Jul 16, 2026 · 58 min · 12 segments
What if most of what we get wrong about sex — in the bedroom, the doctor's office, and the comments section — starts with asking the wrong questions? In this candid, wide-ranging episode, Natassia…
Birna GustafssonGuestNatasha MillerHostI'm really interested to hear how do you navigate these conversations? 'Cause I know that it's not just consent with someone who's going through dementia, but with someone who can, um, have other health conditions, uh, mobility, all the things that prevent them from really expressing their consent.

I think it- For me, it's not telling them, like telling the nurses, "This is the playbook, and this is how you know if someone's consenting or not," because in reality we only know what someone's telling us.

Um, when you're patient-facing or in a clinical practice of any kind, you don't always know what's going on behind the scenes.

So what I want to give them is kind of a toolkit for these conversations, how to ask follow-up questions, how to physically, like, present your face and your voice-

Um, because sometimes people tend to shut down when they feel like they're being judged, or people tend to also kinda get defensive if they feel like they're being patronized.

Um, so for someone with a disability, for example, where mobility is an issue and they might not be able to give, like, a physical consent, um, where it's like they might be not, not be moving as much as other people during sex, they might feel a little bit judged by the questions in a different way.

"Are you assuming that I don't want this?" Um, so it's not about, like, how do we make sure someone's consenting or not, but it's how do we ask questions to ask about their safety? "Are you safe to say no? Tell me about the last time you had sex.

and than kind of just talking at a patient about, like, this is what consent is and not.

You kinda have to gauge where they're at in that and see how open they are to having those conversations.

Um, but then there's also gonna be tons of patients where you have to educate them about things because they're engaging in behaviors that are just unhelpful or not serving them or unhealthy, um, either to themselves or to their partner, and that's something where you have to kinda step in and play a more educator role.
I'm really interested to hear how do you navigate these conversations? 'Cause I know that it's not just consent with someone who's going through dementia, but with someone who can, um, have other health conditions, uh, mobility, all the things that prevent them from really expressing their consent.

I think it- For me, it's not telling them, like telling the nurses, "This is the playbook, and this is how you know if someone's consenting or not," because in reality we only know what someone's telling us.

Um, when you're patient-facing or in a clinical practice of any kind, you don't always know what's going on behind the scenes.

So what I want to give them is kind of a toolkit for these conversations, how to ask follow-up questions, how to physically, like, present your face and your voice-

Um, because sometimes people tend to shut down when they feel like they're being judged, or people tend to also kinda get defensive if they feel like they're being patronized.

Um, so for someone with a disability, for example, where mobility is an issue and they might not be able to give, like, a physical consent, um, where it's like they might be not, not be moving as much as other people during sex, they might feel a little bit judged by the questions in a different way.

"Are you assuming that I don't want this?" Um, so it's not about, like, how do we make sure someone's consenting or not, but it's how do we ask questions to ask about their safety? "Are you safe to say no? Tell me about the last time you had sex.

and than kind of just talking at a patient about, like, this is what consent is and not.

You kinda have to gauge where they're at in that and see how open they are to having those conversations.

Um, but then there's also gonna be tons of patients where you have to educate them about things because they're engaging in behaviors that are just unhelpful or not serving them or unhealthy, um, either to themselves or to their partner, and that's something where you have to kinda step in and play a more educator role.
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