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This paper explores how the educational and career paths of Indigenous people in STEMM are impacted by ethical, cultural, and/or spiritual conflicts. Based on a survey of over 400 Indigenous students and professionals in STEMM fields, plus over 30 follow up interviews, we find that these conflicts cause some Indigenous people to leave particular fields altogether, others to avoid certain tasks within their chosen field, and still others to intentionally select particular fields. By understanding these pathway impacts, STEMM leaders and educators can initiate relevant changes to policy and practice in order to increase access and retention of Indigenous people in STEMM.