Sexuality and the approaches to sexuality adopted by care staff are challenging and ever-present issues in group homes for young people in care. This chapter outlines the current state of research on this subject. Firstly, it shows that young people in care can be classified as a vulnerable group from a sexual health standpoint—because of factors such as gaps in their knowledge or a propensity to risky sexual behavior—and that improved sexuality education provision for this target group is needed. Secondly, sexuality is investigated as an element involved in interactions between care staff and young people in group homes. Young people undergoing puberty in care settings are supported—but also monitored and supervised—by staff. Staff members are thus a helpful resource for young people attempting to overcome sexuality-related challenges, but, by opening up to care staff, young people risk having their freedom to act as they see fit curtailed. The relevant processes are also strongly affected by taboos, intimacy, and shame or embarrassment. This chapter, thirdly, identifies multiple approaches to delivering sexuality and relationships education and summarizes the current state of research on each: one-to-one support provided to young people on the basis of trusting relationships, group education sessions, media, additional resources including friends and outside agencies, outreach work with parents, and the general organizational conditions that are prevalent in care settings. On the basis of the existing data, it is clear that the delivery of relationships and sexuality education and the approaches to sexuality adopted in residential care need to be overhauled and that further research in this area is desirable.