Clinical Blindspots series

Clinical BlindspotsTM: Large Diameter Sexual Penetration

Heather Edwards, PT, CSC and Alex Papale, PT discuss fisting and large diameter sexual penetration and how it applies to the pelvic region. They discuss the how's and why's and do some myth-busting on common ideas about fisting. They cover risk-reduction and how to counsel patients/clients on their questions, concerns, and hopes on this topic. If you are a pelvic health therapist or medical provider who works with sexual function, this course will deliver a solid base for you to be able to analyze and advise on fisting and large diameter penetration while circumventing shame and kink-stigmatization. 


Write your awesome label here.
This video is a short intro we did on "why we did this topic for a Clinical Blindspots" as well as a little about who we are. Be on the lookout for our Friday @ Five virtual get togethers!

We want you to feel confident in offering clients advice on fisting and large diameter toy play!

We know that there's not much (really NONE) research on this topic. So, for the conscientious clinician who wants to advise in an evidence based way, that leaves you dangling a bit. 

This course talks through the conventional wisdom on this topic, explains the practice and talks about risk reduction from two pelvic health therapists who ALSO have a great deal of experience with this topic. 

We will break down this topic for you:
  • Why people do this
  • What are the myths and misconceptions that can make this experience less safe
  • What communication needs to happen for safer experiences
  • Preparation
  • The process and techniques
  • Exiting safely
  • Aftercare
Write your awesome label here.

Tell me about the course: 

  • Objectives: 
    • Participants will be able to advise clients on how to have conversations to facilitate safer procedures
    • Participants will be able to list 3 reasons why people would be interested in fisting and/or large diameter penetration
    • Participants will be able to counsel through prep and safer techniques for fisting and/or large diameter penetration. 

Who is this for?

Clinical Blindspots is a course series for professionals (medical and mental health) who work with pelvic and sexual health. 

About Clinical BlindspotsTM

This series focuses on the psychosocial aspects of caring for other humans in all of their glorious complexity. 

Clinical Blindspots is set of short courses that dive into topics that aren't usually part of the discussions in pelvic health. Some of them talk about bigger concepts of communication and clinical reasoning, while some offer specific instructions for kink and sex acts that can help clinicians navigate advising clients who enjoy doing these things. All of these courses are sex-positive, pleasure-positive, and trans-inclusive. 

Alex Papale, PT, DPT, Sex Educator (them/they)

Alex Papale PT, DPT (they/them) is a pelvic health physical therapist and sex educator based in Boston, MA. They treat patients at Flourish Physical Therapy, as well as develop and teach trainings and continuing education courses on sexual and pelvic health, BDSM, and LGBTQ+ healthcare. Alex began their professional career as an inclusivity consultant for a major medical institution in Boston, while co-creating and teaching one of the first national con-ed courses on pelvic health PT for the trans and gender non-conforming population. Since then, they’ve lead over 20 workshops and trainings to audiences ranging from a handful of people to national conferences on sex toys, kink, pelvic health, and gender, and they continue to expand their specialized training as a sex educator. Their pandemic hobbies include hanging out with Honey their 4ft snake, reading about kink and queer history and being an overbearing plant parent.
Patrick Jones - Course author
Meet the Clinical blindspots creator:

Heather Edwards, PT, Sex Counselor & Educator, Founder of Clinical BlindspotsTM (she/they)

Heather Edwards, PT, CSC has been a pelvic physical therapist for 18 years and is an AASECT certified Sexuality Counselor as well as a Sex Educator. They achieved their dual certificate at the University of Michigan Sexual Health Certificate Program. They founded Vino & Vulvas in 2015 and it quickly became their favorite thing to do. They have presented at APTA and AASECT conferences and teaches for Pelvic Guru Academy on the topic of Trans-Inclusive Sexual & Pelvic Health. In addition to education and clinical work, Heather is an artist and illustrator of the coloring book series "Coloring Books for the Crotch Enthusiast". To connect with Heather, email vinoandvulvas@gmail.com. H
Patrick Jones - Course author
Created with