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Much work on sexual health has emphasized adverse outcomes such as sexually transmitted infections/HIV, unintended pregnancy, and sexual violence. Although these objectives are of continued importance, they reflect a global tendency to focus on negative sexual health outcomes. Far less prominent in health promotion, policy, and programing is a sustained recognition that sexual pleasure is an important aspect of sexuality. This commentary centers sexual pleasure within the contexts of sexual rights and sexual health. Our larger objective is to provide a framework for addressing sexual pleasure in law, policy, advocacy, public health, and clinical practice which might reduce the burden of disease.