This article is written by five women from different settings in social work and academia, who are all qualified social workers. Their personal experiences and sexual identities are also different, but they hold a coherent commitment to improving social work practice by addressing sexuality issues in their work. The article considers a number of areas of relevance and interest to social work practitioners, managers and researchers, all focusing on issues around sexuality. Using an amalgamation of personal narratives and practice reflections, the authors combine these with evidence from the literature, to raise a number of key difficulties about reflection as a tool for social work practice. By including heterosexual perspectives alongside lesbian ones and by highlighting some of the parallel difficulties, the paper begins to uncover some of the pathologising and patronising perspectives often adopted in social work practice.