Under cisheteropatriarchy, women's and gender expansive individuals’ bodies are highly stigmatized. Research finds internalizing stigma about the genitals has negative implications for sexual satisfaction, but this work has predominantly focused on heterosexual cisgender women. We examined associations between genital stigma and partnered sexual satisfaction among Queer (including any minoritized sexual identity) women (cisgender and transgender) and gender expansive people. We also examined whether comfort communicating with a sexual partner mediated the relation between genital stigma and sexual satisfaction, and whether positive LGBTQ+ identity may buffer against internalized genital stigma (i.e., moderate relations between stigma, communication, and sexual satisfaction). We analyzed survey data from 452 Queer women and gender expansive people. We tested a moderated mediation model. Mediation was supported—greater genital stigma was associated with less comfort communicating with a sexual partner, and greater discomfort communicating was associated with lower sexual satisfaction. Moderated mediation was supported, as the negative association between genital stigma and comfort communicating with a partner increased as participants’ LGBTQ+ identity positivity decreased. Our findings offer novel insights into genital stigma and factors that may facilitate and hinder Queer women's and gender expansive individuals’ sexual satisfaction.