Extending prior research on the communicative intersections of bondage, domination, and sadomasochism (BDSM) and disability communities, the present article presents preliminary findings on sexual and boundary-setting communication overlaps in relational minority groups and partnerships with disabilities. Both disability and BDSM communities engage in preparatory, open, and boundary-setting sexual communication that prioritizes shifting physical, emotional, and relational needs. Highlighting reflections from partnerships navigating chronic illness, pain, and neurodivergence, our findings extend previous recommendations for boundary-setting to focus on relationships with disability, identifying intersections as including (1) reflecting upon needs and boundaries amidst shifting symptomatology, (2) (re)write sexual and intimate scripts to prioritize (dis)ability, (3) (re)negotiate relational needs and set expectations, and (4) bring awareness to the role of mental health and medication. Findings focus on implications for disability and sexual communication, the disruption of traditional sexual scripts, and therapeutic and clinical application. Limitations and future research are discussed.