Abstract Young disabled people are disproportionately excluded from equal control, access, and choices concerning their sexual and reproductive rights. While sexual citizenship is founded on a rights-based approach and is closely connected with social work values such as empowerment and entitlement to full participation, many social workers do not include dimensions of sexual well-being in their scope of practice. This phenomenological study explores how social workers address the intersection of sexual well-being and disability from the perspectives of young disabled people. A total of twenty-four semi-structured interviews were carried out with individuals between the ages of 17 and 24 in Ontario, Canada, who identify themselves as disabled and have had prior interactions with a social worker. Social workers adopting risk-averse approaches negatively impacted the trust between young people and their social workers. Young people expressed their discontent with sexual well-being being deprioritized in practice, as participants considered dimensions of sexual well-being to be closely related to their physical, mental, and emotional health. Participants overwhelmingly reported that social workers should discuss sexual well-being with service users using sex-positive perspectives. The findings highlight the importance of holistic and comprehensive social work practices, including sexual well-being and sex-positive perspectives.