This narrative review argues that the current conceptualization of sexuality in exstrophy–epispadias complex research places value on the achievement of sexual function to the detriment of psychosocial factors. It is argued that the adoption of a new conceptualization of sexual health would provide a framework for addressing this concern. This argument is developed through critique of current evidence and supported by further relevant arguments from within health and disability fields. Consideration is given to how potential implications for research and clinical practice arising from this change could be overcome.