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This study examines middle school teachers' perspectives on sexuality across subjects and their need for support to improve self-efficacy. Through a multi-site case study of urban STEM, Humanities, and Health educators, it explores how teachers perceive and navigate sexuality in their classrooms. Findings reveal that teachers' views and practices are shaped by factors that either support or constrain a holistic approach. While educators see sexuality as relevant, they need more resources to connect it to their teaching and classroom environment. This research also highlights inequities, with lower-resourced schools serving more racially minoritized students offering less sexuality education than higher-resourced schools. These disparities emphasize the need for equitable implementation of sexuality education.