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This paper uses ethnographic and archival methods to understand how ways of knowing about youth sexuality influence community health work. Youth sexual health promotion is a lens through which to view our cultural anxieties about unrestrained female sexuality, failure to adhere to white, middle-class childbearing norms, and an out of control welfare state. Because youth sexual health work is always already about teen pregnancy, and teen pregnancy is always already about race, I utilize a case study of a racialized Northeastern city that sustains a reputation as a place of hyperfertile young Latinas. “Stockton” is a post-industrial city widely known as a community with a large Puerto Rican population, the state’s highest teen birth rate and high levels of poverty, school dropout, unemployement, substance abuse, and violence. I collected data in multiple ways: participant observation at committee meetings, conferences, and community events; key informant interviews with policymakers, educators, and service providers; and collection of a wide range of documents, both historical and current. Analysis followed Adele Clarke’s “situational analysis” method and highlights the “situation” of youth sexual health promotion in Stockton, or what I call the “teen pregnancy prevention industrial complex.” I begin by providing a history of the city that focuses on colonialism, industry, migration patterns, and shifting racial composition. I trace how historical discourses of sexuality and reproduction in Puerto Rico inform present day understandings in Stockton. Finally, I sketch a portrait of how teen pregnancy prevention became industrialized in Stockton and how stakeholders understand their work.