The family life of Aboriginal and Torres Strait Islander people is predominantly structured around complex kinship systems, which locate each person within a clan structure, with clear lines of rights and obligations to others within the family, the clan  and ultimately the linguistic group. Children are highly valued by their families and clans. Until the recent past the education and socialisation of young children took place within the rhythms of family life with an emphasis on observation, imitation and interaction with extended family and their country. These ideals of family life have been radically disrupted for some families, particularly those that have suffered separation of children from their families, the destruction of extended family networks and the decades’ worth of living in oppressive circumstances, evidenced by poor health, early deaths, poor housing, poor educational outcomes, high unemployment and high numbers of Aboriginal people in custody. Despite these hardships, the Aboriginal and Torres Strait Islander family remains the primary and preferred site for developing and protecting culture and identity. In this context, sexual and reproductive health should be highly valued by Aboriginal and Torres Strait Islander women and health service settings that set priorities, specify outcomes, design appropriate services, allocate resources and evaluate the effectiveness and efficiency of the services delivered. In the absence of a coordinated national sexual health or Aboriginal and Torres Strait Islander women’s health strategy; the most vulnerable and marginalised community in Australian society is falling through the gaps in sexual and reproductive health, rather than closing the gap. This presentation will present issues for First Nations women in Australia and reflect on what we need to do to improve sexual health and wellbeing.