Modern sexuality is … complicated. And talking about our sexual health, even with a doctor, can be awkward – awkward enough that many of us will avoid it, even when we have a problem that needs solving.

Enter consultants like Bianca Palmisano, owner of Intimate Health Consulting, who’s helping doctors, nurses, and other medical and health care professionals speak openly and non-judgmentally to their patients about issues of sexuality.

Bianca Palmisano On Sexual Positivity

Gennev CEO Jill Angelo talked with Bianca about sex, sexuality, and why it’s so darn hard to have those important conversations.

“Sex positivity” means understanding sex and sexuality as a normal, healthy part of life with a wide range of modes of expression. We asked Bianca if the notion of sex as a positive part of life is gaining some traction in a culture that has an often unhealthy approach to sex.

What are the trends out there when it comes to sex positivity and women in midlife? Bianca has good news for us – one, the medical profession is innovating to give women “more options in the toolkit” for treating menopause symptoms that impact intimacy, and two, more sex educators are talking about sex at midlife and helping women understand the physical and emotional changes at menopause.

So, if it’s a good idea to talk about these things with your doctor, how do we start the conversation? Bianca talks about how she provides both medical professionals and patients with strategies for starting, continuing, and finishing the conversation satisfactorily.

How can women get educated about healthy sexuality? The problem with a taboo subject is that …well, it’s taboo. So, not much info. Except there is. Bianca says you can look beyond your doc if that person isn’t someone you can go to, and she gives some ideas on places to look for answers. (see below as well)

So what is “sexual health competency” and why do medical professionals need it? “Knowing how to have conversations in a way that puts your baggage on a back shelf,” says Bianca. We all have ideas and opinions on sexuality and what we feel is “right” or even “normal” – Bianca helps doctors understand how and why they should ditch the preconceptions when talking with patients.

Why is good sex so important? There’s an important dynamic between sex and relationships, according to Bianca. But relationships can get thorny in midlife, given all the life-stage stresses and physical changes, so how do we stay intimately connected to one another?

But relationships can get thorny. How do women initiate conversations about sex with their partners? Probably not when pulling out the condoms in the 10 minutes before Johnny comes home from soccer practice, Bianca says. Hear her ideas on a better way to bring it up.

Women in midlife often experience some profound changes in their sexuality. Careers are solid, kids are grown, the house is settled on its foundations … are you? Bianca addresses how some women make important decisions and have major revelations about themselves, their lives, and their sexuality.

Want to learn more about sexual health and sex positivity? Visit Bianca’s website, Intimate Health Consulting, and check out these other sexuality experts: Sex educator, writer, and speaker Walker ThorntonJoan Price, author of The Ultimate Guide to Sex After 50 and Naked at Our Age; Certified Sexuality Educator Melanie Davis, PhD, and Dr. Myrtle, author of the series The Recipe for Ecstasy. 

Bianca Palmisano is a sex educator and medical consultant serving the DC community since 2012. As 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. She also serves as the Community Outreach Chair for the Metro DC PFLAG Board of Directors.

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.


Shannon Perry

June 29, 2017
Director of Programming & Media

Medically Reviewed By

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