ABSTRACTHealthy sexuality includes relational, emotional, and physical elements as noted in the sexual wholeness model. Genital acceptance (emotional comfort with reactions to genitalia) and physical sexual knowledge (knowledge of the physical aspects of sex) are two areas of physical relationships that may be associated with sexual satisfaction. Attachment is a factor that has been associated with sexual relationships and may be an intervening variable between the physical aspects of sex and sexual satisfaction. Data from a dyadic sample of 515 couples were analyzed. Structural equation modeling was used to estimate the direct and indirect actor and partner effects of physical sexual knowledge and genital acceptance on sexual satisfaction, working through mechanisms of anxious and avoidant attachment. Findings revealed that genital acceptance and physical sexual knowledge, particularly knowledge about the female body, were associated with lower levels of insecure attachment and greater satisfaction with sexual relationships.