Study design: This presentation was originally given as 'The Sullivan Lecture' at the International Spinal Cord Society Meeting in Reykjavik, Iceland on 30 June 2007. Setting: Named lecture at an international meeting. Results: The development of the autonomic component standards of the International Standards for the Neurologic Classification is described. Research pertaining to sexual responses after spinal cord injury is presented as a model for ways the impact of varying patterns of spinal cord injuries on other organ systems could be studied. Future challenges and opportunities facing the field of spinal cord injury are also discussed. Conclusion: The addition of a standard form of communicating the impact of spinal cord injury on autonomic responses should improve clinical care and research related to spinal cord injury. Using the knowledge that can be obtained from detailed assessment of persons with spinal cord injuries will help provide increased understanding of neuroanatomy in the able-bodied persons. This added value from studying persons with spinal cord injuries provides further justification for research in this area. © 2008 International Spinal Cord Society All rights reserved.