Advancing disability sexual health is the radical idea that people with disability are sexual and have the right to reach their full potential as sexual citizens. This discourse should be more explicitly present in mainstream social work practice, education and research in our fight against health disparities, advocacy toward social justice and clinical best practices. For those of us championing sexual health equity, people with disabilities and, more specifically, those with intellectual disabilities are often left out of both social work and sexuality scholarship. This chapter discusses a conceptual model, sexual voice, as a tool for sexual justice to support the love, romance, desire and sexual needs of people with intellectual disabilities (ID). The chapter is situated with a recollection of my own start as a social worker supporting this marginalized group. Case studies are provided to illuminate both their sexuality and my missed opportunities to be a better social worker. Lessons learned and suggestions are offered for clinical practice and social work education to infuse more sexually literate and disability aware social work.