Paternoster's parents met while both teachers for the Elizabeth Public Schools. Her mother, Leslie Okun, who Paternoster has described as "culturally Jewish", was an art teacher who now resides in Florida. Her father, Angelo Paternoster, gave her her first guitar lessons before she taught herself to play as a teen. Paternoster grew up in Elizabeth, New Jersey and attended Roselle Catholic High School and later Rutgers University's Mason Gross School of the Arts, where she became interested in music and formed Screaming Females. An only child and an introvert, she grew up with a passion for comics, drawing, and, before long, guitar.
Sleater-Kinney influenced her to start a band with bassist Mike Abbate and drummer Jarrett Dougherty in 2005. In a 2012 list, she was named the 77th greatest guitarist of all time by Spin magazine.
Paternoster is an out lesbian and has spoken about how bands like Sleater-Kinney gave her the confidence to be a queer woman in music. Her go-to karaoke song is Meat Loaf's "Paradise by the Dashboard Light".

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