Using grounded theory methods, this study examines the experience of African American women during their caregiver-child conversations about sex and the impacts of the conversations on their sexual attitudes. The process of these conversations begins with an unplanned topic and progresses further to identify six essential themes of these conversations: gender differences, race and religion, protective/emphasis on protection, lack of knowledge, withholding knowledge, and sex negativity/shame. African American women’s description of the process included feelings of shame and negativity towards their sexuality. Caregivers promoted positive messages about sex by having open conversations that advocated for equality between the genders, empower women to explore their sexuality, and provide a well-rounded education about all elements surrounding sexuality. The findings from this study will aid clinicians, educators, parents, and communities as a whole to better understand the parts of the conversations that often lead to feelings of shame and negativity surrounding sex and sexuality for African American women