American adolescent sexual health research and policy is guided by two paradigms: the abstinence-until-marriage paradigm and the adolescent-sex-as-risk paradigm. International comparative research shows these paradigms fail the goals that they purport to serve, and ignore important physical, emotional, and relational aspects of adolescent sexual health. Drawing on quantitative and qualitative data from the United States and the Netherlands—two countries on opposite sides of the spectrum in terms of adolescent sexual health outcomes—this paper presents a new paradigm
(and ABC) for adolescent sexual health that promotes adolescent
*a*utonomy, *b*uilding relationships, and *c*onnection between
adolescents and parents and other caregivers.