Genuinely user‐centred mental health services claim to respond to the wants and aspirations of people with mental health problems. Surveys of service users' wants show that they are much like those of the rest of us ‐ a decent home, a reasonable income, a good social life and activity we find meaningful. However, mental health service users' wants in terms of sexual expression, romance and parenthood are in practice ignored, or seen purely as ‘problems’. We reprint here an article from the States that starts to explore positive ways to respond to the aspirations of service users.