Individuals with intellectual and developmental disabilities (IDD) are often excluded from conversations about sexual health; when included, well-meaning researchers and support workers often speak for individuals instead of creating opportunities for their voices to be heard. To support the sexual agency of people with intellectual disabilities, who refer to themselves as self-advocates (SAs), we embarked on a Research-based Theater (RbT) project, Romance, Relationships, and Rights, with the goal to address misconceptions of individuals with IDD and sexuality. Throughout the project, ethical tensions percolated from ableist assumptions about “legal capacity,” consent both on and off stage, and conflicting perspectives on aesthetics. Throughout this article, we discuss these ethical dilemmas and offer recommendations for future work with SAs in co-creating RbT through the lens of disability justice and critical disability studies.