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Women with a spinal cord injury (SCI) have had their sexual health and sexual desires dismissed by medical and mental health professionals. Not much data are available that address the complexity of the sexual lives of women with SCI, and clinicians have struggled to identify appropriate treatment paradigms. We review the literature on sexual self-constructs and sexual behavior of women with SCI emphasizing sexual pleasure, sexual health, and sex-positive therapies. Third-wave cognitive-behavioral approaches are explored, and a clinical example is illustrated to provide mental health professionals with new perspectives about interventions for promoting sexual pleasure among women with SCI. [ABSTRACT FROM AUTHOR]