you’re talking about, of what does Kelly need? Or what does this person that RO harmed need and how do we center them? But we also can’t, then, just pretend that the person who caused the harm is not human, is not part of the community anymore. 

Dawn Serra: It’s messy and complicated. And, I think that’s what makes people so eager to be like, “I’m shunning you. You can’t be a part of this.” It’s because we need to feel like we’re doing something and sometimes there’s not anything to do, except to just be really fucking uncomfortable for a little while while we work internally on stuff or we go to therapy, or we center the survivor for a while. They may not know what they need for a while. And so that’s an uncomfortable place for people, too, because everyone wants to feel like they’re doing.

Bianca Palmisano: Yeah, no, absolutely. And I mean, we don’t know whether the person that RO is seeking closure with, is going to get to a place where they can have this conversation. Also, feel like they can hold RO accountable, but also move through their own pain and maybe find forgiveness. I would love to see that but I don’t know if it’ll ever happen. But, in terms of how RO can move forward, the big bulk of the question was really – how do I find my mojo? How do I tap into this part of me that I feel afraid to utilize now because I have been a person who’s violated and I’ve been a person labeled a rapist? Can I still be dominant? Can I still find safety in that action? And, my feelings on that is you can, but I think it’s going to be a long warm up period. 

So, if you’re doing – I don’t know what kind of relationships or what kind of sex you’re having – if you’re doing pickup play, I’ve always been nervous about doing anything associated with dominance, with people I don’t have an established dynamic with because it’s so easy for stuff to go wrong. And I don’t think that’s going to feel safe for you for a very long time. I’ll be honest, it’s just not. But, with relationships that you set a firm foundation with, I think it can come back. And what I have done with a lot of my relationships and things like that is I approach every new person as if they are a survivor of intense and very serious trauma. So I had a partner who had a long term stalker and partner that turned out to be abusive, and a rapist. So starting a dynamic with that person meant being incredibly purposeful about my actions, being super transparent, being like, “I want to do this. Is that okay? Can I kiss your belly? I want to nuzzle your hair. How does that sound?” Literally every action I did, and we built – that laid this cement foundation for our interactions that allowed us to explore other stuff that was more in the power dynamic realm. Because they knew from the very first interaction that consent was my number one priority. This is what is centering all of our interactions and I think when you build that foundation then the other rooms of the house that you’re building can have more flourishes and can involve those power dynamics and things like that. So I don’t know what the timeline is going to look like for this person. It could be you only need one or two interactions to build that nice solid foundation. Maybe it’s many months before that dominant mojo can come back. But I don’t think that it’s gone forever. 

Dawn Serra: Yeah. I love that advice so much. And I honestly don’t have much to add, I think you’re so right. If you can find a little bit of kindness for yourself and if you can just start approaching all of your relationships from that deeply consent-based place, there’s the potential for really, really wonderful things to be built and learned, and practiced and explored. And that may you and the other person feel safe. And I love that one of the things that RO mentioned just was being very upfront with potential partners around, “Hey, this thing happened. I want you to know about it. That’s important.” I mean, I think that’s a really powerful, brave thing to do that helps people to also trust you and to see you’re doing the work, and you’re taking responsibility.

Bianca Palmisano: And I think it fights off a little bit of the hypocrisy too. If you’re trying to set yourself up as this person saying, “I prioritize consent. I want you to feel comfortable, but I also have to acknowledge that I have made a big fuck up in the past.” And that’s the weird part about, for me, having these conversations as an educator and on air, and things like that. I’m like – this same partner that I felt like I did a really really fucking good job of setting the foundation of our relationship, they were the person that assaulted. Because shit happens in relationships and it wasn’t okay what I did. But we had a process where we moved to it being okay, and yet I still need to hold myself accountable in a whole lot of other spaces to be like, “This happened. I’m not hiding it. I’m not sweeping it under the rug. I’m not pretending that I’m this perfect person, and that I’ve never made any mistakes. I’ve never hurt anyone.” And I think RO is already doing that work and that’s the hardest work of all.

Dawn Serra: Yeah, it really is. That self-accountability and being able to even name it, I think, is a huge step that a lot of people don’t get to. They just try to deflect and downplay, and find excuses and there’s a confronting that’s clearly happened. I’m sorry that this happened. I’m sorry that people got hurt. I’m sorry that it’s so ugly. And, I think the thing to remember is the human condition is fucking messy. We are not yet very well equipped with skills that help us to navigate ugly situations. We’re all kind of flailing and communities don’t handle things like this well, and don’t really have the tools for centering survivors and for managing harm. It’s just messy. It’s unfortunate and it’s just the truth, and the best we can do is try to learn from it and grow from it, and move ahead – hoping and trying our best to do better and to be a better person, and to be really honest about that journey. 

Bianca Palmisano: Yeah. And I would be remiss if I didn’t briefly mentioned, I don’t know how common of a problem alcohol is for this listener. But, it may be beneficial to seek out some kind of support around the relationship with alcohol. Because it seems very clear from this narrative that this situation would not have happened if you weren’t drinking. And so, the way that alcohol changes, our behavior is so powerful and so it’s something that obviously needs to be treated with care. So I will always support people in saying, “Hey, this has become a problematic element of my life. And maybe it’s time to step back from that.” Because queers are – we’re so soaked in alcohol because it’s like a coping mechanism in a stressful world that is mean to us sometimes. 

One thing that I do very actively is seek out sober communities within queer spaces, and I felt like that has helped me find places where I feel safe. But also could be helpful for you in making sure that behavior in the future is what you want it to be. Because you’re not relying on a substance that makes your behavior unpredictable. 

Dawn Serra: Thank you for sharing that. Yeah, that’s important. And thank you to RO for sharing this with us and letting others grapple with it too. Because I can guarantee you, there are people listening who are in a similar situation or have done something similar and probably need to grapple as well. So, thank you for letting us be a part of that.

Okay, so we need to close because we’ve gone well over our hour. We need to go hop over into our little Patreon bonus chat all about orgasms, female price of pleasure. But before we do that, can you share with everyone how they can stay in touch with you and find you online? 

Bianca Palmisano: Yes, please stay in touch with me. So I am not good about having uniform social media presence but my website is www.intimatehealthconsulting.com. So there’s a Contact Us page on there. I occasionally blog. I need to be better about that. And then I’m very, very active on social media. Facebook is facebook.com/intimatehealthconsulting. Instagram is @intimatehealthconsulting. And then, Twitter is the one that doesn’t match. I am @Fun_Size_SexEd with underscores between fun and size, and between size and sex. So, that or you can also just look my name up, Bianca Palmisano and you’ll find me. I love, love, love talking to people on all social media platforms. Definitely stay in touch that way.

Dawn Serra: Well, I will have all of those links at dawnserra.com for this episode. And, of course, I love hearing from you. If you have your own question, something you’re grappling with and could use some advice around, there is a contact form at dawnserra.com where you can submit anonymous questions if you’d like. And, of course, you can also find out how to support the show on Patreon. Bianca and I are off to talk about yumminess for all the Patreon supporters and thank you to you for listening. Thank you to you, Bianca, for joining. This was super fun and that hour flew by

Bianca Palmisano: I know. It so did. Thank you for having me. This was great.

Dawn Serra: Okay, I will talk to everybody next week. Bye.

Bianca Palmisano: Bye, all.

Dawn Serra: A huge thanks to The Vocal Few, the married duo behind the music featured in this week’s intro and outro. Find them at vocalfew.com. Head to patreon.com/sgrpodcast to support the show and get awesome weekly bonuses. 

As you look towards the next week, I wonder what will you do differently that rewrites an old story, revitalizes a stuck relationship or helps you to connect more deeply with your pleasure?