Sex education, especially in the southeastern USA, remains steeped in an Abstinence-Only-Until-Marriage (AOUM) approach, which sets up barriers to the education of sexually active students. Research confirms that science education has the potential to facilitate discussion of controversial topics, including sex education. Science teachers in the USA, however, may face legislative challenges influenced by the local political and social climate. This study aims to understand how science teachers address and construct curriculum related to sex education topics in AOUM environments. A Foucauldian lens is used to examine how teachers' discourses influence decision-making concerning sex education. Findings from the study suggest that the AOUM curriculum influences the ways in which science teachers make decisions about the curriculum and taboo subjects such as homosexuality and abortion. The study also suggests that students learn about sex and sexuality in ways directly related to their personal experiences. Finally, study findings suggest that personal controversies, such as those relating to sexual health, can be integrated into science education through forms of teacher education and professional development attuned to the different ways that AOUM policies affect science teaching practices.