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What does the human sexuality education that doctors-in-training receive consist of? Although sociologists have devoted much attention to medical education, and to sex education in the context of K-12 schooling, we know little about the processes by which teaching and learning about sexuality are accomplished within medical schools. In this paper I provide a history of medical sex education from the 1960s to the present, and outline key themes and lingering questions. I then draw upon ethnographic data collected from participant observation at “Buena Vista” Medical School to provide thick description of the empirical complexities of medical sex education today. At Buena Vista, sexuality education was a haphazard affair characterized by ambiguities. Definitions of “sex,” “sexuality,” and their relevance to human health and medical practice were elusive. Faculty believed that sexuality was important, but a set of compounding, mutually-reinforcing dynamics kept sexuality relegated to the status of “orphan topic.” Many of the challenges associated with providing medical sex education in the 1960s and 1970s were found at Buena Vista in the present. Although popular culture may be increasingly sexualized, formal knowledge about sexuality remains elusive in our society.