Development agencies have conventionally viewed sexuality as a health issue. Sex has been regarded as a source of danger, harm and disease. The words 'love', 'desire' and 'pleasure' are absent from the development lexicon. This article draws on discussions at a workshop at the Institute of Development Studies, Sussex, in September 2005, at which activists, practitioners and academics came together to debate the challenge of realising sexual rights, and to share experience of practical initiatives of working with a more positive, enabling approach to issues of sex and sexuality. It calls on development agencies to redress the marginalisation of sexuality in their policies and programmes, and recognise the significance of sexual well-being for all dimensions of development.