Questions as to the mental capacity of an individual to consent to sex are an increasingly important aspect of legal scholarship and professional practice for those working in care. Recent case law has added new layers of complexity, requiring that a person must be able to understand that the other person needs to consent and can withdraw that consent. While this has been welcomed for asserting the importance of the interpersonal dynamics of sex, it has significant implications for practice and for the day-to-day lives of people with cognitive impairments. This collection brings together academics, practitioners and organizations to consider the challenges posed by the current legal framework, and future directions for law, policy and practice.